What's the standard duration of initial therapy?

[Apples Mk.II]

It is something that I have never had very clear. When I contacted the GID unit they mention about one or two years... They also mentioned a girl that had done it in just three months.

When I met the therapist from the support association, she told me that the 23 years MTF I was going to me had been on therapy for around one year and a quarter, and still was pre-everything, but doing great.


Is it normal that it takes this long? I know that it is different for each person, but I thought the media would be of around 6 months. As usual, the feeling of not wanting to wait more time with the T wreacking havoc.


Some times I want to run and do it ASAP. Others... I read this and lose any interest:

http://ai.eecs.umich.edu/people/conway/TS/Warning.html


Maybe that article is probably over the top, but Jesus, it does get scary. And 14 days left to start therapy...

[Beverly]

Many studies have looked at the 'failure rate' of post-op transitioned people and it is routinely cited at 1% or 2%. Like any process it will go better for some than others.

One guaranteed route to failure seems to be to rush into it and do it too fast without any consideration of what you are really getting into. Reading those case studies that you linked to I noticed that they were full of "red flag warnings". Every single one of these people had problems that should be been noticed and address. There is a reason why slower transitions are generally better or safer - they give time to back out.

These stories also illustrate the absolute importance of undergoing a successful social transition first.

One point that nobody ever considers - and I have had this discussion several times with my medical people - and that is that SRS is socially unimportant. Everybody goes on about how irreversible it is. Well maybe so, but what hormones are doing to my body, hair and face are far, far, far more noticeable socially and have a far bigger impact on how people treat me. SRS will have no affect in that way because nobody ever checks what is in my pants but a lot of these hormone effects are irreversible as well.

---- Red flags ----

Renee Richards
Renée had been a long-term intense crossdresser, and had gone back and forth about whether to transition. In one early phase, she went on hormones. Then as self-doubts began to set in, she detransitioned off of hormones and even had her new breasts surgically removed!

Unfortunately, Richards now generalizes from her own sad experience and now proclaims that NO one in their 40's or older should transition. Readers should be aware that Richards is totally out of contact with the large community of successful postop women, and has no clue that many later transitioners actually do very well. It is sad to see her generalize in this sweeping way about late transitioners, and to do so in ignorance of the many successes out there.


Danielle Berry
Her comments that CD's/TG's transition "so you can wear women's clothes and feel cuter than you do now" and that "I was a cross-dresser for all of my sexual life and had always fantasized going fem as an ultimate turn-on" reveal that her motive for transition was a male CD sexual turn-on.


Sandra MacDougall
it seems clear that Sandra is an intense CD (she has "more than 80 dresses, bags of makeup, and a whole cupboard full of shoes"). It is also clear that she (i) wasn't prepared or emotionally ready for social transition, (ii) had no idea how people were going to react to her afterwards given her lack of preparedness, and (iii) apparently somehow thought that undergoing SRS was going to magically do what she herself had not yet done by other means  - i.e., change her social persona and apparent social gender to female.


Charles Kane
Then we have those who "change sex" on a whim and have the financial means to do so, then afterwards have regrets and sue everyone in sight who "did this to them" - while not taking any responsibility whatsoever for their own actions.

For example, consider the case of "Samantha Kane", and then think about the damage that this impulsive person has done to himself and about the harm he is now doing to trans women everywhere by his irresponsible actions - both in transitioning and then in lashing out as those who tried to help him in the first place.

[Apples Mk.II]

It's not the first time I read that article, and it always leave me in a really low mode, like "Are you sure this is for you?". I Reached the article through detransition news, in a link to a "detransition" after a failed "Classic" RLE. Since I won't be doing the stereotypical one (3 months crossdressing) I am afraid of the errors that I can easily commit.

- On one side I want to get it done as soon as possibly to avoid more testosterone changes in the meantime, losing more hair or letting my voice drop more.

