There is no solution to this.....or maybe there is!

[jayne01]

Jayne,

in Arch Sex Behav (2012) 41:759–796 DOI 10.1007/s10508-012-9975-x
Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder

"In particular, those with late onset are more likely to have had unre- markable histories of gender nonconformity as children, and are less likely to be primarily sexually attracted to individuals of their natal gender, at least prior to gender transition (Lawrence, 2010)."

This is the guidance document for the APA that established the diagnostic criteria for the DSM-V.

As many of us have said, here you have it from the experts: GID with late onset tends to in fact not include childhood experience of GID, that is you're the rule not the exception.

Thanks for the link to that article. It is a long article with lots of medical terms which went over my head. However the article starts by talking about "Diagnosis and treatment of Gender Identity Disorder..." My therapist has told me "Being trans is not a disorder, therefore you are not going to receive a "diagnosis".". Those are her exact words quoted from an email she sent me. That is in direct contradiction with the article.

There is a lot of that article I did not understand due to all the medical terms.  I don't know what to believe anymore. I am more inclined to trust my therapist who has been seeing me in person for 8-9 months than an article I don't really understand. This is all adding to my confusion.

[PipTheCat]

Hi Jayne,

It is usually something as simple as passing a woman in the street who looks similar age and similar build to me. Also, seeing two women together (as a couple) sets me off, maybe because I am attracted to women, not men.

In then get thoughts in my head wishing I was these women. When I think about it, I start to feel really creepy. These women are just going about their day minding their own business and here is me wishing I could be them. That seems so messed up. It makes my own skin crawl, imagine what these ladies would think if the could read my mind. Yuck!.....I've just creeped myself out now just writing that.

I get that too seeing women on the streets on wanting to be shaped like them and as far as I remember it only started later in life. The creepy-ness that you have I had to an extent and was helped with gender therapy to integrate those feelings into my psyche as a whole (on going over past 2.5 years). In my case it was also mixed up with bad feelings about my father who had gender issues and psychological issues which didn't end in a good way. I guess what came from therapy is to trust that what I feel isn't wrong (it is indeed you who are feeling these feelings).

In what way do you want to be like these women, is it breasts, is it hips/bottom, is it what's they wear, is it how they carry themselves or is it the whole package? Maybe you could identify one aspect of being a women and work on that and see if that helps. Baby steps, which helped me with my aspergian resistance to change.

Now alternatively, though I am not a mental health practitioner, is seems that seeing women on the street is triggering the "instrusive" and unwanted thoughts of wanting to be like them and causing you to obsess about being transgender all of a sudden, is characteristic of Pure O OCD (I think OCD was mentioned previously). Maybe you could see if your psychologist(s) thinks it a possibility and help you work though that.

Edit spelling
Regards, Pip

[Sno]

Hi,

I'm enjoying the reading that trying to help is making me do - so many discoveries, and little pieces of information that helping me understand myself better. So to carry on

From above (trigger warning):

It is usually something as simple as passing a woman in the street who looks similar age and similar build to me. Also, seeing two women together (as a couple) sets me off, maybe because I am attracted to women, not men.

In then get thoughts in my head wishing I was these women...

...

This I believe is a memetic desire - the process that we all have when we see some-one doing something that engages with us at a deeper level. It is a form of internalized imitation - our brains trying something out - an internal 'what would it be like, to be like that'. these sorts of desires that are commonly talked about are physique, wealth, material possessions and success

As humans, we all do it all the time, the positives are it helps us innovate, empathize and problem solve, (the darker ends of it are envy and jealousy... ). It sounds like this is a challenge, because these desires are in direct conflict with what you think you should be desiring.. if that makes sense...

take care

Sno

[SadieBlake]

Thanks for the link to that article. It is a long article with lots of medical terms which went over my head. However the article starts by talking about "Diagnosis and treatment of Gender Identity Disorder..." My therapist has told me "Being trans is not a disorder, therefore you are not going to receive a "diagnosis".". Those are her exact words quoted from an email she sent me. That is in direct contradiction with the article.

