Author Topic: Red flags  (Read 18090 times)

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Offline suzifrommd

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Red flags
« on: March 30, 2014, 02:17:29 pm »
There are so many therapists who do not have our best interests at heart, that I think it might be helpful to compile a list of “red flags” that a gender therapist is inappropriate and that someone should stop seeing them. Here is what I have so far. Note that everything on this list has either happened to me or to someone who posts on this site.

Are there any you would add? Any that you would remove or change?

* They don’t seem knowledgeable about transgender. They don’t know simple vocabulary or don’t seem to have an understanding of the steps of transition.

* They ask you to “prove” your gender issues by artificial gestures and exercises before they offer support or a referral for moving your transition forward.

* They express concern about how your transition might violate religious principles, when you didn't raise such concerns.

* They express an opinion of whether you are or aren't transgender that seems at odds with what you think to be true.

* They state or imply that you aren't physically or mentally fit to transition or to take some step involved in transition.

* They express a negative opinion of or attribute negative characteristics to transgender or gender non-conforming people.

* They seek to dissuade you from transitioning or taking steps to transition, beyond simply pointing out facts that you don’t already know.

* They raise their voice, use disrespectful language, or treat you in a disrespectful manner.

* They don't use your preferred gender pronouns or name.

* They dismiss or disparage your gender concerns.

* They seem overly focused on your sexual history, or in what sexually arouses, stimulates, or satisfies you.

* They imply that the absence or presence of some symptom or experience precludes your being transgender. Or, conversely, they insist that the absence or presence of some symptom or experience definitively labels you as transgender.

* They discourage you from finding allies, doing research about gender identity or transition, or disclosing information about your gender or transition.

* They make statements about transition you know to be false or express certainty your transition will be unsatisfactory.

* They withhold or refuse material support, such as a referral letter, for some step in your transition when you need for it.

* They chastise you or threaten to retaliate for seeking help from another professional. Or they discourage you from seeking a second opinion on advice they've given you.

* They state or imply that you are not competent to make decisions about or to carry out your care but don’t cite a specific psychological diagnosis of a severity that would warrant such an implication.

* They are more interested in the well-being of the people around you than yours.

* They state or imply that transitioning would necessarily be harmful to children in your life.

* They express outdated views such as that being transgender results from a need for sexual gratification, from unhappiness, abuse/neglect as a child, your relationship with your parents, or autogynephilia, or state or imply that they consider it a psychological disorder or mental illness.

* They claim you can be cured of being transgender.

* They are uninterested or uncomfortable when you discuss the feelings or circumstances surrounding your gender identity or transition.
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Offline Emerson

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Red flags
« Reply #1 on: March 30, 2014, 05:23:05 pm »

kelly_aus

Re: Red flags
« Reply #2 on: March 30, 2014, 05:47:44 pm »
Is a single one of these enough to seek a new therapist? Or should there be more than one?

The reason I ask is that my therapist has done or said at least 2 of these things..

* They express concern about how your transition might violate religious principles, when you didn't raise such concerns.
This one came up during a discussion about my family - which includes a Minister.. His concern was how that family member would take my transition, so it was a valid concern.

* They express an opinion of whether you are or aren't transgender that seems at odds with what you think to be true.
This one is kinda frustrating, because he has turned out to be right. Long ago he made the suggestion that perhaps I was more genderqueer than I was letting on.. I canned the idea at the time, but a year later, I'm forced to admit he was right..

And there was one I did think was quite right..

* They state or imply that you aren't physically or mentally fit to transition or to take some step involved in transition.
There are a number of circumstances in which this is quite valid. There are medical issues that can exclude hormones.. WPATH advise that any comorbid mental health issues be in control.. Neither of these need be a permanent issue.

Offline suzifrommd

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Re: Red flags
« Reply #3 on: March 31, 2014, 11:10:25 am »
http://psychcentral.com/lib/therapists-spill-red-flags-a-clinician-isnt-right-for-you/00015051


This stuff is important too.
Yes. Thanks Emerson. That's a great list.

* They express concern about how your transition might violate religious principles, when you didn't raise such concerns.
This one came up during a discussion about my family - which includes a Minister.. His concern was how that family member would take my transition, so it was a valid concern.
Not sure it's the same thing. He wasn't actually concerned about your violation of religious principles, just how you would get along with your family.
* They express an opinion of whether you are or aren't transgender that seems at odds with what you think to be true.
This one is kinda frustrating, because he has turned out to be right. Long ago he made the suggestion that perhaps I was more genderqueer than I was letting on.. I canned the idea at the time, but a year later, I'm forced to admit he was right..

