Frequently Asked Questions

1. After the call, you get access to the Imago app. You are a member now!

2. You complete three steps: (1) the payment (made using an international paygate, Stripe) (~1 min.); (2) filling intake forms (20-30 min.); (3) blood tests (it is up to you how quickly you provide us with results – you can arrange these prior to sign up to speed things up if you like).

3. Once we have all three of the above, you can make the appointment with our doctor at your earliest convenience. It takes approximately 1-2 weeks to get a booking.

4. After the appointment, we are obliged to conclude the formalities: we will need your completed consent form to receive therapy, and to confirm your details with us.. (~5 min.)

5. Your first prescription takes a few days to process, but once we have the above details, we can send it either electronically (primarily accepted only in the United Kingdom, Germany, Ireland, and Netherlands) or ship a wet ink prescription to you (postage usually takes about 10-14 working days to arrive and is non tracked).

Of course! The process depends on your medical record. Having at least up-to-date (max. 3 months old) blood results will already speed up the procedure.

1. Please always be considerate of other members of the community. Many trans people who run out of hormones desperately need our help. You can easily cancel your appointment with a 24-hour notice . In case of a late cancellation or a no-show, we will charge €50 for providing an additional slot. Please, make sure you are on time! Don’t worry if you have to wait for a few minutes.
We always do our best to be on time, but don’t worry if you need to wait for a few minutes (in case the previous call goes on longer than 20 minutes).

2. Please make sure your hardware & software is functional before the call. Having video on is always mandatory, and we make no exceptions. Calls will be conducted through Google Meet.

3. Before setting up the call, please read our website carefully, especially check the Principles & Values and Mission & Vision sections, as well as our FAQ and Blog.

4. Please prepare your questions before the call and send them.

We are very happy to take over your care. Even if you are already on HRT, we will still need to review bloods, and it would be a great help if you have a copy of a recent prescription or treatment summary.

We are using Stripe, the leading international paygate.
We do not accept cash or direct bank transfers.
The app will guide you at each stage so you do not need to worry, and our will team will be here to help in case you encounter any issues.

Yes.

If you let us know in a 24-hour advance, no problem. However, if you just don't show up, you will need to pay a fee for another appointment, and rejoin the queue to book for the next available appointment. The demand is extremely high so wasting a slot another person in need could have used is not acceptable. Please be considerate of other members of the community!

All our appointments and correspondence will be carried out through English only. If you have limited English, you will need to bring someone to help translate to your appointments.

If you are moving within the EU/EEA/UK – yes. In other cases, it may not be possible but don't hesitate to ask and we’ll try to find a solution.

That depends largely on your local regulations. For under 16 patients, parental consent is however absolutely necessary. Please refer to your country's legislation, and if you’re still unsure, don’t hesitate to reach out to us before the call.

We will not impose any additional restrictions where legally possible to provide care, however unfortunately, in many such cases this mature minor consent ability does not extend to GAHT or any procedure/ treatment that has been deemed "high risk".

Feel free to reach out to us in these cases and we can assist in checking this for you.

While it unfortunately not the case for everyone, please know we would be happy to share some information with your parents if this could help gain their support by addressing any concerns.

The offer is the same for everyone.
Imago will send valid prescriptions, letters outlining your needs regarding gender-affirming care, suggestions for private providers of blood tests, as well as ongoing guidance and support for your situation as needed. Please be aware that our Swedish members on masculinising therapy, you will need to cross borders to a neighbouring country to dispense testosterone.

No. As much as we understand the desire of some trans people to stay anonymous, it would be both illegal and unethical for us to provide medical services in that way. Therefore, video connection is obligatory during all calls with us.

No! That would be against everything that we stand for. The only subject having authority over such a fundamental component of one's own identity as gender is that very individual. Usurping such authority by governments or medical bodies is a barbaric and inhumane violation of the human rights of trans people guaranteed by international treaties and conventions. Not to mention, the concept of diagnosing gender dysphoria as currently practised is pseudoscientific and equally absurd as an attempt to diagnose whether another person experiences pain. If you need a referral for a surgery, we can provide a document testifying that you are under our care. Every situation is unique, but we always try to do what’s best for you.

Whether you are sure of your path, at the very start of your journey, or considering options, we are always happy to talk. You can book a call free of charge, to get to know us a little better without committing to our service. It is crucial to proceed at your own pace with a decision of this magnitude. Take your time. Whenever you are ready, we'll be here for you.

On top of ongoing medical care, we can provide access to our very own mental health counsellors, our fertility counsellor, and our vocal coach. All to encompass a holistic approach to your journey. Please note that additional sessions are not included in your subscription.

You can cancel at any moment without extra costs. Previous subscription charges and your onboarding fee are not refundable.

Unfortunately, no. You will need to arrange your own bloodwork, and purchase your medications in the pharmacy with the prescriptions we provide. You can ask your pharmacy for pricing if you are unsure of medication costs.

Yes! Whether you’re looking for conventional therapy, or microdosing, we’d be happy to make sure your specific needs are addressed.

