TL;DR:
- Learn how to prepare for your first FOLX clinician appointment to start estrogen or testosterone and make the most of your gender-affirming hormone therapy (GAHT, sometimes called HRT for hormone replacement therapy) virtual visit.
- FOLX visits are similar to a regular clinician visit, except all online! You’ll log onto Zoom and talk about your goals and care plan with your clinician.
- If you’re new to GAHT, be prepared to talk about what changes you hope for and what side effects you have questions or concerns about.
- If you’re not new to GAHT, come prepared with your current medication (like dosage and route). We want feedback about what has/hasn’t worked well for you in your gender-affirming care so far.
- Make a list of your questions to maximize your time with your clinician.
- Before and after your visit, your care team can help you with resources, pricing, options for using insurance versus out-of-pocket costs, billing and shipping issues, and more.
This article was clinically reviewed by Michelle Forcier, MD.
We use the terms gender-affirming hormone therapy (GAHT), HRT (which stands for hormone replacement therapy), and gender-affirming HRT interchangeably throughout this article.
FOLX clinicians partner with you to navigate every aspect of your gender-affirming healthcare journey. We are experts in gender-affirming care; you are the expert on you! We know there is no one way to be trans or gender-diverse. That’s why we celebrate and nurture the spectrum of ways you can authentically align your body with your gender identities and goals.
If you’re wondering what to expect at your first appointment with FOLX, or you just want to be prepared, read on!
How do I start gender-affirming hormone therapy (GAHT)?
Gender-affirming hormone therapy is a process of taking hormones so you can affirm your gender identity. Many transgender and nonbinary people choose to take hormones as part of their gender affirmation. However, not everyone who seeks gender-affirming care takes hormones to feel affirmed. Your identity is valid–whether you take hormones, start and stop over time, or never start hormones at all.
Our clinicians will work with each member to create a plan of care using an informed consent process for both estrogen and testosterone. We will review your medical history, discuss your options for getting the best benefit from your gender-affirming HRT and address any health concerns arising from hormone therapy (or other medications).
We know that sometimes sharing the details of our medical histories is hard or uncomfortable. At FOLX, we take a trauma-informed health history. We understand that life can be hard and complicated, and will never judge you for that. Please understand that we want to have a complete medical history so that we can provide the very best care, avoid problems, and ensure your well-being and safety.
During the informed consent process, we discuss reversible and irreversible changes on GAHT, side effects, and rare but serious risks that could occur.
What happens before my first appointment?
Once you’re a FOLX member and have booked your first appointment, you’ll need to fill out your health history intake. The questions on this form will ask for a complete medical history – any current or past medical diagnoses you have, medications you are taking, allergies, history with gender-affirming HRT, pharmacy info, and insurance info (if it applies), etc. In order to make the most of your time with your clinician, it's critical to complete your health history before your appointment so that your clinician does not have to spend time inputting your history into your chart during your visit. You want to spend that time talking about your gender affirmation goals and plans!
What will we talk about in my first appointment?
Your Goals
Be ready to talk all about your goals for HRT and your dreams for your gender transition. Discussing the specifics of your “wants” versus “want to avoid” help you and your clinician pick the best medications and doses for your specific goals. Do you experience “gender dysphoria?” When do you experience gender euphoria? What are you hoping to achieve from gender-affirming HRT? Your clinician will document all of this information in your medical chart so that as you work together over the months and years, you will be able to check back and make sure you are achieving your goals.
Your Questions
Make a list of your questions to ensure you address your core needs during the visit. This is your time to ask your clinician whatever is on your mind. No question is too big or too small, no question is silly. FOLX clinicians have spent an average of almost 10 years working in gender-affirming care, and they are here to help you understand your options, your care, and your treatment plan.
