In order to transition from male to female, transwomen usually take two hormones for the rest of their lives: estrogen and progesterone.Pre-orchidectomy surgery they may also take anti-androgens. This is usually the first medical step on your transition journey after changing your name and possibly living as your preferred gender for a short period of time. The Looking Glass Society has detailed information about HRT (hormone replacement therapy) here.
Your GP or doctor in Jersey is very unlikely to prescribe hormone replacement therapy for you. They will not have the necessary skills in gender care to decide whether hormone therapy is right for you. It will be your gender therapist who will start you on HRT. However, they will need to send their recommendation for your starting dose and the subsequent progress of your dose to your GP or psychiatrist in Jersey. Depending on what versions of HRT you have been advised to take, your GP or psychiatrist may be able to write the prescription for you or arrange for you to see the island’s endocrinologist, either privately or through the health service, who will write the prescription for you. HRT is a life-long commitment for transwomen and the cost of the hormones is not cheap so the majority of transwomen will elect to get help through the States of Jersey’s usual free prescription scheme.
There are a number of different forms in which HRT can be administered (injections, subcutaneous slow-release capsules, gels, patches) and Jersey offers most of the versions available. However, not all the versions of HRT delivery are on the GPs’ list of drugs they can prescribe. The States of Jersey’s endocrinologist has access to a much wider range of HRT delivery methods through the hospital’s pharmacy.
Whether your GP or psychiatrist can prescribe the type of HRT delivery recommended by your gender therapist or not, they will almost inevitably have to refer you to Jersey’s endocrinologist at some point for monitoring of your hormone levels. The endocrinologist is based at Overdale in the Department of Metabolic Medicine or can be seen privately at the Little Grove, St Lawrence.
Even if you start by seeing the endocrinologist privately, you can ask them to refer you through the health service for all follow ups. You will need to see the endocrinologist regularly, at least to begin with. The endocrinologist will monitor your blood to ensure that the hormones are being absorbed and used correctly by your system. They will ask you to ask your GP to arrange to take blood tests as needed. The results will be returned to the endocrinologist who will then discuss them with you. Once your hormone levels are steady and at the same level as a natal female, your visits to the endocrinologist will become less frequent and you need only telephone their office to request repeat prescriptions, which are sent down to the hospital pharmacy where they are filled within about 48 hours and where you collect them.