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PSA for my US trans friends: there's a Telehealth HRT clinic called QMed (QueerMed) that serves adults and minors in 47 states (excluding DC, unfortunately). They accept lots of private insurance (but not medicare/medicaid), and also offer a payment plan that covers appointments and lab tests for people without good insurance.
Their program is great for people going stealth or living in unsafe environments, as they don't need referrals or anything else from your primary doctor. They send all lab orders to a LabCorp location of your choice, and prescriptions are sent to any pharmacy. (including mail-order pharmacies and chains like Walgreens and CVS that will ship your meds for a small fee.) If necessary, the entire process can be private and zero-contact except for the labs.
They work with transfem, transmasc, and non-binary people, and many of their staff are themselves trans! They follow WPATH SOC-8 and target modern (cis-equivalent) hormone levels, while still being flexible enough to work with whatever your personal goals are. In my experience, their target seems to be "whatever makes you feel best within safe limits". With me, they've been willing to explore non-standard doses, injection schedules, and hybrid approaches as long as I can provide research showing it's effective or at least safe.
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I can't speak to the transmasc experience, but I first started seeing them as a fem-aligned non-binary person who was already on oral Estradiol, Progesterone, and Spironolactone at mild doses. They had no issue with that, and later helped me increase those doses as I explored whether more "female" hormone balance would feel better. (still as part of a "non-binary" hormone plan!)
When I eventually realized I was binary transfem, they were just as understanding and helpful. They suggested changing Estrodiol forms to stabilize my levels at higher doses, and later helped me transition to injections when Spiro stopped working and other T blockers weren't an option for health reasons. (side note: they were actually willing to prescribe puberty blockers as an anti-androgen, but insurance wouldn't cover them and I couldn't afford the cost. I still think it's cool that they were forward-thinking enough to even offer that option, though!) I want to emphasize that I was not an easy patient for injections. I had severe needle-phobia, was clueless about the process, and proceeded to freak out many times over non-issues as I slowly learned how to inject. Through all that, they were patient, supportive, and never made me feel bad for panicking. Eventually I figured it out and even cured my needle phobia, for which they celebrated with me.
Now that I've finally achieved stable levels at the dose that feels best to me, they've let me transition to long-term HRT maintenance. This means 12-month prescriptions, infrequent tests, and minimal appointment requirements. This is something I was rather worried about, as my last provided never allowed long-term maintenance for various reasons. But with that, I'm now fully onboarded into the program and can speak to the whole experience. My overall opinion: QMed is the best HRT provider I've used, and the entire process has been smooth, flexible, and affirming.
#HRT #Transgender #Trans #PSA #Advice #Transition #Gender #GenderAffirmingCare #QMed #QueerMed