There is a lot of that article I did not understand due to all the medical terms.  I don't know what to believe anymore. I am more inclined to trust my therapist who has been seeing me in person for 8-9 months than an article I don't really understand. This is all adding to my confusion.

I agree with your therapist as do most trans people. However this is the language of medicine and so it's characterized as an illness. Note that this is changing and so for instance many things in psychiatry used to be characterized as disorder (e.g. being gay) and have long since been modified or removed from the DSM

This entire thread is about disphoria which is known to the medical profession as GID - gender identity disorder. Many practitioners prefer the term gender variant.

I suggest not getting hung up on the semantics (and yes I see this as another strawman). The medical establishment and especially the insurance people need a diagnosis in order to offer a 'treatment', hence the term disorder.

A rose by any other name would still smell as sweet - and still has thorns .

[jayne01]

It makes no difference to me if it is called an illness, disorder, or anything else. They are just words. The article talked about being "diagnosed", yet no one is prepared to diagnose me. Everyone tells me I need to self diagnose, which as I previously mentioned seems to be in direct contradiction with the article.

If calling it a disorder will get me a diagnosis, then call it a disorder. Why is everyone so resistant to diagnosing me? The most likely explanation is that the diagnosis would not be transgender. Why is it such a big secret and no professional wants to tell me? I could not care less if it called an illness or disorder or any other word you can think of.

[LizK]

No one has Diagnosed me as such...2 Psych's and a Psychologist agree with me that I have gender Dysphoria and Transition is my best choice of "treatment". I do not care less what some Psych thinks unless he is the one giving me my letter for further treatment(which I have). Here in Australia you must get written approval for HRT from a Psych. But even still that letter said nothing other than I was ready to commence HRT...no diagnosis. I did get a kind of Diagnosis from my pain management Psychiatrist, but even then it was not definitive.

You want what I wanted I think

Someone to tell you that you have XXX wrong and XXX will fix it. but because there is also a chance they might say you don't have gender dysphoria it winds you up!!

Do you think you are Trans? Yes? Then guess what....you are. How many "straight cis males" do you know that have spent all the time you have worrying about their gender identity. I asked my brothers this question and the answer was immediate and blunt...never was the answer!

The tough part for many of us is the self-acceptance we are trans and what that means for our lives...is this where you are stuck? It is an odd situation because we are so used to seeing a Medical Professionals telling us what is wrong and then giving us something to fix it, when it comes to something like this they seem to be floundering.

Liz K

[jayne01]

The tough part for many of us is the self-acceptance we are trans and what that means for our lives...is this where you are stuck? It is an odd situation because we are so used to seeing a Medical Professionals telling us what is wrong and then giving us something to fix it, when it comes to something like this they seem to be floundering.

Liz K

Why is it so much to ask for a mental health professional who treats trans people every single day to be able to tell me if I am trans or not. I have asked that question directly many times and I always get a round about answer that tells me nothing. I also ask what is wrong with me and get told nothing is wrong with me. It feels like I am being played with. If there was nothing wrong then why have I spent so long going to session after session? How the hell am I supposed to know if am trans or not when I have never even met s trans person? It makes no sense to me.

[JoanneB]

I can imagine among the big problems therapist have dealing with potential GD clients is that "Signs & Symptoms" are often couched, denied suppressed or otherwise misinterpreted by the client. Shame, Guilt, Internalized Transphobia, Curiosity, Questioning, WTF???, or I had these fantasies of.... can all say different things. Conversely "Damn the torpedoes full speed ahead" or similar types must also cause some level of concern and need to explore various feelings

For some it can be like peeling an onion. Many layers till you get to the good stuff

[Sno]

I'm struggling with words today (friend has made a post that has triggered, elsewhere), hopefully you will be able to follow along.

I think it may be because of the way that you are asking the question too - if you ask to compare an apple with an apple - the answer would be 'no difference'. If you asked to compare an apple against a crab apple, then the answers would be 'bigger, sweeter, uniform colour'. The important part is the comparison. So trying to rephrase 'what is wrong with me' to allow comparison - you might say 'how do I compare to ...', making sure to leave the question open. that way you might be able to get some personal perspective. You could also phrase it along the lines of 'if I were trans, would this experience be normal?'

