2 years and still getting nowhere

[Vii]

I've switched therapists once, with the first one I just got nowhere. He kept asking me how he could help me and I said I want HRT, not so much help with anything else just yet and he refused. After some 8 or so months he did send me to the endo but without papers whatsoever, simply to get my blood checked. And after that he told me he still won't let me do HRT because he doesn't feel like I'm really female enough or something, so I told him I'm gonna ditch him and self med and that I won't be his high-life city girl, cause I'm from a rural area and down to earth and certainly not a ->-bleeped-<-.
So 2 months later I had my pills and was happy for a while, then fast forward 12 months, I got myself a new therapist and it seems to be the same damn story. Every time I go I make damn sure to look as passing as possible and behave however she wants me to, because screw that noise, but she's just sitting there, making me talk, is actually totally convinced that I wanna transition, that I got FFS already scheduled and that I also want SRS, but she just refuses to sign me any papers aswell.
Now the first one was a psychologist and probably put off by the fact I'm bipolar, my new shrink is a psychiatrist and doesn't seem too bothered with it, but why exactly am I seeing any "professionals" if they ask me how they can help me but when I say I want HRT, they tell me no...? Feels like I'm doing nothing but wasting money on train tickets.

At this rate I'm starting to wonder if I can get SRS outside of WPATH, I'm not sure what I can do anymore. She gave me an appointment in 3 MONTHS on our last meeting. And I literally got VFS 1 1/2 months before and FFS 3 weeks after that appointment. 

[Obfuskatie]

Make sure to ask your prospective therapists whether they have had trans clients or would be willing to do an evaluation for writing a letter of recommendation based on the WPATH standards before you commit to more sessions. Remember you are paying them, so you have the ability to hire and fire them. The evaluation period for written letters tends to require ~ 3 months or something like 6 to 12 hours in session. Make sure you and assertive and try not to view the situation as something when you need to prove yourself or get combative.
Don't lose hope, and know that you may need a psychiatrist for psychotropic prescriptions, while a psychologist/therapist may be more likely to help with transgender stuff. If you can, keep looking to find the right fit for you.


     Hugs,
- Katie
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[suzifrommd]

And after that he told me he still won't let me do HRT because he doesn't feel like I'm really female enough or something

Please don't every stay with any health care practitioner who tries to make this decision for you. Therapists simply have no right to withhold documentation for necessary medication based on their judgment of your gender. WPATH guidelines are very clear that the decision to start HRT is your decision and your decision alone and the therapist is there only to advise you and document that you are competent.

Have you considered an online therapist?

[Vii]

Make sure to ask your prospective therapists whether they have had trans clients or would be willing to do an evaluation for writing a letter of recommendation based on the WPATH standards before you commit to more sessions.

Ironically, she's trans herself, so I'd expect she knows the deal.
I have another therapist for trans unrelated things, he keeps a careful distance from the trans stuff, but he's much more on my side and more annoyed by the fact that I have to pay for FFS than I am myself, which I find pretty cute.
Do you think I could print out the WPATH standards and ask him to write a referral? I don't think he's actually qualified for this and I'm his first trans patient. I'm not really sure what sort of doc it takes to make surgeons perform the SRS.

Please don't every stay with any health care practitioner who tries to make this decision for you. Therapists simply have no right to withhold documentation for necessary medication based on their judgment of your gender. WPATH guidelines are very clear that the decision to start HRT is your decision and your decision alone and the therapist is there only to advise you and document that you are competent.

Have you considered an online therapist?

I only saw today that online therapist are an actual thing. But after booking VFS and FFS I'm pretty much out of money right now and it seems I'd have to pay quite a bunch for them to assess me. Would you happen to know how many sessions it takes with one such? If they're also months apart I'm gonna go nuts.

[Obfuskatie]

It depends on whether you do 45 min sessions or 90 minute ones. Most therapists use those two session lengths because of insurance billing policies. But I'm pretty sure the 45 min ones are once a week, and 90 min are biweekly or monthly. But the 3 month thing is for a general guideline for the evaluation period for writing a letter, and whatever their preference on scheduling determines the number of sessions for the period.