I think that would be OK. He didn't say "well, I think you're genderqueer". That would be expressing an opinion. That's very different from a suggestion, "Do you think you might be more concerned about your gender than you're letting yourself see?"

He isn't pronouncing you genderqueer or not genderqueer, he's inviting you to explore the possibility.

* They state or imply that you aren't physically or mentally fit to transition or to take some step involved in transition.
There are a number of circumstances in which this is quite valid. There are medical issues that can exclude hormones.. WPATH advise that any comorbid mental health issues be in control.. Neither of these need be a permanent issue.

This one maybe should be worded better. I was thinking of the stories we see here where GT says "you're too fat to transition" or "you shouldn't transition until your depression symptoms go away". You're right that there are physical conditions that preclude certain medical therapies.
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Offline King Malachite

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Re: Red flags
« Reply #4 on: March 31, 2014, 04:13:24 pm »
I would also like to add that word of mouth can be effective in determining whether one should go to a therapist or stay away from them.  I did online therapy and had narrowed my list down to three therapist and asked if anyone had used them here.  The therapist that I eventually chose, only two people here had used and only one guy had responded to my questions about her, and gave her a good rep, so I felt comfortable going to her.  Granted, I had heard good things about the other two, but when I emailed them, they NEVER responded back to me, which was very unprofessional, while the one I chose did.

Just something to consider, whether it's online therapy or not.  Word of mouth can be an excellent tool in deciding who to go to.
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Veronica M

Re: Red flags
« Reply #5 on: March 31, 2014, 04:36:26 pm »
Wow, I must have gotten extremely lucky... I have gotten none of those things on your list from my therapist. In fact quite the opposite. She is extremely supportive and if anything is encouraging about my transition. After ten minutes of me blurting 40 years of frustration out... She pretty much said when do you want to start HRT?  It was my chose to wait to lose weight first then start HRT. I guess I'm a lucky girl...

eli77

Re: Red flags
« Reply #6 on: March 31, 2014, 07:01:39 pm »
*Any conflation of, assumptions about, or pressure to alter your sexuality in the context of your gender.

There are unfortunately still therapists who will expect you to be straight in order to be trans. If this happens and they don't respond to gentle correction, I would recommend terminating sessions if other options are available.

*Any conflation of, assumptions about, or pressure to alter your preferred gender expression in the context of your gender.

This is an issue that more feminine trans guys and more masculine trans girls can easily run into even with fairly well-meaning or otherwise knowledgeable therapists. They are likely to respond to correction, but if they don't it would be advisable to look elsewhere.

Offline Shaloxeroligon

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Re: Red flags
« Reply #7 on: April 01, 2014, 12:16:56 pm »
If it hasn't been done already, I vote we make this thread sticky so that more people can have access to it.

Veronica M

Re: Red flags
« Reply #8 on: April 01, 2014, 12:32:15 pm »
If it hasn't been done already, I vote we make this thread sticky so that more people can have access to it.

Not a bad idea at all...

Miss_Bungle1991

Re: Red flags
« Reply #9 on: April 01, 2014, 08:56:48 pm »
Wow, I must have gotten extremely lucky... I have gotten none of those things on your list from my therapist. In fact quite the opposite. She is extremely supportive and if anything is encouraging about my transition. After ten minutes of me blurting 40 years of frustration out... She pretty much said when do you want to start HRT?  It was my chose to wait to lose weight first then start HRT. I guess I'm a lucky girl...

Yeah, I never had that problem either. It took several visits before I actually got my HRT letter but I got a GID diagnosis after the first session. He just wanted to go in more detail about certain specific things since I was pretty much a motormouth during that first session and he was able to speak for 15 minutes during the introductory session which was 90 minutes.  :D

Veronica M

Re: Red flags
« Reply #10 on: April 01, 2014, 09:08:06 pm »
Yeah, I never had that problem either. It took several visits before I actually got my HRT letter but I got a GID diagnosis after the first session. He just wanted to go in more detail about certain specific things since I was pretty much a motormouth during that first session and he was able to speak for 15 minutes during the introductory session which was 90 minutes.  :D

Yeah that was pretty much me too... Even though I had this well rehearsed speech planed, as someone here said "I blurted it out like a drunk getting tossed out of bar at 2am that threw up on the bouncer"... I have to say my therapist handled it pretty good... In the last several week I truly look forward to seeing her each week.

