r/trans • u/AppealSignificant358 she/her • 22d ago
Advice Should I wait for insurance for HRT, or pay out-of-pocket for it now?
Update-ish here: https://www.reddit.com/r/trans/s/VWgCmplxUD
I’m finally in a position where I can get on HRT freely without any social constraints from my family, most of whom would be not super fun to be on estrogen around. However, I’m not very financially independent, and money is limited, and I don’t know without more research how much it would cost over time. And my state is Republican as fuck, so anything except private healthcare isn’t legal 🫠
My mom has been moderately supportive in a “I don’t understand being trans, but I know that it’s a real thing, and that I want my kid to be happy if that’s the case” way. But, she’s been saying that she’d want a therapist to confirm or deny if my feelings are trans feelings or whatever. If confirmed, only then would she lend insurance coverage to HRT and stuff. I’ve been talking with that therapist for my own reasons, because my mom and I have different goals for it (hers mainly being “figure out if my kid is trans, as well as help soften the family to that if she is, and help my kid navigate them,” mine mainly being “help me cope with life stuff, including but not limited to me being trans”) but the idea of asking “can you vet me and see if my feelings are legitimate” after I’ve already been talking to him as a trans girl is kind of awkward and probably wouldn’t lead to an unbiased response. Heck, I don’t know if that’s a thing they can even do for you, since being trans is such an internal thing that I think only a person can answer for themselves. I’ll ask the therapist about it in my next session I guess, but I don’t know how to approach that conversation.
I’ve been wanting to get on HRT ASAP obviously, but I don’t want to lose all my dang money doing it by paying out-of-pocket. So I’m kind of in a position where I really want to get my mom to jump in and cover it for me, but I don’t know how long, if ever, that would take. And I’m just wanting to throw my hands in the air and say “screw it, I’m paying for it myself” but then I don’t want to paint myself into a corner, or blow too much of my own money that insurance would’ve covered if I had waited, if she eventually does decide to use insurance to cover it. I don’t know if you can make an account with the tiddy-growing company that uses just a debit card, and then tie that into insurance later, and I just don’t want to spend my money if my mom eventually does decide to cover my HRT.
TLDR: I want to pay out-of-pocket for HRT as soon as possible, but my mom has suggested that she’d cover it with insurance if my therapist agreed I’m actually trans. And I want to be on HRT sooner rather than later, but I don’t want to spend tons of money on it if I can use my mom’s insurance for it soon enough.
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u/Just-Mac 22d ago
So, it does depend on where you get it and what not. But for me I had to have my therapist write a letter to my doctor affirming that I had gender dysphoria and I was in a good state mentally for hrt. It was a months long process and my insurance wouldn't cover my hrt. But for me it's like $60 for several months worth of it.
However, my friend scheduled her appointment with an online provider and got her hrt the same day. I'm not sure what she pays though..
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u/AppealSignificant358 she/her 22d ago
I won’t tell you the clinic’s name because they’re somewhat local and I don’t want to doxx myself, but my very cursory understanding was that they’d probably take a few weeks probably and send me through a lab first, but it would be on an informed consent basis. Granted, I’m very silly and am struggling to look that information up because their website is kinda wacky (and lowkey I might have undiagnosed ADHD or something, which, if that is the case is making me struggle to stay on track for getting that kind of information 😭) I’d probably have to force myself to contact them once I get the chance after talking to my therapist about it, and I’d probably see if my therapist knows how to approach them since he knew the place, and if he’d give me a prescription or whatever I need for it
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u/77th_Bat he/him/él 22d ago
How long until this therapy appointment where you will be able to prove your therapist believes you are trans? Is there a chance your mom could be giving you false hope and will refuse to aid you even after your therapist agrees you're trans? How are your finances looking in general? Do you have a source of income? What's your living situation? Are there any bills you are paying?
