GID and co-morbid mental health problems.

[licht]

Hello, gents.

I'm new to this board; want to extend my greetings to all of you. Many of your posts have been helpful to me in the past.

I'm awaiting an appointment for a psychiatric evaluation of GID; I have the diagnosis pre-emptively from a psychologist, but a psychiatrist's independent evaluation is needed before I can receive a prescription for testosterone or consider (funded) top surgery.

I'm worried about this because I have a lot of pre-existing mental health issues. I had an abusive childhood, both sexual and neglect-based, and over the past two years have developed significant sequelae. I've been diagnosed with major depression, an anxiety disorder, an eating disorder, and a personality disorder.

Although I am in therapy now, and am starting to slowly see improvements in my mental status, I am quite concerned that the psychiatrist that has to perform my GID evaluation may gatekeep because of all of the other problems compounding that potential diagnosis. I am also concerned that such gatekeeping may be in appropriate benefit; I cannot, at this point in time, rule out the possibility that my gender dysphoria is NOT because of what I experienced as a child. Logistically, it would make a lot of sense.

Have any of you fellows experienced anything like this? Did any of you walk into an evaluation of import with pre-existing mental health problems or an emotionally-suspect childhood? How did you separate what happened to you as a child from the individual you are today? Did you even need to?

Individuals without knowledge of this particular arena, but that have gone through a GID evaluation, are encouraged to comment as well. I would welcome all thoughts and opinions.

Thanks.

[geek]

AFAIK as long as things get treated, a good psychiatrist will work with you so that you are able to transition AND manage anything else that is wrong with you. At least thats what my psychiatrist said

[spacerace]

My process with it all worked out a bit different from what you are describing, but I too went through a sort of crisis and wondered where being trans fit in with diagnosed mental health problems.

Although I am in therapy now, and am starting to slowly see improvements in my mental status, I am quite concerned that the psychiatrist that has to perform my GID evaluation may gatekeep because of all of the other problems compounding that potential diagnosis. I am also concerned that such gatekeeping may be in appropriate benefit; I cannot, at this point in time, rule out the possibility that my gender dysphoria is NOT because of what I experienced as a child. Logistically, it would make a lot of sense.

I talked to my therapist about the possibility that the mental health stuff I have going on is influencing the trans stuff, and eventually I came to the conclusion that the trans stuff is just normal me, and it's actually the most stable part of myself at this point. 

I was actually really worried about it at the beginning, I thought maybe the trans stuff was more just part of the other problem and not authentic. I'm bi-polar and thought being trans was some crazy conclusion I came to in the middle of a manic episode. I also thought maybe it was influenced by some stuff that happened to me while growing up, it seemed to make perfect sense in context as well.

This terrified me because realizing I was trans seemed to answer so many questions for myself and gave everything else in my life perspective and meaning.  The thought of losing what I had just found due to it actually being part of other mental issues was devastating.

I was able to work through it with my therapist and I feel tons better about it now. It takes time and self-reflection.

For me, even in the context of the mental health issues, I realized I absolutely have to transition to even want to exist at all and see a future for myself. This eventually answered the question for myself. So my advice would be to work out stuff during therapy, listen to yourself, and try to imagine a future where you aren't trans and don't transition.  Can you be happy in that future?

Do previous life experiences, especially negative ones experienced during childhood, influence decisions and thought processes ? Of course, but that doesn't change what you need to do to feel comfortable with who you are going forward.

Additionally, we don't know what makes one person trans and the other not. It's probably not one thing, it's probably a combination of things, but then maybe not that either. Like everything else - genetics, experiences, environment, parenting, family interactions, life stability, hormone balance, brain chemicals, brain structure - we just don't know what exactly causes what yet (though we are getting better at it), and we certainly don't know it for any individual person. You can only know yourself and what you want for your own life.

For me, even if I came to the conclusion I'm trans when my brain was acting manic, even if I'm trans because of what happened to me as a kid - I'm still trans, 100%, it doesn't change a thing. I'm medicated and stable and still my brain feels male, I am happier when people see me as male, and every step I take to become more male socially and physically is a positive step in my life.

All this doesn't mean you should rush the issue for yourself. Quite the opposite - talk through everything with yourself and your therapist, make sure you know what you want and your reasons for it. Hopefully, the people gate-keeping you will see this process occurring for you and everything will come together once you are ready.

apologies for the lengthy reply and long post.

[Adio]

I think as long as you are being treated and are stable, then it shouldn't be a problem.

I was diagnosed as bipolar I in my senior year of high school.  Had major depression for years until an episode of mania broke through due to a medication change and I had to be hospitalized for a week.  I've also had anxiety problems (way less on T and post-op top surgery) and some compulsive behavior issues in the past.  None of this stopped my therapist from giving me the go ahead for T and surgery.  My therapist is pretty amazing though so...It just depends on your situation. 

[licht]

Thanks, Space, Adio, and Casey.

Space, I really appreciated your in-depth reply. It helped me gain some perspective, not the least of which being the understanding that my childhood experiences and current mental health problems do not exist in isolation of transition. And this is a good thing. I'd been linking the two together, but not in a flexible way. And when I read my anxiety through the lens of what you're saying, I realize that your answer, along with Casey and Adio's, makes a pragmatic amount of sense.

I'm finishing my degree, I'm working, and I'm also working to better myself mentally. And regardless of transition, what happened to me as a kid is never going to change. But the way that I move forward from it will continue to evolve.

Thanks, guys. I really appreciate the time you took to write.

[dky]

Hey Licht, it is hard for me to post this here but I struggle with several mental health disorders. I am bi polar, have general anxiety disorder, ptsd and d.i.d, which is a dissociative disorder caused by extreme childhood abuse.(i was raised in a cult). D.i.d. Means I split into several parts or personalities to deal w the ->-bleeped-<- I experienced and witnessed.  I have male parts inside me, in fact most of them are male. I'm basically just at the beginning of sorting out my gender in connection to my d.i.d. I have a d.i.d. Specialist therapist, she isn't a gender specialist but she us helping me separate what belongs where and why. I don't know if I will ultimately transition at this point. But I'm really worried that if I need to,i won't be allowed to bc of having d.i.d, or that taking t will be contraindicated with my bipolar meds. I don't normally out myself this way but I feel your pain and worry. I strongly encourage to make sure you are transitioning bc you really are trans, not reacting to your bad childhood. You seem a bit unsure, and t will make
permnt changes. I wish you the best in sorting thru everything.