Miss_Bungle1991

Re: Red flags
« Reply #11 on: April 01, 2014, 09:13:15 pm »
Yeah that was pretty much me too... Even though I had this well rehearsed speech planed, as someone here said "I blurted it out like a drunk getting tossed out of bar at 2am that threw up on the bouncer"... I have to say my therapist handled it pretty good... In the last several week I truly look forward to seeing her each week.

I said that "I was here for 'gender issues'" and then VROOOOM off I went. I started at age 4 all the way up to the present day at that time.

Veronica M

Re: Red flags
« Reply #12 on: April 01, 2014, 09:24:14 pm »
I said that "I was here for 'gender issues'" and then VROOOOM off I went. I started at age 4 all the way up to the present day at that time.

Yep, I was 11 when I knew... Started wearing moms cloths in secret.... Now 45 years later here I am... And believe me those 45 years have been a roller coaster ride that ended in a train wreck. Now it's one day at a time and a sense of calm I haven't felt in a long long time.

PS: Didn't mean to derail the thread... LOL

Just Shelly

Re: Red flags
« Reply #13 on: April 01, 2014, 09:51:51 pm »
There are so many therapists who do not have our best interests at heart, that I think it might be helpful to compile a list of “red flags” that a gender therapist is inappropriate and that someone should stop seeing them. Here is what I have so far. Note that everything on this list has either happened to me or to someone who posts on this site.

Are there any you would add? Any that you would remove or change?

* They don’t seem knowledgeable about transgender. They don’t know simple vocabulary or don’t seem to have an understanding of the steps of transition.

* They ask you to “prove” your gender issues by artificial gestures and exercises before they offer support or a referral for moving your transition forward.

* They express concern about how your transition might violate religious principles, when you didn't raise such concerns.

* They express an opinion of whether you are or aren't transgender that seems at odds with what you think to be true.

* They state or imply that you aren't physically or mentally fit to transition or to take some step involved in transition.

* They express a negative opinion of or attribute negative characteristics to transgender or gender non-conforming people.

* They seek to dissuade you from transitioning or taking steps to transition, beyond simply pointing out facts that you don’t already know.

* They raise their voice, use disrespectful language, or treat you in a disrespectful manner.

* They don't use your preferred gender pronouns or name.

* They dismiss or disparage your gender concerns.

* They seem overly focused on your sexual history, or in what sexually arouses, stimulates, or satisfies you.

* They imply that the absence or presence of some symptom or experience precludes your being transgender. Or, conversely, they insist that the absence or presence of some symptom or experience definitively labels you as transgender.

* They discourage you from finding allies, doing research about gender identity or transition, or disclosing information about your gender or transition.

* They make statements about transition you know to be false or express certainty your transition will be unsatisfactory.

* They withhold or refuse material support, such as a referral letter, for some step in your transition when you need for it.

* They chastise you or threaten to retaliate for seeking help from another professional. Or they discourage you from seeking a second opinion on advice they've given you.

* They state or imply that you are not competent to make decisions about or to carry out your care but don’t cite a specific psychological diagnosis of a severity that would warrant such an implication.

* They are more interested in the well-being of the people around you than yours.

* They state or imply that transitioning would necessarily be harmful to children in your life.

* They express outdated views such as that being transgender results from a need for sexual gratification, from unhappiness, abuse/neglect as a child, your relationship with your parents, or autogynephilia, or state or imply that they consider it a psychological disorder or mental illness.

* They claim you can be cured of being transgender.

* They are uninterested or uncomfortable when you discuss the feelings or circumstances surrounding your gender identity or transition.

I think many of these are valid concerns a good therapist should bring up, as long as the therapist makes the questions or observations in an educational manner or social advice but not if they are done in a demanding or abiding way.

There are very few gender therapists that trained specifically to treat transsexualism, <not allowed> or whatever you would like to call it.  Some of the red flags you mentioned are ones I actually brought up with my first therapist, second and third. One of my first concerns was to find a cure for what I was suffering, at the time if they could of cured me to be a male without any gender dysphoria present, I would of took it. The thing is, in most cases the cure is transitioning to the gender you were meant to be.

The religious questions can also be valid concerns to be brought up, as long as they don't put their concerns before yours.  Most of the people that will abandon you will be the ones that have strong religious beliefs, a good therapist will point this out. My main concern stopping me from transitioning was my strong belief in God, once I started to believe what I was doing was not against how I believed God made me or directs me, I could move on.

The ones I bolded are concerns no therapist should ask or at least be directed differently. My first three therapist all had some flaws but also helped me progress along my journey. My final therapist was a clinical social worker with no transgender experience or even knowledge, I was one of her first. She provided the needed help to further become the women I was already. Much of what we talked about had little to do specifically with TG, we talked much about depression, anxiety, insecurity and lack of assertiveness, but these are also many of the same problems transgender people suffer from.

