When should I start seeing a therapist?

[Kaylee Angelia]

Hi, I'm at the very, very beginning of transitioning meaning I have made the decision to start exploring my options. Should I start seeing a therapist right away? Does the US healthcare/insurance system have a time requirement regarding therapy before a person can have SRS?

Any help/advice along those lines would be great.

Thanks,

Angelia

[Alaia]

You are going to have to review your provider's benefits and see what's covered and if they have any restrictions. For example, the insurance I have through my employer still follows the WPATH SOC v6. In the benefits document it states I am required to have either a documented RLE of 3 months or a period of psychotherapy with a mental health professional (usually a minimum of 3 months) before starting HRT.

So I had to start with psychotherapy, get a letter from my therapist recommending HRT (took me about 4 months), then I had to schedule an appointment with my primary care physician because the endocrinologist wouldn't see me without a referral from my MD. After that I was finally able to see the endocrinologist and start HRT.

As for SRS, I have to do at least 12 months on HRT (if no contraindications) as well as 12 months real life experience before that is covered.


Your insurance could have different stipulations though. You'll need to look through the summary plan description or summary of benefits and coverage document to find out (ask for the SPD or SBC).

[katiej]

Yes, get yourself to therapy soon.  They'll help you figure yourself out and help you make decisions along the way. 

It also sounds like you really need to go into research mode.  You'll learn a lot around here.  I also suggest spending time on tsroadmap.com  You'll find some good basic information there.

SRS is a long way off.  HRT first, then real life experience.  And most have some sort of laser or electrolysis for facial hair removal.  A lot of us also have FFS or some other plastic surgery before SRS.

Welcome to Susans, and I wish you the best!

[helen2010]

Yes, get yourself to therapy soon.  They'll help you figure yourself out and help you make decisions along the way. 

It also sounds like you really need to go into research mode. 

SRS is a long way off.  HRT first, then real life experience.  And most have some sort of laser or electrolysis for facial hair removal.  A lot of us also have FFS or some other plastic surgery before SRS.

Welcome to Susans, and I wish you the best!

Great advice.  While you will need 'alone time' to process the torrent of information which is coming your way, take small steps, own each decision and each stage of your journey.  Finding and working with a good gender therapist is the very first step.  We are each here to listen, share stories, perspective and advice.  Welcome and enjoy!

Safe travels

Aisla

[Jessica Merriman]

Just make sure you are ready and comfortable. You will have to talk about some difficult topics and be completely open or Therapy will not help. As with anything you get out of it what you put into it. I am glad you are thinking about including a Therapist in your transition plans. Mine personally has been a life saver and good confidant. They have the ability to see things you may not and can ease your transition. Good luck sweetie!

[Allyda]

I'm currently looking for a gender therapist myself. Anyone know of a good one in West central Florida?

Thanks in advance!

Ally

[Missy~rmdlm]

The fact that you are on site that is a pretty good indicator that a therapist/psychologist is a good idea. The issues of gender are weighty. I don't really advocate for a "gender" therapist, just a therapist that isn't hostile.
Determining if a therapist is competent or hostile can be learned from recommendation or the hard way. For example I had a good marriage counselor, she refined all the problems between me and my ex down to very simple straight forward facts, which allowed my ex to have the clarity to make the right choice for her, and one that was acceptable to me(divorce.) On the other hand the marriage counselor's referral to a sex addiction therapist for me was laughable, that wasn't hostility, it was incompetence in working with people like me.
My first therapist(excluding marriage counselling) was from an internet list, second and third ones were from recommendations from other people. The first one was dropped due to expense, I have retained both newer therapists including in my post op status anymore. They are covered very well by insurance, a $20 copay.

[JoanneB]

The absolute best thing  I did for myself when I started my journey was seeking out a TG support group. At the time I was living in rural West Virginia. After months of fruitless Googling after work for therapist and groups in my area I happened upon one only 90 miles away. Well, it sure beats 2 1/2 hour drive to either Pittsburgh or Baltimore / DC. I was so lucky finding this group, really my family now. From others from the big city I was told they were unique. In part of how it became established and out now retired benevolent dictator, moderator, and hostess. Also I think to the isolation we all have being scattered about in a rural area.

