The start of a journey to become my true self.

The long and winding road, taken 14 years ago, 4 km from Dodburn, Scottish Borders, Great Britain.

I am a trans woman. I have been living as a woman for sixteen years. It has been almost sixteen years since I last wore men’s clothing.

And yet I have not begun the gender transitioning process.

I finally decided to begin the gender transitioning process at the end of last year. On December 30, 2020 I did some research to determine how to go about it. I found a document on my health insurance provider’s website containing the following information: “Hormone therapy is usually initiated upon referral from a qualified mental health professional … competent in behavioral health and gender dysphoria treatment”. I also learned that my insurance provider provides various telehealth options for Sexual Orientation and Gender Identity Counseling.

So, on December 31, 2020 I scheduled an appointment with a service called MDLIVE for January 20, 2021 at 1:00 PM CST.

The appointment on January 20, 2021 was a disappointment. At the beginning of the appointment I was asked what my goals are. When I mentioned that my ultimate goal was to begin HRT I was informed the MDLIVE cannot assist with that. The therapist suggested I contact my insurance provider to request information on how to go about starting HRT.

So later that day I used the chat feature of my health insurance provider’s website to request information on how to go about starting HRT. The response was devastating: “I apologize yet Hormone replacement therapy is not a covered benefit under your medical plan since it is considered as experimental, investigation and unproven.”

I was devastated.

Fortunately my health insurance provider has this new program in which they assign their customers a Nurse Case Manager.

I was contacted by two Nurse Case Managers today.

The first Nurse Case Manager I was assigned is not familiar with Gender Dysphoria. When I mentioned to her that I am a trans woman and I am planning on starting HRT soon I was reassigned to another Nurse Case Manager who is familiar with Gender Dysphoria.

My Nurse Case Manager is named Spring.

I mentioned to Spring that I had been informed that hormone replacement therapy is not a covered benefit and she reassured me that Hormonal therapy is covered under their “Treatment of Gender Dysphoria” policy. She sent me their Gender Dysphoria Policy document.

In the document the following services are listed as “Medically necessary treatment for an individual with gender dysphoria”.

  • Behavioral health services
  • Hormonal therapy
  • Gender Reassignment Surgery (with some exceptions) including “Male to female reconstructive genital surgery”.

Unfortunately some services that are deemed to be “not medically necessary service” are not covered. This includes the following.

  • Facial Feminization
  • Breast augmentation
  • Voice therapy

I have requested a referral to an endocrinologist from my Primary Care physician. They have referred me to Texas Diabetes & Endocrinology and I should be contacted by them next week. Spring confirmed that Texas Diabetes & Endocrinology accepts my health insurance and they are considered to be an in-network provider.

In other words, I am finally becoming my true self at the age of 44. I am so happy.

It has taken me many years and a great deal of pain to get to this point.

When I was a child my parents did everything they could to beat masculinity into me (see Do not try to force boys to be masculine. You will only break them.). They kept me from even realizing that there was an option to being a man. This is why I emphasize with what Vanyel Ashkevron went through in the book Magic’s Pawn: Valdemar: The Last Herald Mage; in this book Vanyel’s weapons master and father went to great lengths to keep Vanyel from realizing that homosexual relationships were possible.

I was married, to a woman, before I ever heard the word transgender.

When I finally accepted that I am transgendered, it ruined my marriage. The first thing my wife said to me was “I did not marry a woman.” She then accused me of marrying her under false pretenses.

It has been a long, winding, and extremely painful road. Everyone in my life who should have helped me instead put up road blocks. But I am finally here.


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