How many sessions until I can start HRT?

If you’re 18 years or older…


Many people are anxious to start HRT (aka cross-sex hormones), and think they need a letter from a therapist to begin. If you are an adult, this may not be the case, depending on where you live.

Many places provide cross-sex hormones on an informed consent model (the same model for most surgeries. Just like you don’t need a therapist’s note to get a nose job, you don’t need a therapist’s note to start cross-sex hormones at these places).

If you live in Travis County or near Austin, Texas, Planned Parenthood of Greater Texas and the Kind Clinic offer gender care.

If you live in Western North Carolina (WNC), Planned Parenthood’s Asheville Health Center and Western North Carolina Community Health Services (aka WNCCHS) provide transgender care.

how to get a letter for hrt
hrt letter in north carolina and texas

If you are an adolescent…

…many endocrinologists only ask that you are currently seeing a therapist in order to start working with you.

Many adolescents don’t start on cross-sex hormones, but begin first on puberty blockers. Starting them is a discussion between you and your pediatrician or endocrinologist.

If you don’t already have a referral, your therapist can provide you a list with endocrinologists who work with transgender issues. There are multiple doctors who work with transgender adolescents, including WNCCHS in North Carolina and the Kind Clinic in Texas.

While support for adults starting HRT isn’t required, it’s often helpful to have a clinician help guide you through the different steps. Starting your physical transition can be scary, intimidating, and exhilarating all at the same time, and you don’t have to go through it by yourself.

Counseling for transgender teenagers and young adults

Want more support through your transition? Vered Counseling is a trans-affirmative counseling practice in Texas and North Carolina.

Learn about our counseling for transgender teens and therapy for transgender adults. We also provide support for parents of trans adults and youth.

Check out the Vered Counseling blog for more helpful tips, like what is gender therapy like, understanding what is gender dysphoria, and what are puberty blockers.

If you or a family member would like some support during gender transition, you can schedule a time to talk with a gender therapist.


<3 Vered

hrt when to start