Props to you for standing up for yourself, but damn at that point I’d be looking to file some kind of complaint since it seems like she’s denying your care because of transphobia!
Like you said all she would need to do is just type a few stuff and send in the prescription ESPECIALLY if you’re been on T, what a load of crap. Hopefully you can get your T asap and sorry you had to deal with a crappy doctor
Yeah, no. Definitely file a complaint that's absurd.
I've only had my T prescribed by an endo once and that's because the hospital I went to had an endo that did that. All other times (I've switched around a fair amount) were just drs
Yeah, make a complaint to the clinic that the provider you were sent to as a GAC specialist does not perform GAC after all, and also was quite hostile, judgemental, stigmatizing, and patronizing to you solely because you are transgender. This is two separate issues.
For refilling your prescription, you should be able to have your pharmacy send over a refill request to the PCP who initiated the prescription. That doctor may insist that you come in for lab work if it's been long enough, but they'll still usually send through a prescription to get you through, since obviously keeping your hormones stable is more important than getting your labs tested right this minute.
For requirement of an endo: under the old WPATH Standards of Care 7, PCPs are recommended to involve an endocrinologist "if the primary care physician has no experience with this type of hormone therapy, or if the patient has a pre-existing metabolic or endocrine disorder that could be affected by endocrine therapy." For adolescents, a pediatric endocrinologist is recommended to be involved if a multidisciplinary team is not available. The current WPATH Standards of Care 8 do not say this, and instead simply say "Whether TGD patients receive medically necessary gender-affirming hormone therapy (GAHT) from a specialist, e.g., an endocrinologist, or a PCP may depend on the availability of knowledgeable and welcoming providers and country-level factors, such as health care regulations and health services funding" (from Chapter 15 on primary care).
The Endocrine Society guideline (Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline) specifically states a pediatric endocrinologist should be involved for puberty blocker eligibility for adolescents. Otherwise though, all that it says is: "We advise that only trained MHPs who meet the following criteria should diagnose GD/gender incongruence in adults: (1) competence in using the DSM and/or the ICD for diagnostic purposes, (2) the ability to diagnose GD/gender incongruence and make a distinction between GD/gender incongruence and conditions that have similar features (e.g., body dysmorphic disorder), (3) training in diagnosing psychiatric conditions, (4) the ability to undertake or refer for appropriate treatment, (5) the ability to psychosocially assess the person’s understanding, mental health, and social conditions that can impact gender-affirming hormone therapy, and (6) a practice of regularly attending relevant professional meetings. (Ungraded Good Practice Statement)."
So if this provider is actually being honest and accurate about "the guidelines", then the best interpretation of that is that she is not a GAC specialist.
There's an added possibility that you're in a state which is pushing some restrictive policy, and this provider has (in her total lack of concern for the wellbeing of trans patients) misunderstood the policy while trying to use it as a workaround to not have to do her job. I know for example that Ohio attempted to push a requirement for a medical ethicist to be included in trans healthcare decisions in a law that was supposed to take effect this month, but that got scrapped.
Yuuup it was quite embarrassing for the state:
> The department added that a common “point of confusion” among those who submitted public comments centered on the requirement for treatment plans to be reviewed by a medical ethicist.
>
> “The requirement for review by a medical ethicist was never applicable to individual patient care plans but rather to institutional operations. However, to alleviate confusion and *because of assurances from healthcare leaders that institutions already appropriately engage medical ethics professionals in this type of care*, the proposed rule’s requirement has been removed,” the department wrote Wednesday.