Does this help?

[hugs]

Sno

[LizK]

Why is it so much to ask for a mental health professional who treats trans people every single day to be able to tell me if I am trans or not. I have asked that question directly many times and I always get a round about answer that tells me nothing. I also ask what is wrong with me and get told nothing is wrong with me. It feels like I am being played with. If there was nothing wrong then why have I spent so long going to session after session? How the hell am I supposed to know if am trans or not when I have never even met s trans person? It makes no sense to me.

A psychiatrist should be able to give you a definitive diagnosis...here is Australia unless you are a DR you are not able to make a diagnosis. You need to be a recognized practitioner so people like counselors or even Psychologists can't make a legal diagnosis. My Psychologist did say to me that "in her experience and with what I have described then she agreed with me that I appear to have gender Dysphoria" that was as close as she is allowed.  There is no standard diagnostic test for Gender Dysphoria, there are so many variables so it makes a diagnosis more of an informed guess than a scientific fact.

Technically you have Gender Dysphoria by definition because you display signs of distress(Dysphoria) about your gender...as to how intense that is and what the best course of treatment for you is...well, I guess that it up to you to decide.

I hear the anguish and frustration in you posts and it must be getting really hard for you. Am 100% sure I am doing the right thing...yes...do I have my moments of doubt...Yes...Will I continue despite these doubts...absolutely. Because on balance I can see that the direction my life is taking, is a positive.

Do you think you are trans..apart from the normal doubts is there any one big red flag for you that makes you think you are not?

Liz K

[PipTheCat]

Hi Jayne, sorry to pipe in again, I know this must be frustrating for you.

Being transgender is like being lesbian/gay/bisexual, you can't be told that you are, it is a self discovery process which may be quick or may be long and somewhat protracted. It seems you are trying to short circuit the discovery process by getting someone to tell you that you are transgender, but the best you can get in terms of a diagnosis is gender dysphoria.

If you would like an action plan here is my go at it... note I'm not a mental health professional but I have been round the traps as a consumer so to speak.

As I see it there are 2 options for you to move forward and could possibly be happier than the status quo.

1. Work with your psychologists to reduce the impact of these GD feelings when they occur, maybe accepting the feeling has become prominent in your psyche and let it fade away, a bit like acceptance therapy combined with a bit of mindfulness. Because when you let it fade away you don't go down the rabbit hole to figure out what it all means and do the if this then that decision tree (I had this problem). In this scenario you come to accept that you have these feelings but choose not to do anything about said feelings but only to acknowledge they exist.

2. Work with your psychologists to integrate the GD feelings (not be afraid of accepting them as part of your psyche) and explore the GD feelings that you do have and understand possibly what makes you you. Self discovery even when guided by a MHP is very empowering. Maybe as as of a result of this process you maybe able to answer the question you want answered, are you transgendered.

Sorry, if that wall of text hard to comprehend and I hope I got what meant to say across.

Hope this finds you well. Hug

Regards, Pip.

[SadieBlake]

A psychiatrist should be able to give you a definitive diagnosis...here is Australia unless you are a DR you are not able to make a diagnosis. You need to be a recognized practitioner so people like counselors or even Psychologists can't make a legal diagnosis. My Psychologist did say to me that "in her experience and with what I have described then she agreed with me that I appear to have gender Dysphoria" that was as close as she is allowed.  There is no standard diagnostic test for Gender Dysphoria, there are so many variables so it makes a diagnosis more of an informed guess than a scientific fact.

This is true in the US also, Jayne, I hadn't considered that but Elizabeth is dead on in her suggestions here.

I had the good luck to choose a real gem of a psychiatrist for my therapy -- it had to be an MD because I wanted the option of antidepressants and have used them I  the past as help in getting over the brunt of depression problems.

Because she also believes in talk therapy we have developed a very solid working relationship, I'm thankful every time I get to see her that I have someone so committed to working with me.

I get that you want a diagnosis, maybe it will help to know that while the WPATH guidelines require a diagnosis from a PhD or MD for surgery, recommendation for hormone therapy can be from any qualified mental health professional.

