How do you thnk transition should be done.

[Mariah]

 
Okay folks. here is the thing. as long as this remains a civil and thoughtful discussion we will leave this thread open. As soon as it crosses any lines we will shut it down. Please keep all the TOS in mind especially TOS 5, 9, 10, and 15. Thanks
Mariah

[iKate]

I like the path that I am on. Informed consent for HRT with absolutely no therapy necessary and 1 year RLE minimum for GCS.

The reason for IC for HRT is that if you change your mind you can pretty much stop hormones early on with no drastic changes. Freeing one from the therapy requirement also allows people to see if HRT is for them and it is psychologically important because it gives you a sense that you've started transition without waiting for a letter. I think that gatekeeping at this stage is kind of pointless and harmful. IC is a harm reduction strategy as it can help discourage self-medicating or "DIY."

Therapy is important for many people because there are issues that need to be resolved for many trans women. Some can go without it. I've found it helpful. I wish I could afford to go more often.

GCS is irreversible so it makes sense to let people try out presenting female first because of the "measure twice, cut once" principle.

[Harley Quinn]

I believe that it should be 100% at your own discretion. Give me my prescription and a list of resources if I so choose.

RLE doesn't seem like a valid tool. Like saying I haven't been "living" before... I live how I want to live. Your idea of "real life" and mine may be very different. I may not ever want to "check" all the blocks... does that mean I'm not "living". RLE (to me)= I pay my bills and can handle my life.

Therapy isn't for everyone. It's only as effective as you want to believe it is.

SRS should be no different than any other elective surgery... it's like saying you need a therapist's letter for Breast Augmentation, or a Vasectomy, or nose job... imagine the public crying foul when they have to see a therapist before any and all elective surgery. Or a step further... see a therapist to get a letter for tattoos or piercings!

A guy turns himself into a lizard, another one turns himself into a cat with piercings and tattoos... and apparently transforming your body into a better looking feminine form is something that requires regulation... Hmmm... seems like there's a little more crazy out there than I thought.

In summary, I believe that everything should be available for everyone. Provide resources for them to utilize, or not... but definitely don't make it so difficult, or give it this horrible "Stigma".

[Lagertha]

Informed consent for HRT. Documented therapy and RLE for GCS, final judgement and recommendation by psychiatrists.

[KyleeKrow]

Preferably with a magic wand, but i do think therapy is important. Not so much to confirm one's gender, but to have help accessing supportive resources and have somebody to talk to about all the stuff one has to go through while transitioning. Its been a big help having somebody to go to for advice. Although I suppose some people do have supports in their every day lives as well and that works out fine for them. The people that I thought would have been the most supportive pretty much turned out to be opposite of what I had expected when I came out to them, though.

[Serenation]

I think if you have a diagnosis for Gender identity disorder or Gender dysphoria from a psychiatrist you should be able to have access to HRT. There should not be long wait times on this. RLE should be something you have to do before SRS not before HRT and I agree with currently needed two psychiatric referrals for SRS, you should have to see them a certain amount of times, not just walk in a get something signed. I do think there should be a minimum time between initial diagnosis and SRS. I also think seeing a psychologist during transition should be an option available but not a requirement.

[stephaniec]

I like the way its happened for me. I had no intention of transition or had any thoughts about it . The process just unraveled itself as I was seeking help from preventing myself from saying goodbye. It just turned out good for me in that it just was a natural progression fro seeking help to having the path open up for me and moving along to where I feel quite good about what I'm doing. There's been no pressure and everything is in my  hands as to how I want to proceed.

[iKate]

I believe that it should be 100% at your own discretion. Give me my prescription and a list of resources if I so choose.

RLE doesn't seem like a valid tool. Like saying I haven't been "living" before... I live how I want to live. Your idea of "real life" and mine may be very different. I may not ever want to "check" all the blocks... does that mean I'm not "living". RLE (to me)= I pay my bills and can handle my life.

Therapy isn't for everyone. It's only as effective as you want to believe it is.

SRS should be no different than any other elective surgery... it's like saying you need a therapist's letter for Breast Augmentation, or a Vasectomy, or nose job... imagine the public crying foul when they have to see a therapist before any and all elective surgery. Or a step further... see a therapist to get a letter for tattoos or piercings!

Well it's not so simple.

