When my partner and I were in Philadelphia for the Trans Health Conference earlier this month we were surprised to learn that it was no longer necessary for a trans* person to see a therapist and get a letter of recommendation to take to an endocrinologist before being prescribed hormones. We were told in multiple different workshops that the new WPATH Standards of Care promote the use of an “informed consent” model where a trans* person can be prescribed hormones by their primary care physician (regular doctor) as long as they sign a consent form stating that they understand the effects of hormones and the decision they are making and are capable of making said decision for themselves.
Well, if you live in the South, like me and my partner, finding a doctor, even an endocrinologist, who will prescribe hormones using the informed consent model may be impossible. In fact, my partner has been told that the closest doctors that who may be willing to work with them using the informed consent model have offices two hours away from where we live, and we live in the state capitol. I’m expecting even bleaker results as I look into possibly procuring a hysterectomy or tubal ligation and endometrial ablation. In fact the comprehensive “Transgender Resource and Referral List” for my state doesn’t even list any surgeons at all. The single trans* friendly OB/GYN listed for my area is Planned Parenthood, and I kind of doubt they’ll have much to offer me in the way of help or advice.
The reality of living below the Mason-Dixon is that while national attitudes towards queer and trans* people may be improving, the removal of Gender Identity Disorder from the DSM, DOMA being declared unconstitutional, and the new WPATH Standards of Care mean little here. Nothing has changed for us. We still have to jump through the same hoops and fight the same fights, and we still face monumental barriers to accessing necessary medical care.