Your prayers have finally been answered- you have found an endocrinologist for HRT! They are affordable and/or are covered by your insurance, they are close enough to you that travel isn’t a problem, and you are ready to go, armed with your letters to start hormones!

You walk into their office, your heart pounding, but something just rubs you the wrong way the moment you walk in the door. You shrug it off- this is your miracle, after all- and proceed to see the doctor.

However, every minute you spend there, your “miracle” is slowly becoming a nasty twist of fate as you realize that this doctor is just not doing things in a correct manner. What is this “correct manner,” you ask? Well let me give you some signs that this endocrinologist may not be the right choice.

1. The fact that they handle transgender care isn’t advertised clearly

Admittedly your endocrinologist will not display a glowing neon sign that says, “HRT available now!!” But, if your doctor seems to be incredibly secretive of providing HRT for transition unless directly asked, that may be a reason to be on your guard. (It is important to note that since some doctors will not blatantly advertise it at all, this alone is not a reason to find another doctor. But if they try to give an excuse and you can couple it with a few other signs on this list, it’s time to look elsewhere.)

2. They throw too many obstacles in your path.

Depending on where you live and what doctor you go to, the steps to obtain hormones may vary. Some require a letter from a psychotherapist and/or psychiatrist, while some just require informed consent. But, if the doc is often finding new reasons to not give you your hormones at every appointment, or is implying that you’re not “trans enough,” it’s best to walk out of there.

3. They seem too eager to give you hormones

Inversely to the above, it is also a red flag if your doctor rushes through the steps needed or doesn’t thoroughly discuss all the effects, possible side effects, or why you feel the hormones are right for you. Some clinics, as horrible as it sounds, may think that by giving out HRT like candy on Halloween they are doing a favor for the trans community. It can be very harmful. It’s important for you to know EVERYTHING that could be in store for you when starting hormones and have a clear and open line of communication along the way. You want to be prepared, should you run into health issues along the way or lessen the chance of figuring out that you went too fast with transition and hormones are not what you needed.

4. The doctor is very rarely available or often postpones appointments.

I’m going to be very direct- hormones are not an afternoon stroll down the street! Your blood levels need to be checked frequently (for me when I first began, it was every three months). Your doctor needs to keep track of any health changes, and you need to be able to see your doctor in urgent cases (non-emergency, but still cases of concern). It’s a huge problem if your doctor has for the fifth time in a row called you and said, “I can’t do next week after all. How does a month and a half from now sound?”

5. They misgender and deadname you to your face

Any doctor who truly cares about their transitioning patients should take care to use preferred pronouns and chosen names, even if they have not been legally changed yet. Any mess-ups should be followed by a brief apology and self-correction (as should be from those in your everyday life). Constantly misgendering and deadnaming, followed by laughing, or shrugging off corrections is a sign of you being thought of as a walking dollar sign. They are completely able to call you “Sandra” to your face while your legal papers still say, “Harrison,” or refer to you as “they/them” when you have an “F” marker on your license, as long as they do any official filing or prescribing under what’s legally your name/gender marker.

6. They are constantly delaying prescriptions, or are doing things illegally

The first endocrinologist I went to would almost every time be lazy with sending out my prescription, and I’d get it at the last minute. When I called for a new one (as I kept getting the vials for only two injections), I was told my last prescription had two refills on it. Hormones, by law, are controlled substances and are non-refillable. You need a fresh prescription every time. Start looking elsewhere immediately if this is happening to you!

7. They refuse to let you do your own shots

While it’s good to have a loved one you’re around often enough who knows how to help you do your shot, you need to know how to self-inject as well. What if said loved one is on vacation, or is sick and can’t touch your syringes? While having them as backup, it’s essential to know how to and be able to do your own shots. It is your doctor’s job to teach you that, and beware if they straight up tell you no to teaching you.

A lot of this comes not only from my own experience with a bad doctor, but also from horror stories I’ve heard and read about. Doctors are humans- no doctor is perfect; so don’t count on any doctor being so. But some give you good reasons to say goodbye and leave their practice. While I understand one doctor may be your only choice, that doesn’t mean you need to put up with insufficient care. Call them out on their errors, research other options and talk with friends, other doctors you already trust (such as your GP or your psychiatrist), and online communities about finding a new endocrinologist. Your body is yours- you have a right to do things properly and in a healthy manner!