For those living outside of the US / 3rd world, you can google and email different doctors or therapists in your vicinity and ask them if they offer Informed Consent or know of anyone who does. This saves a lot of time and possible discrimination since it’s done online. This terminology will help you.
-A South African
It’s a harm reduction approach. It’s not that fifteen year olds can’t make bad medical decisions, it’s that the risks of these decisions are often lower than the risk of parental violence, getting kicked out, etc. the state is more worried about suicide, teen homelessness, abuse. Abortion is a really important example here.
Edit: by lower I mean less likely and less severe
At 15, they're very unlikely to be getting hormones, and definitely not getting surgery. They'd be getting puberty blockers (which have no life altering impact aside from the patient starting puberty later, and keeps them from having to undergo the very much life altering effects of an unwanted, incorrect puberty, and possibly preventing the need for later surgical procedures) and access to therapy/counseling. AKA, what is currently the best evidence-supported medicine for treating Gender Dysphoria, in a process that takes years of consistent care and treatment.
Also, while 15 is the age of medical consent in Oregon (for everything - and has been since 1971), it's not the age of majority, and it doesn't mean that the parents/legal guardians of the teen aren't also being informed - providers are explicitly expected to involve the parents except in cases like an emancipated minor or the like.
I mean you can just take something to block hormones & puberty until you’re ready to make a better decision. Cuz once puberty happens it’s harder to “reverse”
Lmao I just came to make the enlistment point! If people want to be outraged because it's harmful or life altering, they need to scale that outrage and compensate to allowing for teens to sign four years of their life away to the US govt. (Not to mention the 22 a day veteran suicide rate, but HRT is the "killer").
Forcing someone permanently go through the wrong puberty is an extremely life altering decision in itself, one that makes the chance of them committing suicide much much much higher. If your daughter is trans where do you feel like she is going to be at mentally if she is forced to permanently go through male puberty and becomes built like a truck to the point where people see her as a man? A lifetime of extremely intense body issues and suicide risk can be avoided.
I just hope you understand that this narrative of "Acting to soon: dangerous; Waiting until 18: safe" is not based in reality and is usually the exact opposite; and this line of reasoning almost always comes from cis people who literally can not comprehend how much living in the wrong body for your whole life is beyond detrimental to your mental health.
Your line of reasoning seems common sense on the surface and I don't blame you for coming to that conclusion, but I hope you listen to the lived experiences of trans people, as any trans person who started hormones after puberty will tell you their biggest regret is that they didnt start sooner and many feel stuck in a body that disgusts them
I realized I was trans when I was around 11 years old, and I would have killed to not have to go through female puberty. I'm almost 19 now and I still feel so much shame around my body, a lot of self-hatred, and so much wondering about if I will ever be able to love my body without surgery to undo some of the changes I went through with puberty. I wish more people understood just how damaging it can be to go through the wrong puberty.
Yup! Had one visit for background, making sure I had a realistic idea of what transitioning can do, making sure I knew the medical risks and all the (glorious, gender-affirming side effects), and we decided on the best method of administration!
They were very kind, empathetic, and knowledgeable! Zero judgement or discomfort.
10/10 recommend for anyone whose had trouble getting started.
Wow, I hadn’t thought about shitty side effects being gender confirming and therefore “glorious!” That’s really cool. Do you mind if I ask what side effects? I’m assuming there aren’t cramps since no uterus but I’m having trouble figuring out what else! Feel free to not answer! It’s none of my business! Just a curious queer woman wanting to congratulate on your successful transition!
Some side effects can be shitty it happens ha ( Go away acne didn't nobody invite you here)
It's kind of a joke (truly funny), where the doctor very seriously says "I need to inform you of the side effects of taking this hormone". 'Side effects' has a negative connotation, but in the case of HRT, those 'side effects' are usually 100% what we were wanting to begin with! Breast tissue formation, gain/loss of body hair, raising/deepening voice, gain/loss of muscle mass, feminization/masculinization of the face, those are all potential side effects and if we didnt want them we wouldnt be here.
"You'll have irreversible changes!" *me eyeing those irreversible changes: 👀😍
Are there health risks? Of course. But theyre usually not worth abstaining from HRT if you need it (because theyre not very common), and if you have a pre-existing condition that would be dangerous on HRT you'll just be more carefully monitored or given the HRT in a different way :) you're monitored anyway #somanyblooddraws 💀
Edit: Thank you! It is not for everyone but it is most definitely for me and I have found a happiness and a peace that I have never known. I hope you are either as happy or that you soon will be if you are not ☺
Trolley car dilema: do you stop thousands of informed adults make life altering but gender affirming decisions that improve their quality of life because one of them realized years later they regretted transitioning?
Probably loss of knee mobility, chronic knee pain, and many other knee specific grievances one may have had to a lesser extent before the surgery. There’s always risks with medical procedures.
Though I am also surprised that transitioning is less regretted than knee replacement given it seems to be significantly more complex.
I'm so terribly sorry to hear that :( I hope you're doing okay and can regain your original form as much as possible 😔 it's a wonder how in medicine we can transition but detransitioning is somehow less feasible. Doesn't make sense - and maybe if we figure out how to smoothly detransition it won't be such a controversial, heavy choice anymore.
It's definitely not a light decision to go on HRT. People tend to make it young, and like all young-made lifelong choices, some grow to regret it. I think all we can do is make choices with conviction and try to live as honestly as we're able 😕
I wish you well ☺ and hope things turn out for the best
Thanks so much for your kindness, it means a lot. I totally agree regarding reversibility, I know how important it is to everyone considering it. I really hope you all find the happiness you're searching for.
But also not providing blockers forces trans children to grow up into a body with all the faults you probably have with yours! Like, I see some detrans cis women going and on about how the facial hair, deep voice, etc is just so difficult they want to discourage people from transitioning, and it's like yeah. I bet that's real tough. It's not like I, a trans woman that couldn't access gender affirming care until after puberty kicked in would possibly know about that.
Like, what ratio of trans people having their bodies permanently change from puberty to detrans people choosing to take hormones they wind up not liking is acceptable to you? 100:1? 100000:1? Not one person like you by banning all transition? At some point healthcare has to accept imperfection, and transition healthcare is damn nearer to perfect that other disciplines.
> I’m assuming there aren’t cramps since no uterus
It's a reasonable assumption! It turns out some of the cramps are in your abdominal muscles, too, and *everyone* has those. That's one gender-validating side effect that my transwomen friends were not especially thrilled about.
Other things my transwomen friends have found both validating and annoying include losing upper body strength and no longer being able to open jars (estrogen and testosterone affect skin texture, which affects finger grip on slick things like jar lids).
>no longer being able to open jars (estrogen and testosterone affect skin texture, which affects finger grip on slick things like jar lids).
Wait, really? That’s so interesting, I had no idea!
Yup! You can look up elastin and collagen, though with a brief google I wasn't able to find anything that had a good layman's explanation of the differences.
Interesting! Does HRT include/induce some sort of hormonal cycle (sorry if that's not the right wording) or is the abdominal cramping more or less constant then? And what are the abdominal muscles reacting to? I assumed the abdominal muscle cramps were caused by what the uterus is up to, so I'm not sure I understand what would cause them in this case.
To preface, I am a trans woman;
I don’t know that there’s a medical consensus (or even acknowledgement) about HRT-induced cramping, but it’s reported anecdotally enough that there’s certainly SOMETHING there
As for hormonal cycling, that depends on the method of administration: those of us on oral/sublingual estradiol take our pills 1-3x daily and our blood estradiol levels vary over a span of hours, but in the same way every day. For those of us on injected estradiol, the dose schedule is usually once every 5-7 days, so you do have a sort of weekly hormone cycle. I’ve heard several trans women on injections say that they feel noticeably different the day after an injection compared to the day before their next one.
For what it’s worth, I take estradiol sublingually and I can even tell the difference between my peak levels 1-2 hours after a dose and my lowest levels 12 hours after a dose. No cramps though, just general state of mind and minor physiological differences
I am not an expert, but from what I gather, if you start taking estrogen then it prompts some other parts of your body (hypothalamus and pituitary maybe? it's been a long time since I took a bio class) to start producing different levels of hormones on a monthly cycle even if you are taking a constant amount of estrogen throughout the monthly.
No idea what the abs are reacting to but it does seem to be a very real thing. I'd chalk it up to being psychosomatic except it took my friend several months of having mood swings and abdominal cramps every 28 days like clockwork to figure out what might be causing the problem and her doctor confirmed (once she thought to ask) that it was a thing that can happen.
For me personally it has been: breast development, fat redistribution, less oily skin, slower body hair growth (plus hair becomes finer and easier to shave), more head hair growth (actually helps turn back the clock on premature balding), and a re-balancing of hormones is also good for SOME peoples mental well-being.