For SRS you need two letters from two different mental health professionals, either therapists or psychiatrists. I highly recommend you do get all the pertinent WPATH stuff for the guy you already have rapport with that is very supportive. You might want to give your trans therapist space and time to give you a clear response, but were I in your position, I'd bluntly tell her I want to avoid seeing her as a gatekeeper and ask what I need to do to make her feel comfortable in my choice to begin HRT and transition.


     Hugs,
- Katie
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[Vii]

Funny, my therapists send me away after some 15 minutes.

I believe last time I already bluntly told about that gatekeeper stuff, but she takes everything she can to distract from writing my referral. I said sometimes I feel kinda ADHDish and so she wrapped that thing up, said we'll do a test and then before I can say anything further she already kicked me out and sent me to the secretary for a new appointment. And they're usually so far apart I'm always getting anxious when she's looking at her screen and writing down some new appointment in 2 months or something. Oh, she also likes to explain how bureaucracy with my health insurance will take a long time so its not a big deal if I have to wait for some more appointments. That stuff gets my blood boiling.
July next year marks my 3rd year in "treatment" and I'm still sitting here forced to self-med. It's getting pretty ridiculous and I'm out of ideas. If I was to find a new therapist, it'd only be the same story all over again and I'll have to sit half a year on some waiting list ontop of that.

i feel come next appointment, I'll be very direct as much as my ravaged voice allows me. I dunno if a "give me the referral or I'm out" thing is a good idea, but I don't think the purpose of seeing a shrink is to grow anger for them.
If I ditch her too however, I could at best try to find someone new in a whole different city.

[Obfuskatie]

The policies I know of are based on living in the US, it's probably different in other countries, especially ones with nationalized healthcare. But if you're in the US, there are lots of other people you can see, maybe try to find newly practicing and inexpensive sliding scale psychologists near major universities.


     Hugs,
- Katie
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[Vii]

No, sadly this is EU. Germany to be precise, but I've already considered moving to the US for a while, provided a friend of mine gets his visa and can provide shelter.

[Obfuskatie]

I've heard Germany is one of the more progressive EU countries, so I don't know if moving to the U.S. will make a positive change for you. But you can find a liberal city in a lot of countries, maybe Heidelberg, Berlin, Köln etc. Even in very conservative/religious places like Texas in the US, cities like Houston and Austin are bastions of liberalism and open mindedness.

     Hugs,
- Katie
Sent from my iPhone using Tapatalk

[Vii]

I've heard Germany is one of the more progressive EU countries, so I don't know if moving to the U.S. will make a positive change for you. But you can find a liberal city in a lot of countries, maybe Heidelberg, Berlin, Köln etc. Even in very conservative/religious places like Texas in the US, cities like Houston and Austin are bastions of liberalism and open mindedness.

That's a good point, but I got next to nothing keeping me here. I'd probably end up in San Francisco if I moved in with my friend. EU guidelines will stay as there are, no matter the city. In terms of trans healthcare, Germany is still pretty much stoneage.

[Mariah]

True, but just because are trans or in her case a therapist doesn't mean we are well acquainted with the WPATH guidelines. SO, it is important to ask anyway. Like others have said, if she isn't a good fit or it isn't working out please do try another therapist. A good fitting therapist is really important. Hugs
Mariah

Ironically, she's trans herself, so I'd expect she knows the deal.
I have another therapist for trans unrelated things, he keeps a careful distance from the trans stuff, but he's much more on my side and more annoyed by the fact that I have to pay for FFS than I am myself, which I find pretty cute.
Do you think I could print out the WPATH standards and ask him to write a referral? I don't think he's actually qualified for this and I'm his first trans patient. I'm not really sure what sort of doc it takes to make surgeons perform the SRS.

I only saw today that online therapist are an actual thing. But after booking VFS and FFS I'm pretty much out of money right now and it seems I'd have to pay quite a bunch for them to assess me. Would you happen to know how many sessions it takes with one such? If they're also months apart I'm gonna go nuts.

[Obfuskatie]

Just know that rent is pretty high in the San Francisco Bay Area. I'm living about 45 minutes outside the city, albeit in a nice neighborhood, and my rent is pretty high despite being a studio. But if you can afford to live in San Francisco, I love it here. I think Portland would be my next choice, although I do love Southern California's weather and beaches.


     Hugs,
- Katie
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