What am I supposed to talk about at therapy?

[supergirl23]

I have seen my therapist twice now and even though when I initially chose her the website said that she works with transgender people, she hasn't. I am her first transgender patient.

After doing a little bit of her own research she has agreed to write my recommendation letter for me. But I still don't think she really knows what exactly to talk about. Pretty much the only thing we have discussed is my relationship with my parents and how coming out is going to affect them.

So how can I educate her in a way that would be conducive to the both of us. The only thing I could really think of was to talk a little about dysphoria. Or should I just find another therapist? I don't really want to start all over again as she will be writing that letter for me. But I want to do therapy the right way.

[Rachel_Christina]

If you know exactly what you want, stick it out snatch that letter "byyeeee" and be gone so fast down that road lol.
Thats what I did, my therapist new what she was talking about and I got what I needed after one session.
Its up to you, if you are 100% certain you are female like O was this is a great situation you are in, get that paper.
But if you are not certain her incompetance may bite you, seek out someone who really understands the situation, its a real mess to go down this path and think "what have I done" :S
So you know you best, you have to decide
Wish you the best, Christine

[DavidC]

Hi! I'm in the same boat as you, my therapist has never written a letter before. It's hard to come up with topics with someone that you're not immediately comfortable with, but talking about how having dysphoria effects you & how you feel about it can definitely help her understand. As a last resort, i'd bring printouts lol.

It's definitely a learning experience for some therapists, but i think that advertising that she has worked with transgender people when she hasn't is a bit of a red flag.. Some of the things I talk about with my therapist are: when i was in school, my parents & family, dysphoria, and my plans for the future (such as any surgeries and hrt). Try to come up with a list of topics that you want to discuss, such as what I talk about, and bring it with you to the next session.

I hope this helps!
~David   

[Jean24]

I'd recommend not going to therapy ever. It serves no purpose other than to control our medical care.

[Elis]

If a therapist follows the WPATH standard they should ask questions to gage if you have any serious mental health issues that could be harming you instead of the GD, have a constant history of GD or if you've fully thought through transitioning. My therapist who did follow WPATH asked me stuff like what was school like for me, what my current job is like as I came out at work, what my family was like and what my plans were fir medically transitioning.

I definitely think you should report her. She could have trans people come to see her in the future who need proper guidance and help sorting out their thoughts. Her lack of experience will do them more harm than good.

[SadieBlake]

Therapists gain their experience working with clients. Willingness or desire to work with transitioning clients is good however I wouldn't want a therapist who's just going through the motions or representing that she has experience to get clients.

You're going to need two letters for srs anyway and one must be from someone with a PhD. So if you feel it's a therapeutic relationship that's working I'd stick with it, otherwise maybe find someone else.

I chose my therapist looking for a psychiatrist because I was facing major depression and wanted someone who could prescribe and also a competent and compassionate therapist and happily she's both. When I have questions about brain chemistry or even if I'm talking about my work she has the scientific education to keep up and help me understand the implications of meds etc. As an MD she's also qualified to write the letter but there's no way she'd go so pro-forma. I didn't select her for trans experience and so there's been a mutual learning curve and she's  worked hard for me - including presenting my case at a conference and getting feedback from her peers.

Stay with this woman if you feel it's productive. Best luck and wishes.

[becky.rw]

I have seen my therapist twice now and even though when I initially chose her the website said that she works with transgender people, she hasn't. I am her first transgender patient.

I haven't read that website of course, but to me, this suggests not a claim of great experience, but a willingness to try.   Someone will always have a first trans patient; help her understand you, you'll learn a bit about yourself in the process, get your letter, and move on.   She'll improve with each patient, just as all physicians do.

[JoanneB]

"Getting your letter", albeit just CYA for the doc, is only a part of the equation. My letter went into great length detailing my therapists trans specific CV as well as some detail of the group she worked out of which focused primarily on the 'T' in LGBT.

When I first started looking around for a therapist I was in living in rural WV. The Psychology Today doc find became a sort of guide. Back 7 years ago about half had checked of LGBT and 1/4 Transgender. After quite a few phone calls I learned that basically translated into "I once had a class (or chapter in a text book) that mentioned TG". A lot like me going off to design a bridge because I once had to take a course on "Statics and Dynamics".  In the end I wound up putting my TG Groups recommendation to work since he was already "Trained"

Back to; What to talk about? Well, when I first started anything dealing with transitioning was off the table, not even a blip on the radar. Been there tried it twice. I was going because over decades of being TG and not really dealing with it I had a ton of baggage I needed to get rid of. Much of due to being TG. My goal was simply to become a real person and not this lifeless, soulless thing I had grown into. For that I needed help. In time I came to see, learn, and experience that being truly alive also meant being truly me.