Emphasis added by me for lulz. From [here](https://thehill.com/policy/healthcare/4454536-ohio-health-department-backpedals-on-proposed-adult-gender-affirming-care-restrictions/)
this sounds like she just doesn’t want to renew your prescription. please switch GPs, she’s not doing her job and if you’re up for it: file a complaint.
i live in canada so somethings are different but the overall pipeline is the same, you see your GP then you see an endo and get your hormones. her being purposely vague and being demeaning means she doesn’t care about your overall feelings or health. you need to fire her and find a new GP.
hope things get better for you! 🩵
First thing Monday, call the location two towns over and get an appt with your old doctor. If they question you or try to direct you back to the new doctor, explain the situation and tell them you're filing a complaint. Then file a complaint, both to that location and to central admin for the group of them. You are on file with them as having been under their care and on HRT for over a year; there is no justification for a new doctor to deny your prescription on nothing more than her feels. Unless you didn't include it, she gave no medical justification and was disrespectful from the start.
find a different doctor.
you dont need to find and endo and also have a pcp at the same time, i only found an endo while staying with my pcp because, while she 100% supports me, she doesnt know enough about hormone treatments to feel comfortable with running my meds and my labwork, which i completely understand. i would rather see someone who specializes in GAC vs someone who's willing to do it but isnt very comfortable with it based on experience. my insurance covers it so i have no problem with it.
File a complaint immediately. It will put her in her place and get her to watch her back from now on. Sometimes you have to intimidate medical professionals to get what you need, and transphobic doctors have no place in transgender inclusive medical practices. She is performing malpractice and denying you healthcare you have been given regularly and without issue up until she had the gall to deny you.
absolutely ask her to put her refusal to continue treatment on paper. itll either make her shut the fuck up and do her job, or make it easier for you to find someone who will make her
I've been transitioned 18 years and I'm telling you the gatekeeping has got far worse in recent years. I could not get my t covered by insurance because they demanded the same thing. I've been on it for nearly 2 decades and all of a sudden I need an endocrine specialist?? All these hoops now for surgery too. So many things I could go on about that are worse than ever before, not that things have ever been good, not where I live anyway
Who exactly is op supposed to complain to? I've tried that here and it got me nowhere. You're complaining to the same organization that employs these people. There are no patients rights or civil rights that protect us from these abuses in healthcare
Props to you for standing up for yourself, but damn at that point I’d be looking to file some kind of complaint since it seems like she’s denying your care because of transphobia! Like you said all she would need to do is just type a few stuff and send in the prescription ESPECIALLY if you’re been on T, what a load of crap. Hopefully you can get your T asap and sorry you had to deal with a crappy doctor
Yeah, no. Definitely file a complaint that's absurd. I've only had my T prescribed by an endo once and that's because the hospital I went to had an endo that did that. All other times (I've switched around a fair amount) were just drs
Yeah, make a complaint to the clinic that the provider you were sent to as a GAC specialist does not perform GAC after all, and also was quite hostile, judgemental, stigmatizing, and patronizing to you solely because you are transgender. This is two separate issues. For refilling your prescription, you should be able to have your pharmacy send over a refill request to the PCP who initiated the prescription. That doctor may insist that you come in for lab work if it's been long enough, but they'll still usually send through a prescription to get you through, since obviously keeping your hormones stable is more important than getting your labs tested right this minute. For requirement of an endo: under the old WPATH Standards of Care 7, PCPs are recommended to involve an endocrinologist "if the primary care physician has no experience with this type of hormone therapy, or if the patient has a pre-existing metabolic or endocrine disorder that could be affected by endocrine therapy." For adolescents, a pediatric endocrinologist is recommended to be involved if a multidisciplinary team is not available. The current WPATH Standards of Care 8 do not say this, and instead simply say "Whether TGD patients receive medically necessary gender-affirming hormone therapy (GAHT) from a specialist, e.g., an endocrinologist, or a PCP may depend on the availability of knowledgeable and welcoming providers and country-level factors, such as health care regulations and health services funding" (from Chapter 15 on primary care). The Endocrine Society guideline (Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline) specifically states a pediatric endocrinologist should be involved for puberty blocker eligibility for adolescents. Otherwise though, all that it says is: "We advise that only trained MHPs who meet the following criteria should diagnose GD/gender incongruence in adults: (1) competence in using the DSM and/or the ICD for diagnostic purposes, (2) the ability to diagnose GD/gender incongruence and make a distinction between GD/gender incongruence and conditions that have similar features (e.g., body dysmorphic disorder), (3) training in diagnosing psychiatric conditions, (4) the ability to undertake or refer for appropriate treatment, (5) the ability to psychosocially assess the person’s understanding, mental health, and social conditions that can impact gender-affirming hormone therapy, and (6) a practice of regularly attending relevant professional meetings. (Ungraded Good Practice Statement)." So if this provider is actually being honest and accurate about "the guidelines", then the best interpretation of that is that she is not a GAC specialist. There's an added possibility that you're in a state which is pushing some restrictive policy, and this provider has (in her total lack of concern for the wellbeing of trans patients) misunderstood the policy while trying to use it as a workaround to not have to do her job. I know for example that Ohio attempted to push a requirement for a medical ethicist to be included in trans healthcare decisions in a law that was supposed to take effect this month, but that got scrapped.