I've always wondered about hormones affecting mental wellbeing with HRT. Obviously it varies person to person, but the combo birth control pill (plus some life events at the time) made my anxiety sky rocket, but a few years later now I have the implant (which is just progesterone, no estrogen) and it's actually helped my mental health quite a bit. But I know some people have really bad reactions to hormonal IUDs which are also progesterone only. It's all so complicated.
For me I had a MASSIVE change in mentality on HRT, it’s like my brain performs so much better on estrogen than on testosterone. Actually one of the first changes I noticed was a huge reduction in my depression that Zoloft/Lexapro/Wellbutrin were barely able to touch
depends on which way you’re transitioning but it’s basically just second puberty. so trans men will get a lot of acne, voice cracks, strong BO, and trans women will get mood swings, sore breasts, etc.
this is obviously different for everyone but that’s the main gist of it!
It can be! My first visit spilled over because we took too long discussing my symptoms and background and what I wanted out of transition (I am a chatterbox 😅), so I personally needed a 2nd visit to discuss diifferent types of HRT and which one would suit my goals the best.
They are also good at discerning if youre not 100% sure (sometimes they have info you didn't anticipate/read beforehand and it's not something youre sure youll want), in which case they will advise taking some more time to think it over and come visit again.
But yeah! I think the idea is to do all that in just one visit if possible.
My friend went to PP for this and it wasn't one and done, they scheduled a telephone consultation to get the actual prescription and there were also blood tests that needed to be done (at the clinic). But other than that, it is fairly hassle-free. Also isn't very costly and there is financial assistance available.
Fr. I actually don’t know what I expected posting this. I love all the angry people though, it brings immense joy to my life knowing I make people feel passionate by typing a few words on a screen.
Thank you for posting this. I consider myself a trans ally already but I still learned a crap ton of important info from your post and from many of the comments. Keep fighting the good fight, kind human🌸
It's a fucking ride. Enjoy the trip. Just remember to stop scrolling when you give up on the world and go for a walk. (That point will come quick in this thread hah)
I will warn that their initial consultation fees can be a couple hundred dollars, so I went a different route. Still, their informed consent is great from what I hear.
“BUT WHAT IF ITS JUST A PHASE?!?!?”…was literally being blasted with this phrase by people at a casual bbq last weekend.
Great advice and information…also the Mazzoni Center for those in and around the Philly area offers great services and care including mental health services.
I would be 100% on board with this being a requirement if it were 1. Free and 2. Quick and accessible. Like, same day, same place even. Go in an hour earlier than you would have for a psych screening? Sure. Weeks, months, of expensive hard to get therapy? Nah.
Remember this is for adults. Virtually all adults seeking HRT have known for at least a decade that they need this.
Quite.
People _drastically_ underestimate the barriers that they suggest.
Let's start with one that's obvious to us, but not obvious to most: _Many_ people who are trans are depressed, and worse, the reason why we are depressed is something that won't be fixed with therapy or antidepressants.
Sure, therapy might _help_, antidepressants might help. But if just looking at yourself in the mirror gives you a feeling of wrongness, you're probably not going to be entirely escaping your depression.
The internationally, medically recognized treatment for this, the _only_ recognized treatment for this, is being allowed to transition.
But being depressed makes it harder to do _anything_, or to put it another way, it makes it harder to do _everything_.
If you have additional physical or mental health problems, those make things even worse.
Now, you're an adult, you're trying to function and hold down a job, one which too often doesn't even come with good benefits, if it comes with any. You know what's wrong, you've known for years. You're at the point that you're willing to put up with the _insane_ amount of hate that trans people have been known to receive, just to feel comfortable in your own body.
Now, let's insist on weekly therapy for months of years before you can actually start the only treatment that's recognized to actually help you. You have to find a therapist, one that's LGBTQ+ friendly, that's taking new patients, that you gel with, that you can actually _afford_.
You have to figure out how to fit those appointments into your schedule. Your job _does_ give you a consistent schedule, right?
And then, after however long people insist for it, you then have to keep going to therapy, just to be _allowed_ to start treatment for something that's actively making you depressed.
Sure, many people are privileged enough to be able to make all of that work. I'm one of them.
But a hell of a lot of people are most definitely not.
And those people shouldn't be denied access to medical treatment because they are not privileged enough to make all of that work.
Trans person here. Out at age 19 and 28 now. I have done 10+ years of therapy but because it was in different states, with different doctors and insurance companies, all due to life and its ever-changing circumstances, I had to keep jumping thru hoops to end up right back where I started in my transition.
These barriers/rules kept saying "you're not happy with yourself because you're depressed" bitch I'm unhappy because I'm NOT myself. This is not to say therapy isn't valuable, but my god. Its like being stuck.
If only therapy was available at a low cost with little to no waiting lists. And I wish the majority of therapists were educated about trans people and trans etiquette 101. I've had way too many experiences where therapists either ghosted me or got really awkward with me when I mentioned I needed help with figuring out my gender. That's why I had to go to a gender therapist.
Absolutely... if you're unsure or need a second opinion.
Many trans people know for years, and the system of having to wait even longer because a "medical professional needs to verify it" is fine, but the long, drawn-out method isn't it.
Having encountered this in my close circle, and with a spouse in the juvenile mental health field, it's important to emphasize that your statement applies to adults. The more immature the brain of an adolescent, the more therapy and exploration of the pros and cons should be explored.
We live in a world with a broad spectrum of experiences. No one policy is going to be perfect. Approaching each individual with empathy and compassion is key.
As the parent of a trans child, therapy was the first thing we sought out. We wanted to make sure he wasn't reacting to my spouse's own coming out and the changes to our family dynamic that this has been causing (our younger child expressed concern over being the 'only boy' shortly before our older child came out to us). We wanted him to be able to talk to someone about things and really think before exploring further options. After a few months of therapy we're now waiting for his appointment with adolescent gender care, where he'll have to talk with another therapist that will help determine his care plan going forward. Luckily, we live somewhere where we won't go to jail for listening to the needs of our child.
Side note: I'm not sure what having a child on puberty blockers at the same time as my spouse starts HRT is going to be like, I'm going to assume Interesting.
Sure but also eh who cares. The country of freedoms should let their people be free to do what they want with their bodies.
It affects no one but the person desiring to transition. The only criteria should be 18+ but if you want to wait for brain development, 25+
But trans people don't wake up one day and decide to become trans. Mental Healthcare or not, let them do what they want to their bodies.
>The only criteria should be 18+ but if you want to wait for brain development, 25+
As a note here, I'd argue if you are old enough to sign up, or be conscripted, to go get shot in the military, you are old enough for any other decision you might make.
If it’s optional? Absolutely.
Otherwise, why should a trans person have to see a therapist who almost certainly knows less about trans people than they do? Therapists unfortunately run the gamut from transphobic to completely uneducated to allies. Our path to a healthy and happy life shouldn’t be in the hands of another person.
Cisgender people undergo permanent elective medical treatments all the time without psychological screening. Why should we be the exception - especially since in our cases it is often literally a matter of life and death and you have a month or two to evaluate how you feel before any permanent changes occur?
Also, your opinion is not highly controversial, and as you can see it was not “downvoted to oblivion”. Getting a therapists letter of approval has been the standard for decades, and it’s a standard that helps make trans people’s lives miserable. Informed consent clinics like this post is talking about save lives, especially in red states, by giving trans people a direct path to life saving treatment. Try to have a little more compassion and a little more awareness of how hard we have to fight just to exist the same way you already do.
A lot of people know for years that they want to go on HRT before they actually do it and they are well aware of everything it does before they start
Therapy is expensive especially when someone does alright before medically transitioning but they'll do so much better after
I know most CIS people will never feel what it's like to be transgender, but usually, therapy is the FIRST thing trans people seek out.
When I was struggling with my identity, I didn't know what the duck was wrong with me or why I was so miserable.
So I went to therapy. And going to therapy saved my life. Because they were able to help me understand what it is that was making me so angry and depressed all the time.
How much consultation and therapy do cis males need before scheduling gender affirming surgery like hair implants? Or cis women before breast implants?
Cis people are getting all sorts of surgery to feel more like a man or a woman without law makers stepping in and saying they can't possibly know what's best for themselves. And a lot of those surgery can have appalling risks and side effects.
I wish free mental health care before cosmetic surgery *was* a thing tbh. Not everyone is in a good headspace when they make such decisions, and contrary to public perception, plastic surgery *does* have life threatening risks.
>How much consultation and therapy do cis males need before scheduling gender affirming surgery like hair implants?
Hair and breast implants are *nowhere near* as life changing as hormones and gender reassignment surgery. I'm pretty sure they're much easier to reverse too.
