How to Get on Transsexual Hormone Replacement Therapy Relatively Easy
This article is designed for the transsexual who is looking to get on hormone replacement therapy relatively quickly and easily. I discuss a number of systems which may be available to use in your community. More often than not, if you live in a giant metropolitan area, chances are that you will be able to get onto hormone therapy using the first method relatively easily.
The reason why one would want to get on hormone replacement therapy quickly is to alleviate much of the stress of being in the wrongly sexed body. I use this terminology because the term "a woman trapped in a man's body" seems foolish to me. We all start out as protofemale in the womb and we develop due to the pattern that the predominant hormone therapy provides for us. Therefore, a transsexual girl who starts her hormone therapy before puberty will look almost indistinguishable from any other girl. The body can feminized to a point with hormones and/or surgery so I would not even call my body a "man's body" even though I am a male-to-female transsexual.
I know this information because I myself have been on hormone replacement therapy and have had sex reassignment surgery without any need for a therapist at all. I am speaking from personal experience and have no intention of retracting anything I say since it is 100% true and correct to the best of my knowledge. I do hope this helps!
A Very Serious Warning Before You Begin
Please, please, please understand that this advice is intended only for the seriously gender dysphoric and understand that they are transsexual. If you have any doubt at all about your transsexuality do not seek out hormone replacement therapy and contact a therapist to discuss these issues. Many Universities offer therapy to the general population on a sliding scale. There is a high cost for those who transition but are not transsexuals and Lynn Conway explains this better than I can.
Also understand that it is highly recommended that you consult a doctor at all stages of your transition to ensure that you are doing the right thing, being monitored for any abnormalities that hormone replacement therapy may cause and that you are physically fit and able to have any therapy that you seek.
In summary: Remember that in the end, you are the only one responsible for your own health and you are the one to suffer the consequences if you do not listen to good advice. In other words, don't blame me if you fuck up!
Your Main Enemy: The Harry Benjamin Standards of Care
The enemy that will keep you from getting any treatment easily is commonly referred to as the Harry Benjamin Standards of Care. It is drafted by the World Professional Association for Transgender Health (WPATH), formerly known as the Harry Benjamin International Gender Dysphoria Association (HBIGDA). They require unnecessarily high levels of therapist intervention before they will allow you to access any care and quite a few doctors in this country require the Standards of Care before they will do anything for you.
Do not lose hope though as there are a few doctors and clinics that can provide you with hormone replacement therapy without any therapist requirements or with little therapist requirements. I will go over some of the more common non-SOC systems out there to give you an idea of what options you have.
Option 1: The Tom Waddell Standards
The Tom Waddell Standards govern hormone therapy and give a general overview of transgender health concerns. This was initially designed by Dr. Tom Waddell who worked in the free/low-income clinics of San Francisco and this was developed with all transsexual people in mind. Today, there are a few clinics other than homeless clinics that provide services to transsexual people under the Tom Waddell system.
I started my hormone replacement therapy at a clinic using the Tom Waddell system without even being aware of it. I started my HRT in November 2007 at Dr. Hunter Hammill's office in Houston, Texas with no therapist requirement imposed on me. It was however a requirement that I attend a few support group meetings in the Houston area which I have before my appointment.
Option 2: Clinics and Providers that Don't Give a Damn
There are clinics out there that either do not require therapist intervention at all or require therapist intervention that does not fall in line with the standards of care. Basically, if you cannot find a clinic or provider in your area that follows the Tom Waddell standards, this is your next best option. Finding these clinics are difficult since they do not advertise what their requirements are.
One thing I would recommend is that you talk with people in the local transgender community to find a doctor that does not care about therapist requirements or has low therapist requirements. These doctors are not uncommon but can be tricky to find. If, however, no one knows of provider or clinic which would accommodate this requirement it is highly suggested that you starting phoning clinics and providers in your local area to find one that will provide services to you at no or low therapist requirement. Generally, OB/GYNs and Alternative Medicine doctors have a higher level of acceptance - especially if they are curious enough to want to learn from the experience. It is highly suggested that you bring them a copy of the Tom Waddell standards so they will have something other than the Harry Benjamin Standards to reference. Ask the clinics and providers with low therapist requirements what they will require and what a letter would need to state in order to get care.
When I say low therapist requirements, what I mean is less than 3 appointments needed to get services. This can be done with a simple sanity check, which a friend has had in order to get her hormone replacement therapy.
I continued my hormone therapy while living in Seymour, Indiana with an Alternative Medicine specialist at the Schneck Medical Centre. I knew about this from talking with another transsexual woman who was helping me with my name change and a number of other transition issues. He did not care about therapist letters or anything like that and he provided me with a three-month script for my hormones.
Option 3: Fake Letters
Remember that this should only be used a last resort in the event that Options 1 & 2 did not work for you. I would remind you that most doctors go through tedious amounts of education and training and may not be easily fooled. But then again, if there can be religious doctors - that is proof that there are gullible doctors. If people in your general area are stupid it can work if you make your own letter.
The Aftermath and an Epilogue
Given the number of views this article has received since I published it, I feel it prudent to make a few designations here, just for clarity's sake. You should never, and I do mean never, self-medicate. That's very dangerous, as our bodies are reliant on hormones in order to function. You can suffer a number of problems if you take these drugs without a physician's supervision.
Furthermore, the SOC expresses a paternalism in the psychological and psychiatric industry, that they need to protect us from ourselves. It's a paternalism that I don't particularly care for and I believe that transsexual people should not have to go through these hoops because they have no basis in science.
I look forward to the day when we can serve rural communities by telemedicine, which is already being tried out by Planned Parenthood. This technology can serve transsexual people in rural communities.
But finally, I would like to say how flattered I am by the trust many of the people who have contacted me through this article asking for advice. I'm sorry that I could not help you, as I am not aware of many physicians who are brave enough to provide these services in many American metropolitan areas. I do hope, one day, to start making cold calls to certain health professionals (endocrinologists and Family Medicine doctors) to get more information about what physicians provide these services without a therapist's letter. But until I get the time to do that, I simply don't know. But thank you very much for trusting me with your stories and requests all the same.