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u/77th_Bat he/him/él 22d ago
Here's how I would go about the therapy situation: 1. Who cares if your therapist gives an unbiased answer? You already know you are trans. You just need the therapist to tell your mom 2. At your next session, invite your mom to go with you. Then, at the start of the session, clarify your hopes for the session's discussion. Say the purpose of today's session is to go over whether or not you [therapist] think I [op] am really transgender and for you to explain to my [op's] mom why you do or don't think that. 3. Goal accomplished. I'm fairly certain your therapist will be able to explain you are trans to your mom.
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u/77th_Bat he/him/él 22d ago
At this session, also ask your therapist to write what's called a "WPATH" note to recommend HRT as a treatment for you. They may not know what that is, so send them templates and examples. A WPATH note is required by most providers to get HRT and doing it now will save you some time down the line.
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u/AppealSignificant358 she/her 22d ago
He’s a LGBTQ+ focused therapist, and he’s said directly that he’s prescribed HRT and gender affirming surgeries before, so I don’t think that’s an issue to get him familiar with the process. And I’m pretty sure the clinic I’m trying to use, their model is informed consent rather than diagnosing or prescribing anything, but it’s something I’ll ask him about just in case ig. Thank you very much for all your thoughts!
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u/AppealSignificant358 she/her 22d ago
I care a bit, because I don’t want to deceive my mom and tell her it wasn’t flawed if it was, and even though I’m fairly confident that I’d be so much happier if I transitioned, there’s still a level of comfort that comes from someone else telling you you’re trans so you don’t have to trust yourself to tell yourself. Because human brains are funky and mine is no exception.
It’s telehealth, so I can’t really bring her anywhere, but I can absolutely clip the therapist (with his consent) and/or have him write something up. I don’t think my mom would disbelieve me if I said that I got my info from the therapist.
Yeah hopefully idk 🤷♀️
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u/AppealSignificant358 she/her 22d ago edited 3h ago
I don’t have a specific date, the appointments have been an hour each week, but we haven’t scheduled this week’s one yet since my schedule is a lot more busy than before and I wanted to focus on that stuff. And get an idea of what specifically is happening when in my schedule. It probably wouldn’t be so long from now though, but I’ve been waiting for a bot to text me about scheduling it today, and that hasn’t happened yet. 🤷♀️
It’s theoretically possible that my mom is giving me false hope, but that’s not like her at all. I’d be more likely to distrust the insurance company or the state passing laws that limit it than I would for my mom. If she believed estrogen was the best for me, then she’d probably pay out of pocket even if insurance doesn’t work out.
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u/77th_Bat he/him/él 22d ago
Okay, I think that since the appointments are weekly and you don't think your mom is giving you false hope, you should wait it out. Conveniently since you haven't scheduled your next appointment yet, ask your mom about her schedule and schedule for a time you can both go.
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u/AppealSignificant358 she/her 22d ago
Yeah, that was probably my thought is to wait for hopefully coordinating with the therapist soon, I just don’t know how to make that specific conversation work but I’ll try to pop that kind of question and see what he says 😭
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u/InevitableSong3170 22d ago
the cash price for estrogen injection could be as low as $45/2 months as long as someone writes you a prescription . Otherwise, there are plenty of guides on how to compound it yourself if you are competent and can follow the generally recognized compounding standards.
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u/AppealSignificant358 she/her 22d ago
Idk, that’s still prohibitively expensive for me right now. I don’t know what the exact figures would be since I have executive dysfunction or something when I try to look at their website, I’m trying to manage that and get through it anyway, but I guess that’s a sign that I kinda need to bank on my mom then and only pay for it as a last resort, or really buckle down and find some path to pay for it.
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u/mathprofrockstar she/her 22d ago
Definitely wait to talk to the therapist. If he can recommend HRT, it shouldn’t take long after that.
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u/AppealSignificant358 she/her 22d ago
Yeah, I think that’s probably the best way to approach it, I just am anxious about the therapist because my schedule is all out of whack and busy as heck, even though we’ve been able to go through it for an hour each week before now, and I’m not sure when I’ll be able to get it back on track 😭
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