Hormone therapy can be initiated with a referral from a qualified mental health professional. Alternatively, a health professional who is appropriately trained in behavioral health and competent in the assessment of gender dysphoria may assess eligibility of, prepare, and refer the patient for hormone therapy, particularly in the absence of significant coexisting mental health concerns and when working in the context of a multidisciplinary specialty team.
— WPATH Standards of Care
As I was driving to my therapy session Tuesday afternoon, I was in a good mood. It was a perfect autumn day — sunny, brisk, breezy. I am down nearly 40 lbs. from my February high, and it shows. The outfit I was wearing was one I’d been dying to wear once the weather cooled; and with the loss in weight, plus my improved skills in padding, makeup, and accessorizing, I honestly looked good. For once, I was actually happy with the woman I saw in the mirror.
It wasn’t until I was in the session and talking about my strangely elated state with Nancy that I realized why I was in such a good mood: because I had decided, somewhere in my subconscious, that it was time to ask for The Letter.
The referring health professional should provide documentation — in the chart and/or referral letter — of the patient’s personal and treatment history, progress, and eligibility.The recommended content of the referral letter for feminizing/masculinizing hormone therapy [includes] an explanation that the criteria for hormone therapy have been met and a brief description of the clinical rationale for supporting the client’s request for hormone therapy.
— WPATH Standards of Care
Well, okay, it hadn’t been entirely unconscious. I had been involved in an online discussion where the participants had encouraged me to bring the topic up if I felt ready, instead of waiting for Nancy to do it. But I hadn’t realized that I’d made that decision — that I felt I was ready — until the moment before I said it out loud.
“I’m ready to do it. I’m ready to take the next step.”
Nancy’s eyes got a little wide. Remember, I’m only six months out from a suicide attempt. But I have met the WPATH minimums for length of counseling prior to a letter; and I was informed about what HRT meant, what it did, and what the risks are; and I was totally rocking my peasant skirt. So she ran through the process with me, looked at her schedule, and said that she should be able to get me approved [I get my counseling through a gender services program, so my case needs to be “approved” by the lead counselor]. I should have my letter next week!
This wasn’t a currently stated goal, but I was lacking for an October goal anyway. So say it with me folks … ACHIEVEMENT UNLOCKED!!!!!!