Where to Start?

[ExceedingLime]

Hello, all. I actually first posted here at Susan's back in August of last year... At the time I did not consider myself a transsexual. I was posting asking the community what they thought about me including a transsexual person as a character in a novel series I'm writing.

That's not what I'm posting about now, though. Since then, and actually in the last two or three weeks, I have come to the conclusion that I am indeed transsexual. I'm not sure how long, perhaps my whole life, perhaps not, but for a long time, at least, I have had times where I wished I could be a girl, even if just for a day. These times came and went, and varied in intensity, but I have noticed that the intensity has grown over the years. And then recently I had a sort of epiphany where I realized that there's no reason I can't become what I keep wishing I could be.

And so here I am. I'm a college student currently trying to buy a car and find a job (and each is so very dependent on the other). I live in the dorms on a scholarship, though I spend most weekends with my mother. She has no idea about my condition, or whatever one wants to call it. I've only told my girlfriend of five years about it so far, and she is very supportive. I've been reading articles and such about transsexuality, I read Cindi Jones' book "Squirrel Cage", and I'm currently reading "Whipping Girl", and all of these have given me some idea what to expect, but I still don't actually know where to start. I live in southeast Texas, in Beaumont, about an hour away from Houston. As far as I'm aware - not exactly a very supportive area for trans people. My girlfriend suggested that I could perhaps seek free counseling that my school provides, which I am considering, but which I am wary of for two main reasons. One, given where I live, the likelihood that one of the school counselors is supportive of transsexuality seems a bit slim. But perhaps more importantly, can a college therapist actually do anything to start me on my coming journey? I mean, I don't really have any desire to sit and discuss why I'm transsexual - I just am. Can college counselors actually prescribe hormones or anything or refer me to councilors who could actually help me, or would it just be a waste of time? Is there any hope that I'd be able to afford anything beyond counseling while I work at a part-time job? Or am I doomed to wait until I've graduated in a year-and-a-half or more (I'm a bit hazy on exactly how long I have left)?

I know I rambled and packed a lot of things into a few paragraphs. I'm just simultaneously excited and apprehensive. Any advice or help that any of you have to give would be much appreciated.

[Kreuzfidel]

Hi and welcome back!  To begin, good on you for affirming your self!  As for where to start, your location may pose a challenge but people have transitioned in far worse places and situations.  I'm not sure about college therapists to be honest - they can be hit and miss.  However they may be able to help you find local support groups who could point you in the right direction.  Don't start off assuming that therapy is the first step - although I live in Australia, I am from Louisiana and know how expensive therapy and medical care can be in the US.  I would actually suggest talking to your doctor before a therapist.  I did and he agreed to start me on hormones straight away.  Therapists and counsellors cannot prescribe hormones - only psychiatrists and medical doctors (and some nurse practitioners) can.

[ExceedingLime]

Thank you, both for the welcome and the congratulations on my affirming of myself! That's good to know, that only psychiatrists and doctors can prescribe me anything. I would love to meet with a doctor, but honestly, I'm not sure I even have one. I see a dentist every six months or so, but I can't even remember the last time I was in a doctor's office. And again, the area in which I live just makes the prospect of seeing anyone about this quite nervewracking, as it seems more likely for them to be nonsupportive than supportive, but as you say, people have transitioned in worse environments. I'm just really antisocial, so I have trouble talking to strangers or people I don't know very well even when I'm not worried they'll harshly judge me.

I think the best solution may be to come out to my mother, though. Getting her on my side would give me the benefit of having her help in finding and dealing with doctors. But of course, given that I have not already told her, I'm obviously very nervous about that prospect... I know she will still love me - being disowned is not something I'm worried about with her - but I have no idea how difficult it will or will not be to get her to accept that my desire is not wrong. I expect that she labors under many false assumptions about transsexuals, because I doubt she's ever thought much about it and it's easier to go with what society tends to think.

But anyway, thank you for letting me know that therapists are probably not the way I want to go, since they cannot help me start transitioning, and at best can just point me to people who can.

[ExceedingLime]

Oh, hey, another question: is it important to be diagnosed with gender identity disorder to be treated? Would it help me to be diagnosed by a counselor, therapist or psychiatrist with the disorder so that I can point to the diagnosis to hopefully get some financial help from insurance? Isn't it even necessary, actually, to be diagnosed in order to start treatment?

[Kreuzfidel]

A formal diagnosis is not legally necessary to start treatment, but different doctors and clinics may require one before they will personally treat you.  As far as I know, only psychiatrists (and possibly psychologists) can diagnose GID.  Therapists cannot.  Also, having a diagnosis of GID is really only relevant in terms of insurance companies covering the costs of surgeries.  Good luck with your mom, too - I still haven't come out to mine officially.

[Felix]

O hai!

I didn't see you right away. I, uh, would be very very careful beginning transition in Texas. Act and try to be (or pretend to be) as confident as possible, and don't be afraid to argue with people. Don't let anybody mess with you or tell you how you're supposed to be. You are who you are. I've never been to Beaumont, though.

By whatever weird twist of fate, I didn't have an official GID diagnosis until today, and I've been out for over a year and transitioning for a lot of that time. I decided I wanted my testosterone at home instead of at the clinic, and for the prescription they had to give me a formal diagnosis. So it's not necessarily a first step.

A lot of insurances specifically exclude GID, so you might want to let it get coded as hormonal imbalance or something.