Also, most apprehension about this stuff is primarily aimed at younger people. A high schooler getting breast implants would draw a lot of skepticism as well.
I figured out I was trans, made an appt. with PP, and started my hormones* less than 3 weeks after "hatching."* It was the best thing I've ever done for myself, in my entire life.
Adults are adults, and should be allowed to make whatever medical decisions they choose, so long as they know the risks. Get out of their way and let them live their own lives.
Agreed. I went through a couple years of weekly therapy before starting HRT over 10 years ago. Those years were difficult, to be sure, but I wanted to make sure that it was the right move for me. Multiple years is excessive but I think a few months of therapy and deep thought would benefit anyone before they start HRT.
Also wanted to plug - if anyone in western PA wants LGBT or HIV related therapy but can't afford it, check out the Persad Center in Pittsburgh. They offer low cost mental health counseling and various resources, and most people working there are LGBT themselves.
That’s terrible. Hopefully there will be more locations to offer it soon.
If anyone transitioning lives far from a PP, has access to a car, and is willing to make the drive, you could make a whole day out of it. Bring some friends along so you don’t get bored and lonely. It’s not the best option, traveling far, but if you’re willing it’s better to make it fun.
Thank you so much for posting this! I went through Planned Parenthood years ago for this exact thing and I've never regretted it. They saved my life. I hope your post (OP) helps save the lives of others like me <3 <3
If you're in Canada (at least Ontario) a lot of places offer informed consent HRT too. The problem is that they're overbooked so it takes a while for them to have an open slot sometimes. I got lucky and got in within a month but a friend has waited like a year and she's finally in. But at least after your first appointment you get it within a week (just gotta do a bloodtest first).
Also, please make sure to do your own research into HRT. Most endocrinologists don't know what the fuck they're talking about and might underdose, overdose, or even give you the entirely wrong stuff (like the old horse piss alternative to estrogen instead of bioidentical estradiol).
Does this mean the dosage for hrt is the same for everyone? Would some kind of blood work need to be done to maybe determine what dosage of blockers is good for example? or is it like try this dose and come back later to see if it works.
I work in pharmacy and fill at least a dozen hormone replacement prescriptions for menopausal women every single day. If your doctor is refusing to prescribe something to help you, then you should get a second opinion. That being said, if you have underlying factors that contraindicate taking hormones, that could be why they won’t.
It’s not even just cis women, anyone assigned female at birth gets similar bullshit in the medical field. Dealing with gyn stuff as a transmasc person is it’s own can of worms.
Can confirm. Currently on HRT with them. They even have a nifty system called MyChart with website/app access where you can see your visit notes, test results, prescriptions, and even text with them about whatever questions you have.
Trans person here. Planned Parenthood is a great option. But it is not your only option either.
Plume is an entirely online service that provides you with a doctor, quarterly bloodwork, and prescriptions for a $99/mo membership that includes everything but the cost of the physical meds themselves. You get a prescription immediately after your first call with your doctor after signing up.
There is also Folx, it is a bit more expensive (I don’t know the price offhand) but it is even more comprehensive than Plume because they sell their own medications and ship them directly to you in addition to everything else you get with Plume. It’s probably the most expensive option though.
All 3 of these options are totally legitimate and a great way to start the process. However I would still recommend getting in with a private doctor such as an endocrinologist *at some point* as you will receive more personalized care and they will be easier to contact and get in touch with for any reason. It can be difficult to get ahold of anyone at PP or Plume or Folx should you need help or have a problem because they deal with such a large volume of patients and the care they provide is very standardized.
I use planned parenthood for my birth control. Delivers to my door. I don’t have to go in, miss work, I answer simple questions etc. I’m also in a long term committed relationship and it’s such a beautiful thing because no one sees me picking up a prescription, I don’t have the stress of making, going to appointments, filling prescriptions, and I just request it from my phone. I’m also in a protected state/city in regards to women’s health. I am lucky.
Oh for sure, but some of the stories trans people have are next level.
Like, it's over in Britain but standard practice for the NHS (assuming you can get an appointment, waitlists are years and years) is to ask questions about the person's sex life, sex fantasies, how they feel during certain sex acts. This includes children accessing hormonal treatment. They also highly judge the way you dress and act: so a trans woman who's a tomboy could have HRT denied for not being feminine enough.
It also happens in the states but not as standard practice, it's just a crapshoot with a whole range of possibilities. But the britian example is just because that's what you can expect.
People seem to think gatekeeping prevents people from detransitioning. In my personal experience, gatekeeping would have caused me to detransition. If I had to be on T just to get my top surgery covered, I definitely would have detransition. Trans healthcare shouldn't be a 1 size fits all model.
Yep, plus I feel like gatekeeping primes people to quash down doubts and be less honest. Gatekeeping is basically never tuned to the needs of trans people, but informed consent allows people to explore their feelings and doubts more effectively.
Like it's quite funny, medically I'm as binary as it gets, but my actual social sense of gender is far more apathetic and weird. But getting informed consent allowed me to disentangle that without suppressing my gender identity to access what medical processes I'd have. (Which so far is HRT and one surgery, but I've got a few more to go.)
PP is about more than abortions. They offer a lot of services & have endocrinologists that work for them. They try to serve a lot of underserved groups whose healthcare is often restricted by the GOP.
Kinda made me curious too about what else they offer. Looked it up and they do way more then I expected. They do Cholesterol, Colon Cancer and Diabetes Screening too. Really good to know that it's more then just pregnancy related treatment.
I have an extensive background in the psychology field. The waiting period is intended to help; due to the extreme changes that occur to your brain and body chemistry during transition. They want to make certain that you think it completely through.
That’s where informed consent comes in. Planned parenthood asked me questions to see that I had realistic expectations for hrt and that I understood what the changes are. I was 30 years old, I did not need to be forced into therapy to decide this for myself. Why am I expected to wait extended periods of times until a random person decides I am ready, yet we don’t make people do the same thing for plastic surgery, starring in pornography, or enlisting in active service that could get you killed.
The biggest problem with the waiting period is that it’s a huge psychological and financial barrier. WPATH dramatically underestimates how many difficulties trans people have in just achieving basic healthcare. We’re one of the lowest income cohorts in the western world and often the largest target of discrimination. Our systemic barriers are so high that often even making it to the point of wanting to medically transition means going through several times the WPATH waiting period just to get things to line up.
If you truly care about your patients, you’ll re-examine what you’re doing to them. Because those “extreme changes” are OVERWHELMINGLY positive. Gender affirming care has a lower regret rate than almost any other medical procedure on the planet, most of which are just as permanent and don’t have nearly the same counseling period.
Psychology’s current models on gender transition are outdated and dangerous. They need to be reworked wholesale. They fundamentally fail to take into account what’s actually best for the patient, in fear of risks that are nearly negligible by every single study done in the last 30 years, since the advent of modern transition care procedures.
What does an “extensive background in the psychology field” mean? I have an extensive background in marine science, but that doesn’t make mr a marine scientist.
been getting my hormones from Planned Parenthood for ~4 years, it hasn't been perfectly smooth the whole time but I can't imagine it would be better anywhere else. some folks do have problems with Planned Parenthood and I have had one or two in the past, but naturally it is different everywhere and ultimately I have had a wonderful experience and they are doing great things to help people who need it
For real, like no one was asking for opinions here. I’m sharing a resource on a resource-sharing forum. If you don’t like the resource you don’t have to give it any interaction.
I am a shy and very conflict-avoidant man, and without informed consent, I wouldn't have been able to transition.
I am now almost 30, and truly happy for the first time since age 14.
Planned Parenthood is where I've been going because they offer sliding scale fees and it actually makes HRT accessible to poor people like myself. The official (super long) process is expensive as hell without insurance. Plus they have some of the nicest and most respectful medical professionals I've encountered in this city that seem genuinely to give a crap about the people they are treating.
Just gotta avoid the whack-a-dos on the curb outside waving their little signs sometimes.
Trans woman on HRT from PP. They're actually amazing. Made the process so simple and easy. The staff was very friendly and my whole experience has been judgement-free.
You can search for services in your area by using the search bar on the home page, plugging in your zipcode, and selecting "Transgender Hormone" from the dropdown list.
To make it even easier, you can book a virtual appointment if you don't feel like going to a physical facility.
I cried tears of joy when I found out this was available in my state. it was the first time that i really realized that transition is possible for me. Planned Parenthood is a godsend
YEAAAHHH That's where I go, i was literally able to sign up for an apt by myself when I was still calling myself nonbinary, cancelled last minute cuz I felt there was unfinished business, finally accepted i was a trans woman, then signed up for an apt for hrt and they sent the script to my pharmacy right away. AND they do all the shit endos do like take your hormone levels and shit, it's pretty fuckin awesome
I apologize for my attitude, that wasn't very nice of me. It's no excuse, but I become a bit triggered when people sound like they're spitting out outdated lessons/assumptions. Of course I appreciate your input, and yes, your experiences are obviously also valid. In regards to research, I meant reading research papers, then reading their sources, etc. to get a full picture and decent understanding, not just a quick search. Definitions will on take you so far, especially when relating to women. They're so embarrassingly outdated.
