Why hormones can be prescribed before a single therapy session

1. Twenty-minute “assessment” is enough for a referral
Several detransitioners describe being handed an HRT letter after one very short meeting. “I sat down with the therapist for about twenty minutes, said I was feeling dysphoria from an identity misaligned with my body … and just like that I was given a recommendation for HRT to start immediately.” – ayesb source [citation:0dbba6f0-59e1-42a8-bafd-b2ae2498b012]. Two weeks later this person was already on testosterone blockers and estrogen.

2. Same-day prescriptions at walk-in clinics
Planned Parenthood and similar clinics often skip any therapy requirement. “I didn’t need any proof I was in therapy to get a T prescription the day of my first appointment at Planned Parenthood.” – Quiet-County-9236 source [citation:9311ccc8-f104-47d8-b8dc-b74b0ded4f1a]. The prescription was written on the spot.

3. Two half-hour appointments and a physical
Even when a clinic claims to “require” therapy, the bar can be extremely low. “Two 30-minute appointments and a physical and BAM I’m on HRT.” – Lisa_Sae source [citation:bd9c9af5-0b9d-49a3-a317-d40f68a0c770]. No deeper exploration of trauma, anxiety, or depression took place.

4. Fear of being accused of “conversion therapy”
Therapists themselves feel trapped. “Gender-affirming therapists are trained to not question their patient’s perceived identity, due to the high suicide-attempt rate … They can’t refuse you hormones or offer alternative treatment. It would be considered conversion therapy.” – lurker_number_69 source [citation:1430719b-2cd2-4c35-8713-1512230ae7d7]. This pressure leads to rubber-stamping the medical route.

5. No follow-up once hormones begin
After the brief encounter, ongoing therapy is rarely required. “I haven’t seen the therapist since.” – ayesb source [citation:0dbba6f0-59e1-42a8-bafd-b2ae2498b012]. The prescription is handed off to an endocrinologist and the psychological work is left undone.

A hopeful closing thought
The stories above show how quickly medical transition can be set in motion, yet they also reveal a clear need for slower, deeper care. If you are questioning your next step, know that thorough, non-medical support—therapy that explores trauma, anxiety, self-esteem, and every other part of you—is available and can bring lasting relief without rushing to hormones. You deserve the space to understand yourself fully before any irreversible decision is made.