Questions about dysphoria diagnosis

[KarlMars]

How hard is it to get the diagnosis? I went to a therapist that was hesitant to write the note because he had seen people commit suicide after they had the gender surgery. He also wanted me to work on my borderline personality disorder. So I have never been officially diagnosed with the dysphoria.

How hard was it for you to get the recommendations for hormones? How long did it take?

If you have other mental health issues did it make it harder for you to get the diagnosis?

Please discuss.

[Deborah]

It took me three visits which was the minimum time with that Dr.   Actually, I was diagnosed in two visits and the third visit was to discuss hormones and be approved for that.  So overall from start to finish was about four weeks because I had to space out the appointments due to finances at the time.

I didn't have any other issues that I know of.


Sapere Aude

[FTMax]

I started hormones via informed consent and didn't get a formal diagnosis of gender dysphoria until I needed a referral for top surgery. It took 3 online visits before he wrote my letter.

I had no issues getting a diagnosis or hormones despite my previous mental health issues. All of them were related to dysphoria, and my providers had no issues seeing that.

[KarlMars]

I started hormones via informed consent and didn't get a formal diagnosis of gender dysphoria until I needed a referral for top surgery. It took 3 online visits before he wrote my letter.

I had no issues getting a diagnosis or hormones despite my previous mental health issues. All of them were related to dysphoria, and my providers had no issues seeing that.

If you get the diagnosis, can you wait a few years before you can afford the hormones?

[FTMax]

I am not sure. You would probably need to check with the doctor who would be prescribing the hormones. I know they prefer that surgical referrals be somewhat recent, but I'm not sure about HRT.

[AnonyMs]

How hard is it to get the diagnosis? I went to a therapist that was hesitant to write the note because he had seen people commit suicide after they had the gender surgery.

I can't speak for the rest, but that's one of the more stupid things I've heard from a doctor. It's a whole lot more dangerous not getting treatment.

[Devlyn]

Off topic, but may I ask which is correct? Your avatar "My status is pre T and no therapist yet."

or your post:

How hard is it to get the diagnosis? I went to a therapist that was hesitant to write the note because he had seen people commit suicide after they had the gender surgery. He also wanted me to work on my borderline personality disorder. So I have never been officially diagnosed with the dysphoria.

How hard was it for you to get the recommendations for hormones? How long did it take?

If you have other mental health issues did it make it harder for you to get the diagnosis?

Please discuss.

[Ashey]

Thankfully it was a smooth process for me. I'd say maybe four months, going maybe twice a month, 45-60 minutes sessions. My therapist was a great guy, and actually cared. Since I went into it knowing exactly what I wanted, he understood that I didn't have any doubts or anything and just went through the motions. I talked about my feelings, my past, my goals, and he came up with a list of topics we needed to cover and got it done. Then I got my letter of recommendation to start HRT.

....And then I found out, almost a year ago when my friend started transitioning too, that my endo didn't even need a letter.

[Emileeeee]

The first time it took about 5 years. The second time I switched therapists and told them how it was when I walked in. Had it after the second visit. I did do informed consent, but the therapist letter got me way ahead of a 2+ month waiting list.

[Kylo]

3 psychotherapist consultations over 4 months. The third consult she said she was putting my case forward to the relevant doctor to discuss the next steps. She never actually said "I've diagnosed you transsexual" but it effectively meant as much.

I have anxiety issues, which I mentioned. And a bunch of stuff which I didn't mention. I can only assume I said enough of the right things - I've no idea how difficult or easy it is to be diagnosed except a suspicion that they have a bunch of boxes to tick on the usual signs.

She showed me the papers she'd been writing on for 3 sessions which showed all the questions she's asked me and the notes beside and there was a ton of pencil notes all over every page based on everything I'd said, so I guess there was enough for them to go on. I don't actually know how much and what you have to say to be diagnosed.

[FTMax]

Off topic, but may I ask which is correct? Your avatar "My status is pre T and no therapist yet."

or your post:

How hard is it to get the diagnosis? I went to a therapist that was hesitant to write the note because he had seen people commit suicide after they had the gender surgery. He also wanted me to work on my borderline personality disorder. So I have never been officially diagnosed with the dysphoria.

How hard was it for you to get the recommendations for hormones? How long did it take?

If you have other mental health issues did it make it harder for you to get the diagnosis?

Please discuss.

Dev, I think his post is referencing when he had previously spoken with a therapist. Not currently.

[KarlMars]

I can't speak for the rest, but that's one of the more stupid things I've heard from a doctor. It's a whole lot more dangerous not getting treatment.

He wasn't a doctor. He was a lousy therapist. I agree that it would make someone a lot more suicidal to not get treatment. I don't have the money right now to do anything yet. I'm on medicaid and disability. When I get a chance I'm going to try to get a job. I'll probably have to wait a few years at least before hormones even.