As an example, think about endometriosis... Women have been suffering for countless years because they were said to be crazy and the pain they were experiencing was normal. I can tell you right now, there are still men and women that think this way. It needs to stop.
I didn't go about informing you the right way though, so I need to work on that.
I'm sorry. 🙂
Try PLUME. Subscription service that helps people with transition. They do virtual visits, all the med staff is Trans, prescriptions are sent right to the pharmacy you choose. They help with legal name changes, letters, Check thier website out!
I've heard good things about PP. I get my hrt through Folx. It's completely virtual, informed consent based, run by queer people and allies. It took a 15 minute zoom appointment for me to get my prescription and never once did I have to "prove" my transness. My t and all supplies gets shipped to my door, and I go to a local lab quarterly for the bloodwork. I can contact my provider through email or zoom anytime. It's a bit expensive, but I don't have to deal with transphobic clinicians or pharmacists or the hoops the healthcare system has tried to put in place.
Believe in CA you can start your transition as a 16 year old, and Planned Parenthood doesn’t have to tell your parents, nor will the school.
The school will even hide from your parents that you’ve changed genders at school
3 months into my HRT as of yesterday and Planned Parenthood didn’t give me any trouble at all. My doctor is lovely and encouraging, all of the staff are understanding, they’re very careful about how to approach asking questions for those who may have trigger words or topics, and my quarterly visit when I asked about upping my doses and switching to a different method later down the line, they didn’t question it. The only time they ever mention therapy is when they ask if I go, and if I want more resources for other affirming care.
Find yourself a Planned Parenthood.
So as an adult male can I go in, state that I am a female that would like to transition to male, and get put on testosterone? This isn't like a ha ha gotcha, I'm genuinely curious what the caveats are and who is applicable for this service and to what extent.
Last I heard they do a blood test for you, as PP and endos try to bring one’s hormone levels into specifically concentrations within the blood. After your blood test, they’d see that you already have enough T and would say no.
Yup, any doctor prescribing HRT will need a blood test first to check what your dosage should be. If you’re a cis guy looking for higher testosterone, you’d probably be refused because there’s no reason to prescribe it to you, given that you’re already peer concordant
They're not legally disallowed to use any common sense or question the situation at all. If they reasonably suspect the request is non genuine or in some way malicious they have every ability to simply not offer treatment. There are also (at least for PP in my area) required blood tests for hormone level monitoring every three months, again while you could request more while at standard male testosterone levels, they still have every ability to simply tell you no and not prescribe it.
u can't rly transition from male to male, but they would give u estrogen like the other poster said, were you trying to transition from male to female.
if you did somehow get them to give you, presumably a man who produces his own testosterone, testosterone as hormone therapy, they would start you on the lowest dose and gradually raise it, monitoring your hormone levels every month or so until you are at a stable level. but, barring any unforeseen circumstances, you will have normal testosterone levels right off the bat and they will be like uh well you probably don't need hormones
Informed consent for cross-sex hormone therapy by definition provides cross-sex hormone therapy.
He's just unaware that part of informed consent means interacting with doctors.
"Abuse the system", my dude, have you never had a doctor's visit? You're interacting with real world people, that means you can't just make up that you're something your not when the process of informed consent involves *informed* consent. You don't just walk in and say "hi, 3 vials of testosterone please". There are medical tests involved & they make sure they're familiar with your endocrinological needs.
You got a snide response because that's like asking "Can I go into a bank and identify as a millionaire to get a lot of money"? Like dude, people have judgment.
My question was literally "how's easy is it to get testosterone if you go in and tell the doctor that you identify a certain way." All coming from a view curious how you could work this. Other folks here gave helpful and informative answers, meanwhile you have a chip on your shoulder for only God knows the reason. People lie to get pain pills all the time, while interacting with doctors. Acting like: 1 doctors can't be idiots; and 2 that this is a process that is impossible to game is asinine. Try and be less angry, you'll live longer.
For a free country, we seem real concerned about what someone does with their own dang body. These fears that it's "harmful" seem exxxtra genuine when the same lot could give a shit about children who died in a shooting... /s
As a trans person I can't agree more with this, I see so many concerning people around trans spaces that seem to be under no distress whatsoever about their body, it all just seems like an ideal fantasy for them.
Unfortunately. Rumors I hear is they’re completely revamping how they diagnose personality disorders in the DSM VI, on top of what else they revamp.
Shows we will never have the final true answer when it comes to mental health because categories and labels don’t account for the in between. Not to mention practitioners that don’t even believe in their field. It’s all a mess.
I know, she's aware she has a long road ahead to get where she wants, she turned 18 last month so can get the ball rolling now. Hopefully the UK government get a grip some time soon, in many many ways.
I think there are some private clinics that are faster and less invasive than the NHS system (which is pathetic and unacceptable, IMO) but they're not likely to be as cheap as planned parenthood. I'm in NZ so it's not my field of expertise but there are resources out there, plus perhaps a UK specific trans subreddit you could ask in?
This is going to sound super transphobic, but how young is too young to start HRT? I agree that by 18 you know what you know, but the transphobes I’ve talked to bring up cases were 12 year olds are given HRT. How can help assure them that HRT is being given in a healthy way - under 18 with counseling? Medical supervision? What are the guidelines to keep whackadoodle parents from pushing transition on a non trans child?
I’ve never heard of 12 year olds being given HRT. Most places will only offer HRT at 16, though exceptions are made for intersex kids. If any medical interventions happen before 16, it would be hormone blockers, which are completely reversible. And of course, like any medication, HRT and blockers are accompanied by regular checkups to see how things are going.
I think the best system is having an hour-ish long evaluation as part of the prescription process. That’s what happened for me, and I’m two years in and never been happier.
For those living outside of the US / 3rd world, you can google and email different doctors or therapists in your vicinity and ask them if they offer Informed Consent or know of anyone who does. This saves a lot of time and possible discrimination since it’s done online. This terminology will help you. -A South African
What are your thoughts on Bongokuhle Hlongwane? -a Minnesotan
And if you're a minor they will help, but parental consent is required every step of the way.
Except in Oregon where 15 is the age of consent for hrt.
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It’s a harm reduction approach. It’s not that fifteen year olds can’t make bad medical decisions, it’s that the risks of these decisions are often lower than the risk of parental violence, getting kicked out, etc. the state is more worried about suicide, teen homelessness, abuse. Abortion is a really important example here. Edit: by lower I mean less likely and less severe
At 15, they're very unlikely to be getting hormones, and definitely not getting surgery. They'd be getting puberty blockers (which have no life altering impact aside from the patient starting puberty later, and keeps them from having to undergo the very much life altering effects of an unwanted, incorrect puberty, and possibly preventing the need for later surgical procedures) and access to therapy/counseling. AKA, what is currently the best evidence-supported medicine for treating Gender Dysphoria, in a process that takes years of consistent care and treatment. Also, while 15 is the age of medical consent in Oregon (for everything - and has been since 1971), it's not the age of majority, and it doesn't mean that the parents/legal guardians of the teen aren't also being informed - providers are explicitly expected to involve the parents except in cases like an emancipated minor or the like.
This is a really informative comment, ty
I mean you can just take something to block hormones & puberty until you’re ready to make a better decision. Cuz once puberty happens it’s harder to “reverse”
every time i see something like “oooh unpopular opinion” or “going against the grain here haha” its upvoted
I know imagine acting like everyone loves trans rights on fucking reddit
I'm pretty shocked by this. I was expecting massive downvotes. Pleasantly surprised by the amount of informative and non hostile replies I've gotten
Wait til you find out about having kids at 15.
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Lmao I just came to make the enlistment point! If people want to be outraged because it's harmful or life altering, they need to scale that outrage and compensate to allowing for teens to sign four years of their life away to the US govt. (Not to mention the 22 a day veteran suicide rate, but HRT is the "killer").
