do i have to have a therapist to continue hormone treatment?

[latoya fox]

i was just wondering if i have to continue seeing a therapist in order to receive my hormones, i've been on hormones since sept 17 and cut down seeing my therapist to once a month since then, (due to money reasons) and because i just don't like having to travel back and fourth to portland ( i live in saco maine and portland is a half hour drive) my father always gives me rides to things, hair appointments, shopping, visits to my endo, pretty much everywhere i need to go, and to be honest, i only went into therapy so that i could go on hormones and really didn't like the thought of seeing a therapist to tell me what i am. i KNOW i am a woman. and as far as i can remember, always was. my therapist called me the other night bitching because she hadn't heard from me in so long. and i told her that i was sorry and that i had been busy as of late, and she said i was making up excuses and that i needed to schedule to see her this month, which i can't because i can't afford right now to give my father gas money for the ride, and she was hesitant, and for some reason, wanted to discuss things about my past, like when i was a child, i'm like um what the hell does this have to do with my transition? and she kept bringing up about how there's certain parts of town that i don't go to because i'm scared ( people i went to school with) and do not want to bump into them. which is true, but i am not gonna put myself into a uncomfortable situation just to satisfy her needs. she insisted that i figure a way to do it and to do it through email ( i do not have email and have no idea how to email) and she insisted i go to the library to do it ( the place i avoid because of ignorant bigots. but anyways, i no longer plan to go back to therapy as i do not care to discuss my past because i don't care about then and prefer to focus on now and my transition, anyways sorry for the rant, but do i have to continue therapy to receive hormones?

[Katie]

I never went to a therapist ever but for two days prior to srs to tell him I though it was a joke I was having to see him.

As a matter of fact in the standards of care that people like so much you can find a statement saying some people don't need therapy.

Am I suggesting you not see a therapist? No I don't know you. I am only saying some people don't need to see one.

Katie

[latoya fox]

thank you katie, yes i feel like it's a joke too. i just don't like being told what i already know, so no i will not see a therapist again

[JLT1]

Latoya,


There is something in WPATH about psychological conditions that a transgendered person may have that would affect their ability to make good decisions and be able to function well in the correct gender.  I don't recall that there is a number of visits one has to make.  However, a gatekeeper mentality could make things difficult if you do not see that person.  If you go back, you may want to discuss this. 

Good Luck.

Hugs,

Jen

[Tori]

Some doctors may still want a letter from a therapist, but not all do.

There are several reasons I can think of as to why a doc would want a letter.

1. They are not convinced you are committed to transition.
2. They have not worked with many trans patients.
3. They are morally opposed to transition.
4. They legitimately fear transition will do you more harm than good.
5. They want/need a second opinion.

I do think more mature patients generally have an easier time explaining with conviction to a doctor they are trans. Remember, mature and old are not synonymous. It means psychologically or physically developed. You can be young and mature.

Katie often talks about going in to a doc in full female mode, and others swear by this method. I just went in looking like a guy... but there was no doubt or question in my voice. I needed HRT. The people who have the easiest time getting fast tracked seem to be the people who are convinced, do not speak in uncertain terms, and frankly, can talk openly to a doctor about being trans like it is the most normal thing in the world. It takes inner strength to transition and many docs may be more willing to follow your lead if you can quickly display such strength.

If a doctor practices informed consent, that is a good sign they have worked with a good number of trans patients. If they are unwilling to start you out or continue your treatment, consider their advice, ask for their reasoning, and consider a second opinion.

Latoya, you live in a region where you should have several options if you ever hit an obstacle.

And remember, your doctor works for you. As long as you are not asking them to harm you, you have every right to make suggestions and even insist on certain forms of treatment. You pay them, not the other way around.

As for your shrink, she may just want your money, she may have reason to think you should keep going to therapy, or she may simply be fascinated by you. It may be a combination of all three. Not every therapist gets to work with someone through their entire transition, and IME, that can make folks like us quite the catch for them. Shrinks are people too. They get tired of hearing the same stories every day from cis folk. We often spice up their day.

[Katie]

You know something when I look back on the days when I was working for trans people and exposed to a LOT of such......... I would say the majority I came in contact with probably needed therapy. The funny thing is the therapy they needed had nothing to do with being trans. They were just needing to address common people problems.

Take for example a sex offender that was troubled because she could not get the state to change her gender marker on the sex offender registry page. Or the prostitutes that had HIV/AIDS and were troubled by that. Or the drug addicted trans person that was troubled. I met them all and I don't think they needed a special therapist.

Crap you know something for the first time in my life if I really wanted to be honest I probably could use a therapist. The reason is the loss of my family due to having transitioned. It troubles me at times and I get angry that I had to pay that price to be me.

But no I never ever felt the need to pay a therapist to agree with something I already knew. And yes often the professionals cannot take people seriously when they show up as a boy and tell them they are a girl. HA


Katie

PS what's this MODE thing. Boy mode and girl mode? I know my truck has modes, one for two wheel drive and one for four wheel drive and you can select the modes. On the other hand when I hear a person saying they are in girl mode or boy mode I just start wondering..............

