Topic: How do you find a gender therapist?

[iskra]

How does one find a gender therapist anyway? Can I find one who accepts medicaid do you think? What happens in these sessions? How many sessions exist in the process?  Do You find out if you're transgender during this therapy? I'm pretty embarrassed to ask about it . Would be mtf questions.

[Ellie_Arroway]

Hi iskra,

I used the betterhelp website to find mine. Betterhelp are an intermediary that connect patients with therapists and provide online sessions. Before you are matched with a therapist, you are asked about your issues. If you find that the therapist you are matched with is not a good fit, you can change to a different therapist.

I was matched within a day or two with a therapist who had experience of dealing with transgender issues. That worked out very well for me.

I understand however that if you are in the USA, you will be matched with a therapist who has a licence to treat in your state. If you are outside the USA, like me, you can be matched with a therapist from any state, so there is a much greater pool from which therapists can be selected in that case.

I don't know anything about medicaid. They do have a way to apply for funding if you do not have enough funds to cover the costs yourself. I paid for my care.

There are of course other options. That's just the one I went with. - E

[Rakel]

Dear iskra,

I suggest calling your local medicaid office and asking for referrals to counselors who take medicaid payments. From that list you could look up each local therapist to see their credentials and areas of expertise. If you feel comfortable discussing your situation with the medicare office people, you can also specify a counselor experienced in gender issues.

I know that this is  a bit time consuming, but I do not know of a better way to find a local therapist for face to face meetings.

[ChrissyRyan]

How does one find a gender therapist anyway? Can I find one who accepts medicaid do you think? What happens in these sessions? How many sessions exist in the process?  Do You find out if you're transgender during this therapy? I'm pretty embarrassed to ask about it . Would be mtf questions.

Maybe this resource will help you find a therapist:

https://www.susans.org/forums/index.php/topic,243630.0.html


Chrissy

[randim]

I found mine by exploring the resource links for LBGT centers in my area.  I found possibilities and looked at their web sites and bios, eliminating those who didn't mention transgender care.  My therapist featured it prominently on her page (and it turns out about 3/4 of her clients are trans).  Something like that is a start.  Could also attend a trans support group meeting and get some suggestions there I would think. 

[Daylight]

I don't think I can add much more than others on finding a therapist, but I can make a comment on Medicaid. Basically, I think it's going to depend a lot on where you live.

Ten years ago I lived in Minnesota and was on Medicaid. The coverage was unbelievably good. So many options. I found a therapist that specialized in sexual issues including gender specifically to talk about these things, fully covered. I don't believe I even needed a referral to get it covered. I was too afraid to bring up the subject once I got there, but that's not Medicaid's fault.

I am in California now and again on Medicaid. The coverage is pretty poor. The only mental health services covered are limited sessions through a company that I didn't see any sex or gender specialists for and that has awful reviews online. Getting a referral wouldn't do anything for me in terms of getting someone out of network covered. Instead I searched online to find a nearby specialist and am paying out of pocket. I'm not in a good spot financially and don't know how often or how long I can continue. But it was definitely worth it for me to talk to someone that knows about these things.

So you'll probably have to check on your own situation, probably in the way Rakel mentioned. I hope you are able to find someone good and that your time with them is covered.

[Gertrude]

I used google and some LGBT org sites and found some. GLSEN was one site.

[iskra]

Thanks for your suggestions. It looks like I'm going to have to pay. That's ok, so long as it doesn't take too many sessions.

[Confused1]

Google "Psychology Today therapist directory" It gave me a list of therapists by state and cities. Each one of the listings had information about each one and a website to go look at. You can see what they specialize in and price per hour. I picked one that was listed for transgender and a specialty for non-binary. YMMV. I had no idea if she would be what I needed and may have just been lucky. I got a good one right out of the box. I asked about her price on the website. Since I am on Medicare and they don't pay for just a therapist she said she usually has a few that aren't covered by insurance that she gives a discount to. She cut the price substantially. The number of sessions depends on what you need. I would ask questions right up front.

[iskra]

I did that. I can use that resource I suppose, if one is available, since the one I contacted was out of town for the summer. We have an informed consent approach in Arizona, so I don't need a letter. But I'm certainly not ready to start hrt based on what I know now, without an exploration of the labyrinth that is my gender. I may never use hrt.
I may try the transgender clinic to see if they can refer me to a therapist, but I doubt it will work. I may be able to see a therapist through the same group providing my psychiatric care, though that person may not be a specialist in gender identity issues. 

[DebbieB]

The best and quickest way is to find the local LGBT center, and find out if they have any transgender support groups.  Often, the center will have the cards of a few dozen excellent gender therapists.  Then you get the list of medicare therapists and see which ones are a match.  Often you will find several who are good gender therapists and are in the medicare system.  Some cards will even tell you they accept Medicare.

Unfortunately the copays for an LCSW are a bit high, so there will be some out-of-pocket expenses, but the therapist can be a critical element of a successful transition.  Transgender support groups can also provide help and help you form the social network skills in a safe environment.  The LGBT centers often have social activities, and can provide information about clubs and restaurants and other safe environments for getting real life experience.

The gender therapist has certain main duties:
   1 - To verify and support Real Life Experience which means actually living as the target gender at least half time.
   2 - To provide any assignments necessary to facilitate an effective Real Life Experience
   3 - To get feedback on the assignments and activities to make sure that social skills in the new gender are developed
   4 - To help set goals and plan activities necessary to successfully transition to full time.
   5 - To provide the necessary information to a psychologist who can provide the necessary signatures on identity documents and other legal documents as well as confirmation of need for HRT.
   6 - To support HRT and transition to full time.

How much time is needed with the therapist can depend on many things.  If there are no other unresolved issues, the assignments are completed, the social interactions experienced and reported, successes and failures accepted as learning experiences, and there is no cheating and other support groups are also used, the therapist might be needed every other week initially, and eventually once a month.  That's a lot of ifs.

[ChrissyRyan]

Look online for transgender care clinics, transgender or gender therapists, and transgender support centers and groups.

The support centers are not for profits that are in place to help transgender communities in many ways, directly or indirectly:  socially, events, information sharing, maybe hosting support groups,  therapy referrals, physician information, clothing exchanges, legal/name changes, friendly hair and nail salons, and so on, even finding others to go shopping with you for you to look for and try on the clothing of your correct gender.  Plus they help in other ways including helping parents and significant others.

Chrissy

[AllieSF]

Hi Debbie,

The Real Life Experience requirement is not a requirement any more.  I can't speak about Europe or the UK where the NHS reigns supreme and months or years behind schedule for appointments and medically necessary treatment for transgender patients.  I do believe that social experience is very important to those who need it.  However, not all need it and Informed Consent can get them "there" sooner rather than later.

Here in the USA many States now have Informed Consent, which I and many others here have used.  I got my HRT from an LGBTQ+ clinic in San Francisco.  They also closely monitor my transgender health as my GP monitors my overall health and both are connected to each other.  Once I knew where I was going, I also knew what I needed to do to get there as soon as possible.  Sites like this gave me all the information I needed.  All I needed were the letters, where required, and the people, medical and therapy providers, to make it happen and keep Medicare happy, and they have done so, so far.

Allie