Care Process – Queer Med

Telemedicine

In many parts of the US, it is difficult to find doctors who are knowledgeable about transgender health and hormone therapy. Telemedicine enables us to care for patients remotely, using a video conference on a laptop, tablet, or smartphone.

With telemedicine technology, our team of healthcare professionals based in Atlanta can provide affirming care to trans patients across the Southeast. Most insurance plans cover telemedicine, making it both convenient and affordable.

Register in our medical system by clicking on the Book Appointment button. Please use the current legal name and gender listed on your ID or insurance. Allow 24 hours for your registration to process, and then you will get an email to set up your Patient Portal account, where you can book an appointment with any of our providers.

Step 1: Register

FAQ: Why do I need to register with my legal name and gender? Billing, labs, and medicines all need to be submitted through our system using the information exactly as it is listed on your insurance or ID. If these do not match, we can’t prescribe medicines, order labs, or file insurance claims. But we promise to NEVER use your dead name! When you login for your first visit you will be asked to provide the name and gender pronouns you use.

FAQ: Does it matter which provider I see? At QMed, all of our providers are queer. We are all passionate about providing affirming care to our transgender and nonbinary patients. All of us will be able to start your hormone therapy treatment and we look forward to meeting you!

FAQ: Do you take my insurance? We accept the following insurances: Aetna, SOME Blue Cross PPO plans (see insurance/fees page for details), Cigna, Humana, PHCS, and United. We DO NOT take Medicare, Medicaid, Peachstate, Ambetter, or Kaiser. Regardless of whether we accept your insurance, please be sure to check your deductible, because you may still be responsible for the full cost of your visit if you have not met your deductible.

Step 2: Intake Appointment

During the first visit, we will review your full medical history as well as any history of gender dysphoria. The goal will be to evaluate whether hormone therapy is needed and to make sure any medical conditions or current medicines will be compatible with hormones. If there are any medical or other barriers to your desired treatment, we will develop a plan to work through those issues. We will review the medication(s), side effects, and risks and benefits of treatment.

FAQ: Do I need an in person visit? Prior to the spread of COVID-19, an in office visit was required for the initial consultation for testosterone. However, the government has waived this requirement until further notice, so we are only offering video visits until the pandemic is under control to protect our patients, families, and staff.

FAQ: Will I need to undergo a physical exam? You will never be required to undergo any physical examination that makes you uncomfortable. Sometimes evaluating parts of the body over video can be helpful to determine puberty stages, but it is not essential, and we will do everything we can to protect your privacy and comfort.

Step 3: Meet with a therapist (OPTIONAL)

QMed uses an INFORMED CONSENT model for patients 18 or over, so a therapist visit is not required. However, mental health support during transition is a very important part of care for most patients. Transition is ideally an exhilarating and affirming experience, but may also be disruptive and challenging. Professional support from a mental health provider can be a key component of care during this time.

FAQ: Where can I find an affirming therapist? We recommend working with a mental health provider (psychiatrist, psychologist, social worker, or counselor) who is familiar with transgender care prior to starting hormone therapy. You can find a list of great providers on our Resources (link to page) page for a list of mental health providers, organized by states. Most are offering video visits due to COVID-19. If you know of any great providers who are not on our list, please let us know!

Resources

Step 4: Lab tests

Before starting any treatment, we will need to perform blood tests. We typically check your starting hormone levels, kidney and liver function, and anything else that may be needed prior to starting hormone therapy. If you would like to get lab testing done before your first visit, please contact us via the patient portal to ask for a lab order. That way we may be able to start hormone therapy sooner!

FAQ: Where do I get lab tests done? We use Labcorp for all of our blood tests. We will send an electronic order to Labcorp, and then you can book a blood draw appointment at labcorp.com. Ask them to look for your “electronic order” (sometimes they look for a fax by mistake.) Lab results will be sent back to us automatically, usually within 2-3 days. If you plan to use insurance for your lab tests, be sure to bring your ID and insurance card. If you don’t have insurance or prefer not to use it, please let us know if you would like the QMed price of $99 BEFORE we order your labs. If you use QMed’s $99 price, nothing will be charged at Labcorp, and payment will be due at the time of your video visit with QMed.

FAQ: How much do labs cost? Many insurances will cover the cost of labs, even some insurances that are not accepted at QMed. Without insurance, lab testing is typically $300-$500. If you don’t have insurance or prefer not to use it, we offer lab testing for $99. Please let us know if you would like the $99 price BEFORE we place your order at Labcorp. If you use QMed’s $99 price, nothing will be charged at Labcorp, and payment will be due at the time of your video visit with QMed. If you are charged more than this by your insurance, you can let us know and we may be able to retroactively apply our discount.

Step 5: Hormone Therapy

Once the full medical assessment is complete and any concerns have been addressed, you will be ready to start hormone therapy! We will send your prescription to any pharmacy of your choice. This process can be accomplished in as few as 1-2 visits in most cases, but may take longer if there are any issues to address.

FAQ: How long will it take to start hormone therapy? If you meet the criteria for hormone therapy, we can get you started after the first visit and labs! The first visit usually lasts 45 min to one hour. For some people under age 18, those with complex medical conditions, or other issues it may take slightly longer.

FAQ: How much will my medicines cost?

That is a great question! It is often hard to tell in advance what will or won’t be covered by your insurance. But the best way to determine your out-of-pocket cost is to look up prices on GoodRx (or a similar discount site.) When looking up medications, here are the names and typical doses of commonly used medicines:

Testosterone cypionate (a 1ml vial typically lasts 2-4 weeks)

Estradiol tablets (typical dose is 2-6mg per day)

Estradiol patches (typical dose is 0.025-0.1mg/day, applied twice weekly)

Estradiol valerate injections (a 5ml vial typically lasts 2-3 months)

Spironolactone (typical dose is 200mg per day)

Progesterone (typical dose is 100mg per day)

FAQ: How often will I need visits after I start hormone therapy? At first, you will need a visit and lab testing every 3 months until your doses and hormone levels are stable. This usually takes about a year. After that, you will need a visit 1-2 times per year.

Step 6: Follow-up Visits

Once hormone therapy is started, you will need blood tests and a visit every 3 months to monitor your treatment. We will start at a low dose to minimize side effects and see how you feel on the medicines. As long as your hormone levels and other lab work is normal, we can increase your dose. It typically takes 6-12 months for hormone levels to get to stabilize. At that point, we can space out visits to every 6 or possibly every 12 months with long-term therapy. Follow up visits are typically 15-30 min.