Gender Reassignment Evaluations

[SarahSchilling]

My local therapist doesn't have the credentials to write anything but the secondary letter for Dr. Chettawut, so I got a referral to this psychologist, whom I've never met.
I'm a bit nervous about it. Could anyone who has been through one of these things fill me in about what exactly goes on? She says it's a clinical interview, a mental status exam, and psychological testing. What do these things even mean?

What if I fail the test? How can anyone, aside from myself, ever really know whether I'm mentally transgender or not ? Or even sane, for that matter!

AHHHH! lol

[Jen72]

Where I live sounds exactly what I am looking forward to to get HRT. Would like to have a vague idea too and I would guess just that a vague idea as I would assume its more of a personal case by case thing. In a sense I wonder the same thing will they let me have HRT am I really trans or not. All I really want is to try it and find a truth about myself. The only thing I know is they test to make sure you do not have certain mental things driving the dysphoria other then that it seems its all up to you. Would be nice if there was some sort of help with deciding but it seems not really just listening to your heart.

For me however it does go it doesn't matter I will come out transitioned in one form or another by finding my true self and that is the important part:)

Disclaimer atm I don't really know squat.

[Muffinheart]

My local therapist doesn't have the credentials to write anything but the secondary letter for Dr. Chettawut, so I got a referral to this psychologist, whom I've never met.
I'm a bit nervous about it. Could anyone who has been through one of these things fill me in about what exactly goes on? She says it's a clinical interview, a mental status exam, and psychological testing. What do these things even mean?

What if I fail the test? How can anyone, aside from myself, ever really know whether I'm mentally transgender or not ? Or even sane, for that matter!

AHHHH! lol

I think every psychologist, psychiatrist and therapist session I've had in the past, I always went into those sessions doubting myself. I always wondered what do they want to hear?
Just be authentic, be yourself, you'll be awesome.
Good luck!

[SarahSchilling]

Where I live sounds exactly what I am looking forward to to get HRT. Would like to have a vague idea too and I would guess just that a vague idea as I would assume its more of a personal case by case thing. In a sense I wonder the same thing will they let me have HRT am I really trans or not. All I really want is to try it and find a truth about myself. The only thing I know is they test to make sure you do not have certain mental things driving the dysphoria other then that it seems its all up to you. Would be nice if there was some sort of help with deciding but it seems not really just listening to your heart.

For me however it does go it doesn't matter I will come out transitioned in one form or another by finding my true self and that is the important part:)

Disclaimer atm I don't really know squat.

Oh, I know I'm transgender. If, for whatever reason, she won't write me a surgery letter, then I will try another place. If I can't find one, then I will use the thai psychologist before surgery. I just hate to leave it until the last minute.

I really meant, how can anyone ELSE truly know that I am mentally female, at least in such a short time? I guess we'll see. It's probably just an expensive formality.

I think every psychologist, psychiatrist and therapist session I've had in the past, I always went into those sessions doubting myself. I always wondered what do they want to hear?
Just be authentic, be yourself, you'll be awesome.
Good luck!

LOL, yes that is basically it. What magical words can convince some stranger that I am genuine.....and if I do make the effort to formulate them, then, at that point, am I being dishonest by the very act of formulating them?

At any rate, it's good to know I'm not the only one who uselessly wonders about such things. Thanks. I'm sure after the first 15-30 minutes of our session I will run out of things to say and end up being myself by default!!

[Jen72]

Something else I would like to add well from my point of view at least the fact that we are admitting there is a problem we need help with makes us sane not loony. If I was truly delusional then I wouldn't be doubting either and from sounds of it you are saying same thing.

Also yes being honest is the best thing no matter how it goes. As for how one can define being genuine or not really I think it does come down to how you answer if you are honest and forthright then that is genuine but if you are trying to make up things well then that's where it gets grey. After all as the saying goes caught in a lie and really this isn't something to lie about its your life.