A support group can also provide some very good information. Not just about life, and transitioning. But also the nity-grity How-To part and the pot holes you'll encounter. Especially when it comes to finding knowledgeable or at least supportive health care providers, including therapist. 

[Kaylee Angelia]

You are going to have to review your provider's benefits and see what's covered and if they have any restrictions. For example, the insurance I have through my employer still follows the WPATH SOC v6. In the benefits document it states I am required to have either a documented RLE of 3 months or a period of psychotherapy with a mental health professional (usually a minimum of 3 months) before starting HRT.

So I had to start with psychotherapy, get a letter from my therapist recommending HRT (took me about 4 months), then I had to schedule an appointment with my primary care physician because the endocrinologist wouldn't see me without a referral from my MD. After that I was finally able to see the endocrinologist and start HRT.

As for SRS, I have to do at least 12 months on HRT (if no contraindications) as well as 12 months real life experience before that is covered.


Your insurance could have different stipulations though. You'll need to look through the summary plan description or summary of benefits and coverage document to find out (ask for the SPD or SBC).

Thanks that's great information. I'll check with my insurance and find out what they require. I definitely want to take things slowly so knowing how long your journey was/is is nice to know.

Yes, get yourself to therapy soon.  They'll help you figure yourself out and help you make decisions along the way. 

It also sounds like you really need to go into research mode.  You'll learn a lot around here.  I also suggest spending time on tsroadmap.com  You'll find some good basic information there.

SRS is a long way off.  HRT first, then real life experience.  And most have some sort of laser or electrolysis for facial hair removal.  A lot of us also have FFS or some other plastic surgery before SRS.

Welcome to Susans, and I wish you the best!

Thank you. Yes, I'm definitely in research mode and have a lot to discover so thanks for the resource and insights. I was definitely wondering about the facial hair removal and didn't know about the FFS options so thank you for mentioning that.

Just make sure you are ready and comfortable. You will have to talk about some difficult topics and be completely open or Therapy will not help. As with anything you get out of it what you put into it. I am glad you are thinking about including a Therapist in your transition plans. Mine personally has been a life saver and good confidant. They have the ability to see things you may not and can ease your transition. Good luck sweetie!

Thank you. One of the things I'm really grateful for right now is that my transition is starting after a little over 14 years of deep inner personal work with some therapy mixed in. I've come a long way and finally feel like I've integrated most of my past and am growing quickly into being my own person  (Thank goodness!!!) and transitioning is part of that.

A support group can also provide some very good information. Not just about life, and transitioning. But also the nity-grity How-To part and the pot holes you'll encounter. Especially when it comes to finding knowledgeable or at least supportive health care providers, including therapist. 

Thanks for that Joanne. I live in the Austin, TX area and have discovered, at least online, some therapists that run support groups so I'll connect with them as I know I'm going to need "lots" of support throughout this entire process.
--
Thank you everyone for your replies and for making me feel welcomed. 

[Kaylee Angelia]

I just made my first therapy appointment. It just so happened that the therapist is a trans woman and I couldn't be happier about that. It'll be nice to be able to talk to someone who's been there.

[rfhaas]

I had my first therapist appt.  Last week and can't wait until my next one in.a.week. I have weekly appointments after this, the holiday:( I am currently only "out" to her. A HUGE sigh of relief just hearing the words "I am transsexual " coming out of.my mouth for someone else to hear.  Goodluck and keep us posted

[Kaylee Angelia]

I had my first therapist appt.  Last week and can't wait until my next one in.a.week. I have weekly appointments after this, the holiday:( I am currently only "out" to her. A HUGE sigh of relief just hearing the words "I am transsexual " coming out of.my mouth for someone else to hear.  Goodluck and keep us posted

Thank you and congratulations to the both of us!

This is my first official step. I'm so emotional right now...

[Rachel]

Congratulations on your therapy appointment. I think you made a wise decision.   

[stephaniec]

congrats, it helps

[missymay]

I think that you should start seeing a therapist as soon as possible, they are invaluable in helping you sort things out, and they can help you to formulate a plan for transition.