- Looking reallistically, it is far too dangerous. I need to address BDD and self-confidence first of the symptoms will aggravate. Since the therapy works as a gatekeeping, they are supposed to tackle first on other disorders to see if the dysphoria goes away with them. Although I have mentally accepted myself (but not my body), I still have not adapted to society or have any idea of how it is going to be. I am even afraid of coming out since I still keep a posibility of the GID being caused by another underlying problem. In the last months I have been with two different therapists. One regards me as far better mentally healthy than I really thin and with lack of confidence as my biggest issue that would solve all the other things. The other was a GD therapist that truly believed in me, even more than myself. So maybe I think of myself as "false" or "not apt for transition" because of my lack of confidence, what also makes me more prone to all the other disorders and depressions...

My general therapist uses to say that I have something I am really good at: That I am quit intelligent and always see what's the real problem. That instead of hiding, I have a desire of fix improve my life, and over everything else, that I am never afraid of opening, talking, being sincere and tell everything, without lying.

Come to think, it is what happened with the GD Therapist: When I am so sincere, things as the BDD dissapear. It is the same as with the job interview. There are moments on which the confidence invades me and I turn for a few moments into the person I was and I want to be, not the pitiful state I am in now. When the BDD temporarily goes away, all my fears go with it.

[suzifrommd]

In the past few months I've met around two dozen MtFs in various stages of transition. Most of these came to my Transgender support group, a couple I met up with from Susan's, and a few from other places.

These are real people whose lives have not been sensationalized or trumpeted to make a point. They have wisdom and craziness, confidence and uncertainty, insight and cluelessness. Some transitioned young (I know a girl, started going full time at 12) some late (a lovely 82-year old woman transitioned in her late 70s).

But they're making their transitions work, not with high expectations but by facing reality every day.

Your story is a cautionary tale, sure, but it doesn't seem to match the in-person reality I've seen.

[Ms. OBrien CVT]

Stories like that are why there still is the requirement of RLE for a minimum for a year.  Some should really go through RLE, but others already know and are more than ready.

And there is where therapy can come into play.  One may find that they are just as happy being a cross dresser.  And that is fine.  Others will detransition and still fight against their GID.  Again also fine.

there is no "right" way to go about transition.  You transition the way you wish.  I don't care who might argue that your way isn't right.  It is right for you, and you are the one who will most benefit from it.

A long time ago, I started transition and then detransitioned, and for the 20 plus years I was tormented.  Now 4 years after beginning again, I really wish I had stayed the course back then.  But hindsight is 20/20.

[peky]

ask yourself: "In addition to GID, what other mental problems do I have, and why?

When you talk to the therapist they (the other mental problems) are going to be become evident.

Some people need almost no therapy while other have to have some therapy for the rest of their lives, even while transitioning or post-op.

Most endos require a letter from a psychological therapist.

The purpose of the psychological therapy is to diagnose you with GID, and to evaluate your overall mental health. Most therapist will give you the 'go ahead" letter after three month of therapy provided that you do have GID, and that you do not have other major mental issues

So, what is the aim of therapy for the other mental problems? To heal your soul and to tech you to do effective "thought management."

[Apples Mk.II]

ask yourself: "In addition to GID, what other mental problems do I have, and why?

B.D.D. and slight Social Anxiety. As for the why, in what we know from therapy they come for bullying and bad parenting. Prior to deciding I wanted to go through transition, I knew that I needed to adress the social anxiety and confidence or I would not be able to do it. The real stinkbomb came when B.D.D. appeared as the main culprit for the other two.

The purpose of the psychological therapy is to diagnose you with GID, and to evaluate your overall mental health. Most therapist will give you the 'go ahead" letter after three month of therapy provided that you do not have GID, and that you do not have other major mental issues

The GD Therapy here is part of a big psychological care unit that deals with practically everything instead of a separate GD Therapist, so they tackle on several issues at the same time. When I started to have major depression I told the doctor so he would reroute me to a psych, but it was like "If you think you have GID, all the others things can be linked to it, so I can't send you to another specialist. Take this pill to keep the anxiety controlled and hold on until you get to that appointment, they will address everything and know what to do. Although if you want my opinion, it is only that you have the biggest lack of self-confidence I have ever seen. You need to believe in yourself more, you are a good person and need to stop tormenting yourself".

