Any tips for being politely blunt with your therapist?

[MatthewAmbrose]

I'm 19 years old, 20 when I start my therapy. I known that I was trans for as long as I can remember, now, 6 years after coming out I'm finally making my own money and beginning to get on my feet in life.

My dysphoria came and was obviously here to stay since I started to realize something wasn't quite right, in other words, female puberty.

Though I am at (slight) suicidal risk, and have been unofficially (could never afford medicine) diagnosed with depression by a previous therapist, I did not specify that when signing up, nor do I plan on making that a focal point with my therapist... I really just want to get my letter, I know that my depression and gender dysphoria are directly correlated and the only way to relieve it is through hormone therapy, and other procedures but I don't want to get ahead of myself. If I still experience depression after that, which I highly doubt, of course I'll go back for help, but right now I know I want HRT and I've had more than enough time to think about it and know what I need to know.

I truly think therapy is completely unnecessary, and at a certain point it's just a money gobbler. Any advice?

[Dena]

Welcome to Susan's Place. The job of a therapist when writing letter is to certify that you have no mental conditions that would prevent you from making an informed decision about treatment and that you have sufficient knowledge to make that decision. Withholding that information will not allow the therapist to do their job. If anything, I suspect that depression will re-enforce the diagnosis of gender dysphoria as so many of us have it.

I would recommend that you be completely truthful with your doctor. When I was in therapy, one of the members was unhappy about some of the testing and started picking different answers. That ended up delaying progress because the results indicated a mental condition that needed treating.

A therapist is a partner in your transition and not an adversary unless you withhold information.

As for therapy being a waste of money, my last therapist was worth every cent I paid and more. Without him my transition wouldn't have been possible and after surgery I moved into a new life without any baggage from the past.

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[AnonyMs]

I always find having other options is the best way to handle things, so you can say what you want without fearing it will all blow up. I've been very blunt with mine, but I could always just go find another one if I had any problems.

The WPATH Standards of Care say that therapy is not strictly required before HRT, but plenty of doctors don't actually follow it even when they say they do. I've found therapy quite helpful but I wanted it and stopped when it was no longer useful. I've also had good therapists and can afford it. There seems to be quite a few bad ones out there as well.

Depending on where you live you may have access to informed consent, and just skip the entire therapist step.

[julia-madrid]

Hello Matthew

Correcting your gender dysphoria is a reasonably long journey.  If your desire is to make surgical changes you really do need to establish a positive relationship with a therapist for the duration, since no reputable surgeons will proceed without paperwork from two psychologists.   I fully understand your goal of getting that letter.  It's an important start, but you will find that once you have it things tend to get more complex - that's when the really difficult work starts.

Remember as well that a reputable psychologist will be looking to treat all of your issues, which you say are depression and dysphoria.  But it is part of their obligation to look deeply at how these things are linked in order for you and your therapist to be sure that you are treating the right things in the correct order.  Putting it bluntly, there are enough cases where dysphoria is a consequence of depression or some other underlying issues, and often enough the person isn't even aware of it. 

Like others who have replied here, I am very supportive of working with a good therapist and establishing a positive relationship.  Not only will you learn much more about who you really are, but it will be one of the best ways for a buddy (yes!) to help you navigate the complexities of a trans journey.

Good luck!
Julia

[kelly_aus]

If the therapist is at all skilled and competent they will know about your depression whether you mention it or not. For example, mine knew I was depressed even without me mentioning it - he was also able to determine that anxiety was not on my list of issues. I also used to opportunity to offload a lifetimes worth of mostly unrelated baggage - a clean start for the new me.

Your attitude will play a big part in how successful therapy is for you and you've already stated that you think it's a waste of time. The therapist is not there to diagnose you with dysphoria, they are there to ensure you have no co-morbid issues that may prevent or hinder a successful transition. And, as previously mentioned, future surgical options will require that you have a good working relationship with your therapist.

PS: Hormones are not what resolved my issues with depression.. Transition itself was, HRT is just a small part of that.

[kat69]

I can't provide any insights that haven't already been brought forward, but I can speak to my experience.   I played a bit of a game at first with my therapist because I only gave some information out.   I have severe problems with anxiety and I hoped that the therapist would help me deal with that and I wouldn't have to truly open up.  Then I let out that I have an attraction to men...and as a biological male....well we spent a lot of time talking about being gay and such. 

In reality I knew I was transgender for a long time, but I didn't let that out until just over a year ago.  Looking back on it, I would likely have been better off now if I had been honest from session number 1.  Perhaps I might have already had GCS and become a complete woman.   

My point is that the therapist is your best ally and supporter.  If there is one person you should be 100% open with it's the therapist.  The therapist will help you lay the groundwork for all other interactions.   

I hope this helps.