If your working relationships with your therapists are positive and they are helping with your understanding then you probably want to stay with it, if not you may need to see someone different. For my own part I use therapy for a lot more than just my gender dysphoria and it works well for me. I also chose not to return to the therapist I'd worked with 15 years ago because I felt that as positive as that had been then, I needed a different set of skills for the things I'm dealing with here and now.

[jayne01]

This is true in the US also, Jayne, I hadn't considered that but Elizabeth is dead on in her suggestions here.

I had the good luck to choose a real gem of a psychiatrist for my therapy -- it had to be an MD because I wanted the option of antidepressants and have used them I  the past as help in getting over the brunt of depression problems.

Because she also believes in talk therapy we have developed a very solid working relationship, I'm thankful every time I get to see her that I have someone so committed to working with me.

I get that you want a diagnosis, maybe it will help to know that while the WPATH guidelines require a diagnosis from a PhD or MD for surgery, recommendation for hormone therapy can be from any qualified mental health professional.

If your working relationships with your therapists are positive and they are helping with your understanding then you probably want to stay with it, if not you may need to see someone different. For my own part I use therapy for a lot more than just my gender dysphoria and it works well for me. I also chose not to return to the therapist I'd worked with 15 years ago because I felt that as positive as that had been then, I needed a different set of skills for the things I'm dealing with here and now.

One of my psychologists was a PhD. She didn't give me a diagnosis either. I am really losing all faith in therapy. I don't know what the purpose of therapy is or what I should be expecting from it, but I don't think it is for me. I am not compatible with it. My brain doesn't seem to work with all the touchy-feely therapy stuff. I just want the facts, and no therapist wants to give me any facts, they keep beating around the bush.

[SadieBlake]

One of my psychologists was a PhD. She didn't give me a diagnosis either. I am really losing all faith in therapy. I don't know what the purpose of therapy is or what I should be expecting from it, but I don't think it is for me. I am not compatible with it. My brain doesn't seem to work with all the touchy-feely therapy stuff. I just want the facts, and no therapist wants to give me any facts, they keep beating around the bush.

PhD psychologist still isn't an MD, so there's that. And of whatever stripe medical professionals tend to run extremely conservative for good reason, your health is their responsibility.

Moreover, we've told you, what works for most of us is we know we're  transgender and therapy is -- well for me anyway -- getting help and feedback on choices in addressing what to do with that fact.

I think I get what you're saying, having experienced plenty of frustration that my former therapist would not engage in my idea of rational discourse. It took me a couple of years to learn that she was right and how to practice accepting my feelings as valid instead of running myself in circles trying to understand them.

Here's how I think of it. A zen monk whose writing I have found helpful said something like this:

Meditation is hard, if meditation isn't what you want to be doing then don't do it because if it isn't nt what you really need in the moment then 'meditating' won't do anything anyway.

Same thing goes for therapy. If it isn't working then don't do it. However if your objection to therapy is that it's hard work then you just have to choose whether you're ready to do that work. If you truly believe that you can address emotional problems with a rational, dialectical approach then go and do that.

In my case I ultimately agreed with my therapist, the dialect approach wound up spinning me in circles. I'm still prone to doing that because like you I have this big and competent tool called a brain. What I found ultimately was that once I simply accepted my emotions then I was more able to make decisions and yes that's back to rationality.

For me, therapy is a place where I can talk about things that I really don't have other outlets for. Talking about depression with people I know and care for doesn't help, it's not their job to help me and relationships, friendships have complexities that aren't part of therapy. I certainly couldn't talk to my GF about transitioning as she has historically been pretty negative on the subject and so I can't rely on her for objective views. (Eventually of course I talked to her but that was after making the decision I needed to proceed with hormone transition.)

I see you going in circles and recognizing that from my own past I think therapy is probably a useful tool however I can only offer my own experience, you're the one who decides whether it's the right process for you and also how it goes. You're the boss of your own life.

[Gendermutt]

Transgender has no tangible facts Jayne. What makes a woman a woman?  or a man a man?  There is male and female, which is a direct fact of genetic sex. male has a P, female has a V. Woman or man though is entirely abstract, non tangible. It can only be what you are inside.