[ExceedingLime]

Kreuzfidel:
This might seem obvious to some people, but what is the difference between a psychiatrist and a psychologist?

Thank you for the luck in dealing with my mom! She's pretty awesome, so I think it'll end up being fine... I'm just not sure how much explaining it will take. We'll see.

Felix:
Thank you for the advice! Yeah, your warning about transitioning in Texas is definitely heard. And I will definitely keep in mind the confidence thing. I will try my hardest to be as confident as I can - I feel really confident inside, and feel like I'd be able to act how you say, but I won't be able to tell for sure until I'm actually in the situation.

If you don't mind my asking, why did you bother getting a diagnosis, then, if you've already been transitioning? Also, this is one of those things that doesn't seem to ever be explicitly spelled out in things I read: how are hormones taken? Like, do you take pills, or get shots, or something else? Everything just seems to mention taking hormones, without mentioning the actual method.

But anyway, good to know GID might not be necessary, and in fact might be harmful in dealing with an insurance company. Assuming I get mom on my side soon, I can have her check and see what our insurance company's policies are (I believe at the moment I am still on her insurance she gets from teaching that my younger siblings are also on).

Another general question, and this might vary a whole lot depending on where you are and how much your insurance company helps you, but generally what's the price range to start this stuff? Like, assuming I started with hormones (rather than electrolysis or something), how much do they typically cost? Also, maybe neither of you would be able to answer, but then again maybe you do know something... I've heard that taking hormones tends to make one sterile over time. So I would want to put some sperm in a sperm bank, so that my girlfriend and I can eventually have children. Any idea how expensive that is? Expense is kinda going to be a big factor in how soon I'm able to transition, as might be expected.

[Keroppi]

This might seem obvious to some people, but what is the difference between a psychiatrist and a psychologist?

http://frontierpsychiatrist.co.uk/psychiatrist-vs-psychologist/

how are hormones taken? Like, do you take pills, or get shots, or something else? Everything just seems to mention taking hormones, without mentioning the actual method.

FTM testosterone is typically (always?) via shots. MTF anti-androgen can be pills and shots depending on what you're prescribed. Estradiol can be pills, patches, cream, and shots.

Another general question, and this might vary a whole lot depending on where you are and how much your insurance company helps you, but generally what's the price range to start this stuff? Like, assuming I started with hormones (rather than electrolysis or something), how much do they typically cost? Also, maybe neither of you would be able to answer, but then again maybe you do know something... I've heard that taking hormones tends to make one sterile over time. So I would want to put some sperm in a sperm bank, so that my girlfriend and I can eventually have children. Any idea how expensive that is? Expense is kinda going to be a big factor in how soon I'm able to transition, as might be expected.

I can't comment on how much things are in Texas, but I can tell you that storing spem itself is relatively cheap, at least compare to IVF. That's what is the really expensive part, though of course you wouldn't have to pay that until later.

[Felix]

I didn't actually ever try to get a diagnosis. It was kind of an obvious thing and was treated as a given by my regular doctor. The diagnosis didn't make it into my chart until I needed a written prescription for off-site injectable testosterone. They had to have an on-paper reason for why they were authorizing me to get needles and hormones.

Honestly it kinda turned my stomach to see it spelled out in black and white, right next to my legal name and birth gender.

- Btw - Just in case you aren't aware or have forgotten, we aren't allowed to discuss dosages here. Methods are okay.

[ExceedingLime]

Keroppi:
Thank you! Especially for the nifty link explaining the difference between psychiatrists and psychologists. Very handy.

Yeah, I figured shots or pills were gonna be the most likely ways. Anti-androgens are typically always necessary from what I understand, yes? They're kind of an essential part? And Estradiol is the name of a common estrogen hormone, as I assumed and a quick Google search verified. I like that there are quite a few options for Estradiol, but since you describe only two for anti-androgens, it seems I cannot escape either shots or pills. Which is annoying, but not unexpected and not something I won't overcome.

Oh, I'm pretty phobic of needles and have a really intense gag reflex, btw. If you were wondering why I'm so averse to those two methods. I've actually never successfully swallowed a pill, and I'm almost 22. Yeah, I realize it's a problem.

Ah, geeze, I hadn't even thought about the cost of IVF. Bit shortsighted. My girlfriend hadn't thought of it either. But we'll deal with that when the time comes... it's a long way off now anyway. Good to know storing sperm should be relatively cheap, though.

Felix:
Ah, okay, that makes a lot of sense. Sorry for the stomach-turning the situation produced... I wonder if I'd have a similar reaction.

Oh! I honestly did not know that was not allowed, thank you for informing me! I wasn't interested in doses anyway, as I figured specifics like that could wait to be talked about with a doctor, but I'm still glad to have been warned, just in case. But yeah, methods are all I'm interested in - I've just never really known what the common ones were.

[sweettexastgirl409]

ExceedingLime, I too am from Beaumont, TX! What a small world, huh? Ive also decided recently to transition! I know it can be tough. Maybe we could help support one another. That could help alot!

[Stephe]

Where to start? Working on your voice can be relatively cheap, requires no diagnosis and takes a long time to master. Also many doctors will start you on AA without any diagnosis and these will do a LOT towards helping relieve the symptoms. Also, in themselves are a good tool to see if you really need/want HRT at all. if you don't like what AA do, you won't like E either.