For cosmetic reasons you can sure get a BA. However for other reasons such as reconstruction after mastectomy due to cancer or some other disease you need certification. This is because someone else is likely paying for it, but it's because you need it.

Do we want to categorize our necessary surgeries in the same manner as cosmetic surgeries? People already say we are pretending. I'm not pretending and RLE is one tool to establish sincereness. It's not perfect but if there is a better means I'm all for it. Besides surgeons want you on hormones for a year anyway and most have waiting lists.

The other issue is who is paying. If it is being paid for by insurance or government subsidy then there may have to be a vetting process so that it isn't abused.

Also remember that WPATH SOC isn't law or regulation, it's a guideline that surgeons follow. They have to worry about insurance and malpractice lawsuits. Much of medicine is defensive, not just treatment for gender issues.

[Tamika Olivia]

I'm torn. I honestly believe that many people are capable of knowing themselves and making these decisions without the input of a therapist or the trial of RLE. Those people shouldn't be stopped from pursuing their bliss with gates that only serve to confirm what they already know.

At the same time, it's a verifiable fact that some people are protected from hasty or uninformed decisions by the processes of therapy and RLE. There are people that undergo therapy or live through RLE, and find that transition is not the right option for them, or that a certain step in transition is not one they need or want.

Is it right to delay, possibly dangerously delay, the former to protect the later? Is it anymore right to expedite for the former at the expense of the later? 

[kittenpower]

I only know how my transition was supposed to be done.

[Wednesday]

Totally done by informed consent both GCS and HRT . No therapy or RLE required.

For me this is the fairest option with no doubt. Not everyone needs RLE nor therapy, and everyone should be granted access at their own will with no prior requirements, just informed consent.

Since you cant establish who may benefit/need from therapy or RLE and who may not, asking for any requirement is arbitrary and a potential loss of resources.

Is it right to delay, possibly dangerously delay, the former to protect the later? Is it anymore right to expedite for the former at the expense of the later?

Is it right to delay anybody in their own benefit at the expense of restricting their own will over what to do with their bodies? It depends on where do you place the right to choose what you think is right for you.

Should be informed consent be more extensive, explanatory? Sure. Should be the transitioner adviced to ask for therapy? Sure. Required? Never. Should be adviced to ask for RLE? Sure. Required? Never.

Therapy should be available to everyone, but one should ask for it. If you don't ask for it, I think its not fair to blame on the doc or even on the system. You can ask them to inform yourself as much as they can, you can ask them to warn you about the lots of dificulties that transition implies, you can ask them to told you may need therapy and therapy may make some things easier for you. This is in the end just a very-well informed consent. You should be free to choose.

People already say we are pretending.

I'm glad they don't say I'm an android pretending to be a human. It'll be a long and boring existence of endless Touring tests

Now, seriously speaking, we shouldn't let uneducated people's foolness have that weight. They have the right to educate themselves.

The other issue is who is paying. If it is being paid for by insurance or government subsidy then there may have to be a vetting process so that it isn't abused.

There's a nice point here. Had GCS/HRT services been proven abused anytime? In fact, can this be abused? The idea of those services being abused sounds really remote, but even if they could be abused, just diagnostic should be enough just when speaking about insurances and government.

[stephaniec]

All very interesting replies. The only thing I'm leery about and this is just me personally is straight out GCS with out any counseling. I could care less about RLE because I've been doing that for the most part since I was 4 years old. Hormones  most definitely done by informed consent . For me personally I like therapy so it's not a problem , but I understand others problem with it.

[diane 2606]

Is it right to delay, possibly dangerously delay, the former to protect the later?

Tamika, could you possibly explain what you mean by dangerously delay? I've been scratching my brain, since I first read your comment yesterday, trying to figure out how and why it would be dangerous for someone to not get SRS on demand.

I agree we're not all the same, so a one-size-fits-all approach isn't going to satisfy everyone's needs. But asking any competent, qualified surgeon to begin cutting before one has proven s/he is capable of functioning in society as the new gender is stretching what can reasonably be expected. Although I have no doubt you could find an unqualified moneygrubber who will promise to make your dreams come true, tomorrow, cash only, no questions asked; good luck to you. Those who say genital reconstruction is no different than asking for a nose job or breast augmentation miss the point. Those surgeries are minor. MtF SRS is a major, invasive medical procedure, and it will completely change one's life.

