First session with a new therapist

[cindy16]

I just had my first (online) session with a new therapist. He is the first one I have spoken to who specializes in gender variance and related issues. Before this, I had seen a therapist for a few weeks who was not a gender specialist and so those sessions stopped being useful after a while. I had posted on
https://www.susans.org/forums/index.php/topic,185040.0.html when I stopped those sessions.

Coming to this new therapist, he is from India but based in Australia, so it seems like he understands both cultural contexts. I am in India so we had to do a video call on Skype, about an hour long, but it was very useful. I have read and heard about him from others too, so I was quite assured anyway to begin with.

Since this was the first session, a lot of it was spent on my story so far etc, but he did not let me meander too much and kept the focus on gender and related issues. He was also taking notes continuously, unlike my previous therapist and a psychiatrist that she had referred me to, both of whom simply spoke or listened to me without ever writing anything down.

My situation is not a cut-and-dried one, as I am married, want to preserve my marriage anyhow, did not know about my gender issues until recently, and am still figuring out how much and when I may need to transition, so it will take time and possibly many sessions of therapy to get through this. However, he did say that he is not a gatekeeper and his job is not to tell me a 'yes' or 'no' about whether I am really trans* or whether I need to transition. Instead, he will only help me figure things out, try to rule out any other possible explanations for what I am going through, and ensure that I know what I am getting into. Also that he would have to talk to my wife at some stage, even if she is currently not open to talking to a therapist herself.

We also agreed on what we might discuss in the next session, and spoke about what are the next few (non-permanent) steps towards transition that I am planning to take. Overall, it was a good experience, and I felt much better after it than I had felt after any of the sessions with my previous therapist.
If anyone wants to know his name and contact details, I'll be happy to send a PM.

[suzifrommd]

Congrats, Cindy. Seems like this guy was tuned in to your issues. I'm glad to hear you're getting help. I think on-line therapy may be the wave of the future, since it's often so hard to find decent therapists locally.

[Mariah]

Cindy, Congrats. It's sounds like you have a great therapist that your able to see via Skype. It sounds like is i tune with your needs. Good luck and hugs
Mariah

[cindy16]

Thanks Suzi and Mariah.

A few more things I forgot to mention earlier:
1.) This therapist CAN write a letter to certify / refer me for HRT or surgeries if we come to that stage. So unlike the previous therapist where the help I sought was only psychological, in this case there is a practical goal to look forward to as well.
2.) He not only took notes during our session, but also put them in a letter and sent them to me within a few hours. It is good because it helps both of us keep track of everything, and also correct any facts that may have been misheard or misinterpreted (there were 2-3 minor ones today, for example). In this way, it also adds more transparency to the interaction because now you know not just what you said, but also how the other person actually heard and remembered it.
3.) I shared my legal/given name with him in the beginning of our session, along with my background etc. He said that helped build authenticity and put my situation in a proper context etc, because until now, I had only interacted with him through an email ID with the name Cindy which is not my legal/given name, and so he had no face and no other details like age, location etc that he could associate with that name. He then asked me which name should he use, and I was ambivalent and said he could use either of my names as he wishes. He continued to refer to me as Cindy, which I later realized that I found really validating because this was the first time someone knew both these names and chose to use Cindy.
(My previous therapist only knew me by my given name. She never asked for my preferred name or pronouns, nor did I ever tell her to use them. My wife knows that I use the name Cindy here but we anyway use so many nicknames for each other, many of them gender-neutral, that it doesn't matter between us.)

[JoanneB]

This is all great news Cindy. I am happy for you.

Wanting to maintain a life while making a better one takes a lot of finessing, along with time, patience and understanding by all near and dear to us. Talking through options with someone else who is not emotionally involved is good.

[cindy16]

Thanks Joanne.

I must say that your posts in this regard have been a great help.

[cindy16]

I had another session today, and this time he went into some more personal questions, some of which made me uncomfortable so he didn't probe too much. But he explained at every point why he was asking stuff, and at the end, he suggested that I should go for a psychiatric evaluation at 2 different places that he'll recommend. This is to rule out any other possible disorders or conditions, which is fair enough I think.

He also asked 2 important questions regarding choosing between transition and marriage, but I think I'll post them in the 'transgender talk' forum as it might be more relevant there.

[cindy16]

So he referred me to 2 hospitals in a different city for a psychiatric evaluation. I got these done last month. One was a government hospital where I was given the Rorschach and MMPI tests, and the second was a private hospital where I was given the MCMI test.

The Rorschach showed no psychopathology. The MCMI turned out to be invalid because I was apparently too defensive. The MMPI, meanwhile, showed an elevated score (76) on the Masculinity-Femininity scale while everything else was normal, so the psychologist there wrote it was 'indicative of GID'.

From what I understand, the MMPI was the only one which even had some way of measuring for GID. The MCMI was more a personality assessment and the Rorschach is more to rule out delusions etc from what he told me.

After these, I had my third session with him last week, and he asked me why I was defensive during the MCMI. I said it could have been that the psychologist was sitting right in front of me as I wrote the test, and maybe because I am still not too open about certain things.
(In my last session with him, I had become uncomfortable by some of his personal questions too. The way I see it, I am clear about who I am and I don't want to go into too many details of my personal life with anyone else to prove myself. It's between me and my wife, and not even for a psychiatrist or my parents or anyone else to know.)
The MMPI had also returned a K-score of 62 (above 65 or 70 would have meant that I was hiding too much there too) so it was not too surprising.

I asked him if that meant I would have to take the tests again. He said no, it was only to rule out any psychopathologies and that job was done. Now, he could move forward with the rest of therapy, but he would also need to talk to my wife at some point. And my somewhat unusual situation would mean that we would have to take things slow, which I am anyway going to do. So now I'll be talking to him only about once in 2 months, while I slowly figure out how to push the envelope with my appearance at work etc. And then when I am ready to start HRT, maybe a year from now, maybe more, then he might go ahead and give me a letter and also put me in touch with an endo.

[JoanneB]

I often exercise my futility when dealing with my wife and doctors. No matter how often I tell her "Their ball, their rules" she just doesn't get it. Sure, plenty of things the medical professions asks/demands makes little sense to us. A lot is CYA. Add in my buddies need work so go get these tests or see this guy. Be the least bit non-compliant and your a trouble maker. You are one of those people that want the magic pill or for me to wave my magic wand to make you well again.

While I often tend to agree with my wife, at the end of the day if you don't play along with them, you are not going to get them to help you. I was the queen of hiding and lying by omission. (just ask my wife!) It would have been hard to find someone more tight lipped about themselves and their feelings than me. After a few TG support group meetings that sure changed. One of the first "Opposite George" moves for me. I knew what was not working so.... With my group members and my therapist I doubt that there is any personal subject area I won't open up about. (OK what I get paid beyond too much for all the fun I get out of working and/or not enough) Perhaps part of it is due to my wife's influence. She self describes as "Pathologically Honest".

[cindy16]

Thanks Joanne.

In fact, my therapist clearly said these tests were meant to be CYA for him.
The MMPI M-F score was just an added validation, but I don't think it would have mattered either way, unless of course I showed some other serious issues.

About what I do not like to share, it's just a matter of privacy between me and my wife. My therapist understands so he didn't probe beyond a point.