Sorry longwinded just me:)

[Muffinheart]

Not to beat a dead horse, but after having had 10 gender therapist session, and another 4 with psychologists/psychiatrists, I think I have a few thoughts. I went into those sessions wanting to be true to myself. Questions can be answered so many different ways, I think they're just trying to determine what level of dysphoria are you. Remember, you're trying to show them that being you is essential to your health, well being, relieving angst and anxiety associated with be dysphoric.
I think routine questions will be about your past relationships and perhaps your sexuality.
I was asked 2-3x about whether I contemplated suicide.
What if I couldn't go on hormones, for some medical reason, would I still transition?
They wanted to know was I sociable, have lots of friends, family, hobbies, interests.
I found, or thought beforehand they would throw curve balls. Looking back, all I did was just remind myself over and over, that this feels good to be honest and upfront of who I really am.

[Flan]

I had to go to a PhD psychologist for one of my letters. It was mostly a diagnosis session (MMPI :< ) and interview about gender identity and figuring out if I had realistic expectations regarding surgical outcomes.

She says it's a clinical interview, a mental status exam, and psychological testing. What do these things even mean?

You can't "fail" the test but it may indicate psych issues and I use the word may liberally (using the "4 D's" of abnormal psychology). The clinical interview is what it sounds like on the tin: question and answer. Mental status exam is to make sure you are orientated and aware and reflects the ability to consent to treatments. Psychological testing is to assess personality disorders (not necessarily atypical conditions associated with mental health).

[Jen72]

Much thanks Muffnheart!:) It does help to at least have a vague idea what I am stepping into and given also in Canada would guess same guidelines or at least similar between provinces. in alberta btw. I think I get what they are about to ask really and for me I think it will let me truly figure out where I am going. More accepting of who I am just still confused feel I am a paradox. But in time I will figure it out:) Just darn waiting lol.

Sorry rambled a bit thank you again for giving an idea what lies on the road next!")

[imissmymama]

for someone who is suffering from alot of depression, for different reasons, i suppose i am screwed. I will never have the surgery then.

[Eva]

Dr Brassard requires 2 letters and a year on HRT with a letter from my doctor who prescribes it and all of those letters up front before you can get a date set from what I gather...

I have one letter from a Psy D psych... Im gonna try to start seeing my new psych soon.... At this point after getting my first letter, nearly done with electrolysis/laser on my face, had VFS and now FFS, "full time" for more than a year, nearly a year on HRT ect... I dont feel like I have to prove to anyone Im a woman...

My first psych was a real tool though and I felt like I was getting nowhere with him... One day out of the blue I just asked him straight up when Id get his letter??? What do I need to do to have you write it??? I want to start seeing someone else, im getting nothing out of this ect... Well he wrote the letter a week later

Im thinking with my new psych who is a woman with more experience with TS women than my first one Im just gonna be me, honestly lay it all out there and hopefully even get something out of it...

All you can do is be yourself but it cant hurt to point out that you meet all the WPATH requirements, already have a date set with Dr Chett, and you expect a letter as soon as the psych is comfortable that your not nuts... If you can get some actual benefit from the therapy that would be great too but I cant see how it would hurt to make it clear upfront that your just there to get the letter for Dr Chett

[Muffinheart]

Dr Brassard requires 2 letters and a year on HRT with a letter from my doctor who prescribes it and all of those letters up front before you can get a date set from what I gather...

I have one letter from a Psy D psych... Im gonna try to start seeing my new psych soon.... At this point after getting my first letter, nearly done with electrolysis/laser on my face, had VFS and now FFS, "full time" for more than a year, nearly a year on HRT ect... I dont feel like I have to prove to anyone Im a woman...

My first psych was a real tool though and I felt like I was getting nowhere with him... One day out of the blue I just asked him straight up when Id get his letter??? What do I need to do to have you write it??? I want to start seeing someone else, im getting nothing out of this ect... Well he wrote the letter a week later

Im thinking with my new psych who is a woman with more experience with TS women than my first one Im just gonna be me, honestly lay it all out there and hopefully even get something out of it...

