How to start
Depending on where you live, your age and other factors, you may be able to access a clinic or provider that provides trans-specific care.
Getting a hormone readiness assessment
As we mentioned above, you do not need to engage an assessor if your primary care provider can provide the readiness assessment. In some cases, however, a primary care provider may recommend an assessment from a mental health provider.
If you choose to work with an endocrinologist, you’ll need to engage a mental health professional who can provide a readiness assessment (such as a counsellor, social worker, psychologist or psychiatrist).
Most mental health providers are private-pay. There are some public (free) options for hormone readiness assessment in the community; these may require a referral. If you have been told to get an assessment from a mental health provider or if you need information on low-cost options, you can contact us now.
What is a hormone readiness assessment?
A hormone readiness assessment is an evaluation conducted by a qualified professional to determine if a patient is ready to begin hormone therapy. The WPATH Standards of Care requires an assessment before hormone therapy starts.
What happens during a readiness assessment?
Some people feel anxious about the readiness assessment. They worry about saying the wrong thing and being denied treatment that is very important to their health and wellbeing.
It may ease your fears to know that the focus of the assessment is on supporting you. Your assessor or primary care provider will ask you about:
- Your gender and feelings about your body, including your embodiment goals
- The effects you expect to see from estrogen-based or testosterone-based hormone therapies and effects you would rather avoid
- Your expectations for timing of desired changes and understanding that responses are individual and are influenced by many factors (for example, your genetics and metabolics)
- Your health history (current and past medical and mental health conditions, surgical history, medications, allergies, smoking status, exercise, nutrition, family history, etc.)
- Your understanding of the risks and benefits associated with hormone therapy
- Your support network and strategies for thriving in your changing gender expression with family and friends, at work and at school
Your prescribing provider may recommend a physical exam to check your heart and lungs. They will give you a requisition to do some laboratory work, such as a blood test.
What happens if a person doesn’t meet all the criteria?
In some cases, health care providers may prescribe hormones even when these criteria are not met. For example, a health care provider may use a harm reduction approach and prescribe hormone therapy as an alternative to someone obtaining hormones outside the health care system.
It is important to note that having mental health concerns (such as depression or anxiety) or addiction does not necessarily mean you do not meet the criteria. Instead, these concerns will need to be reasonably managed prior to, or during, hormone therapy.