How to find therapists and doctors for trans HRT (Gender Analysis 16)

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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.

Example:

  • 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.)

Example:

  • 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.

Example:

  • 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)

More of these clinics are opening all the time, and you can check out TransYouth Family Allies and Gender Spectrum for more information on services for trans kids.

 

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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About Zinnia Jones

My work focuses on insights to be found across transgender sociology, public health, psychiatry, history of medicine, cognitive science, the social processes of science, transgender feminism, and human rights, taking an analytic approach that intersects these many perspectives and is guided by the lived experiences of transgender people. I live in Orlando with my family, and work mainly in technical writing.
This entry was posted in Health care, Psychology and psychiatry, Trans youth and tagged , , . Bookmark the permalink.

6 Responses to How to find therapists and doctors for trans HRT (Gender Analysis 16)

  1. Lee Anne leland says:

    In the South Carolina Lowcountry a group called The Trans Love Fund (they give micro grants to SC trans people for health care) has a resource page with this information. If more support orgs. would do this it would make things a lot easier. Health care is still a quagmire though. Blue Cross has 80% of the policies in the state and they only cover what the state mandates. And trans services are usually not even on their radar

  2. sly says:

    One more for the Informed Consent list: Gender Health Center (Sacramento, CA)
    http://www.thegenderhealthcenter.org/

    They offer (amongst many things) a free clinic run by volunteer doctors and local medical students. Bloodwork, HRT, letters for other doctors, etc…they do it all and with a smile.

    Keep up the good work! :3

  3. Reese Matthews says:

    That’s a wealth of information, and a boon to the trans community.

    Even though you only mention it for an instant, you answered a question I could not get answered elsewhere. You said at 0:23, “Although not every trans person seeks a medical transition….” I didn’t know and couldn’t find if there were others who don’t take or want hormones.

    For younger transgender people, their physical health makes it easier to cope with the risks associated with HRT. But for an older person (I’m late 40s, one year into transition), the risk of high blood pressure, stroke and other problems are a concern. I’m very fit for my age and have never had any serious medical issues, but don’t want any, either. Although I would like to get HRT, for the sake of my long term health I’m choosing not to.

    I’m also fortunate that I live in Taiwan, another place that has excellent medical services for transgender people. Veterans General Hospital in Taipei offers all the services needed – psychiatric evaluation, therapy, HRT, surgery, and others.

    • Vhel Inamarga says:

      Im here in taiwan sir. Please help me to find that hospital for hrt. I really like to trans. Im 23 years old and working as an operator in ase chungli. Is there any posible to contact you. Please im begging you

  4. Miranda says:

    Hi my fiancée wants to take females hormones and we live in OC California and we are trying to find a transgender dr clinic we need help can someone help us please

  5. Wisewomen69 says:

    I have a question I’m want to just grow breast mtf will it affect my Sperm count or erections I don’t want to be on hrts very long just long enough to get a cup size . Can anyone help me

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