All you can do is be yourself but it cant hurt to point out that you meet all the WPATH requirements, already have a date set with Dr Chett, and you expect a letter as soon as the psych is comfortable that your not nuts... If you can get some actual benefit from the therapy that would be great too but I cant see how it would hurt to make it clear upfront that your just there to get the letter for Dr Chett

My two letters for Brassard were from my endo and my family doctor. Both could vouch for my being full time....think I even provided information to my former employers and my pastor who could also attest to my presenting full time.
I had been full time and HRT four years

[SarahSchilling]

Just to clarify, my current therapist referred me to this lady to get a letter. I am going for a gender reassignment evaluation, not therapy. It's a 2hr session and that's it, from my understanding.

On a side note, Chet makes zero mention of having to live fulltime for any amount of time and doesn't accept letters from medical doctors. It's has to be a primary letter from a psy d psychiatrist or a PhD psychologist, and a secondary from another therapist, usually a gender therapist.

Maybe it's just Thai law. *shrugs*

[Eva]

Well that sounds different.... Id say that as long as you meet Dr Chetts or WPATH or whoever's requirements and the psych cant find a reason to think your nutty your gonna be fine

[SorchaC]

I don't think you'll have anything to worry about. I've now had 4 pre surgery psyche evaluations. What they're looking for is your mental capacity to understand exactly what having the surgery will mean. Nobody can tell you if you're trans or not. They will want to be sure you understand how permanent the surgery is and to see you don't have any doubts.

I have never hidden or even tried to hide what's happening in my life, They may not agree with my lifestyle or my choices but they don't don't have to. I did most of my transition in UK where the Psyche had a huge say in when things happened and they liked to see certain things taking place so I was scrutinised quite a bit. My advice is just go in there and be yourself and be honest. They'll see you know what you're doing and will write the letter

On a side note, Chet makes zero mention of having to live full time for any amount of time and doesn't accept letters from medical doctors. It's has to be a primary letter from a psy d psychiatrist or a PhD psychologist, and a secondary from another therapist, usually a gender therapist.

Maybe it's just Thai law. *shrugs*

Chett has a database containing the names of psyches and therapists. If someone from that list writes a letter then it's approved without further questioning. I have never been asked how long I've been full time or anything about how long I have been on hormones. I think Chett leaves such things to the people who write the referral letters to establish. In most cases these people will know you allot better than he ever will.

Good Luck, Have you got a surgery date yet?

Hugs

Sorcha 

[Zumbagirl]

When I did my transition, my primary therapist who saw me through my entire process was the one who wrote my first letter. I would say that that if your therapist has the medical credentials to write the second letter, they can probably write the primary letter.

Once I found the second shrink (a psychiatrist) I made an appointment. I went in and filled out the usual medical intake forms and also gave him a copy of the letter from my primary therapist. He gave me a medical questionnaire with some simple questions on it, like family mental health background. Nothing outrageous. He asked where I should send the letter to, and I gave him the info for Dr Brassard's office. I paid $250 and was out the door. A few days later I get a package in the mail with the original letter signed by the doctor and some medical stamps on it and a copy of a fax receipt indicating that Dr Brassard had received the fax.

The funny part of all this though is that on the day I show up for surgery, I gave them both of the original letters, plus a letter from my endo proving that I had been on hormones for over a year and no one even cared. It was never mentioned, asked for again, verified, anything. Who knows what happened after that. They were just filed away I assume for safe keeping.

[suzifrommd]

What if I fail the test? How can anyone, aside from myself, ever really know whether I'm mentally transgender or not ? Or even sane, for that matter!

I failed the test. The psychologist said he was not comfortable writing my letter. I ended up going to another guy and getting a letter from him. The second therapist was a trans guy who gave me no trouble at all.

