Fear of being blamed for suicide keeps clinicians from saying “slow down.”
Many doctors and therapists believe that if they ask a patient to pause and talk first, the patient might become suicidal and the clinician will be held responsible. One woman who later stopped taking testosterone recalled how her therapist “was trapped making the same diagnosis every patient they get, and offering the same treatment for all of them,” because, in the therapist’s own words, “they can’t refuse you hormones… it would be considered conversion therapy to some, and contribute to suicidal thoughts.” – lurker_number_69 source [citation:1430719b-2cd2-4c35-8713-1512230ae7d7]
The “informed-consent” model lets clinics hand out hormones on day one.
Places such as Planned Parenthood do not require any proof of counseling; you simply sign a form saying you understand the risks. One young woman described walking in and leaving the same afternoon with a prescription for testosterone: “I didn’t need any proof I was in therapy… Both therapists I talked to… actively encouraged me to move forward with medicalization.” – Quiet-County-9236 source [citation:9311ccc8-f104-47d8-b8dc-b74b0ded4f1a]
Referral letters are rubber-stamped after a single brief chat.
Even when a letter from a therapist is required, the meeting can last only twenty minutes. A man who later detransitioned said the counselor simply asked how he felt, then “just like that I was given a recommendation for HRT to start immediately… I haven’t seen the therapist since.” – ayesb source [citation:0dbba6f0-59e1-42a8-bafd-b2ae2498b012]
Underlying problems such as eating disorders, self-harm or personality disorders are often ignored.
Because the visit is so short, serious mental-health issues never surface. One woman who had been hospitalized for an eating disorder wrote that the doctor “had on record that I had a previous history of mental health issues… Somehow this didn’t raise a red flag for her.” – [deleted] source [citation:33273ec1-e0ca-4f64-912b-8cf6f84b2915]
Clinicians fear lawsuits or being called discriminatory more than they fear rushing treatment.
Providers worry that any delay could be framed as trans-phobic or bring legal trouble, so they err on the side of speed. After only five minutes with an endocrinologist, one patient received a testosterone shot while the doctor displayed “an almost frightened attitude… they didn’t want to be seen to be discriminating or invalidating me.” – littlendn source [citation:33ebb3bb-e661-4174-9640-ac974f295c0f]
If you are wondering why hormones can appear faster than ordinary antibiotics, the answer is a mix of legal fear, clinic business models, and a belief that asking questions is harmful. Real healing, by contrast, starts with space to talk about depression, trauma, or discomfort with sexist expectations—no prescription pad required. You deserve time, reflection, and support to explore those feelings safely; your well-being is worth far more than a five-minute appointment.