Jayne, you have this incredible ability through what you have written to describe my prior thoughts and emotions. (feeling creeped out) Got that one covered. Looking in the mirror, and yeah, I am a guy, what was I thinking and why. I am not feeling it now, so why then??  Why now and not when I was younger? 

Pretty much everything you have described apart from not feeling a connection to dressing in women's clothing has made a connection to how I have felt previously. But even with the women's clothing, I would suddenly feel creeped out by what I was doing, how I was feeling and the feeling would change from comfort and relaxation to one of self loathing.

For nearly 30 years I tried just about everything I could to "fix" myself. Come to find out, I am fine as I am. The only thing that really needed fixing was me trying to fix something that isn't broken, just different than most.

[jayne01]

If it is just a feeling on the inside and I don't want to feel that way, why then is so hard to get rid of? If I don't think I am a woman on the inside, why do I need to force myself to accept that I am especially if I don't want to? My therapist keeps telling me that feelings only come about when you believe your thoughts to be true. I don't believe my thoughts to be true, yet the feelings are still there. I have so much conflicting information coming at me from all angles I don't know what to believe.

[Deborah]

Being trans is what somebody is and has nothing to do with choice.  If you are then you are and liking or disliking it makes no difference.  According to my psychologist, if you are then there is also no known way to make it go away.  So all you are left with is deciding what, if anything, to do with it.  That can range anywhere from simply accepting that it is and living with it to a full transition and all points in between.  Continuing to kick against the pricks though is entirely counterproductive. 

That is unless it is really something else like insanity.  But if it were that surely your therapist would have done something by now!


Sapere Aude

[PipTheCat]

If it is just a feeling on the inside and I don't want to feel that way, why then is so hard to get rid of?

Because the mind is an incredibly complex system and you can't just excise feelings and because you are generating those feelings and they are a part of you. The only way is the lessen the impact of those feelings by therapy.

If I don't think I am a woman on the inside, why do I need to force myself to accept that I am especially if I don't want to?

If you don't want to be a woman then don't, but these feelings may indicate otherwise. Have you told your psychologists that you don't like those feelings and don't want to be a women?

My therapist keeps telling me that feelings only come about when you believe your thoughts to be true. I don't believe my thoughts to be true, yet the feelings are still there.

I had this with not believing my thoughts we true and my feelings not real, but as Sherlock Holmes says when you have eliminated the impossible, whatever remains, however improbable, must be the truth? A psychiatrist should be able to determine whether you are having something other than gender dysphoria as it seems your psychologist don't seem to be helping you.

I have so much conflicting information coming at me from all angles I don't know what to believe.

Sorry to be so confusing, all theories are working hypothesis until you've had them disproven apply the scientific method.

Hugs

[jayne01]

Being trans is what somebody is and has nothing to do with choice.  If you are then you are and liking or disliking it makes no difference.  According to my psychologist, if you are then there is also no known way to make it go away.  So all you are left with is deciding what, if anything, to do with it.  That can range anywhere from simply accepting that it is and living with it to a full transition and all points in between.  Continuing to kick against the pricks though is entirely counterproductive. 

That is unless it is really something else like insanity.  But if it were that surely your therapist would have done something by now!


Sapere Aude

Yet no one can prove it. It doesn't make any sense at all. It is like saying the tooth fairy is real. I can't prove it but I have this strong feeling that the tooth fairy is real, so therefore it is real.

Obviously I am not understanding any of this. Either that, it I am incredibly stupid, which may also be a possibility. You all say that cis people would not understand what a trans person is feeling. I am not understanding what you are all telling me, isn't that more reason to believe I am not trans?

[jayne01]

If you don't want to be a woman then don't, but these feelings may indicate otherwise. Have you told your psychologists that you don't like those feelings and don't want to be a women?

I tell them almost every single session. They keep telling me I need to accept it.

...A psychiatrist should be able to determine whether you are having something other than gender dysphoria as it seems your psychologist don't seem to be helping you.

Isn't a psychiatrist and a psychologist the same thing except that a psychiatrist is an MD and can prescribe medicine?