Wrapping things up for today

You nod. The safety planning makes sense—you can see that, even through the fog of tears and exhaustion. But there's something else pressing against the inside of your chest, something that won't wait.

"I want to do the safety stuff," you say, dabbing at your face with a tissue. "But I also—I need to talk about HRT. Hormone replacement therapy. And other transition stuff. I want to get started right away."

Dr. Vasquez sets her pen down again. She regards you with that steady, unhurried attention.

"Okay. Tell me what you already know about what you want."

"I've been reading. A lot. Since last week." You straighten in the chair, pulling yourself together. "Estrogen, progesterone, possibly spironolactone as an anti-androgen. I know there are different delivery methods—oral, patches, injections. I know it takes time. I know there are risks. I know I need a letter from a therapist or an informed consent clinic."

She nods slowly. "You've done your homework."

"I've had a lot of sleepless nights."

"Fair enough." She uncrosses her legs, leans forward slightly—not aggressively, but with professional engagement. "Here's where we are, Riley. I've known you for about thirty-five minutes. I'm not going to write a hormone letter today. That's not because I don't believe you—it's because it would be bad practice. I need to understand your history, your support system, your mental health baseline, before I put my signature on something that affects your body permanently."

Your stomach drops slightly, but she holds up a hand before the disappointment can fully form.

"That said—I'm not a gatekeeper. I don't believe in making trans people jump through hoops for months to prove they're 'really' trans. You've told me who you are, and I believe you. What I need is two, maybe three sessions of getting to know you. Understanding your medical history, any mental health concerns, how your support network functions. Then we talk about next steps. That could be as soon as next week."

Next week. The words land like a door cracking open.

"In the meantime," she continues, "there's an informed consent clinic in Ridgewood—about forty minutes from here. Dr. Amara Okafor runs it. She does HRT consultations without requiring a therapist letter, though she does her own assessment. I can give you her information today if you'd like. Some people prefer going that route—it's faster."

"Yes. Please."

She writes something on her pad, tears the page off, and sets it on the side table between you. A name, a phone number, an address.

"Now—let's do the safety planning quickly, because I don't want you leaving here without at least the basics. Then we'll talk about what medical transition looks like practically, so you have realistic expectations. Sound good?"

"Yeah. That sounds good."

She walks you through it efficiently: emergency contacts (you list Margot, Priya, Chloe), safe spaces (the estate, Petal & Thread, the library), grounding techniques for when the dysphoria spikes (5-4-3-2-1 sensory exercise, cold water on wrists). She writes it all down and hands you the sheet.

"One more thing," she says as the session winds toward its end. "The nightmare. The crowd chanting. That's your nervous system trying to protect you from something that already happened—the rejection. It's normal. It's not a prediction. But if it keeps happening, or gets worse, I want you to call me. We can do a check-in between sessions."

She writes her cell number on the bottom of the safety plan.

"Same time next Tuesday?"

"Yes."

"Good. Riley—" She stands as you do, and her hand finds your shoulder briefly. "You're going to be okay. Not today, maybe not tomorrow. But you will be."

You fold the safety plan and Dr. Okafor's information into your crossbody bag. The afternoon light has shifted—the session lasted its full hour. You walk back down the hallway, past the leather couch and the unread magazines, and push through the front door into the cool Millbrook air.

The yellow Victorian sits behind you. Ahead, two blocks away, The Brass Kettle waits. And so does Janelle.