One other thing should be considered, many places in the US are working overtime to restrict a woman's right to do as she chooses with her body. Do you really think the society doing that is going to make it easy on you?

[Wednesday]

Those surgeries are minor. MtF SRS is a major, invasive medical procedure, and it will completely change one's life.

So, may we go on with that criteria and conclude that an extensive and aggresive FFS + BA could be a major and invasive medical procedure that can change completely your life?

Please check your male privileges at the door.

Right to freedom of choice just in my pocket  Sometimes I forget I'm a woman, lol, could that make me not to qualify?

[diane 2606]

So, may we go on with that criteria and conclude that an extensive and aggresive FFS + BA could be a major and invasive medical procedure that can change completely your life?

You'll find this hard to believe, but I don't have a clue what you're talking about?

Right to freedom of choice just in my pocket  Sometimes I forget I'm a woman, lol, could that make me not to qualify?

I suppose it depends which state you live in, doesn't it?

[Martine A.]

I am all in for the informed consent thing at least where the system can not process the demand effectively. For HRT. If one has to wait six months or up to three years [1] to get first appointment with an imposed therapist, the system is doing it very wrong. For what it is worth, reaching the first appointment means one appointment every month or such. Not every week, as it is available in the US.

Personally, when requiring of me to go through a therapist, I want the option to go private, choose who I talk to, have appointment within three weeks and then every week. That simply doesn't exist here, per every point named. So, the fairest thing to do will be to allow signing a doc to get an appointment with endo, and not in matter of months please.

[Wednesday]

You'll find this hard to believe, but I don't have a clue what you're talking about?

What I was talking about is: Where do you exactly place the point to establish when therapy/RLE is needed for a surgical procedure?

Full Facial Feminization Surgery is a very major, invasive, drastic procedure (and oftenly faces can't simply be restored to the initial point) but therapy/RLE are not required for it. Same for other procedures. In fact you can go for Full Facial Surgery and Breast Augmentation in one shot, and no therapy/RLE.

So, where do you place the point?

[iKate]

There's a nice point here. Had GCS/HRT services been proven abused anytime? In fact, can this be abused? The idea of those services being abused sounds really remote, but even if they could be abused, just diagnostic should be enough just when speaking about insurances and government.

Insurance basically forces the RLT requirement and even things that are available on demand usually have certification required. For example my insurance would not cover more than 1mg estradiol without pre certification. Gender dysphoria is a valid reason. The idea is to pay for medically necessary things not just what you desire. Insurance is about making you whole after a loss, not simply funding everything you want. Otherwise insurance couldn't exist.

But I could pay for it myself without any certification.

As I said the RLT is the currently accepted diagnostic. They may make exceptions for those who are suffering extreme gender dysphoria such as people attempting to cut their genitals off. If there was a better way to weed out abuse and fraud I would be all for it.

[iKate]

I am all in for the informed consent thing at least where the system can not process the demand effectively. For HRT. If one has to wait six months or up to three years [1] to get first appointment with an imposed therapist, the system is doing it very wrong. For what it is worth, reaching the first appointment means one appointment every month or such. Not every week, as it is available in the US.

Personally, when requiring of me to go through a therapist, I want the option to go private, choose who I talk to, have appointment within three weeks and then every week. That simply doesn't exist here, per every point named. So, the fairest thing to do will be to allow signing a doc to get an appointment with endo, and not in matter of months please.

Do you have any option to go private at all there?

We don't have nationalized healthcare here which is why we aren't basically forced to wait.

[Naomi71]

I can only speak for myself. But I'm 44 now, have lived with my gender identity for the last 37 years, am mentally stable, raised a son and own a small business. I'm a big girl, know exactly what I'm doing and actually feel patronized and disempowered having to wait over a year before I can even start with HRT. Subjecting myself to this awful process is the only way I can transition, otherwise my medical insurance won't pay for it.

I feel I deserve to just get my treatment if I indicate that's what I need. Gender dysphoria is basically a self diagnosis and I often experience even having to explain myself as intrusive to my personal privacy. All these questions I have to answer about my sexuality and personal life to some psychologist who just came out of college, the way in which a family member or close friend needs to come and talk about me as well, it's an insult to me.

I just go along with it because it's the only way. Just give me my hormones already.