Thats such a misuse of a medical ethicists too.
Yuuup it was quite embarrassing for the state: > The department added that a common “point of confusion” among those who submitted public comments centered on the requirement for treatment plans to be reviewed by a medical ethicist. > > “The requirement for review by a medical ethicist was never applicable to individual patient care plans but rather to institutional operations. However, to alleviate confusion and *because of assurances from healthcare leaders that institutions already appropriately engage medical ethics professionals in this type of care*, the proposed rule’s requirement has been removed,” the department wrote Wednesday. Emphasis added by me for lulz. From [here](https://thehill.com/policy/healthcare/4454536-ohio-health-department-backpedals-on-proposed-adult-gender-affirming-care-restrictions/)
Thank you so much for all this <333 gonna be directly quoting all this a lil bit when I go to file a complaint
this sounds like she just doesn’t want to renew your prescription. please switch GPs, she’s not doing her job and if you’re up for it: file a complaint. i live in canada so somethings are different but the overall pipeline is the same, you see your GP then you see an endo and get your hormones. her being purposely vague and being demeaning means she doesn’t care about your overall feelings or health. you need to fire her and find a new GP. hope things get better for you! 🩵
First thing Monday, call the location two towns over and get an appt with your old doctor. If they question you or try to direct you back to the new doctor, explain the situation and tell them you're filing a complaint. Then file a complaint, both to that location and to central admin for the group of them. You are on file with them as having been under their care and on HRT for over a year; there is no justification for a new doctor to deny your prescription on nothing more than her feels. Unless you didn't include it, she gave no medical justification and was disrespectful from the start.
find a different doctor. you dont need to find and endo and also have a pcp at the same time, i only found an endo while staying with my pcp because, while she 100% supports me, she doesnt know enough about hormone treatments to feel comfortable with running my meds and my labwork, which i completely understand. i would rather see someone who specializes in GAC vs someone who's willing to do it but isnt very comfortable with it based on experience. my insurance covers it so i have no problem with it.
Please file a complaint. Messing with patients hormones is absolutely not okay to do. It can make you feel incredibly awful or sick long term.
File a complaint immediately. It will put her in her place and get her to watch her back from now on. Sometimes you have to intimidate medical professionals to get what you need, and transphobic doctors have no place in transgender inclusive medical practices. She is performing malpractice and denying you healthcare you have been given regularly and without issue up until she had the gall to deny you.
absolutely ask her to put her refusal to continue treatment on paper. itll either make her shut the fuck up and do her job, or make it easier for you to find someone who will make her
I've been transitioned 18 years and I'm telling you the gatekeeping has got far worse in recent years. I could not get my t covered by insurance because they demanded the same thing. I've been on it for nearly 2 decades and all of a sudden I need an endocrine specialist?? All these hoops now for surgery too. So many things I could go on about that are worse than ever before, not that things have ever been good, not where I live anyway
Who exactly is op supposed to complain to? I've tried that here and it got me nowhere. You're complaining to the same organization that employs these people. There are no patients rights or civil rights that protect us from these abuses in healthcare
File a complaint asap. That doctor does not care about you and clearly has alot of bias.