So, what is the aim of therapy for the other mental problems? To heal your soul and to tech you to do effective "thought management."

Been there for four months, and My issues just got enlarged since I started the therapy. At first everything was working wonderfully and regaining my confidence, but as soon as we unlocked the oldest things, everything started getting worse. From the point of view of the therapist, "Don't worry, it is quite normal. You are doing fine and you are at that low point where after we have uncovered everything we start repairing it". And "You are far too harsh with yourself. You can't see that you are much better, sane and functional than you think, but you still keep causing pain to yourself. Can't you see that everybody loves you? From what you have told me, a person with the mental issues you keep telling me you have could not be doing what you achieve everyday at work".


But you have put it very well there, "though management". It is something that I can't keep very well under control anymore and as automatic as breathing the "thinking about deformities and illnesses". Prior to letting it running rampant, everything was so easy.

[luna nyan]

Thought management isn't an easy thing.
It's like someone telling you not to think about pink elephants... that'll be what you end up thinking about next.
I looked at the regrets page, and it does make one sanguine about the whole process.  It is all too easy to jump through the hoops if you're reasonably intelligent, and then end up being in a place where you don't really feel right.

As I keep saying, therapy has its place, and how long it goes for really boils down to whether or not your therapist believes:
1.  You don't have other underlying issues that may be part of the GID
2.  That you're really sure about the course of action that you want to undertake.
3.  That you're mentally strong enough to go through the process.

For some, that process may take only a month, others, a lot longer.  I asked an orthodontist once, how long does it take to straighten teeth?  His answer was simple - they're done when they're done and not a moment before.

[Apples Mk.II]

WPATH SOC pages 23 to 26, everything's there...

When I contacted the UIG (The therapy service) I already warned them that mentally I was a nutcase and I was already meeting another therapist. The answer? "It's the usual thing, very few people come here in a perfect state. Keep visiting that therapist and get us in contact with her, it will help on making things much easier and faster"

The issue is that when I booked the gender therapy several months ago, my head was quite normal, I was happy and showing a lot of improvement in my life. I could not expect things would get so bad in the meantime to the point of depression.

[peky]

Thought management isn't an easy thing.
It's like someone telling you not to think about pink elephants... that'll be what you end up thinking about next.
I looked at the regrets page, and it does make one sanguine about the whole process.  It is all too easy to jump through the hoops if you're reasonably intelligent, and then end up being in a place where you don't really feel right.

As I keep saying, therapy has its place, and how long it goes for really boils down to whether or not your therapist believes:
1.  You don't have other underlying issues that may be part of the GID
2.  That you're really sure about the course of action that you want to undertake.
3.  That you're mentally strong enough to go through the process.

For some, that process may take only a month, others, a lot longer.  I asked an orthodontist once, how long does it take to straighten teeth?  His answer was simple - they're done when they're done and not a moment before.

Putting neurological issues aside, 'thought management" is the basis for acquiring and/or increasing you "emotional intelligence." Yes, I will agree with you, it is not easy. It requires trust on your therapist, focus, and practice.

The alternative: a life of misery...of a perpetual belly aching...never ending bitching...blaming others while avoiding "personal responsibility."

My Mom had a terribly childhood, full of abandonment, abuse, and the horrors of war (WWII). She spend most of her adult life in and out of psychotherapist offices, never getting any results. As she was dieing she confessed to me: "it is all in you head, you know." The poor woman was consumed with self-pity and hatred, along the way she was not a good mother because she was so distracted by her own misery she could not "mother her own children."

So, yeah, "thought management" is hard, your life, your choice.