[KarlMars]

Off topic, but may I ask which is correct? Your avatar "My status is pre T and no therapist yet."

or your post:

I am pre T and I left that therapist back in the summer of 2015. So what I meant is I didn't have a decent therapist.

[laurenb]

I got the feeling from my therapist that her role wasn't so much to render a "diagnosis" of gender dysphoria. Her purpose was to make sure that there weren't any other issues that would seriously compound or hinder my progress toward transition (if that's what I wanted). Of course she also gives guidance and tools to deal with the GID. Actually, I don't think there even is a "diagnosis" anymore since the guidelines have changed as diagnosis implies illness. Gender identity, according to the latest DSM, is self defined (Am I right there?). Anyway, that all being said, we all got issues and I believe a good therapist is worth their weight in insurance premiums.

[Denise]

As for how long - each (2) therapist I've seen said they were pretty sure after one visit and were definitely sure after two.  I only know that because I asked.  Which is kinda funny since it wasn't until after visiting the Medical Dr and describing to him what was going on and he stopped me and said "Bingo - that's Gender Dysphoria."  To be honest - that made me feel 100 times better knowing that I wasn't mis-self-diagnosing and the therapists just "going along for the ride."

Note this - I learned something the other day about therapists. I should have paid more attention earlier on in the process.  The letters after their name is important.

I don't really know what all these letters mean (Ed.D, LCPC, NCP, DAPA) but apparently they hold weight for insurance companies and medical doctors. But the first therapist I was seeing had these after her name: MA,  LPC, ACCHT.  Apparently that is not enough in the eyes of insurance at least.  it also means $100/hour vs $180/hour.  But as the old saying goes, you get what you pay for.  Also note some therapists will adjust their pricing based upon income. 

Also drug companies will help out too if you can't afford prescribed medications.  Consider asking a pharmacist to see if there are any discount drug programs for the specific drugs being prescribed.  Or look online at pharmaceutical web sites to find help.

[KarlMars]

I got the feeling from my therapist that her role wasn't so much to render a "diagnosis" of gender dysphoria. Her purpose was to make sure that there weren't any other issues that would seriously compound or hinder my progress toward transition (if that's what I wanted). Of course she also gives guidance and tools to deal with the GID. Actually, I don't think there even is a "diagnosis" anymore since the guidelines have changed as diagnosis implies illness. Gender identity, according to the latest DSM, is self defined (Am I right there?). Anyway, that all being said, we all got issues and I believe a good therapist is worth their weight in insurance premiums.

Thank you very much for that good bit of information, miss. I hope that you transition is or has gone well for you.

[KarlMars]

As for how long - each (2) therapist I've seen said they were pretty sure after one visit and were definitely sure after two.  I only know that because I asked.  Which is kinda funny since it wasn't until after visiting the Medical Dr and describing to him what was going on and he stopped me and said "Bingo - that's Gender Dysphoria."  To be honest - that made me feel 100 times better knowing that I wasn't mis-self-diagnosing and the therapists just "going along for the ride."

Note this - I learned something the other day about therapists. I should have paid more attention earlier on in the process.  The letters after their name is important.

I don't really know what all these letters mean (Ed.D, LCPC, NCP, DAPA) but apparently they hold weight for insurance companies and medical doctors. But the first therapist I was seeing had these after her name: MA,  LPC, ACCHT.  Apparently that is not enough in the eyes of insurance at least.  it also means $100/hour vs $180/hour.  But as the old saying goes, you get what you pay for.  Also note some therapists will adjust their pricing based upon income. 

Also drug companies will help out too if you can't afford prescribed medications.  Consider asking a pharmacist to see if there are any discount drug programs for the specific drugs being prescribed.  Or look online at pharmaceutical web sites to find help.

Thank you very much for this information and input. I am just asking for future reference. Right now I am on disability and medicaid which I doubt will cover anything. I hope someday they pass laws for medicaid to cover HRT at least. Due to my mental health issues and changing moods I must wait awhile to think about even starting hormones. In the meantime I'll have plenty of time to talk this out with a therapist.
I want to make sure I can keep at least a part time job and have some way to support myself before I consider any transition. I lack stability right now due to temporarily living with and caring for my dying grandmother and my family needs lots of help. I apologize for too much information. I don't want pity. People seem to like it when I give more information rather than type a few words around here.

[Moneyless]

Been seeing my psychologist for about 6 months now. I would've been on T 2 months ago if I wasn't required to be 18. So basically for about 4 months, once a fortnight. He didn't question me at all, however he has two other patients my age who he refuses to write letters for also due to their mental or physical health.

[Swayallday]

six appointments and 8 months further now.

no step further 

[WorkingOnThomas]

It took months to get my referral, but that's the norm at the clinic I go to. And now there's a long wait to see the endo.