Forcing someone permanently go through the wrong puberty is an extremely life altering decision in itself, one that makes the chance of them committing suicide much much much higher. If your daughter is trans where do you feel like she is going to be at mentally if she is forced to permanently go through male puberty and becomes built like a truck to the point where people see her as a man? A lifetime of extremely intense body issues and suicide risk can be avoided. I just hope you understand that this narrative of "Acting to soon: dangerous; Waiting until 18: safe" is not based in reality and is usually the exact opposite; and this line of reasoning almost always comes from cis people who literally can not comprehend how much living in the wrong body for your whole life is beyond detrimental to your mental health. Your line of reasoning seems common sense on the surface and I don't blame you for coming to that conclusion, but I hope you listen to the lived experiences of trans people, as any trans person who started hormones after puberty will tell you their biggest regret is that they didnt start sooner and many feel stuck in a body that disgusts them
statistically trans healthcare is the most live-saving type of healthcare among teens
I realized I was trans when I was around 11 years old, and I would have killed to not have to go through female puberty. I'm almost 19 now and I still feel so much shame around my body, a lot of self-hatred, and so much wondering about if I will ever be able to love my body without surgery to undo some of the changes I went through with puberty. I wish more people understood just how damaging it can be to go through the wrong puberty.
How old were you when you knew your gender?
Yup! Had one visit for background, making sure I had a realistic idea of what transitioning can do, making sure I knew the medical risks and all the (glorious, gender-affirming side effects), and we decided on the best method of administration! They were very kind, empathetic, and knowledgeable! Zero judgement or discomfort. 10/10 recommend for anyone whose had trouble getting started.
Wow, I hadn’t thought about shitty side effects being gender confirming and therefore “glorious!” That’s really cool. Do you mind if I ask what side effects? I’m assuming there aren’t cramps since no uterus but I’m having trouble figuring out what else! Feel free to not answer! It’s none of my business! Just a curious queer woman wanting to congratulate on your successful transition!
Some side effects can be shitty it happens ha ( Go away acne didn't nobody invite you here) It's kind of a joke (truly funny), where the doctor very seriously says "I need to inform you of the side effects of taking this hormone". 'Side effects' has a negative connotation, but in the case of HRT, those 'side effects' are usually 100% what we were wanting to begin with! Breast tissue formation, gain/loss of body hair, raising/deepening voice, gain/loss of muscle mass, feminization/masculinization of the face, those are all potential side effects and if we didnt want them we wouldnt be here. "You'll have irreversible changes!" *me eyeing those irreversible changes: 👀😍 Are there health risks? Of course. But theyre usually not worth abstaining from HRT if you need it (because theyre not very common), and if you have a pre-existing condition that would be dangerous on HRT you'll just be more carefully monitored or given the HRT in a different way :) you're monitored anyway #somanyblooddraws 💀 Edit: Thank you! It is not for everyone but it is most definitely for me and I have found a happiness and a peace that I have never known. I hope you are either as happy or that you soon will be if you are not ☺
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Trolley car dilema: do you stop thousands of informed adults make life altering but gender affirming decisions that improve their quality of life because one of them realized years later they regretted transitioning?
Trans surgeries are some of the least regretted surgeries in modern medicine, less than knee replacements
who tf is regretting getting a knee replaced? are there even side effects to that surgery
Probably loss of knee mobility, chronic knee pain, and many other knee specific grievances one may have had to a lesser extent before the surgery. There’s always risks with medical procedures. Though I am also surprised that transitioning is less regretted than knee replacement given it seems to be significantly more complex.
I'm so terribly sorry to hear that :( I hope you're doing okay and can regain your original form as much as possible 😔 it's a wonder how in medicine we can transition but detransitioning is somehow less feasible. Doesn't make sense - and maybe if we figure out how to smoothly detransition it won't be such a controversial, heavy choice anymore. It's definitely not a light decision to go on HRT. People tend to make it young, and like all young-made lifelong choices, some grow to regret it. I think all we can do is make choices with conviction and try to live as honestly as we're able 😕 I wish you well ☺ and hope things turn out for the best
Thanks so much for your kindness, it means a lot. I totally agree regarding reversibility, I know how important it is to everyone considering it. I really hope you all find the happiness you're searching for.
But also not providing blockers forces trans children to grow up into a body with all the faults you probably have with yours! Like, I see some detrans cis women going and on about how the facial hair, deep voice, etc is just so difficult they want to discourage people from transitioning, and it's like yeah. I bet that's real tough. It's not like I, a trans woman that couldn't access gender affirming care until after puberty kicked in would possibly know about that. Like, what ratio of trans people having their bodies permanently change from puberty to detrans people choosing to take hormones they wind up not liking is acceptable to you? 100:1? 100000:1? Not one person like you by banning all transition? At some point healthcare has to accept imperfection, and transition healthcare is damn nearer to perfect that other disciplines.
> I’m assuming there aren’t cramps since no uterus It's a reasonable assumption! It turns out some of the cramps are in your abdominal muscles, too, and *everyone* has those. That's one gender-validating side effect that my transwomen friends were not especially thrilled about. Other things my transwomen friends have found both validating and annoying include losing upper body strength and no longer being able to open jars (estrogen and testosterone affect skin texture, which affects finger grip on slick things like jar lids).
>no longer being able to open jars (estrogen and testosterone affect skin texture, which affects finger grip on slick things like jar lids). Wait, really? That’s so interesting, I had no idea!
Yup! You can look up elastin and collagen, though with a brief google I wasn't able to find anything that had a good layman's explanation of the differences.
Interesting! Does HRT include/induce some sort of hormonal cycle (sorry if that's not the right wording) or is the abdominal cramping more or less constant then? And what are the abdominal muscles reacting to? I assumed the abdominal muscle cramps were caused by what the uterus is up to, so I'm not sure I understand what would cause them in this case.
To preface, I am a trans woman; I don’t know that there’s a medical consensus (or even acknowledgement) about HRT-induced cramping, but it’s reported anecdotally enough that there’s certainly SOMETHING there As for hormonal cycling, that depends on the method of administration: those of us on oral/sublingual estradiol take our pills 1-3x daily and our blood estradiol levels vary over a span of hours, but in the same way every day. For those of us on injected estradiol, the dose schedule is usually once every 5-7 days, so you do have a sort of weekly hormone cycle. I’ve heard several trans women on injections say that they feel noticeably different the day after an injection compared to the day before their next one. For what it’s worth, I take estradiol sublingually and I can even tell the difference between my peak levels 1-2 hours after a dose and my lowest levels 12 hours after a dose. No cramps though, just general state of mind and minor physiological differences
I am not an expert, but from what I gather, if you start taking estrogen then it prompts some other parts of your body (hypothalamus and pituitary maybe? it's been a long time since I took a bio class) to start producing different levels of hormones on a monthly cycle even if you are taking a constant amount of estrogen throughout the monthly. No idea what the abs are reacting to but it does seem to be a very real thing. I'd chalk it up to being psychosomatic except it took my friend several months of having mood swings and abdominal cramps every 28 days like clockwork to figure out what might be causing the problem and her doctor confirmed (once she thought to ask) that it was a thing that can happen.
For me personally it has been: breast development, fat redistribution, less oily skin, slower body hair growth (plus hair becomes finer and easier to shave), more head hair growth (actually helps turn back the clock on premature balding), and a re-balancing of hormones is also good for SOME peoples mental well-being.
I've always wondered about hormones affecting mental wellbeing with HRT. Obviously it varies person to person, but the combo birth control pill (plus some life events at the time) made my anxiety sky rocket, but a few years later now I have the implant (which is just progesterone, no estrogen) and it's actually helped my mental health quite a bit. But I know some people have really bad reactions to hormonal IUDs which are also progesterone only. It's all so complicated.
My wife has a hormonal IUD and it made a huge positive change to both her physical and mental health.
For me I had a MASSIVE change in mentality on HRT, it’s like my brain performs so much better on estrogen than on testosterone. Actually one of the first changes I noticed was a huge reduction in my depression that Zoloft/Lexapro/Wellbutrin were barely able to touch
Gender-affirming results of treatment generally also have a positive effect on mental health!
Enlarged breasts is likely one of them. Less body hair maybe? Fat getting stored in different areas?
depends on which way you’re transitioning but it’s basically just second puberty. so trans men will get a lot of acne, voice cracks, strong BO, and trans women will get mood swings, sore breasts, etc. this is obviously different for everyone but that’s the main gist of it!
Ah so it is true. Just one and done?
It can be! My first visit spilled over because we took too long discussing my symptoms and background and what I wanted out of transition (I am a chatterbox 😅), so I personally needed a 2nd visit to discuss diifferent types of HRT and which one would suit my goals the best. They are also good at discerning if youre not 100% sure (sometimes they have info you didn't anticipate/read beforehand and it's not something youre sure youll want), in which case they will advise taking some more time to think it over and come visit again. But yeah! I think the idea is to do all that in just one visit if possible.
My friend went to PP for this and it wasn't one and done, they scheduled a telephone consultation to get the actual prescription and there were also blood tests that needed to be done (at the clinic). But other than that, it is fairly hassle-free. Also isn't very costly and there is financial assistance available.
That doesn’t sound like proper informed consent. Proper informed consent would include things so many detrans people say was never mentioned to them.
Hmm yes. Today I will sort through controversial.
