One of the questions most often asked about receiving hormone replacement therapy is whether or not we offer Informed Consent.
Erin Everett, NP-C is one of the few providers in the Atlanta area offering Informed Consent for the purpose of transgender hormone replacement therapy. Below, I provide some greater detail on what Informed Consent HRT means, and what to expect at your first visit to our practice.
What is Informed Consent?
At its most basic level in a healthcare setting, Informed Consent is a legal document that is used to outline a patient’s consent to have a procedure or receive a specific medication or treatment plan. By signing the Informed Consent document, the patient is confirming they are fully aware of all the implications of that procedure or treatment plan, as well as the risks and side effects of the taking of certain medications.
It is common for patients to sign Informed Consent documents before undergoing surgery, or in the case of transgender patients being treated at our practice, signing Informed Consent before receiving hormone replacement therapy (HRT).
Depending on the type of transition a patient is desiring (MtF or FtM) the Informed Consent will be different and will cover the hormones that will be taken during the process. For patients who identify as non-binary, we provide them with the appropriate consent based on the hormone being dosed.
Informed Consent HRT for 18+ Patients
It is critically important to note that I can only offer Informed Consent for patients who are 18-years and older, since patients younger than that do not have rights to sign their own consent, and must have a parent or legal guardian present to sign the Informed Consent for them.
In fact, I only treat patients over the age of 18, for both primary care and/or hormone replacement therapy, but there are other clinics in Atlanta that do.
Do You need a Therapy Letter before Informed Consent HRT?
It’s not uncommon for some HRT providers to prefer their patients to have a therapy letter, prior to receiving transgender HRT. Some providers prefer to have a mental health care provider document the patient’s readiness for medical transition. Other providers also utilize this approach in order to document the journey/timeline of gender incongruence.
While you are NOT required to have a therapy letter before starting Informed Consent HRT with me, I recommend that all of my patients see a mental health care provider — especially once they’ve decided to undergo hormone replacement therapy.
When it comes to wanting to transition, most of my patients have felt this way for a long time, and clearly do have gender dysphoria, but mental health care is so important to help as any patient undergoes hormone replacement therapy. My background and training in psychology allows me to practice more comfortably with certain diagnostic criteria that other providers may not be as well versed in.
What Does the Informed Consent Process Entail?
Informed Consent Review
Before I even meet with a hormone replacement therapy patient for the first time, I go ahead and draft a personalized Informed Consent document to go over with them in person.
During the initial visit, we go through the Informed Consent document together, allowing the patient to ask any questions they may have before signing it. The document lists risks, benefits, the expected time frame, and the expected physical changes of taking hormones. The document also covers the emotional changes that might occur.
Our Informed Consent also includes a schedule of follow-ups and bloodwork, because it’s very important that patients come in for follow-ups to make sure that there are no negative side effects occurring from the hormones.
We can not, in good conscience, refill any hormones if we have not made sure that a patient’s health is in good condition, and that they are not suffering from any negative side-effects from the hormones.
Signing the Informed Consent HRT Document
After I’ve gone through an Informed Consent document with a patient, I go ahead and leave the room and get a support staff member to come in and witness the patient’s signature on the consent.
This witness is simply there to verify that the patient signed the document on their own, that I didn’t make them sign it or force them to sign it in any way.
It’s impossible to witness someone’s level of comprehension of the consent, so I stress to patients that once they’ve signed the consent, they are confirming that they have understood all the information on the consent form and are ready to begin treatment.
Once the patient and the witness sign the document, the Informed Consent demonstrates the patient’s understanding of the treatment and its implications.
Next Steps Following Informed Consent
Once the patient has signed their Informed Consent HRT document, we are ready to begin the medical transition. I am present with my patients along the way and available for any and all follow up questions and concerns.
The transition looks different for different people, depending on their goals. We develop an individualized HRT plan, draw blood work and, in most cases, my patient leaves with a prescription for their medications.
We ensure patients have the necessary training to administer their medications safely, this is a well documented process and by doing this we can make sure the patient is supported every step of the way!
To schedule an appointment to discuss Informed Consent HRT, please contact my office.