 

[stephaniec]

I was in therapy for other reasons dealing with life . This gender thing was intertwined with these other issues, so when I finally realized I was transgender I was already in the system.

[Ltl89]

I don't know whether you really need to keep seeing one.  I guess it depends on how your endocrinologist handles things.   I'm pretty sure mine only wanted the initial letter and that was all.  If she needed updates or anything, it was something that was never said to me.  However, I do still see my therapist, but generally it's more to help with my poor self esteem and lack of confidence.  I think therapy could help everyone in some way, but I don't care for the gatekeeping mechanisms some use.  To be honest, it sounds like your therapist was being quite manipulative and overly intimidating by calling you up like that. 

[Tori]

Katie, the "Mode thing" is just something the kids say, and I felt pretty silly typing it. It does save on syllables and keystrokes.

So, "Girl mode" meant "Not presenting as a male". See? More efficient, but a pretty silly sounding term.

I have read many of your posts and take much of what you say to heart. Your thesis, to me at least, is inspiring, "Being who you are is a right. It is not something that requires apology ever."

Since I live thousands of miles away from my closest friends and family, much of my coming out has happened over the phone and email. Not optimal.

Right now, I must transition on what I can afford to spend which is very little. I was kind of rushed into things by an attempted suicide. It will take me time to create a wardrobe, make up, hair removal and surgery, but I simply had to see if transition would help give me a desire to live. It did.

So, for a variety of reasons, my transition has been from the inside out and not the opposite, it goes against everything I expected and the advice many around here offer. I am surprised at how well it is working.

This is very much a transition for me. I can't just flip a switch, although I would love to.

But I digress... sorry Latoya.

[Katie]

I guess the MODE thing kind of strikes me as a crossdresser sort of comment since they switch back and forth.

On the other hand if your a transsexual your ONE sex. Your appearance might betray that but you still are one sex.

Regardless yes I am very proud of you. You learned something that a lot here don't seem to have gathered and that is transition is about what's inside you more than anything else. When someone gets to that point the rest of the things like the outside appearance tend to fall into place automatically. Take the most amazing thing. Ever hear a crossdresser talk? Sure you have? HAS any of them ever sounded like a woman? LOL NO because they are men. Their minds have not switched to being a woman. Carry that further people here talk about practicing your voice........... well crossdressers practice and they sound like a cartoon character.

On the other hand someone that actually transitions....... it becomes apparent really quickly that the voice has to fit and the mind will automatically adjust. Sure there are some tips I picked up over the years for speaking but those were subtle things. As the Nike saying goes JUST DO IT.

Katie

[Rachel]

If your state allows informed consent then no. All you would need is a provider that will prescribe with informed consent.

I go to an informed consent provider for HRT.

I go to therapy to address past issues and current changes.

[Tori]

Katie, that is a very difficult point to convey here without someone taking exception. Often, I think people object to how the point is made rather than the point itself.

For example: It is likely just a matter of time before someone has something to say about your cross dressing/voice point. I get what you mean, though. Living something is both a physical and a mental process. The combined effect can have a profound effect on one's mindset and behavior, and these in turn, will have an impact on how the world treats you... as well as how one thinks and even dreams about them self.

There is more to it than that, or no trans person would ever need plastic surgery to feel better or "Pass".

But getting the body and mind working together does not always require therapy, and neither should HRT.

[Tori]

If your state allows informed consent then no. All you would need is a provider that will prescribe with informed consent.

I am not entirely certain it is that simple in all cases. Even doctors that provide informed consent are not revolving doors to HRT, you still have to convince them it is right for you, although that is much easier to do, I imagine, if you are already on HRT.

[kathyk]

Why not call the Pride Center at Oregon State Portland, or the Q Center in Portland.  I'm sure they can give you some info about therapists that work on sliding scales, and a few resource centers have staff therapists that can assist in continuing your HRT.  I know there's a few girls in the Portland area who are on Susans for time to time, and maybe they can also help wth a little advice.

An alternative might be getting a therapist to do telephone appointments every 6 to 8 weeks.  I do that when I'm in Michigan by calling my therapist in California every 4 weeks.  It keeps me current for her wpath requirement for referal to a surgeon next June, and I don't have to worry that I'll be cut off of HRT for not seeing someone.

[latoya fox]

i live in saco maine and was born in portland maine kathy, not oregon

[TaoRaven]

I've never seen a therapist for HRT. My Doc prescribes on Informed Consent.

I would imagine that it depends on the doctor, but I would question why any doc would require anything more than an initial referral letter anyway.

[Jessika Lin]

The short answer is 'no'. The SoC states (if I recall correctly) that ongoing therapy is *not* a requirement for HRT.
Personally, I saw my therapist 4-5 times. On my last appointment I got my letter and she asked me if I had any other issues I wanted to discuss with her. I said 'nope', she wished me a happy transition, and that was my last meeting with her.