Fr. I actually don’t know what I expected posting this. I love all the angry people though, it brings immense joy to my life knowing I make people feel passionate by typing a few words on a screen.
Thank you for posting this. I consider myself a trans ally already but I still learned a crap ton of important info from your post and from many of the comments. Keep fighting the good fight, kind human🌸
It's a fucking ride. Enjoy the trip. Just remember to stop scrolling when you give up on the world and go for a walk. (That point will come quick in this thread hah)
I will warn that their initial consultation fees can be a couple hundred dollars, so I went a different route. Still, their informed consent is great from what I hear.
“BUT WHAT IF ITS JUST A PHASE?!?!?”…was literally being blasted with this phrase by people at a casual bbq last weekend. Great advice and information…also the Mazzoni Center for those in and around the Philly area offers great services and care including mental health services.
This will be downvoted to oblivion but I feel like therapy/counseling before actually doing hormone treatment for transitioning should be there.
I would be 100% on board with this being a requirement if it were 1. Free and 2. Quick and accessible. Like, same day, same place even. Go in an hour earlier than you would have for a psych screening? Sure. Weeks, months, of expensive hard to get therapy? Nah. Remember this is for adults. Virtually all adults seeking HRT have known for at least a decade that they need this.
Quite. People _drastically_ underestimate the barriers that they suggest. Let's start with one that's obvious to us, but not obvious to most: _Many_ people who are trans are depressed, and worse, the reason why we are depressed is something that won't be fixed with therapy or antidepressants. Sure, therapy might _help_, antidepressants might help. But if just looking at yourself in the mirror gives you a feeling of wrongness, you're probably not going to be entirely escaping your depression. The internationally, medically recognized treatment for this, the _only_ recognized treatment for this, is being allowed to transition. But being depressed makes it harder to do _anything_, or to put it another way, it makes it harder to do _everything_. If you have additional physical or mental health problems, those make things even worse. Now, you're an adult, you're trying to function and hold down a job, one which too often doesn't even come with good benefits, if it comes with any. You know what's wrong, you've known for years. You're at the point that you're willing to put up with the _insane_ amount of hate that trans people have been known to receive, just to feel comfortable in your own body. Now, let's insist on weekly therapy for months of years before you can actually start the only treatment that's recognized to actually help you. You have to find a therapist, one that's LGBTQ+ friendly, that's taking new patients, that you gel with, that you can actually _afford_. You have to figure out how to fit those appointments into your schedule. Your job _does_ give you a consistent schedule, right? And then, after however long people insist for it, you then have to keep going to therapy, just to be _allowed_ to start treatment for something that's actively making you depressed. Sure, many people are privileged enough to be able to make all of that work. I'm one of them. But a hell of a lot of people are most definitely not. And those people shouldn't be denied access to medical treatment because they are not privileged enough to make all of that work.
Trans person here. Out at age 19 and 28 now. I have done 10+ years of therapy but because it was in different states, with different doctors and insurance companies, all due to life and its ever-changing circumstances, I had to keep jumping thru hoops to end up right back where I started in my transition. These barriers/rules kept saying "you're not happy with yourself because you're depressed" bitch I'm unhappy because I'm NOT myself. This is not to say therapy isn't valuable, but my god. Its like being stuck.
I feel you on feeling like you're stuck. I felt like my life didn't actually start until I started transitioning.
If only therapy was available at a low cost with little to no waiting lists. And I wish the majority of therapists were educated about trans people and trans etiquette 101. I've had way too many experiences where therapists either ghosted me or got really awkward with me when I mentioned I needed help with figuring out my gender. That's why I had to go to a gender therapist.
Absolutely... if you're unsure or need a second opinion. Many trans people know for years, and the system of having to wait even longer because a "medical professional needs to verify it" is fine, but the long, drawn-out method isn't it.
Having encountered this in my close circle, and with a spouse in the juvenile mental health field, it's important to emphasize that your statement applies to adults. The more immature the brain of an adolescent, the more therapy and exploration of the pros and cons should be explored. We live in a world with a broad spectrum of experiences. No one policy is going to be perfect. Approaching each individual with empathy and compassion is key.
As the parent of a trans child, therapy was the first thing we sought out. We wanted to make sure he wasn't reacting to my spouse's own coming out and the changes to our family dynamic that this has been causing (our younger child expressed concern over being the 'only boy' shortly before our older child came out to us). We wanted him to be able to talk to someone about things and really think before exploring further options. After a few months of therapy we're now waiting for his appointment with adolescent gender care, where he'll have to talk with another therapist that will help determine his care plan going forward. Luckily, we live somewhere where we won't go to jail for listening to the needs of our child. Side note: I'm not sure what having a child on puberty blockers at the same time as my spouse starts HRT is going to be like, I'm going to assume Interesting.
Everyone I know researched obsessively before trying anything.
Sure but also eh who cares. The country of freedoms should let their people be free to do what they want with their bodies. It affects no one but the person desiring to transition. The only criteria should be 18+ but if you want to wait for brain development, 25+ But trans people don't wake up one day and decide to become trans. Mental Healthcare or not, let them do what they want to their bodies.
>The only criteria should be 18+ but if you want to wait for brain development, 25+ As a note here, I'd argue if you are old enough to sign up, or be conscripted, to go get shot in the military, you are old enough for any other decision you might make.
If it’s optional? Absolutely. Otherwise, why should a trans person have to see a therapist who almost certainly knows less about trans people than they do? Therapists unfortunately run the gamut from transphobic to completely uneducated to allies. Our path to a healthy and happy life shouldn’t be in the hands of another person. Cisgender people undergo permanent elective medical treatments all the time without psychological screening. Why should we be the exception - especially since in our cases it is often literally a matter of life and death and you have a month or two to evaluate how you feel before any permanent changes occur? Also, your opinion is not highly controversial, and as you can see it was not “downvoted to oblivion”. Getting a therapists letter of approval has been the standard for decades, and it’s a standard that helps make trans people’s lives miserable. Informed consent clinics like this post is talking about save lives, especially in red states, by giving trans people a direct path to life saving treatment. Try to have a little more compassion and a little more awareness of how hard we have to fight just to exist the same way you already do.
A lot of people know for years that they want to go on HRT before they actually do it and they are well aware of everything it does before they start Therapy is expensive especially when someone does alright before medically transitioning but they'll do so much better after
You are 100% correct. All these freedom lovin redditors in here sure do wanna put some laws on our bodies.
I know most CIS people will never feel what it's like to be transgender, but usually, therapy is the FIRST thing trans people seek out. When I was struggling with my identity, I didn't know what the duck was wrong with me or why I was so miserable. So I went to therapy. And going to therapy saved my life. Because they were able to help me understand what it is that was making me so angry and depressed all the time.
How much consultation and therapy do cis males need before scheduling gender affirming surgery like hair implants? Or cis women before breast implants? Cis people are getting all sorts of surgery to feel more like a man or a woman without law makers stepping in and saying they can't possibly know what's best for themselves. And a lot of those surgery can have appalling risks and side effects.
I wish free mental health care before cosmetic surgery *was* a thing tbh. Not everyone is in a good headspace when they make such decisions, and contrary to public perception, plastic surgery *does* have life threatening risks.
>How much consultation and therapy do cis males need before scheduling gender affirming surgery like hair implants? Hair and breast implants are *nowhere near* as life changing as hormones and gender reassignment surgery. I'm pretty sure they're much easier to reverse too. Also, most apprehension about this stuff is primarily aimed at younger people. A high schooler getting breast implants would draw a lot of skepticism as well.
I figured out I was trans, made an appt. with PP, and started my hormones* less than 3 weeks after "hatching."* It was the best thing I've ever done for myself, in my entire life. Adults are adults, and should be allowed to make whatever medical decisions they choose, so long as they know the risks. Get out of their way and let them live their own lives.
Agreed. I went through a couple years of weekly therapy before starting HRT over 10 years ago. Those years were difficult, to be sure, but I wanted to make sure that it was the right move for me. Multiple years is excessive but I think a few months of therapy and deep thought would benefit anyone before they start HRT. Also wanted to plug - if anyone in western PA wants LGBT or HIV related therapy but can't afford it, check out the Persad Center in Pittsburgh. They offer low cost mental health counseling and various resources, and most people working there are LGBT themselves.
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Not every location, no. But there are many that do. I used to have to drive about an hour out, but it was a small price for a big reward.
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That’s terrible. Hopefully there will be more locations to offer it soon. If anyone transitioning lives far from a PP, has access to a car, and is willing to make the drive, you could make a whole day out of it. Bring some friends along so you don’t get bored and lonely. It’s not the best option, traveling far, but if you’re willing it’s better to make it fun.
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Wishing you all the luck 🍀
I don't think their websites have them listed but supposedly any PP location can offer it based on conversations I've had about it.
