How to approach a psychiatrist?

[Mynona]

Hey guys (and gals)

I've been sneaking and peeking around here for a while but I just registered so I have no clue whether I'm posting this in the wrong place.

Anyway; I came out to myself more than half a year ago and since then I  decided to take some steps towards transition. But I was way too indecisive at that time and let things slide until I became depressed again. I recently found some psychiatrists, but I'm still stuck with sending a contacting mail to one of them. I'm aware that visiting a psychiatrist is obligatory for someone who wants to start HRT but I'm starting to have doubts. How can a stranger understand something that took me my whole life to figure out? I don't want to have to persuade anyone of who or what I am. I would probably fail at that, I haven't done anything to my appearance I haven't even picked a female name yet. Perhaps the psychiatrist decides that my condition is not serious enough ('Almost everyone has a suicidal phase and you don't look like a girl to me.')
To sum it up; I'm running in circles trying to avoid an unpleasant situation and at the same time I know I'll regret it if I don't face it.

So if you have any advice or experience with psychiatrists that could help me along I'd be very grateful. Maybe it'll even make the whole thing a little less scary...

[Mariah]

Everyone moves at a different pace and they understand that. They will help you sort through everything. Just be yourself because if it does turn into a session where it truly feels like your having persuade them then they probably are not a good fit. I was all stressed out coming into my first session and she had to delay the session and my appointment was for 11am, but had to moved since she found out her dog had cancer and they were having more tests run at a second vet that same day. Luckily she able to just move me to a later time that same day. For whatever reason finding out that her dog was sick with cancer took all the stress and worry out of it for me. Once the session started I remember saying something about I hope her dog is going to be okay and then we moved right into all the stuff you normally deal with in a first session. Which brings to one other point, the first session is really just a chance for the psychiatrist to get to know more about you, your past, and what brought you in to therapy. Basically laying the groundwork for your future visits.
Mariah

[Leslie36369]

There are few in my area that I have came across, but I kinda wondered the same thing initially. The guy I decided on seems very well educated on the topic and came pretty well recommended.

The thing is he also treats a number of different things, so it is not a given that that is what I am there for. Since I am still trying to loose muscle and feminize a pretty masculine body I thought it might be awkward. So I decided the easiest way to bring it up is to just say I was reffered her by someone because I heard you were a good gender identity therapist 

I feel like it's a more indirect way of saying it so it might take any of the nerves away (or alot) and I just have to keep in mind that this is what he studied and what he does everyday, also is an area of interest for him. So by no means will he be judgmental toward my transition. He, and all other therapist are there to help and understand the mind in many different aspects. I woud honestly be more afraid if I went to him and had to confess I was hearing voices and seeing shadow people.

[Brenda E]

I'm aware that visiting a psychiatrist is obligatory for someone who wants to start HRT . . .

Are you sure?

My therapist - a social worker - was enough to get me through the door of the local trans-friendly endocrinologist and on to HRT.  No psychological exam or rigorous questioning, no fancy psychiatrist or even psychologist, just a few months talking things through casually and exploring the possibility that I was trans.  Very low pressure, never had to justify anything to anyone.  We talked, I explained how I felt, and I was referred to HRT.

Doesn't have to be a difficult, stressful, expensive or formal process to get a referral letter for HRT.  GCS, that's another matter.

[JoanneB]

Are you sure?

My therapist - a social worker - was enough to get me through the door of the local trans-friendly endocrinologist and on to HRT.  No psychological exam or rigorous questioning, no fancy psychiatrist or even psychologist, just a few months talking things through casually and exploring the possibility that I was trans.  Very low pressure, never had to justify anything to anyone.  We talked, I explained how I felt, and I was referred to HRT.

Doesn't have to be a difficult, stressful, expensive or formal process to get a referral letter for HRT.  GCS, that's another matter.

Pretty much sums it up. Any doctor can give you HRT. Most will not without a CYA letter from a therapist. An LCSW is plenty good enough.

Now, hurdle #2 is I believe WPATH recommends 3 months of therapy or something like that.

Hurdle #3, depending on where you live finding a doc or endo who will and has some TS experience

[suzifrommd]

Now, hurdle #2 is I believe WPATH recommends 3 months of therapy or something like that.

Recommends, not requires. Makes it quite clear in several places that therapy is not a requirement for HRT.

I don't believe there is a specific time frame suggested.

[Mariah]

The only time frames are related to SRS if I remember correctly.

[Mynona]

Perhaps it's dependant on your location? There aren't any social workers around here, they probably wouldn't even accept a hormon letter from one. From what I've read it looks like I have to talk to a psychiatrist for at least a year before I'm officially allowed to start HRT. Be glad that you don't live in Germany, people around here tend to make everything way too bureaucratic and complicated. It almost seems like they want to scare people away from transitioning. On the bright side once you have 'passed as a transsexual' health insurance pays almost everything for you even SRS but to get there you have to be determined and assertive (which I'm rather not). Maybe I'm overreacting but I still haven't written a contacting mail, I wish it was easier to find the right words.

[Zoetrope]

Do see a psychiatrist - and go *prepared*

Do everything you can to show you've thought about it and are serious.

Write lots, *do* the name change, make steps toward going full-time.

If you see a specialist with all of that already going, they won't hold you back x

[Rotika]

Do see a psychiatrist - and go *prepared*

Do everything you can to show you've thought about it and are serious.

Write lots, *do* the name change, make steps toward going full-time.

If you see a specialist with all of that already going, they won't hold you back x

Sorry if I missed something.. but what do you mean by "write lots"? Should I bring my diary with me??

[Zoetrope]

Should I bring my diary with me??

That's what I did ... *looks around* :~o

[EllieM]

Perhaps it's dependant on your location? There aren't any social workers around here, they probably wouldn't even accept a hormon letter from one. From what I've read it looks like I have to talk to a psychiatrist for at least a year before I'm officially allowed to start HRT. Be glad that you don't live in Germany, people around here tend to make everything way too bureaucratic and complicated. It almost seems like they want to scare people away from transitioning. On the bright side once you have 'passed as a transsexual' health insurance pays almost everything for you even SRS but to get there you have to be determined and assertive (which I'm rather not). Maybe I'm overreacting but I still haven't written a contacting mail, I wish it was easier to find the right words.

The laws in Canada are very different. My approach, however would have worked in Germany, given what you have stated here about wait times and psychotherapy. While I was offered HRT early on in my therapy process, I chose to delay, mostly for my wife's sake (yes, I'm older and married). Finding the right words... I think in your case, it would be better to say "recognizing the right words". You have the words, perhaps you just lack the confidence to string them together. Start with an outline. In my case, I first told the psychologist that I believed that I had gender indentity issues. I explained what I meant by that, that I felt that I need to express myself as a female, that it caused me a great deal of confusion because I am not attracted to males sexually. Then, I began to speak of my earliest memory of thinking that I need to be female, I was 4 or five years old, and talked about those feelings through my adolescence and into adulthood. I think that would probably be a fair introduction. You can peruse the Introductions section of the forum. Some of the posts are longer and tell a similar story. You might find that helpful in organizing your own thoughts. Perhaps you could practice by writing an intro for the forum. Feel at ease, you are among friends here and we all want to help.
-e