I started living full time and started hormones in 2008. There were no services in my area at the time so it was an all day ordeal for a simple appointment. I still travel almost 100 miles to get services with the exception of therapists. I do have an initial consultation appointment for breast augmentation only 30 miles from home, however, they have never had a trans patient, so we will see how it goes. Fingers crossed! 🙂