Your Medical History
If you have previous lab results or medications you used for gender-affirming HRT before, be sure to have them ready or written down. Any information on your medical history, previous medical care, and medical records is helpful to have on hand. Ensuring you fill out your health history intake ahead of time will allow this part of the visit to go more swiftly so you can focus on what you really want to talk about - your goals and potential new medications!
How does the video visit work?
All FOLX appointments occur via Zoom. You can also read more about using Zoom for your visit.
Make sure to have a good technical setup (phone or computer), Wi-Fi, a quiet space, and privacy for the best virtual health visit setting. Be sure to join your appointment a few minutes early so you can work out any technical difficulties and maximize your time with your clinician.
What happens after my GAHT visit?
After your visit for gender-affirming hormone therapy, you may be prescribed medications, set up for future lab work, and decide on your next appointment.
How do I get GAHT medications?
After your first appointment, you'll get your prescription for 90 days (three months), as medically appropriate and decided in partnership with your clinician. Your medications will be either delivered discreetly to your door from our FOLX partner pharmacy or sent to the pharmacy of your choice to pick up.
When do I need lab work?
You don’t need labs right away. At FOLX, we don't run unnecessary labs - we order the specific lab tests based on which medications you're taking (estrogen-related labs or testosterone labs). We may check labs and levels of estradiol, testosterone, hemoglobin, creatine, and potassium–depending on what meds you take. For most folks, labs are done once or twice a year.
What if I have more follow-up questions?
Questions between visits? If you have a straightforward question that can be answered by one of our clinical staff, like medical assistants or nurses, you can send your question through your Athena patient portal. If you have more complex questions that need your clinician to assess and discuss with you, you can make a follow-up appointment at any time. We also offer resources on the FOLX Community Platform, including injection training and testosterone and estrogen talks. You can also message our member support team for other logistical concerns about your care, like billing, shipping, etc. They are also available to connect you to resources and referrals.
When will I have my next appointment?
You will decide with your clinician about when your next GAHT visit will be. Some patients starting GAHT may want or need to see their clinician more frequently in their first year of hormone therapy. Talking with your clinician every three months when you first start gender-affirming hormone therapy can help you manage and maximize medications for faster results, make important changes to your care plan, and avoid problems. Once you are on a stable dose and have achieved many of your goals, you may not need to see your clinician as often. After taking GAHT for a period of time, you’ll often only need a yearly check-in visit to continue care and get your hormone therapy prescription.
If you want to learn more about the options and side effects of medication, or what transitioning is like, check out these other articles:
Estrogen
- 9 Myths You Might Have Believed About Estrogen HRT
- Physical Changes on Estrogen HRT
- Microdosing (Low Dose) Estrogen HRT
- Estrogen Gender-Affirming HRT Methods and Dosage
Testosterone
- 9 Myths You Might Have Believed About Testosterone HRT
- Physical Changes on Testosterone HRT
- Microdosing (Low Dose) Testosterone HRT
- Testosterone Gender-Affirming HRT Methods and Dosage
What if I’m not sure I want to start HRT?
For some people, this initial appointment can just be a time to discuss your questions or concerns with your clinician–you may decide you want to start hormones on this visit, or you may just get information, consider your options, and then schedule another visit at a later date to start. There will never be any pressure from your clinician or a timeline you need to follow. You can make decisions on the schedule that works for you.
What if I’ve already taken hormones in the past?
If you are new to FOLX (or you left FOLX and are returning after being gone for more than six months), we will require a video visit with a clinician before starting or restarting hormone therapy with FOLX.
Whether you're just starting your gender journey or you're a seasoned GAHT veteran, we can help. Our clinicians are the experts in LGBTQIA+ healthcare. At FOLX, you can get the medications you need, letters you might need for your transition, and referrals for surgeries and other services.
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FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include virtual primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, preventive care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, or nonbinary, you can find LGBTQIA+-specialized health care that helps you meet your wellness goals. FOLX Health is health care that's queer all year. Get all the benefits of becoming a FOLX member and sign up today!