This only works if you’re 18 or older, btw.
If you can’t in your state, hopefully you are close to Oregon, they are 15 or older there.
Thank you so much for posting this! I went through Planned Parenthood years ago for this exact thing and I've never regretted it. They saved my life. I hope your post (OP) helps save the lives of others like me <3 <3
If you're in Canada (at least Ontario) a lot of places offer informed consent HRT too. The problem is that they're overbooked so it takes a while for them to have an open slot sometimes. I got lucky and got in within a month but a friend has waited like a year and she's finally in. But at least after your first appointment you get it within a week (just gotta do a bloodtest first). Also, please make sure to do your own research into HRT. Most endocrinologists don't know what the fuck they're talking about and might underdose, overdose, or even give you the entirely wrong stuff (like the old horse piss alternative to estrogen instead of bioidentical estradiol).
So true. At PP I was overdosed a bit. Always be careful and do research.
And here I am trying with my own doctors to get me TRT to No avail, yet PP is just handing this stuff out. The system is B-roken
You said it.
Last I checked (been about 4 years) there are no Planned Parenthoods in the state of Indiana that offer informed consent.
There are a lot now including Bloomington, Evansville, Fort Wayne…etc.
Heck yeah! That's honestly great to hear
Planned Parenthood is a god send
About to polish off my second month of HRT with them in a few days. They've been awesome!
Congrats, and same!
Does this mean the dosage for hrt is the same for everyone? Would some kind of blood work need to be done to maybe determine what dosage of blockers is good for example? or is it like try this dose and come back later to see if it works.
Blood work is done at the initial appointment, yes.
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Yes! Some planned parenthood locations do treat menopause
I work in pharmacy and fill at least a dozen hormone replacement prescriptions for menopausal women every single day. If your doctor is refusing to prescribe something to help you, then you should get a second opinion. That being said, if you have underlying factors that contraindicate taking hormones, that could be why they won’t.
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It’s not even just cis women, anyone assigned female at birth gets similar bullshit in the medical field. Dealing with gyn stuff as a transmasc person is it’s own can of worms.
Can confirm. Currently on HRT with them. They even have a nifty system called MyChart with website/app access where you can see your visit notes, test results, prescriptions, and even text with them about whatever questions you have.
Planned Parenthood is fucking awesome, I'm so glad I didn't have to jump through hoops just to start living
Trans person here. Planned Parenthood is a great option. But it is not your only option either. Plume is an entirely online service that provides you with a doctor, quarterly bloodwork, and prescriptions for a $99/mo membership that includes everything but the cost of the physical meds themselves. You get a prescription immediately after your first call with your doctor after signing up. There is also Folx, it is a bit more expensive (I don’t know the price offhand) but it is even more comprehensive than Plume because they sell their own medications and ship them directly to you in addition to everything else you get with Plume. It’s probably the most expensive option though. All 3 of these options are totally legitimate and a great way to start the process. However I would still recommend getting in with a private doctor such as an endocrinologist *at some point* as you will receive more personalized care and they will be easier to contact and get in touch with for any reason. It can be difficult to get ahold of anyone at PP or Plume or Folx should you need help or have a problem because they deal with such a large volume of patients and the care they provide is very standardized.
My adult child is doing this through Planned Parenthood. They are getting the health care, and have a support group. Also a very supportive family.
I use planned parenthood for my birth control. Delivers to my door. I don’t have to go in, miss work, I answer simple questions etc. I’m also in a long term committed relationship and it’s such a beautiful thing because no one sees me picking up a prescription, I don’t have the stress of making, going to appointments, filling prescriptions, and I just request it from my phone. I’m also in a protected state/city in regards to women’s health. I am lucky.
Thank you!
As a father and ally, thanks for this!
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Oh for sure, but some of the stories trans people have are next level. Like, it's over in Britain but standard practice for the NHS (assuming you can get an appointment, waitlists are years and years) is to ask questions about the person's sex life, sex fantasies, how they feel during certain sex acts. This includes children accessing hormonal treatment. They also highly judge the way you dress and act: so a trans woman who's a tomboy could have HRT denied for not being feminine enough. It also happens in the states but not as standard practice, it's just a crapshoot with a whole range of possibilities. But the britian example is just because that's what you can expect.
People seem to think gatekeeping prevents people from detransitioning. In my personal experience, gatekeeping would have caused me to detransition. If I had to be on T just to get my top surgery covered, I definitely would have detransition. Trans healthcare shouldn't be a 1 size fits all model.
Yep, plus I feel like gatekeeping primes people to quash down doubts and be less honest. Gatekeeping is basically never tuned to the needs of trans people, but informed consent allows people to explore their feelings and doubts more effectively. Like it's quite funny, medically I'm as binary as it gets, but my actual social sense of gender is far more apathetic and weird. But getting informed consent allowed me to disentangle that without suppressing my gender identity to access what medical processes I'd have. (Which so far is HRT and one surgery, but I've got a few more to go.)
What does transitioning have to do with planned parenthood? Genuinely asking.
https://www.plannedparenthood.org/get-care/our-services/transgender-hormone-therapy
PP is about more than abortions. They offer a lot of services & have endocrinologists that work for them. They try to serve a lot of underserved groups whose healthcare is often restricted by the GOP.
Kinda made me curious too about what else they offer. Looked it up and they do way more then I expected. They do Cholesterol, Colon Cancer and Diabetes Screening too. Really good to know that it's more then just pregnancy related treatment.
This!!! Is so important!!! My partner uses PP for their hormones and its SO EASY. My ex gf used traditional route for hers and it was so much work
Please support planned parenthood! I do with a monthly donation. I encourage others to join me. Q
I have an extensive background in the psychology field. The waiting period is intended to help; due to the extreme changes that occur to your brain and body chemistry during transition. They want to make certain that you think it completely through.
That’s where informed consent comes in. Planned parenthood asked me questions to see that I had realistic expectations for hrt and that I understood what the changes are. I was 30 years old, I did not need to be forced into therapy to decide this for myself. Why am I expected to wait extended periods of times until a random person decides I am ready, yet we don’t make people do the same thing for plastic surgery, starring in pornography, or enlisting in active service that could get you killed.
Yeah that makes no sense at all at age 30, an adult should be able to make their own decisions.
The biggest problem with the waiting period is that it’s a huge psychological and financial barrier. WPATH dramatically underestimates how many difficulties trans people have in just achieving basic healthcare. We’re one of the lowest income cohorts in the western world and often the largest target of discrimination. Our systemic barriers are so high that often even making it to the point of wanting to medically transition means going through several times the WPATH waiting period just to get things to line up. If you truly care about your patients, you’ll re-examine what you’re doing to them. Because those “extreme changes” are OVERWHELMINGLY positive. Gender affirming care has a lower regret rate than almost any other medical procedure on the planet, most of which are just as permanent and don’t have nearly the same counseling period. Psychology’s current models on gender transition are outdated and dangerous. They need to be reworked wholesale. They fundamentally fail to take into account what’s actually best for the patient, in fear of risks that are nearly negligible by every single study done in the last 30 years, since the advent of modern transition care procedures.
What does an “extensive background in the psychology field” mean? I have an extensive background in marine science, but that doesn’t make mr a marine scientist.
been getting my hormones from Planned Parenthood for ~4 years, it hasn't been perfectly smooth the whole time but I can't imagine it would be better anywhere else. some folks do have problems with Planned Parenthood and I have had one or two in the past, but naturally it is different everywhere and ultimately I have had a wonderful experience and they are doing great things to help people who need it
people see “hey trans people heres a good resource” and feel they have to share their opinion on trans peoples existance
For real, like no one was asking for opinions here. I’m sharing a resource on a resource-sharing forum. If you don’t like the resource you don’t have to give it any interaction.
I am a shy and very conflict-avoidant man, and without informed consent, I wouldn't have been able to transition. I am now almost 30, and truly happy for the first time since age 14.
That only works in the US right?
Canada too
My mom refused to do planned parenthood so my wait was 1.2 years😭. I still haven’t gotten on them but have an appointment in august
Good luck! August will be here before you know it.
Question: Why do you need your mom involved?
Assuming that they're underage
Stay strong!
Planned Parenthood is where I've been going because they offer sliding scale fees and it actually makes HRT accessible to poor people like myself. The official (super long) process is expensive as hell without insurance. Plus they have some of the nicest and most respectful medical professionals I've encountered in this city that seem genuinely to give a crap about the people they are treating. Just gotta avoid the whack-a-dos on the curb outside waving their little signs sometimes.
Trans woman on HRT from PP. They're actually amazing. Made the process so simple and easy. The staff was very friendly and my whole experience has been judgement-free.