Even though I did start to see her late in my transition and much of what we talked about were everyday concerns other women had and parenting concerns, I do believe that even if I started earlier she still would of been a big help. I think a clinical social worker is as qualified if not more!! I do agree that if you do have concerns about how a therapist is treating you, you need to find another one soon or if its later in the treatment then you need to report them to higher ups or licensing officials. You can also give them bad publicity, as long as its not slander.

Just Shelly

Re: Red flags
« Reply #14 on: April 01, 2014, 10:02:55 pm »
* They express outdated views such as that being transgender results from a need for sexual gratification, from unhappiness, abuse/neglect as a child, your relationship with your parents, or autogynephilia, or state or imply that they consider it a psychological disorder or mental illness.

I also think this concern is a very valid one to bring up. I think there are some in the community that have these problems, it doesn't mean they shouldn't transition but finding out that you are suffering from a fetish rather than gender dysphoria could be a good thing. There are many men that enjoy cross dressing and their significant other is fine with it.

I at one time thought I could be happy having a similar situation, even though I knew it was more than this. It finally took my divorce to help me start something I almost did 20 years ago. I am now a "fairly" happy women....I would be 100% happy but don't have the correct plumbing yet!!

Offline timbuck2

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Re: Red flags
« Reply #15 on: April 02, 2014, 01:08:39 pm »
I'm not sure how to word it but I just stopped seeing a therapist who was adamant that I open up to everyone about being trans. My friends should know, my family members should know, everyone should know because if they don't then I'm living a lie and not being true to myself. It really felt like stealth shaming even if it wasn't meant to be.

Offline Shana-chan

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Re: Red flags
« Reply #16 on: April 02, 2014, 01:24:29 pm »
Is, others being able to hear you and the thera/psych even when the doors are all shut a red flag? Any type of red flags for before the session starts like how the office is run etc.?
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Offline Ms Grace

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Re: Red flags
« Reply #17 on: April 02, 2014, 02:02:19 pm »
Quote
* They state or imply that you aren't physically or mentally fit to transition or to take some step involved in transition.

Not something that happened to me, but a variation on this which I've heard of happening... "You look too much like a man, you could never be a woman." :-\

My shrink had virtually zero gender experience. I was referred to him for depression - and although I was aware my trans* past was a definite trigger for my depression I wasn't specifically thinking of transition at the outset. When I decided I wanted to give transition another go he wasn't against the idea per se, just overly cautious. Fair enough I guess, my first attempt was pretty fraught and I had painted a traumatic picture - but I did start to get frustrated with his caution and just wanted a referral to an endo. I felt like his advice on how to proceed came from "Treating a trans* patient 101" and that I was well ahead of the curve he was on.

He was supportive and nice though, and conveniently three minutes from work so I was prepared to stick with him and just push my way through. Had to do some of the lifting myself to find an endo and another shrink for him to refer me to for a "second opinion"/confirmation (not that he needed to do that, he just felt the need to be safe and thorough...the second shrink gave me a full pass after one visit). So yeah, took me two months longer to get to the endo than maybe it could have or should have, but he was worth sticking with.
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Veronica M

Re: Red flags
« Reply #18 on: April 02, 2014, 02:42:47 pm »
Is, others being able to hear you and the thera/psych even when the doors are all shut a red flag? Any type of red flags for before the session starts like how the office is run etc.?

Short answer... No way... When I am in therapy it is a small room with the door closed. Also, there was an agreement signed between us that basically states what is said between us in therapy is confidential and only the therapist and the psychologist can discuss my case between themselves.

Offline aleon515

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Re: Red flags
« Reply #19 on: April 02, 2014, 03:55:08 pm »
How about something like "require you to accept a stereotypical view of gender identity, be binary, or straight"? I know that view exists, never happened to me though.

@Shana-Chan- The only time the session might not be 100% confidential is when you would sign some kind of waiver, say to allow a student/ teacher to observe. Not usually applicable anyway.

@Ms Grace-- I've heard of this too. Where the therapist (doctor, etc) decides how "passing" you might be, so that people who aren't passing might not pass would not be allowed to transition.

Also having another (psychological) dx. Right now there is a question on the FTM forum where some doctor has got it in his mind that someone who (most likely IS trans) is felt by the doc to be Borderline, so he is not allowing the guy to even discuss being trans. I don't think much of the bpd dx, esp as there are so many things this might be. Even if this were the case, there is no reason the person isn't also trans.
I referred him over here, btw.



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