I am not a medical professional.
One of the most common questions I get is: How do you find therapists and doctors who work with transgender clients and prescribe hormones? Although not every trans person seeks a medical transition, therapy and HRT are often the first steps taken by those who do. HRT can reduce certain unwanted sex characteristics, boost the ones you do want, and help relieve feelings of gender dysphoria.
HRT is one of the most beneficial and low-cost treatments available to trans people, but finding providers can require some detective work. If you’re in the United States or another country that lacks national healthcare, it can be difficult to know what your options are. I’ve helped dozens of other trans people find local doctors and therapists, and now I’d like to show you how to do that.
Finding a gender therapist
Seeing a therapist with experience in trans issues is usually the first step of medical transition. In addition to providing counseling services, therapists can issue referrals to doctors who prescribe hormones. When searching for a therapist, it’s important to consider what you’re looking to get out of therapy. Some trans people aren’t necessarily interested in getting HRT, and simply want a qualified counselor to talk to about their gender. Others feel they’re ready for HRT and just need a referral. Some choose to see a therapist throughout the process.
There are a variety of ways to find qualified gender therapists in your area. If you know of other trans people nearby, you can ask them which therapists they’ve seen. Otherwise, you can Google for “transgender therapist” and the name of your city. Keywords like “trans support group”, “LGBT center”, and “PFLAG” can be relevant as well – these groups sometimes offer resources and information about nearby therapists and medical providers.
- transgender therapist Knoxville TN
- trans support group Knoxville TN
- LGBT center Knoxville TN
- PFLAG Tennessee
It can help to narrow down your search by using the site: operator to look within specific websites. Places like T-Vox.org, AskTransgender on Reddit, Laura’s Playground, and Susans.org may have postings about gender therapists in your area – as well as reviews from other trans people who’ve seen them before. (I do not endorse the content of any of these sites. Game experience may change during online play.)
- therapist Knoxville TN site:t-vox.org
- therapist Knoxville TN site:reddit.com/r/asktransgender
Make sure to check the dates on these postings and look for the ones that are no more than 3-5 years old. Finally, even if you haven’t found any therapists nearby, don’t worry – some offer long-distance sessions over Skype.
Once you’ve found some leads, it’s time to follow up. Doing your research first is an indispensable step in deciding which therapist to see. Find their website and email and contact them to ask about the services they provide to trans clients. Do they have experience working with trans people? Are they capable of providing a referral for HRT, and do they have a clear process and timeline for obtaining a referral? Are they familiar with the latest version of the WPATH Standards of Care? Get to know them, and think about whether they’d be a good fit for you when discussing personal issues.
Finding an experienced therapist is crucial – someone who hasn’t learned about working with trans people could have as many misconceptions as the average person on the street. A good therapist can help you understand and accept who you are, and can facilitate your goals in transitioning.
Locating doctors for HRT
If you decide to pursue hormone replacement therapy, the next step is to find a trans-friendly doctor. Prescriptions for HRT, as well as blood tests to monitor hormone levels and overall health may be offered by endocrinologists, gynecologists, general practitioners, or nurse practitioners. Searching for a doctor can be similar to finding a gender therapist. Local LGBT and trans organizations may know of nearby providers, and you can ask other trans people who they see for HRT. Your therapist might also be familiar with local HRT prescribers. When searching online, use keywords like “transgender health” or “gender clinic” along with the name of your city, and search within the websites previously mentioned.
- transgender health Knoxville TN
- gender clinic Knoxville TN
- doctor Knoxville TN site:t-vox.org
- doctor Knoxville TN site:reddit.com/r/asktransgender
HRT providers typically prescribe testosterone for trans men, and estrogen with testosterone blockers for trans women, along with initial blood tests and monitoring every 6 to 12 months. Nonbinary trans people can receiving feminizing or masculinizing treatment as needed. Avoid doctors who only prescribe ethinyl estradiol or Premarin – these are older forms of estrogen that carry a higher risk of side effects. A good provider will ensure you’re on a safe and comfortable regimen that produces the desired physical changes and helps to reduce your dysphoria.
Informed consent clinics
Providers operating on an informed consent basis will offer HRT and monitoring without a requirement for therapy or a referral. These informed consent clinics are less common than gender therapists and other HRT providers, and are usually found in major cities. Current informed consent providers include:
- Fenway Health (Boston, MA)
- Howard Brown Health Center (Chicago, IL)
- Whitman-Walker Health (Washington, D.C.)
- Emma Goldman Clinic (Iowa City, IA)
- CHOICES Memphis Center for Reproductive Health (Memphis, TN)
- Callen-Lorde Community Health Center (New York, NY)
- Mazzoni Center (Philadelphia, PA)
- Fan Free Clinic (Richmond, VA)
- Center for Adolescent & Young Adult Health (Rochester, NY)
- Lyon-Martin Health Services (San Francisco, CA)
- Dimensions Clinic (San Francisco, CA)
- Tom Waddell Health Center (San Francisco, CA)
- Cedar River Clinics (Seattle and Tacoma, WA)
Some Planned Parenthood locations have also recently begun to offer hormone therapy services on an informed consent basis. This is not a complete list, and you may be able to find other informed consent providers in your area.
Pediatric endocrinologists and puberty blockers
Puberty blockers for trans youth are meant to pause puberty and prevent the development of unwanted masculine or feminine secondary sex characteristics. This can help to minimize gender dysphoria and discomfort with their appearance, and reduce the need for more invasive procedures in adulthood. Puberty blockers are a specialized service offered by pediatric endocrinologists who are experienced with trans kids. Some of these providers include:
- Children’s Hospital Los Angeles
- Rady Children’s Hospital (San Diego, CA)
- UCSF Benioff Children’s Hospital (San Francisco, CA)
- Children’s National Health System (Washington, D.C.)
- Lurie Children’s Hospital (Chicago, IL)
- Boston Children’s Hospital
- Children’s Mercy Hospital (Kansas City, MO)
- Cincinnati Children’s Hospital
- Nationwide Children’s Hospital (Columbus, OH)
- Children’s Hospital of Philadelphia
- Children’s Hospital of Pittsburgh
- Hasbro Children’s Hospital (Providence, RI)
- Children’s Medical Center (Dallas, TX)
- Pediatric and Adolescent Transgender Health Clinic (Madison, WI)
Navigating insurance and financing transition
If you have health insurance, therapy and HRT services may be covered. This depends on your carrier and your plan, and many health insurance plans still have blanket exclusions for any services related to transitioning. Make sure to check your summary of benefits and coverage document to see what’s included. If you do have coverage for these services, you can ask your carrier about gender therapists and HRT providers in your network.
Without insurance, therapy and HRT can quickly become expensive. Although monthly prescriptions tend to be affordable, a series of appointments and blood tests can typically cost several hundred dollars. Some trans people crowdfund these expenses through social media and platforms like GoFundMe, Indiegogo, or PayPal donations.
Paying it forward
Therapy and HRT are crucial health services for trans people, and all of these resources wouldn’t be so easily available without the help of trans people sharing this information with each other. If you find a reliable therapist or doctor, tell your friends and get the word out. If you’re a professional who offers these services, advertise yourself – it’s practically guaranteed that trans people are already looking for someone like you.
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