I'm about to burst and need some advice

[Dee]

I wish I had asked for a copy of it, but my therapist read her letter to me, before sending it off.  It was kept very short, something to the effect of:

"(real name) has been coming to my office for counseling for (x number of) months, identifies as a transgendered woman, and prefers use of feminine pronouns.  She meets the requirements for hormone replacement therapy, and I recommend this treatment under the prescribed care of a physician."

Cut and dry.  Her credentials are enough to support her professional opinions and observations, states I seeked therapy, met requirements, and the next step is a prescription for HRT.  A doctor shouldn't need anymore than that.  Recommended from the WPATH page:

The recommended content of the referral letter for feminizing/masculinizing hormone therapy is
as follows:
1.
The client's general identifying characteristics;
2.
Results of the client's psychosocial assessment, including any diagnoses;
3.
The duration of the referring health professional's relationship with the client, including the
type of evaluation and therapy or counseling to date;
4.
An explanation that the criteria for hormone therapy have been met, and a brief description of
the clinical rationale for supporting the client's request for hormone therapy;
5.
A statement that informed consent has been obtained from the patient;
6.
A statement that the referring health professional is available for coordination of care and
welcomes a phone call to establish this.

But that's just literally how to write the recommendation.  I'm sure that more importantly, she needs to know the standards of care, and what the "requirements" are that need to be "met."  You could direct her here:

http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1351&pk_association_webpage=3926

[Serenahikaru]

Thank you, that's a big help.

[Brenda E]

Yes, your therapist sounds like a bit of a wet rag if she doesn't even have the common sense to figure out how to write the letter.  She's happy to take your money though...a shame you can't move on to another one really, but we have to work with what we have at our disposal.

So as Dee pointed out, you're going to have to do the leg work for her.  Find some sample referral letters, print them out, etc.  And if she still can't handle it, go straight to your primary care physician and talk to him/her instead.

I'm not a huge fan of "teaching" the therapist.  While a good therapist should be able to apply their training and experience to many situations, I think that gender identity disorder is an unusual area because the therapy is often diagnostic rather than curative, and you're not going to therapy to make the dysphoria go away; you're going there to have the therapist confirm that it exists and pass you on to the medics who can give you what you need.

(That said, therapy in my case has been wonderful in getting me to come to terms with my own gender identity disorder, and I would not have skipped therapy for anything.  It's good to talk to someone who truly understands what we're going through, because without that mental support, things get hopelessly crazy sometimes.  You don't have to think of therapy as merely a hoop to jump through on your way to HRT, because done well, the therapy process is life-alteringly amazing.)

[Allyda]

What if you simply can't find a therapist within a reasonable distance who'll take on a transgender patient. I've struck out with all therapists locally. None of them want to take on a transgender patient. I may have to resort to using one of the online therapists that see you over Skype. The closest therapist that will see me is an hour and 45 minutes away and I can't afford that kind of fuel expense. I've found some therapists online that see you over Skype. Has anyone ever tried one of them?

Allie

[Serenahikaru]

My current is pretty cool despite her lack of knowledge, and I have an appointment the week before school starts. That means I have at least one more chance and about a month to educate to mom. And I think online wouldn't be bad, it's harder expressing myself face to face.