Hi, welcome to Gender Analysis. 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.
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. 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. 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.
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. 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.
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 in Boston, Howard Brown Health Center
in Chicago, Whitman-Walker Health in Washington, D.C., Emma Goldman Clinic in Iowa City, Iowa,
CHOICES Memphis Center for Reproductive Health in Memphis, Tennessee, Callen-Lorde Community
Health Center in New York City, Mazzoni Center in Philadelphia, Pennsylvania, Fan Free Clinic
in Richmond, Virginia, Center for Adolescent & Young Adult Health in Rochester, New York,
Lyon-Martin Health Services in San Francisco, Dimensions Clinic in San Francisco, Tom Waddell
Health Center in San Francisco, and Cedar River Clinics in Seattle and Tacoma. 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.
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 in San Diego, UCSF Benioff Children’s
Hospital in San Francisco, Children’s National Health System in Washington, D.C., Lurie Children’s
Hospital in Chicago, Boston Children’s Hospital, Children’s Mercy Hospital in Kansas City,
Missouri, Cincinnati Children’s Hospital, Nationwide Children’s Hospital in Columbus,
Ohio, Children’s Hospital of Philadelphia, Children’s Hospital of Pittsburgh, Hasbro
Children’s Hospital in Providence, Rhode Island, Children’s Medical Center in Dallas,
and Pediatric and Adolescent Transgender Health Clinic in Madison, Wisconsin. 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.
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.
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.
I’m Zinnia Jones. Thanks for watching, and tune in next time for more Gender Analysis.