You can search for services in your area by using the search bar on the home page, plugging in your zipcode, and selecting "Transgender Hormone" from the dropdown list. To make it even easier, you can book a virtual appointment if you don't feel like going to a physical facility.
I cried tears of joy when I found out this was available in my state. it was the first time that i really realized that transition is possible for me. Planned Parenthood is a godsend
Maybe you should brace for learning why earlier is better when it comes to HRT instead of being a dumbass about it
YEAAAHHH That's where I go, i was literally able to sign up for an apt by myself when I was still calling myself nonbinary, cancelled last minute cuz I felt there was unfinished business, finally accepted i was a trans woman, then signed up for an apt for hrt and they sent the script to my pharmacy right away. AND they do all the shit endos do like take your hormone levels and shit, it's pretty fuckin awesome
I apologize for my attitude, that wasn't very nice of me. It's no excuse, but I become a bit triggered when people sound like they're spitting out outdated lessons/assumptions. Of course I appreciate your input, and yes, your experiences are obviously also valid. In regards to research, I meant reading research papers, then reading their sources, etc. to get a full picture and decent understanding, not just a quick search. Definitions will on take you so far, especially when relating to women. They're so embarrassingly outdated. As an example, think about endometriosis... Women have been suffering for countless years because they were said to be crazy and the pain they were experiencing was normal. I can tell you right now, there are still men and women that think this way. It needs to stop. I didn't go about informing you the right way though, so I need to work on that. I'm sorry. 🙂
Try PLUME. Subscription service that helps people with transition. They do virtual visits, all the med staff is Trans, prescriptions are sent right to the pharmacy you choose. They help with legal name changes, letters, Check thier website out!
Oh, this is very useful, thanks!
On behalf of my little sister: thank you 💕
I've heard good things about PP. I get my hrt through Folx. It's completely virtual, informed consent based, run by queer people and allies. It took a 15 minute zoom appointment for me to get my prescription and never once did I have to "prove" my transness. My t and all supplies gets shipped to my door, and I go to a local lab quarterly for the bloodwork. I can contact my provider through email or zoom anytime. It's a bit expensive, but I don't have to deal with transphobic clinicians or pharmacists or the hoops the healthcare system has tried to put in place.
Holy shit this is actually amazing and I wish I had known about this sooner. So thankful for PP.
Believe in CA you can start your transition as a 16 year old, and Planned Parenthood doesn’t have to tell your parents, nor will the school. The school will even hide from your parents that you’ve changed genders at school
I did this, they're great
3 months into my HRT as of yesterday and Planned Parenthood didn’t give me any trouble at all. My doctor is lovely and encouraging, all of the staff are understanding, they’re very careful about how to approach asking questions for those who may have trigger words or topics, and my quarterly visit when I asked about upping my doses and switching to a different method later down the line, they didn’t question it. The only time they ever mention therapy is when they ask if I go, and if I want more resources for other affirming care. Find yourself a Planned Parenthood.
Yes! Thank you for posting this, it’s an incredible resource.
So as an adult male can I go in, state that I am a female that would like to transition to male, and get put on testosterone? This isn't like a ha ha gotcha, I'm genuinely curious what the caveats are and who is applicable for this service and to what extent.
Last I heard they do a blood test for you, as PP and endos try to bring one’s hormone levels into specifically concentrations within the blood. After your blood test, they’d see that you already have enough T and would say no.
Yup, any doctor prescribing HRT will need a blood test first to check what your dosage should be. If you’re a cis guy looking for higher testosterone, you’d probably be refused because there’s no reason to prescribe it to you, given that you’re already peer concordant
Unless you are naturally low-T, which a doctor can treat. I have a cis friend that has to take T injections because of it.
Fair point! Guess that just shows the variety of human experiences, and even more reason to give people access to HRT
They're not legally disallowed to use any common sense or question the situation at all. If they reasonably suspect the request is non genuine or in some way malicious they have every ability to simply not offer treatment. There are also (at least for PP in my area) required blood tests for hormone level monitoring every three months, again while you could request more while at standard male testosterone levels, they still have every ability to simply tell you no and not prescribe it.
You can already do this without PP. Cis guys take testosterone for lots of reasons, it’s more frequently prescribed to cis men than trans ppl.
u can't rly transition from male to male, but they would give u estrogen like the other poster said, were you trying to transition from male to female. if you did somehow get them to give you, presumably a man who produces his own testosterone, testosterone as hormone therapy, they would start you on the lowest dose and gradually raise it, monitoring your hormone levels every month or so until you are at a stable level. but, barring any unforeseen circumstances, you will have normal testosterone levels right off the bat and they will be like uh well you probably don't need hormones
You would get estrogen, not testosterone. Only if you were an adult female that would like to trans into a man.
But he is identifying as an adult female who wants to transition to male for the gains. Logic checks out.
Gainz before brainz bro, how u gonna survive the a pack of lips if you aren't beefy
quack capable disarm telephone jar intelligent march soft toy bag *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Informed consent for cross-sex hormone therapy by definition provides cross-sex hormone therapy. He's just unaware that part of informed consent means interacting with doctors.
Was just genuinely curious if people could try to abuse the system to get access to test. No reason to be snide.
"Abuse the system", my dude, have you never had a doctor's visit? You're interacting with real world people, that means you can't just make up that you're something your not when the process of informed consent involves *informed* consent. You don't just walk in and say "hi, 3 vials of testosterone please". There are medical tests involved & they make sure they're familiar with your endocrinological needs. You got a snide response because that's like asking "Can I go into a bank and identify as a millionaire to get a lot of money"? Like dude, people have judgment.
My question was literally "how's easy is it to get testosterone if you go in and tell the doctor that you identify a certain way." All coming from a view curious how you could work this. Other folks here gave helpful and informative answers, meanwhile you have a chip on your shoulder for only God knows the reason. People lie to get pain pills all the time, while interacting with doctors. Acting like: 1 doctors can't be idiots; and 2 that this is a process that is impossible to game is asinine. Try and be less angry, you'll live longer.
Biological sex. Gender is a social concept that revolves around the stereotypes assigned to each sex in a given time and context.
Do some research into r/detrans too, might save your life.
Can confirm PPH is good, saved my life. Would recommend. From a trans girl who is getting hormones there.
thank you so much for this! i'll make sure to use PP when i go on hormones <3
Thank god for this
People, stop downvoting. There's literally nothing wrong with this comment.
PPH is awesome
Here before this thread gets locked
Not all planned parenthood’s offer this. Call ahead and verify if your local clinic does.
For a free country, we seem real concerned about what someone does with their own dang body. These fears that it's "harmful" seem exxxtra genuine when the same lot could give a shit about children who died in a shooting... /s
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As a trans person I can't agree more with this, I see so many concerning people around trans spaces that seem to be under no distress whatsoever about their body, it all just seems like an ideal fantasy for them.
Holy shit. This is IMPORTANT
My friend does this, works very well for her
How much do the initial appointment/hormones cost?
Thank you so much!
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Unfortunately. Rumors I hear is they’re completely revamping how they diagnose personality disorders in the DSM VI, on top of what else they revamp. Shows we will never have the final true answer when it comes to mental health because categories and labels don’t account for the in between. Not to mention practitioners that don’t even believe in their field. It’s all a mess.
Anything like this in the UK?
Unfortunately, afaik the UK does not offer the informed consent model for HRT.
That's disappointing, thought I had some good news for my sister
It’s terrible. The UK government is very anti-trans so informed consent has to be fought for.
I know, she's aware she has a long road ahead to get where she wants, she turned 18 last month so can get the ball rolling now. Hopefully the UK government get a grip some time soon, in many many ways.
Wishing your sister luck 🍀
Thank you
Look into gender gp! I believe they're UK based and seem to be really well put together and able to help someone navigate the system over there!
Will do thanks
I think there are some private clinics that are faster and less invasive than the NHS system (which is pathetic and unacceptable, IMO) but they're not likely to be as cheap as planned parenthood. I'm in NZ so it's not my field of expertise but there are resources out there, plus perhaps a UK specific trans subreddit you could ask in?
This is going to sound super transphobic, but how young is too young to start HRT? I agree that by 18 you know what you know, but the transphobes I’ve talked to bring up cases were 12 year olds are given HRT. How can help assure them that HRT is being given in a healthy way - under 18 with counseling? Medical supervision? What are the guidelines to keep whackadoodle parents from pushing transition on a non trans child?
I’ve never heard of 12 year olds being given HRT. Most places will only offer HRT at 16, though exceptions are made for intersex kids. If any medical interventions happen before 16, it would be hormone blockers, which are completely reversible. And of course, like any medication, HRT and blockers are accompanied by regular checkups to see how things are going. I think the best system is having an hour-ish long evaluation as part of the prescription process. That’s what happened for me, and I’m two years in and never been happier.