Starting therapy, very worried bc of other life issues, any input appreciated

[dky]

I have one of an intended three appts with a gender therapist starting next week.
The idea of being totally honest freaks me out. As does the idea that I'm just to talk and she will basically listen. The more nervous I am the more I talk off topic and expose my vulnerabilities in what feel like awful ways. Plus I'm afraid if I'm honest w any gender therapist I will never be "approved". Exposing my vulnerabilities now: I was raised in a cult, as a response to the abuse and torture, I developed a dissociative disorder, called D.I.D., more commonly known as multiple personality disorder. I promise it is nothing like Hollywood portrays, I'm not a murderer or rapist, etc. I've been working with trauma specialists for over 10 years. Some of the other personalities integrated into me last week. In terms of healing, this is awesome. It represents hard work, stability and a sense of myself as whole instead of fragmented. My trauma therapist supports me in my transition but thinks I should wait a while to move forward medically bc of these integrations, which is an intense, exhausting process.
Bad enough right? I have bipolar disorder, which is biochemical and genetic and cannot be fixed, only managed through medications. So, I also have a psychiatrist with whom I've been working several years. We have finally about fine tuned my meds so I'm not having mood swings. The anti depressant I'm on can push someone w bipolar into a manic cycle. For months it was fine, then I had surgery on my wrist and began to have different sleep and the combination pushed me into a cycle. My dr and I reworked my meds and got it under control again. With bipolar, once you have mania, you will have depression.it is an inevitable part of the disorder. So I'm having a mild depression where my worst symptom is sleep disturbance. Really, as depressions go, this is a cake walk and overall I feel fine.
You can see how telling all of this to the gender specialist might prevent me from being allowed hormone therapy, perhaps? I know I'm ready to do hormone therapy but with my life history, diagnosis and recent experiences how will a therapist, esp one who may or may not understand what D.I.D. Is and isn't in reality.
I'm really overwhelmed trying to figure out what to say to the therapist. I'm very very stressed about it. more than any other thing in my life, I'm having distress over that.
Also, what if in telling her these things, or how painful it is to live in my body that isn't right.
Oh yes, because of my dissociative disorder, my memory is awful and literally non existent for parts of my life. I have no idea what I felt when I was 5, or 7 for that matter. Those memories aren't available to me. How an I to answer, how long have you felt this way?, when my first awareness is at 15, tho I can trace my boyish tendancies back further.
I'm about to swear, but I feel ->-bleeped-<-ed no matter what I do.
I could really use some NON JUDGMENTAL input. Remember, it isn't my doing my parents raised me in a cult or that I have a biochemical problem any more then it's my fault I'm trans. And yes, of course my trauma specialist and I went through my life with as fine tooth a comb as possible to rule out a trauma eitology for my being trans. It would have been irresponsible not to.
Thanks in advance.

[dky]

That part about what if in telling her things....the rest was, what if I cry? I'm that distressed over all this.
Ok, heres a more mundane concern, should I speak in my normal tone of voice or lower it? The appt is 50_80 mins, I've not tried talking in lower tones that long.

[justmeinoz]

I have dealt with a few psychiatrists and psychologists over the years in an attempt to deal with various issues, a lot of which not surprisingly ceased to bother me once I started transition. 

I wouldn't worry about how she reacts, she will have heard a lot of traumatic things in her career and will be used to a lot of tears from patients.  She will probably take that as a sign you are getting into important things. 

The first session or two will probably be spent hearing your life story, and she will probably want to backtrack or go over a few things from a different angle at times  as well. Just be yourself, and let things out honestly.

She is working for you, probably at a fairly pricey rate, so get value for your money.  I had a first session with a new psychologist yesterday morning, for help with the trust issues left by the end of my marriage and other incidents, and we barely reached the start of my transition. That is a sign they are listening properly.

You should be fine.

Karen.

[dky]

Thank you Karen.

All I want from her, all I need is the hormone and dmv letters. I have a therapist I do the rest of my work with. And my insurance pays for my regular therapist. Is it really that important for the gender specialist who literally sees clients two to three times to know my dissociative disorder? Clearly, bc of meds she will need to know about having bipolar disorder. I'm so worried being honest will mean she says she won't write the letter. I will then have to go to another city, three hours away as she us the only gender specialist near where I live. And I can barely afford her much less a more expensive therapist plus train tickets and possibly overnight stays in this other city.
Sorry, not trying to be oppositional, just super stressed.
Thanks for your input again.

[dky]

Karen,
Thanks for your reply.As many others read this thread but only you responded, I want to say thanks for that. And you are right being truthful was the way to go.the gender therapist plans to talk w my trauma therapist and my bipolar dr but it seems like a formality at this point. She seemed pretty confident that hormones would be a good next step for me.
Dky

[Jamie D]

You have to be honest with the therapist, and with yourself.

I wasted a bunch of time and money the first time around.

[Edge]

As you said, you're making progress with the DID and your therapist supports your transition. You bipolar disorder is being treated. Even though you are currently in a depressive cycle, you are managing it well. You and your therapist who specializes in trauma have been careful to rule out trauma as the reason your trans and have determined that you really are trans. Make sure to tell her that stuff.
By the way, congratulations, dude! I know how hard it is to deal with trauma and mental health issues. You sound like you're doing a good job.

[Nero]

Is it really that important for the gender specialist who literally sees clients two to three times to know my dissociative disorder?

Yes. She can't help if you're not honest. She needs to know all the medications you're on and your diagnoses.

[MadelineB]

Karen,
Thanks for your reply. As many others read this thread but only you responded, I want to say thanks for that. And you are right being truthful was the way to go. the gender therapist plans to talk w my trauma therapist and my bipolar dr but it seems like a formality at this point. She seemed pretty confident that hormones would be a good next step for me.
Dky

Congratulations on a good first visit. It's great that you are successfully working through your trauma issues and reintegrating your life. The fact that you are responsible with your medications and have shown great resilience and growing self awareness would be very positive signs for any gender therapist, since those are the same tools that will aid you in a successful transition.

[justmeinoz]

Hope things ar e going well.  You may well find, like a lot of us here have, that starting HRT will help you feel a lot more settled and relaxed.  As well as the direct effects, there is the awareness that you have taken a concrete step forward, and are making progress.

Let us know how you are travelling, and if you need a rant, fire away.  That's what friends and family are for.

Karen.

[Tristan]

Just share with them bit remember not.to share everything all at once if you issues that may seem like your suicidal. I'm only speakimg from first hand experience. To.Mich right away could lead to a 72 hour hold if you have some other major issues

[dky]

Thanks folks for further responses.
Edge, thanks for the recognition.
Madeline, I appreciated your message and the congratulations on my first visit being quite successful.
tristan, no worries, I'm not suicidal.
Karen, thanks for checkin in again.

@ others, thanks for responding, I'd already had my appt by the time you did and had re posted about my appointment, perhaps some of you missed that one? As you responded to original questions without seeming to have updated info. Still your response is appreciated.

At this point, I'm simply waiting for second appointment after all nessacary communication between health care folks is done. My original stress and worries are gone. I'm glad I was open with the gender therapist. I have in the past two days come out of the mild depression bit of my bipolar cycle and feel usual.

[justmeinoz]

Good to hear things are looking good.
Kaz.