No letter = no HRT for me

[PaulaQ]

My therapist doesn't believe in the HRT referral letter. I asked her about this a while ago. She told me "oh, most doctors don't need that anyway." Sadly, my wife kicked me out last week, and I had to rather quickly move out last week. So - I'm in another state now. And in this state - yeah, state law says I need a letter.

My doctor here, who I met with for the first time today, is find with starting HRT for me, but the law is the law, and here in Texas, they watch HRT real closely now. So she has to have the referral letter.

Maybe she'll change her mind - my therapist I mean, and write the letter for me. If not, guess I'll start over with another therapist in this state.

Sucks, huh?

[Rianna Humble]

Sorry to hear the bad news. Sounds like another therapist is the way to go. Perhaps some of our members near you will have some suggestions?

[Michelle.M]

Paula, are you sure about the Texas law? I live in Texas and I've never heard of such a law. If a physician told you that he may be misinformed (yeah, it happens), but more likely he's speaking in a general sense; that the law probably requires him to prescribe medicines only for appropriate candidates, and an HRT letter would identify you as one.

And your therapist just needs to get with the program. Her lack of belief in HRT letters does not square with reality. You need to find another therapist and get your treatment on track.

Where in Texas do you live? Knowing that will help other members here make some recommendations regarding therapists and treatment.

[Angela Campbell]

I agree. If the therapist does not believe in the letter than she does not follow the WPATH standards of care and may not be qualified in gender issues.

[kimdl93]

Send a letter to your former therapist first.

[Jana]

Maybe if you explain your situation, she may reconsider. Otherwise, maybe time to change therapists. Good luck!

[PaulaQ]

Paula, are you sure about the Texas law? I live in Texas and I've never heard of such a law.

I misspoke a bit. It's not so much the written law here she's worried about, it's what the medical board can do to a physician if they decide she's not following the SOC, or whatever other pretense they need to discourage care for trans people. She said the state has started really cracking down on HRT prescriptions, so to protect herself, she dots all i's and crosses all t's.

Wouldn't surprise me, the current governor is pretty hostile to women's issues.

I'm in Dallas. I've got the name of the therapist everyone here uses. The idea of starting over and waiting 2-3 more months makes me cry though. I've been seeing my current therapist for 5 months so far. :(

[Trisha65]

Hi Paula,

Sorry to hear about your issues in starting HRT. As someone who just started it yesterday, I know how important this step can be in ones transformation. I urge you to keep pushing for the letter and I would suggest contacting your former therapist to see if they can help. Good luck.

[stefan37]

Although a letter is not needed,most doctors will not prescribe without one. The first question my endocrinologist asked do you have a letter? I would explain to your current therapist a letter is needed for hrt, and take it from there.

[arbon]

It does not mean no hrt, just a delay till you get a therapist that has some sense.

[melissaK]

I guess there's too much Pirate in me - - - I acted off the grid long ago and have used un-prescribed off-shore HT ever since.
I greatly dislike the rig-a-ma-role of going to a Dr and would rather figure it out myself before I resort to dealing with them.

My prior therapist wrote letters, and I never asked for one. My current therapist is balky about letters, so of course I asked her for one. ;^)

Paula, maybe your old therapist was like my current therapist, a Gestalt trained one. My current therapist is older and was educated under then very new Gestalt principles. Gestalt's totality of the conscious mind approach, and no "shoulds" approach, and quest for integration approach, have been helpful for me. http://gestalttheory.com/psychotherapy/ . So, I don't know that Gestalt therapists do or do not recognize TS at all, as it's a system based upon helping the client develop their own self awareness; I have to recognize myself as a transsexual. Thus, the diagnostic rigidity of WPATH criteria or DSM criteria and placing patients into the cubby holes the criteria create is not the goal of a Gestalt therapist.

From reading Forum comments for years, I can see that some people like the rigidity of a clean clear diagnosis from other counseling methods. I have been very comfortable with my therapists approach which lacks that. And I have no college degree in psychology, or formal training in schools of therapy, so don't consider my statement as advice or a recommendation. It's just where I am, and it's based on the little bit of the world of psychology that I know.

Good luck with a new therapist Paula.

[MatildaJ.]

I'm in Dallas. I've got the name of the therapist everyone here uses. The idea of starting over and waiting 2-3 more months makes me cry though. I've been seeing my current therapist for 5 months so far. :(
Doesn't it seem like a good idea to get a local therapist anyway? You're going through so much, with the separation and move to a new state, and even if you could start HRT right away, it would still be a good idea to have someone near you to talk to, right?

[JohnH]

Paula,

If you live in the Dallas, TX area you might be interested in this. I came across the following on T-Vox

(http://t-vox.org/index.php?title=Physicians_in_the_United_States#Te xas)

[The following is a copy and paste from that website.]