[Muffinheart]

Because my surgery was paid for by OHIP - Ontario Health insurance, I had a few hoops. The only nervous part I had, where I wondered for a millisecond whether I was ready, was two - 1 hour teleconferencing videos.
In those sessions, I had to be able to verbalize a dozen or so risks of GRS, what GRS doesn't fix, describe the operation and the aftercare process.
Yeah, I know, a lot of work, but hey, I didn't have to pony up $20,000. And, I felt I was really prepared.

[SarahSchilling]

Good Luck, Have you got a surgery date yet?

Hugs

Sorcha 

June 2nd! I'm so excited!!! I'll start getting nervous once I get my letters ready, I do my lab tests next month, and the horribleness with the passport agency is over with.

I failed the test. The psychologist said he was not comfortable writing my letter. I ended up going to another guy and getting a letter from him. The second therapist was a trans guy who gave me no trouble at all.

I sure hope that I don't run into one of these gatekeeper weirdos, considering how expensive this evaluation is.

Because my surgery was paid for by OHIP - Ontario Health insurance, I had a few hoops. The only nervous part I had, where I wondered for a millisecond whether I was ready, was two - 1 hour teleconferencing videos.
In those sessions, I had to be able to verbalize a dozen or so risks of GRS, what GRS doesn't fix, describe the operation and the aftercare process.
Yeah, I know, a lot of work, but hey, I didn't have to pony up $20,000. And, I felt I was really prepared.

That sounds awful! I mean, well worth it for 20k, but doing a 2 hour presentation in front of a board or something? I mean, I'm sure I could fill the time, but I would be so nervous!!!

Kudos to you!

[SorchaC]

June 2nd! I'm so excited!!! I'll start getting nervous once I get my letters ready, I do my lab tests next month, and the horribleness with the passport agency is over with.

Well I hope the time passes quickly for you What do you have to do to get the passport sorted out? When I did mine in 07 I just needed a letter from my GP to say the change is permanent and they changed it for me. It has saved me many issues getting that little F on my passport.

The use of Dr Chetts local Psyche to me always seemed like a money making exercise., I know he's in this to make money and I don't begrudge him that but the little things like overpriced Psyches just don't sit well with me. 9500 bht for someone that doesn't know you to sign a letter when they cannot possibly be sure you're ready in the few minutes they chat to you was to me too much so I saw a Sydney Psyche for my 2nd letter and he never charged me. I would advise getting all letters done before heading to Bangkok as once you're there any proble,s will put the surgery in doubt.

I'll be keeping an eye on your threads with interest to see how you get along

Hugs

Sorcha 

[SarahSchilling]

Well I hope the time passes quickly for you What do you have to do to get the passport sorted out? When I did mine in 07 I just needed a letter from my GP to say the change is permanent and they changed it for me. It has saved me many issues getting that little F on my passport.

The use of Dr Chetts local Psyche to me always seemed like a money making exercise., I know he's in this to make money and I don't begrudge him that but the little things like overpriced Psyches just don't sit well with me. 9500 bht for someone that doesn't know you to sign a letter when they cannot possibly be sure you're ready in the few minutes they chat to you was to me too much so I saw a Sydney Psyche for my 2nd letter and he never charged me. I would advise getting all letters done before heading to Bangkok as once you're there any proble,s will put the surgery in doubt.

I'll be keeping an eye on your threads with interest to see how you get along

Hugs

Sorcha 

The little F has proven to be somewhat more elusive for me, as the letter that I sent in along with my other documents and passport application was apparently not good enough, despite my using a template from the travel.gov website to describe what was needed to my doctors assistant.

So now I have to get another letter done and mailed to me, since my endo lives 2 hrs away. I then hVe to send that in to the agency, and hopefully at that point they will send me a passport.

It's super annoying.  Thanks for deciding to keep up with me. I will probably have mildly amusing things to say at some point! Lol.

I will be keeping on eye on your threads as well, since your date is sooner than mine and I'm eager to read as many SRS accounts as possible from Chet girls.

I'll post how the psychological evaluation goes on Friday.