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A Beginner’s Guide To Seeking Transitional Hormone Therapy

Updated: Feb 24, 2020

Ah, so you’ve figured out that you would like to take your transition a step further? Great! It’s an exciting time in your life. Much education, research, exploration, and discussion should come with it. Like most transgender folks, you may have already gone through an initial puberty process related to your sex at birth. And whether it’s due to not quite figuring things out earlier, or lack of support, or lack of resources, or whatever, you may have already undergone some adult physical changes. But that’s okay, because you’re going to work it back. Because while some pubertal changes are permanent, many can be altered with the right combination of medications: hormones!

So how do you go about getting hormones? First of all, please, PLEASE, do not buy them off of other individuals, or off of the internet, or any other method that is not supervised by some type of medical professional. Too many bad outcomes result from expired drugs, fake medications that have poisonous fillers, and unregulated medicines that are unreliable as to the actual dosage and quality you are receiving. I know I know…sometimes healthcare providers are judgmental assholes, and that makes you not really all that interested in having them guide you through this process. I get it. But I also want people safe, healthy, and happy. If your provider is an ass, then bide your time with them while you search for another, but please don’t feel like you have to put off and hide being your true self just because they suck. Lots of people suck, and ultimately, their opinions matter not at all. Please hold your chin up and press forward.

So how to select a healthcare provider? There are so many kinds! MDs (Medical Doctor), DOs (Doctor of Osteopathy), NPs (Nurse Practitioner), and PAs (Physician Assistant) are the ones you are going to most likely be treated by. All of these degree types I have just mentioned are able to prescribe hormones, but it may depend on their specialty as to whether or not they are legally able to. Now, as to what specialty….many gravitate toward Endocrinology, which isn’t a bad choice since hormones are basically an Endocrinologist’s entire job. But other medical specialties can be equally as capable of handling your needs. Family Practice, Internal Medicine, Holistic Care, Endocrinologists, and even OB-GYN’s all have it within their scope of practice to prescribe hormone therapy. But many don’t. Why?

The main reasons for these folks not providing transitional hormone therapy care is due to either a lack of education/training or ignorance/bigotry. There are other reasons, but these tend to be the heavy hitters. Nothing can be done about the bigotry, unfortunately. Not quickly enough anyway. As for the lack of training…I hate to tell you this, but there are only maybe 1% of medical providers out there specifically trained in transitional hormones. The rest of us are self-taught through various means of self-study, continuing education courses, online lectures, and other methods. The average medical school program dedicates only about 5 hours of LGBT content, and that may not even include anything to do with trans folks. So that means you are relying on these providers to actively seek education/training on this topic that they weren’t given in school, on their own time and on their own dime. Which means there just aren’t that many who bother. Sigh. So how do you find out who offers hormone service?

Finding a provider has got to be one of the more frustrating aspects of this part of your journey. There are sometimes a lucky few who live in an area that is very progressive and has a specialty clinic dedicated to this, but most end up hunting for a while or traveling great distances to see anyone. Because even when providers offer this service, they often don’t advertise it. They don’t advertise for many reasons, such as they are often worried they will be shunned by their peers, have property damaged by enraged idiots, or they are just genuinely clueless as to how needed this service truly is. But I can tell you, most of the time, it’s an image thing that either they, or their employer, are worried about. Idiots. So now what?

Unfortunately, if a quick web search doesn’t bring up a dedicated clinic nearby, you may have to go hunting farther afield for that kind of thing. Another option is to cold call clinics that fall under the specialties I listed previously and just point blank ask them if they provide transgender hormone transitional care. Most likely this is not going to be something that a receptionist knows. I would recommend asking to speak with one of the nurses who works with the provider, or even the clinic manager/supervisor. Those individuals will have a bit more knowledge about the types of services provided, whereas the receptionist may know only that they are a Primary Care clinic and so can’t answer specific medical needs questions. So save yourself some time and heartache and just ask to speak directly with someone who would know (or who can ask the providers about it if not).

I should also mention that there are clinics like my own who provide telemedicine services for trans care. What that means is that you are seen by the provider through a live streaming video chat session (like with Skype or FaceTime), and the provider faxes your lab orders and prescriptions to your local facilities for completion. Thus, this will allow a person a bit more privacy in their care as it can be done in their own home from a computer, phone, or other video-capable device. I believe I am the only telemedicine provider like this for the state of MS, but I’m not sure if I am the only one for AZ. I know there is also another company called QueerMed who does a few of the other southern states, such as GA and TN. So these can also be good options for folks who don’t have a provider close by, or who want a bit more privacy.

Once you have a provider located, and an appointment scheduled, you’re on your way! One step closer. But, you really do need to do some self-education on the topic of hormone therapy so that you can be an informed patient. As I have mentioned before, most of us providers have not had formal training in this, and there are some who may mean well by trying to treat trans patients but who know nothing about what they’re doing. So you need to be educated as to the usual protocols so that if things don’t seem right, you can ask. Be your own advocate. This is your chance to flourish, and you want to get it done right.

The most common set of guidelines is the WPATH standards of care. It is a bit dated, but still very commonly referred to. There is a new version to be published in 2020, though, that is hopefully going to be a bit more progressive. Another excellent source of education is the University of California in San Fransisco (UCSF). They have plenty of reading material and even videos on their website pertaining to trans hormone therapy because they have their own program dedicated to it. In fact, I use their videos and reading materials as a part of my own practice by having my patients watch/read the applicable material prior to their first appointment with me. Remember, informed consent is just that…informed. Educate yourself and advocate for good quality care.

Remember, your transition is a journey. YOUR journey. It is personal and should be directed by you with the assistance of a medical provider. There are no wrong choices in how far you wish to go with the transition. Some people seek more of an agender end goal. Some may seek maximum masculinization or feminization. What matters is your happiness and comfort. So the last thing to do prior to your appointment is to try to decide on what your goals of therapy are. How much “maleness” do you want? Full beard, muscles, etc? Maybe a little less? Or how far into the femme realm would you like? Boobs, fat redistribution, softer skin, etc? It’s your choice. Make it count, and be open with your practitioner as to your goals and feelings along the way. And it’s okay if things change. If you want to de-transition, or maybe just back down a bit off of the therapy, that’s perfectly acceptable, too. Here’s what I tell all my patients during the first visit: “You be you, honey. Just let me help however I can.”

Stacie, NP

Spectrum: The Other Clinic

Transgender Hormone Therapy

Telemedicine Clinic in Mississippi

601-466-9495 Text Me!

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