How to Start HRT: A Step-by-Step Guide

Written By Coral Edwards

Your journey, your pace. Here’s what to expect when starting hormone therapy with True U Clinic.

Hormone replacement therapy (HRT) can be a powerful and affirming step for many transgender, nonbinary, and gender-diverse people. Whether you're exploring low-dose options or ready for a full HRT regimen, getting started shouldn’t be confusing or gatekept. This guide walks you through exactly how to begin hormone therapy online — judgment-free and at your own pace.

Step 1: Decide What Feels Right for You

Hormone therapy is deeply personal. You might already know what you want — or you might still be figuring that out. Both are valid.

  • Estrogen therapy
  • Testosterone therapy
  • Low-dose or microdosing options
  • Nonbinary and gender-expansive approaches
A smiling nonbinary person reviews information on a laptop with a coffee cup nearby.

Image description: A smiling nonbinary person reviews information on a laptop with a coffee cup nearby.

Step 2: Book Your Online Appointment

We’ve made it as easy as possible. All you need to do is:

  • Choose a time that works for you on our appointment page
  • Submit a 10% deposit to hold your slot
  • Fill out your intake forms via our secure patient portal
Screenshot of online appointment calendar with available time slots visible.

Image description: Screenshot of True U Clinic’s online appointment calendar with available time slots visible.

Step 3: Meet with a True U Provider

Your first appointment will be 100% virtual and usually lasts around 45 minutes. You’ll talk through your goals, medical history, and any questions or concerns you have. We take an informed consent approach — which means we respect your autonomy and offer education, not gatekeeping.

A gender-diverse person smiling on a video call with a healthcare provider.

Image description: A gender-diverse person smiling on a video call with a healthcare provider.

Step 4: Start Your Hormones — Safely and Affordably

Once your labs are complete and your care plan is confirmed, your prescription will be sent to your chosen pharmacy (we work with many affordable and mail-order options).

We’ll continue to check in and support you — whether that’s adjusting your dose, answering questions, or just being here for the journey.

Step 5: Ongoing Support & Follow-Up Care

Hormones aren’t one-and-done — and neither is our care. True U offers:

  • Secure messaging with your provider
  • Regular follow-up visits
  • Help navigating side effects, fertility questions, and insurance issues
  • Emotional support and mental health referrals if needed
Transmasc person writing in a journal with HRT prescription nearby.

Image description: A trans person writing in a journal with HRT prescription nearby.

FAQs: Hormone Therapy with True U

Is HRT permanent?

Some effects of HRT are reversible, and some are not. We’ll walk you through the details so you can make informed decisions that feel right for you.

Do I need a letter from a therapist?

For folks 18+ yrs old, we use the informed consent model. That means you don’t need approval from a therapist to access care.

Can I do low-dose or microdosing HRT?

Yes. We offer flexible, affirming options tailored to your needs — including nonbinary care plans.

A trans woman smiles confidently outside, wearing headphones and a denim jacket.

Image description: A nonbinary person smiling confidently outside, wearing headphones and a denim jacket.

You Deserve Affirming, Accessible Care

At True U, we’re here to make starting HRT feel less scary — and more like the beginning of something beautiful. Book your appointment today and take the next step toward feeling more like yourself.