No idea what to say

[Kupcake]

My first session with a psych is in three days.  And I didn't even give Kaiser a reason for my visit.  I just told them I wanted an appointment.  I'm really horrible at this kind of thing.  It scares me.

I think I need to explain.  I've trained myself to play the part of the archetypal male in public.  I've got a solid amount of public speaking training, and I've done theater and improv as well, even participating in a few competitions.  I'm not afraid of getting up in front of a crowd, or talking to strangers, or initiating a casual friendship with people I barely know.  If I want to, I can appear outwardly confident, take ownership of the space I'm in, or appear perpetually cool under pressure.  I have enough training that I can do all of that pretty easily, and that's who most people think I am.

But it's really not me at all.  It's all just an act that I've been polishing up over the years, one that I'm only just starting to break away from.  The real me is shy, emotionally defensive, and very hard to connect to.  I can't even stand it if people look at me for longer than a second or two, especially if it's because they're interested in me, which drives me crazy for some reason.  And opening up is very hard for me.  The only person I've ever been able to talk with freely about my personal feelings is my boyfriend.  And it took me well over a year to get to that point with him.

I don't know where to begin or what to say.  I can't even think of a first sentence.  I'm afraid I'll just sink into one of two outcomes.  Either I'll shut down and say nothing, or "that guy" will come out for an hour and accomplish nothing anyway.

I honestly don't even know what I'm asking for from you guys.  It's just stressing me out a lot more than I thought it would, and I'm not really sure what to do.

[Beverly]

Keep it simple. Write on a piece of paper 'I feel am transsexual and need help but I find it difficult to discuss'. Just that - nothing else. When you go in then hand it to the psych and sit down. Then he/she will ask you questions and all you have to do is answer them and that is a lot easier.

I suspect that once the questioning starts, the dam will break and everything will come flooding out so take some paper hankies too.

[Jamie D]

Kupcake, your post is a good start.

Or you can do what I did:

"I have gender issues."

[Kupcake]

Ok.  I can do that.  Guess I just need to avoid overthinking things.

Thanks a bunch.  I feel better now.  Still nervous.  Less afraid.

[Kupcake]

Well, I did it.  I was having real problems on Sunday and Monday, but by the time the day actually came today, I was feeling way better.  Let me talk about what happened.  This might be useful to others who have Kaiser.

It actually went really well.  Kaiser sets you up with a separate person on your first visit, not the clinician you'll eventually be seeing for individual therapy.  In my case, it was a LCSW (which requires at least a Master's degree in psychology or social work, I believe).  He was really nice, and I felt he both knew what he was talking about and was very understanding.  That first visit is primarily for evaluation.  They look at the initial survey you fill out, and then they talk to you to try to get a feel for why you've come in, what your history is, what your current issues are, etc.

Personally, I'm not very good at being direct when I'm talking about something I'm uncomfortable about.  It usually takes me a bit to cut to the chase and spell things out.  But once we got rolling, he really seemed to understand a good bit about trans issues and got a good feel for where I stood.

At the end of the first session, they discuss your options.  They seem to have a lot of support groups, and he recommended some for me.  Primarily the support groups were for some other issues in my life.  I might go to one of them.  In my case, he also recommended I return for individual therapy.  He said they have one person on staff who is very experienced with gender issues, so I asked for that person specifically, and now I'm going to be following up with him.

He told me a little bit about Kaiser and where it stands on the trans issue.  From what I gather, it's actually a great option for trans individuals, provided you're in the right place.  Orange County seems to have one of the very first full programs out there for trans individuals, including surgery.  He even said Kaiser would be willing to cover many of the transition costs.  I'm guessing things might be worse in other areas..

I assumed I would be fighting an uphill battle against my insurance provider for help and coverage, but I instead now feel that Kaiser is in my corner.  I actually feel a lot better because of that.

[MadelineB]

So glad you had a good experience with your evaluation, Kupcake, and that your insurer is on your side!

[Kupcake]

Amazing how fast things are changing.  The first time I encountered transgendered people was in an educational setting, and part of the story which they told us was their battles with insurance providers.  That was only a few years ago.

[JoanneB]

As far as battling insurance goes, all that is needed is required is for them to code you for depression. Like... what trans person isn't?  I haven't had a health insurance policy yet that would pay anything related to transgender, even therapy! Clearly stated as such.

[aleon515]

I had quite a funny phone call before my first session. The therapist called me to set up the appt. He said "Is ______ there?" I said "this is she/I mean he" and then ended up laughing.
Probably told him all he needed to know.

--Jay