We would be happy to provide surgery referrals to our members, but please note we do not offer any type of formal diagnosis. Please check with your surgeon in advance the requirements for your referral, as many clinics will only accept referrals from clinicians in their own country, or from a set pre-approved list. Please also note our mental health counsellors do not provide surgery referrals.

Currently, our strategic partner offers a wide variety of gender-affirming surgeries and other procedures.

Unfortunately, no, not at the moment.

Of course, gladly! Keep in mind that this largely comes down to your doctor’s willingness to work with us. We would be happy to discuss this with them, so please feel free to reach out to our team about this.

It varies greatly as this depends on multiple factors. There aren't any hidden costs on our side. But there is a huge disparity of hormone and blood tests between EU countries, sometimes as huge as 8x! As a very general estimation, we can assume that the cost of feminising HRT is somewhere between 10 to 30 euros per month. Masculinising HRT should range from 15 to 60 euros per month. Please check with your local pharmacy for more information on pricing of your medications.

Your treatment is continually supervised by our medical staff, who will communicate and give you feedback at regular intervals. You can book an additional appointment with our medical team at any point if you so wish (note: additional appointments are not included in subscription fees).

Please read this section carefully, as the tests we require can vary depending on your specific situation. For new members with a complicated medical history, additional tests may be requested.

For those not yet on hormones, looking to start feminising GAHT : 

• Full blood count (white blood cells, red blood cells, haemoglobin, platelets, haematocrit, mean corpuscular volume )

• Liver Function tests (ALT, AST, ALP, bilirubin)

• Fasting glucose 

• Urea and electrolytes/ Kidney panel (Creatinine, eGFR, Urea, Potassium, Sodium) 

• Lipids /cholesterol panel (total cholesterol, triglycerides, HDL, LDL)

• Blood pressure reading, height, weight

• Prolactin (PRL)

• Testosterone and Estradiol (Total Testosterone and E2) 

For those not yet on hormones, looking to start masculinising GAHT : 

• Full blood count (white blood cells, red blood cells, haemoglobin, platelets, haematocrit, mean corpuscular volume )

• Liver Function tests (ALT, AST, ALP, bilirubin)

• Fasting glucose 

• Urea and electrolytes/ Kidney panel (Creatinine, eGFR, Urea, Sodium) 

• Lipids /cholesterol panel (total cholesterol, triglycerides, HDL, LDL)

• Blood pressure reading, height, weight

• Testosterone and Estradiol (Total Testosterone and E2) 

For those already on hormones, looking to continue their masculinising GAHT : 

• Full blood count (white blood cells, red blood cells, haemoglobin, platelets, haematocrit, mean corpuscular volume )

• Liver Function tests (ALT, AST, ALP, bilirubin)

• Lipids /cholesterol panel (total cholesterol, triglycerides, HDL, LDL)

• Blood pressure reading, height, weight

• Testosterone and Estradiol (Total Testosterone and E2) 

For those already on hormones, looking to continue their feminising GAHT : 

• Liver Function tests (ALT, AST, ALP, bilirubin)

• Urea and electrolytes/ Kidney panel (Creatinine, eGFR, Urea, Potassium, Sodium) 

• Lipids /cholesterol panel (total cholesterol, triglycerides, HDL, LDL)

• Blood pressure reading, height, weight

• Prolactin (PRL)

• Testosterone and Estradiol (Total Testosterone and E2) 

Up-to-date (no older than 3 months) results for:

• full blood count (FBC)

• electrolytes (Na, K)

• urea

• renal (RFT) and liver function test (LFT)

• glucose

• estradiol (E2)

• testosterone (TEST)

• luteinising hormone (LH)

• lipids

Typically, levels will be monitored at baseline (when you start with us), every 3 months for the first year or until levels are adequate and stable. This is a rough outline- your doctor will advise when it is safe and appropriate to reduce testing frequency, depending on your blood work and progress.

Timings for blood tests vary depending on the way in which your medication is administered.

Estradiol injections:
Have the test carried out immediately before your next injection.

Testosterone undecanoate injections:
Have the test carried out immediately before your next injection.

Testosterone enanthate/cypionate injections:
Have the test carried out midway between injections.

Patches:
Have the test carried out the day after a patch change.

Gels:
Have the test carried out 4-6 hours after gel application. Measure it at least 1 week after applying DAILY. To avoid contamination don’t apply gel on the lower arms and use gloves to apply gel for three days before your blood test).

Only blockers:
Have the test carried out at any time.

Tablets:
Have the test carried out at any time.

Unfortunately, no. You will need to arrange your own bloodwork, and purchase your medications in the pharmacy with the prescriptions we provide. You can ask your pharmacy for pricing if you are unsure of medication costs.

Of course, gladly! Keep in mind that this largely comes down to your doctor’s willingness to work with us. We would be happy to discuss this with them, so please feel free to reach out to our team about this.

Yes! No exceptions here.

