Hormone replacement therapy (HRT) is a medical treatment that supplements hormones when your body is not making enough on its own. HRT is often used to treat symptoms of menopause in cisgender women, but it is also an option for transgender people looking to undergo medical gender transition.
If you are considering HRT, here is what you need to know about requesting this treatment:
Eligibility Requirements
To be prescribed HRT, most doctors will want to see that you meet certain requirements first:
- You must be at least 18 years old. HRT treatment protocols can vary for adolescents under 18, so you generally need to be a legal adult to consent to HRT.
- You should have a diagnosis of gender dysphoria. A mental health professional can formally assess and diagnose you with gender dysphoria, which is distress caused when your gender identity does not align with your assigned sex. This diagnosis is often required to access transition-related treatment like HRT.
- You may need a referral letter from a mental health provider. Your doctor may ask for documentation from a therapist or counselor to confirm your gender dysphoria diagnosis and readiness for HRT.
If you meet these basic eligibility requirements, you can request HRT during appointments with healthcare providers like doctors, nurse practitioners, or endocrinologists.
Making the Request
When asking your provider to prescribe HRT, being clear and direct with your request is important. Here are some tips:
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- Clearly state that your ultimate goal is to begin HRT. Don't beat around the bush—your provider needs to know you expect HRT rather than just a therapy referral.
- Be ready to explain your gender identity and transition goals. Your provider will want to understand your experience with gender and what changes you hope to achieve through medical transition.
- Come prepared with any necessary documentation, like a letter from a therapist stating you meet criteria to begin HRT. Having these materials already will make the process faster.
- Ask direct questions about available hormones, dosages, delivery methods (injections, patches, pills), expected timeline, costs, and side effect risks. Gather all pertinent information while speaking with your provider.
- Get a concrete follow-up plan for starting hormones or referrals to appropriate prescribers if your current provider cannot or will not prescribe them. Don't leave without clear next steps.
What to Do If Your Request is Denied
Sometimes providers may be hesitant or refuse to prescribe hormones even when you ask directly. There are a few reasons this can happen:
- The provider lacks training in gender-affirming care
- They have outdated views on who "qualifies" for HRT
- There are insurance barriers or restrictions
If your request for HRT is initially denied, stay hopeful and be politely persistent:
- Ask the provider to note in your medical record that you requested HRT and were denied.
- Request a written explanation detailing exactly why they will not prescribe hormones.
- Ask for referrals to providers or clinics that specialize in LGBTQ healthcare.
- Change to a different provider who is more supportive, if possible. Search for doctors knowledgeable on trans care.
- Have your therapist advocate directly with the provider by contacting them to explain your eligibility.
Refusing patients HRT without cause is unethical, so utilize multiple strategies to overcome barriers keeping you from the care you need. Connect with trans communities for localized recommendations on where to successfully access hormones from educated providers. Do not give up on finding an affirming healthcare professional who will prescribe HRT upon your well-informed request.
I hope this overview gives you a helpful starting point for requesting hormone replacement therapy during your gender transition. Every trans person deserves quality care from providers who respect their health decisions. Be empowered to keep seeking HRT until you find an ideal match - you can do it!