Dr April Day
Family Medical Center at Garland
601 Clara Barton Boulevard, Suite 140
Garland, TX 75042
Phone: 972-272-6561
Family doctor who will also prescribe HRT; does not require a therapist's letter.
Anon says: "The staff and nurses in Dr. Day's office are all great. Since I started seeing her they've slipped up with my name and pronouns maybe once, but generally they all call me by my chosen name (even though it's not the name on my medical records) and treat me with the same respect and professionalism that they would any other patient."

[Strictly personal experience - not intended to be considered across the board]
I myself self-medicated, and my primary care physician referred me to an endocrinologist, who prescribed M2F HRT medication to me. I did NOT need a letter from a therapist.

Johanna

[mikiSJ]

I guess there's too much Pirate in me - - - I acted off the grid long ago and have used un-prescribed off-shore HT ever since.
I greatly dislike the rig-a-ma-role of going to a Dr and would rather figure it out myself before I resort to dealing with them.

Can we stop posting about how great it is to circumvent the medical process and do the HRT by internet. Sure, maybe you haven't experienced any bad effects, but I have personal knowledge of someone who killed herself self-medicating.

Stop being the go it alone heroine.

[arbon]

I myself self-medicated, and my primary care physician referred me to an endocrinologist, who prescribed M2F HRT medication to me. I did NOT need a letter from a therapist.



John, most likely the reason they did not require a letter was because you were already self medicating. Its not the same as starting someone on hrt.

[PaulaQ]

Yeah, I'll get a local therapist. I have a reference for the one who sees everyone in the DFW area. It'll mean a delay. I tried not to set my expectations very high yesterday, but I'm still disappointed. I could sure use some relief. I'm worried that by the time I get my letter, I'll have just decided "F this noise, I'm out." I'll probably be OK. But I am scared of this stuff and worried that I'm living on borrowed time. Hopefully I don't completely collapse at work and lose my employment - I'm not performing especially well there lately. I looked over my work from the past two weeks, and I'm just embarrassed by it.

[JohnH]

Arbon,

The main reason for my posting is there is at least one physician in the Dallas area who goes by the informed consent model rather than requiring a letter from a therapist.

The description of my own experience was secondary.

And I say again to anybody out there - if you self medicate, please go to a physician to legitimize your regimen. I discovered my estrogen levels were normal for a healthy woman but my testosterone level was too low for even a natal (genetic) woman.

Johanna

[Marleena]

Paula I tend to get ignored since I'm a newbie in this section and not postop. I do remember our first discussion about this and I told you numerous times in that thread to get a good gender therapist. That is an important first step and can't be stressed enough.

On the bright side your current therapist has helped you with the depression to move forward. If you got this far you can keep working towards that letter with a gender therapist. Think of it as working towards a new goal.

[LeaP]

Informed consent is not a substitute for a therapist's letter. In fact, one of the responsibilities of a therapist before issuing a letter is to make the determination that the client is capable of informed consent! Informed consent is not a means of bailing responsibility.

[JohnH]

Paula I tend to get ignored since I'm a newbie in this section and not postop.

Some of us are non-op such as myself.

Johanna

[Marleena]

Oh... I didn't know that's what you called it Johanna.

[PaulaQ]

OK, my therapist relented. She agreed that I'm ready. She'll give me a letter. Whew. I'm surprised - when I'd talked to her in the past, she was really against them. Yay!

[Marleena]

Yay! Congrats! So ignore my reply there.lol.

[JohnH]

Great! Glad to hear the good news.

Johanna

[FurPus63]

Glad to hear your therapist sent the letter. All is well. Go for it with full confidence! Congratulations!

Paulette

[Angela Campbell]

Maybe she wanted you to show how much commitment you have and made you demand them, lol

[Barbara Ella]

Paula, happy about you getting your letter. Perseverance stays the day dear. i wish you the same luck with your new therapist. Now, just take a deep breath and put all your focus on your work. You need to stay employed.

Barbara

[Marleena]

The story changes a lot. Good ending though..

[Angela Campbell]

Ending? Lord have mercy! She isn't even at the beginning yet! Watch out.

[PaulaQ]

I know, tell me about it! The further down the rabbit hole I go, the curiouser and curiouser it gets, and the faster I seem to go.

I get to see the matrix for what it is, finally, I guess.

[Angela Campbell]

Not going to do the Matrix unless I can look like Trinity

[MatildaJ.]

That's wonderful, Paula! Glad to hear the good news.

[TeresaCD]

OK, my therapist relented. She agreed that I'm ready. She'll give me a letter. Whew. I'm surprised - when I'd talked to her in the past, she was really against them. Yay!
Great news, Paula.
Next step forwards..:)

[CharleneT]

Ya'll moved to one of the worst states you could choose, MOVE AGAIN - SOOON !



really !'

[PaulaQ]

I know Charlene, I know. I have kids and parents here who are supportive. I have a house here that I need to get rid of before I can really move away. I'm getting cheap rent on a nice condo that belonged to my uncle in the gay district in Dallas. But yeah, pretty bad.

[traci_k]

Paula,
Great news about the therapist relenting on the letter so you can move forward. Hope all else is as well as can be!

Hugs,