If someone doesn't have a great deal of experience telling others that he or she is a transgender person or needs to crossdress, the idea of telling one's physician can be frightening and intimidating. So, let's look at reasons 'not' to tell.

If your physician treats either your spouse or a close friend, telling may not be a good idea until you are in the process of coming out to the close people in your life. Certainly, doctors have confidentiality laws to obey, but they may accidentally tell others in an effort to help resolve their concern for your well being. This is particularly so if you are distraught over issues which they believe introduce moral questions.

Another big no-no is telling a 'company-hired' physician who provides you general health care or provides work-related health clearances to your employer. The distinction here is if the doctor reports directly to the employer, telling about your gender issues may not be prudent early on, particularly for people not yet prepared to disclose an upcoming transition to an employer.

One frequent mistake inexperienced people make in the throes of coming to terms with a transgender identity, is asking a physician for hormones. Momentarily setting aside standards of care requirements that gender specialized counseling and a written recommendation are needed, these requests often come as quite a shock to the physician. Most physicians are familiar with a set clinical logic, to prescribe based on their range of experience or whatever clinical literature is closest at hand, to stray from this principal is alarming to many doctors.

That all said, I do not recommend disclosing to your physician until you have actual experience coming out to others and you have developed a plan to hand the physician a professionally written recommendation, which should contain treatment guidelines that he or she can easily understand and follow. The recommendation should also contain guidelines how to handle of insurance and charting issues, of these are concern to you. Being prepared will significantly reduce your chances of being turned down, if the physician truly believes in providing comprehensive medical care to all people - not just to the non-transgendered.

I am often asked if a physician can commit a person to a locked psychiatric ward for solely disclosing gender issues? The short answer is 'this should not occur.' Regrettably this is still done or tried in areas where careproviders are not experienced dealing with gender issues. If a transgender person is a minor, has expressed self-harming ideas, or is perceived to have psychotic thoughts according to the physician - these things increase a persons chances of being hospitalized or institutionalized. Self-harming ideas would include suicidal and auto-castration thoughts.

Before actually disclosing your issues it might be figuratively be wise to go fishing. Ask your physician what he or she knows about the transgender or transsexual persons. Usually the provider will answer the question, and in relaying what (if anything) is known, will also relay a positive or negative attitude. You can then take this information to your therapist or counselor and define a disclosure strategy. You want to be well-versed in how to deal with rejection from individuals and careproviders alike, and know how to differentiate between a bigot and someone who simply is uncertain because he or she is lacking treatment information. If your physician says that transfolk are crazy or sick, flee the examination room, and go find a new doctor!

Another factor to consider when deciding whether to tell a physician, would be if you are taking hormones. Yet, are not receiving blood laboratory testing. Taking any medication without being monitored by a physician is dangerous, and if you have any physical impairments or blood chemistry abnormalities which preclude your taking certain types of hormones - that is information that you need to know. If you cannot disclose your transgender status to your current physician, do not delay in finding a careprovider you can trust. Your life may well depend upon it.

Whether you need to disclose now or later your best interests can be maintained by being prepared. Remember, having a transgender identity is nothing to be embarrassed or ashamed about. And, once you are ready to do so, you'll be glad that you gave special consideration into the timing and presentation of your needs. Never be afraid to ask for the very best medical care.