HRT should not be used as a substitute for therapy or psychiatric care, but your therapist may suggest taking feminizing HRT in addition to the treatments you already have in place. Be sure to involve psychologists and psychiatrists throughout your process to work together for the most productive results.
Is feminizing hormone therapy for me?
This is a question that no one but yourself can answer. Medical transition is not a requirement to be trans, as there are no formal requirements. For those who question their own gender identity and have unanswered worries about whether or not they are transfeminine, reading guides like this can help. Although transit is as old as history itself, the current language we use to describe it is less than 100 years old, so there is so much room to explore your identity and say who you are. No one can take that away from you. If you say you’re trans, you are, with or without HRT.
If you feel you want to pursue the feminization of HRT for your own transition then this is for you.
“Each individual needs to think about their own treatment goals and what they really want when considering HRT,” Ducar said of what a patient should do before considering a medical transition.
Ducar added that not everyone needs to feminize HRT, and you should only do so if you think medical transition is so important to your transition goals.
How to access feminizing hormone therapy? Is HRT covered by insurance?
Getting a prescription for HRT depends on a number of factors. First, it depends on the provider, the location of the provider, and whether the insurance covers the drugs.
Ideally, when seeking HRT, patients will have researched the effects of the treatment online and have an idea of what they are pursuing. A number of clinics in response have started operating under the informed consent model.
According to the American Medical Association, informed consent is when “communication between a patient and a physician results in the patient’s permission or agreement to undergo a specific medical procedure.” This means that as long as a doctor tells patients about potential side effects and risks, and a patient agrees to the treatment, the doctor can provide it.
Many clinicians who do not follow the informed consent model need a referral letter and a formal diagnosis of gender dysphoria to start HRT. For many patients, this can be a time-consuming and prohibitive barrier to affirmation of care.
The informed consent model was born out of the mistrust transgender people have of the medical establishment which has downplayed their needs in the past and has grown in recent years. There is no official, centralized database of informed consent clinics, but when searching for a clinic that offers gender-affirming care, many websites will list providers following this model. If a clinic doesn’t do this, it’s a good idea to call ahead if you want to understand their methods.
Those who still can’t find a supplier in their area, or find themselves in situations where they have to hide their transition, tend to turn to online DIY HRT suppliers. Understanding that access to transition-related care could be a life-or-death need, it is important to note that there are certain risks of taking HRT without the supervision of a doctor.
Ducar says it’s possible to overdose on HRT and you could put yourself at risk of “breast cancer, stroke, blood clots, gallstones and various heart problems” without being properly monitored.
“The most common testosterone blocker, spironolactone, can cause dehydration and weaken the kidneys,” she added. “All of these are potential risks when not monitored by a supplier or someone who is trained and has access to a lab.”
Most major private insurers cover feminizing HRT, however, the types of care covered and any exclusions may vary. As ringside lawmakers attack access to gender-affirming care through public insurers like Medicaid, coverage for HRT feminization can change depending on your state.
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