If your GP is unwilling to cooperate, please contact our support team so we can follow up with your GP directly, and point you toward alternatives in the meantime.
In cases of negligence or discrimination, it is our mission to advocate and fight for your basic right to healthcare access.

Our prescriptions must be dispensed in EU regulated pharmacies, so whatever medication choice you make, your HRT must be available within the EU/EEA.
We work with each patient individually and take into consideration their medical history and preferences: e.g. oral forms are more hepatotoxic so not advised for people with serious liver diseases; some people are afraid of injections; some forms are available only in a limited number of jurisdictions; and so on. Keep in mind that estradiol injections are widely unavailable, so it’s unfeasible in most cases.

Yes, we provide valid EU cross-border prescriptions, both paper and electronic options are available.
We always suggest the form with the highest acceptance rates and lowest probability of causing problems at the pharmacy
We will put a stamp on the prescription, adapt to local prescribing formats and accommodate other archaic and not legal-based formal demands in order to ensure everyone gets their medication. We choose our battles wisely!

As a standard practice, we ship them by registered post at no additional charge within the EU/EEA/UK. In some countries (Ireland, UK, Netherlands, Germany, Spain) it’s possible to use electronic prescriptions which tends to be much faster. However, keep in mind that there is not yet a unified system in place, so our electronic prescriptions are not guaranteed to work in all pharmacies. In other countries (not listed above) we have had limited success but we do have a few patients scattered across the rest of Europe using these successfully so it can still be worth checking with the local pharmacy.

For our UK members, we have partnered with a pharmacy called Live Well, so you can give your electronic prescription token directly to them via email and have the medication shipped to you. They offer several shipping options to choose from:
- Standard delivery (2–3 working days)
- Express delivery (1–2 working days)
- Special delivery (guaranteed next day)

To order your medication through Live Well, you simply email the prescription Token ID, your date of birth, name and address. If you prefer, you can of course still take your electronic token to a pharmacy of your choosing. The e-prescriptions should be accepted anywhere without issue, but Tesco and Lloyds pharmacies are partnered with the Clynxx (e-prescription) system, so those are good options.

More pharmacy partnerships soon!

Please arrange your next blood tests when you have 4 weeks medication remaining and share these results so we can review your treatment and include any changes or adjustments needed in your next prescription.
We will also ask you at this point to share an update on how things are going for you including any side effects you have experienced, any changes, and any updates to your health. This is also a chance to request a change in your medication or dose if you wish to. This will be reviewed alongside your bloods by your doctor who will then pass on their recommendations to you.

While we are a relatively new company, we have had excellent prescription acceptance rates and are willing to work with you to meet local prescribing requirements. While I’m sure this may feel like a leap of faith, please don’t just take our word for it. We ask all our members to share their honest opinions and reviews of us (good and bad) so you can get a fair picture of what you are signing up for. I would encourage all prospective members in doing their research on our service, by reading TrustPilot reviews, or through testimonials from current members so you can get an understanding of what to expect.

Of course, gladly! Keep in mind that this largely comes down to your doctor’s willingness to work with us. We would be happy to discuss this with them, so please feel free to reach out to our team about this.

The average delivery time is between 10 and 14 days. During the summer months, holidays, or times of high strain on the postal system, the delivery may take longer. These factors are outside the control of Imago, but feel free to contact support if you have questions or concerns.

All our prescriptions are shipped in discrete envelopes.

Our team of doctors are experienced in gender-affirming care and follow WPATH guidelines for prescribing and ongoing care. It is important that you are involved in your healthcare decision making so do not hesitate to reach out if you have any questions.

Imago sends international packages containing your prescription, as well as providing you with a tracking number via email the same day as the prescription is sent. The general delivery time with international post is between 10 and 12 days after postage. During the summer months, holidays, or times of high strain on the postal system, the delivery may take longer. These factors are outside the control of Imago, but feel free to contact support if you have questions or concerns.

Imago includes any adjustments or renewals of your prescription in the ongoing monthly fee. Therefore, Imago does not charge for individual prescriptions. However, we do charge for resending prescriptions if they were not received due to your negligence (e.g., you omitted to inform us about changing the address, you went on holidays and did not collect in time etc).

You can successfully use our electronic prescriptions in Ireland, the UK, Germany and the Netherlands. We have had limited success with this in other countries so far but have a few patients scattered across the rest of Europe using these successfully so it can still be worth checking with the local pharmacy.

For our UK members, we have partnered with a pharmacy called Live Well, so you can give your electronic prescription token directly to them via email and have the medication shipped to you. They offer several shipping options to choose from:
- Standard delivery (2–3 working days)
- Express delivery (1–2 working days)
- Special delivery (guaranteed next day)

To order your medication through Live Well, you simply email prescriptions@livewellnationwide.co.uk the prescription Token ID, your date of birth, name and address. If you prefer, you can of course still take your electronic token to a pharmacy of your choosing. The e-prescriptions should be accepted anywhere without issue, but Tesco and Lloyds pharmacies are partnered with the Clynxx (e-prescription) system, so those are good options.

More pharmacy partnerships soon!