How to get therapy moving along?:

[EmmaS]

Hi everyone,

So I went to a therapist and told them about my feelings and uncertainty about my gender and identity in general about 4 months. Since that time by myself mostly I have decided that I really think I want to transition to female. I have not always felt 100% about this possibility, but I feel quite strong about this right now. My next therapy session is in just over a week. How often should I be seeing a therapist concerning this in order to get this process moving along at a safe, comfortable, but not painful pace? Also, recent weeks of therapy have not felt like I gotten anywhere with my therapist, but my new found confidence in my decision is driving me to wonder how to basically "get the ball rolling" on my transition. I understand it is still a long process, and I understand why it has to be, and I am okay with that, but I would like to get "going" a lot more than I currently am. Should I just tell my therapist exactly what I am writing here or are there other questions that I should ask? Please feel free to give me any advice whatsoever at all. I really appreciate anyone's time to read this and give me back an insightful answer. Thank you in advance everyone!

Z

[JoanneB]

Unless you are not seeing a for real gender therapist in a large urban area, you may be noticing around now that you are doin a bit of educating the therapist. That has been the experience of several of the women in my group with local therapists. THe one I am seeing has had several of our group members as clients and I know he is off into the weeds with me as far as trans stuff goes. To be fair, I am a basket case when it comes to that (long complicated life story).

Transitioning was not my purpose for going. Been there, tried it, said nyet, twice.  I had plenty of issues, many of which I believed all led back to being trans. So someone who at least had some handle on TGs and that I can speak openly about it to would be good. Over the past almost 2 years now, transitioning is no longer completely off the table. I've also been living a good part of the past year part-time as female.

My read on this one is that he basically would not play God when it comes to a clearance letter for HRT. Or, as I would call them, a rubber stamper. If you are reasonably stable and know the implications, no prob.

So I would just bring it up plain and simple that you have given transitioning a lot of serious thought. Know a lot of the pros and cons (If you haven't already formalized it, make a list. I found also adding in a weighting factor for each very usefull). That you decided that you want to transition.

In reality transition is just going out in the real world presenting as the real you. About the only thing stopping you from starting is a shopping trip for clothes and perhaps makeup, if you don't already have suitable items for everyday life. A decent wig can take care of any short term, or permanent, hair problems. You don't need a permission slip for these things.

[ChaoticTribe]

Just so you know, a letter is not a requirement. A letter of recommendation is given by a therapist who is presumed to know more about gender identity than a doctor, but as mentioned above, many therapists have no experience whatsoever dealing with gender identity and its variations.

A doctor who is educated about transgender people will feel comfortable giving you hormone replacement therapy even if you have not gotten a letter from someone who talked to you about how you liked to dress and play and think as a child.

The best way is to go to a gender identity clinic, such as Whitman Walker Health, where people can meet you a few times and have enough knowledge to know without a year long wait whether you are truly ready for hormones.

[Beverly]

my new found confidence in my decision is driving me to wonder how to basically "get the ball rolling" on my transition. I understand it is still a long process, and I understand why it has to be, and I am okay with that, but I would like to get "going" a lot more than I currently am. Should I just tell my therapist exactly what I am writing here or are there other questions that I should ask? Please feel free to give me any advice whatsoever at all. I really appreciate anyone's time to read this and give me back an insightful answer. Thank you in advance everyone!

Well, the others are right - you can transition yourself socially by doing the obvious - growing your nails and hair, plucking your eyebrows, slimming down to a more feminine figure, changing your voice, changing your clothing and so forth.

However, I guess you are talking about medical interventions and how that is done depends on where in the world you are. For instance, in the UK you would start by going to see your GP. In the USA it may depend on which state you live in. Canada, Australia and New Zealand have their own procedures.

So it would help if we knew roughly where in the world you are.

[EmmaS]

Thank you guys for the advice already! It has helped a lot. I live in the USA, specifically in Tucson, Arizona and I am a college student at The University of Arizona. I have been working on becoming more and more feminine simply because I do want to. I bought make up for the first time and after watching many many videos practiced a little, but I still am lost haha. I have been wearing girl jeans in public, but the concept of not passing horrifies me to death and that is why I haven't just went full time already. Once I start hormones and enough changes have happened so I can pass, I want to go full time everywhere, and not just at home really. Would you recommend going to an endocrinologist and seeing if they will just let me skip the therapy process then?

Thank you all

<3 Emma

[Nathine]

I'm up in Phoenix. The Tucson community is more advanced than the Phoenix one. There are some good therapists down that way, but be careful of the few that are preaching rather than consulting. If one therapist is not helping, go to another. It is their job to make sure this is right for you, once started, some of the effects are irreversible, and they must make sure it is not a "high" or impulse. Once you start surgery, effects are irreversible, you will become the assigned gender. The suicide rate is high before transition decisions, and still has a strong incidence after, when someone decides, omg what have I done, so they should make sure this is what you want. There is an increasing incidence of post surgical identity dysphoria occurring, but I attribute that to failure to maintain an adequate regime of HRT, (at least 3 years post SRS), otherwise too many are being maintained at post menopausal levels.

As for an endo, they generally will not start HRT until they get a letter, and many of them are at a loss of what to give and how much.

[aleon515]

Do you have informed consent there? I do not understand the whole game re: hormones. I feel that if the person has talked it over and gotten comfortable with this it is really their decision, not the therapist's. I don't believe in all these games that therapists seemingly play. (Of course I don't believe in ANY games that therapists play.) If I go some route that requires a letter, my therapist will sign it tomorrow or a year from now.

--Jay J

[Nathine]

Unfortunately the Guidelines are made by Wpath. What always start out as guidelines become the defacto protocol and requirements, for those who are unable to think, and would prefer to just follow what someone else has devised. These therapists will generally follow the WPATH "rules" and so will the surgeons.

[aleon515]

@nathine-- well informed consent exists. There are also many therapists who will sign those danged letters when the client wants. I don't feel all the games are warranted. I feel I will know when/if it is right for me. I would, of course, want a therapist to say if they think there is a serious concern, but not play to the hilt the roadblock game.

--Jay J

[Janelle]

I started to see a gender therapist at the beginning of this year. I started to feel so good about myself that I started to think maybe I want more. But I know for me talking to someone about all the feelings I've been keeping in side for so long and understanding myself more made me feel better about myself. So just be sure what it is you really want. Now that the high I was on has settled down a little I'm not sure how much I want, I know I want more but do I want to go all the way I don't know. That your time you have as much time as you need to be sure of what you want. Hugs Janelle

[Nathine]

It's always nice to be able to talk with some one. I understand the irritation in making it mandatory, and that some therapists like to play games. My biggest gripe is that I have to pay for this. No one seems to be willing to provide it free of cost. LOL.

[aleon515]

Actually I am getting free counseling thru the trans center. What to say but we have an awesome trans center! Anyway there are some disadvantages as it is pro bono and I get my appt. changed a LOT. Anyway I am seeing a trans guy which is pretty awesome for me.

Yeah I think it is very helpful to talk to someone. I am not in therapy to get the letter as most people around here do informed consent.



--Jay J