Hi, My name is Ronnie. I have a very confusing question but in order to ask i feel i need to include some of my personal information. Im 24 and i was diagnosed in 2012 with Schizoaffective disorder as a result of my attempted suicide. I had problems for years(since around 6 years of age) with it but it was very few and far between. Though 2011-2012 it began effecting me more often. The confusing part of it is prior to having any of these issues i was having issues with my gender. I was born in a males body but i feel and have always felt as i was a female. The feeling of being trapped led to anxiety and depression. I tried medication for the depression but never told anyone how i felt inside. So the meds didn t have any effect, and the doctors were left confused. i found my own solution when i hit high school age and began wearing women s clothes under mine. It was a small thing but it gave me happiness and hope. I then got my ears pierced and this too was a booster to my outlook, and emotions. But it was short lived as it made me realize i was still having to hide myself. I struggled to fit in with others in school but i wasn t able to fully be myself. I couldn t add to conversation with other girls, but i wasn t able to talk with guys as most of the conversation was about sex. I am ready to come clean and be open with everyone, and i ve had success with telling my family and a few friends and they support me. Which was very surprising to me as i had lost a lot of my friends after being diagnosed as Schizoaffective. As i opened up to my family I ve haven t had any issues at all regarding mental he all besides the ever-present depression of not looking how i feel on the inside. Its been 2 years since I ve fully opened up and had no problems. Which brings me to my question, because of the fact I m already diagnosed with Schizoaffective disorder; am i able to get my letter from a psychiatrist for Hormone Replacement Therapy, and Sex Reassignment Surgery? And if so, what steps do i need to take in doing so and finding a psychiatrist who can help me with the process? I do apologize for the length of this but i felt it would help to have some background so i could get an answer that would apply to me. Thank you for your time. I really do appreciate it.