How to Start HRT

Guidelines

The current guidelines surrounding transition management include:

These are general guidelines that cover labs, medication use, and general medical knowledge for treatment of transgender patients.

Consider Your Options

You don’t need HRT to be trans, and even if you decide that HRT is right for you, there are various ways to go about it. Make sure you’ve thought everything through and are in a good head space.

Therapy is a great starting point for this process. Here’s a list of local Gender Affirming Therapists. Note, however, that a therapist letter is not required for Informed Consent HRT, which is becoming more popular in our area. Informed Consent is included in both the WPATH and UCSF guidelines.

Related: Informed Consent and Why it Matters

Make an Appointment with a Gender Affirming Healthcare Provider

Here is a list of local Gender Affirming Healthcare Providers. Call one and make an appointment. It’s really that easy. If you’d like to see a therapist a few times before you proceed, there’s also a list of gender affirming therapists on that same page that you can make an appointment with.

Get labs

If you have insurance, you can pick up a lab slip from your provider and take it to any Quest or Labcorp location.

If you do not have insurance, the cheapest option for labs is Jason Health. Their website allows you to search your own labs without a doctor’s order, and then they order those labs for you at your nearest lab (usually a Quest). The required labs for the transgender health panel (the Tranel, if you will) are:

  • Complete Blood Count (CBC) with Differential and Platelets
  • Comprehensive Metabolic Panel (CMP)
  • Total Testosterone
  • Estradiol

Altogether, these labs cost $96 through Jason Health. Alternatively, you can still get a lab slip from your doctor’s office and take it to any self-pay lab, such as That Lab Place located at 14 W Jordan St, Suite 1H, Pensacola, Florida 32501, which charges $108 for these same tests. Any Lab Test Now‘s Pensacola location is very friendly and accepting, but will cost $198 for the panel.

If you’re uninsured, do not go to Quest or Labcorp! They will charge around $600 for self-pay for these four labs!

The point of these labs is to make sure that HRT is safe for you. Since hormones greatly influence the metabolic system, the CMP is used to tell your provider how your metabolic system will handle a sudden change in hormone levels.

Discuss Your Goals of Therapy with Your Healthcare Provider

Once you’ve had your labs drawn (results take approximately 3 days to get back to your provider), meet with your healthcare provider at your appointment to discuss your goals of therapy.

For instance, do you want full feminization or masculinization? Or are you looking for more subtle effects? Microdosing is an option for non-binary and gender nonconforming patients who want more subtle changes.

Be honest and open with your healthcare provider. We’re fortunate to have a number of providers in town who listen to our community and recognize the broad spectrum of gender identities we encompass.

Medication

After your provider has reviewed your labs and discussed your goals of therapy with you, they will then offer you HRT medications that are both safe for you and will help you achieve your goals.

Here is a list of medications commonly used for Feminizing HRT and Masculinizing HRT.

Your provider may wish to order more tests for you before proceeding with HRT if you have abnormal readings in your labs or if you have health conditions that HRT may complicated. But this doesn’t necessarily rule out HRT altogether.

Go Take Your Meds

That’s it! You’re done!

Health providers will usually want to see you in 3 months to review your follow-up labs. At this point, they may adjust your dosages based on lab results. Once you’re on a consistent HRT regiment, your provider may only need to see you every 6 months.

Happy transitions!