But if all you want is a letter, then..... you likely know what they need to hear. After a few more sessions start hammering away on the "When?"

[cheryl reeves]

I don't have any use for a therapist,i know what my problems are and learned how to face my issues head on. Reasons are I don't trust them,last time I had to see a therapist/psychiatrist was when I was 18 and mandated by the school,the other reason they wanted to put me on psych meds,i have bad experiences and you couldn't pay me enough to go see one nowadays period. If I want to transition I could do so without hrt if it came to that for I already have boobs.

[Devlyn]

I have seen my therapist twice now and even though when I initially chose her the website said that she works with transgender people, she hasn't. I am her first transgender patient.

After doing a little bit of her own research she has agreed to write my recommendation letter for me. But I still don't think she really knows what exactly to talk about. Pretty much the only thing we have discussed is my relationship with my parents and how coming out is going to affect them.

So how can I educate her in a way that would be conducive to the both of us. The only thing I could really think of was to talk a little about dysphoria. Or should I just find another therapist? I don't really want to start all over again as she will be writing that letter for me. But I want to do therapy the right way.

You state right at the beginning that you chose her because she works with transgender people, suggesting to me that you know you're transgender. I think for a lot of people, a therapist is a tool along the way to making, and accepting, that same decision. I don't think therapy is necessary if you know who you are and where you're going in life.

Wanting to help teach her is a great idea, and it shows that you have a caring heart. If you want to stick around and do that, good on ya! Have you mentioned this site to her? I don't mind bragging, we're the best source of transgender information on the internet. She could learn a lot here.

Hugs, Devlyn

[supergirl23]

So I should only stay in therapy until I get my letter? Because I know I am trans. And when I get the money for SRS I should see a therapist with a doctorate? If I stay any longer will I be wasting my time?

[Michelle_P]

I started HRT about 10 weeks ago, and I see my gender therapist every 3 weeks or so, and go to a monthly (soon bi-weekly) group session.  My need for therapy is driven by issues in just getting on with my life, the whole "Trans vs The World" thing.  I get guidance on dealing with other people, with the many family related issues, and with coming out to others.

I have found therapy to be a tremendous help in clarifying my own thinking, and separating my needs from those imposed on me from outside that I've internalized.  I'll keep going, probably through going full-time and eventual SRS.

[Dena]

So I should only stay in therapy until I get my letter? Because I know I am trans. And when I get the money for SRS I should see a therapist with a doctorate? If I stay any longer will I be wasting my time?

Being transgender creates a number of other problems in your life. A therapist can be helpful in working through them so I would suggest you discuss with your therapist how often you need  a visit. It could be once a week, once every two weeks or once a month but staying in contact will help should you face difficulty. I have seen people who after several months into the transition are ready to quit because some difficulty has occurred. A therapist will help work through the issue and speed the transition.

[SadieBlake]

So I should only stay in therapy until I get my letter? Because I know I am trans. And when I get the money for SRS I should see a therapist with a doctorate? If I stay any longer will I be wasting my time?

Time I've spent in therapy has never been wasted, on the othhand there have been many more years I didn't feel I needed it than I have.

If you're feeling OK about life then there's nothing wrong with only putting in the time needed for the letter.

Again, you need two letters for most surgeons, if therapy is covered by insurance there may be no cost difference, if you're paying out of pocket then it's a fair bet a PhD is going to cost you more money per session so it might be better to put in the major time with your current and get the 2nd opinion letter --usually  in just one or two sessions -- with the PhD or MD.

p.s. I'm not principally engaged in therapy due to being trans, more like I was already there working on other stuff and along the way I discovered it was time to get serious about transition

[supergirl23]

Okay, thanks for everything everybody!


Sent from my iPhone using Tapatalk

[Jacqueline]

Most therapists know when you don't need to see them as often. They will ask you about cutting back sessions.

There are a lot of things we all go through day to day. It brings up issues that sometimes needs an objective outlet. Therapists can be that.

It is not always just about checking the boxes off the list. It is often about support and guiding through the process.

I am sure there are some that disagree (even having read through the above posts). However, if you can afford it, I don't think therapy is ever a waste.

Example: I have been in  therapy for about a year and a half. Between the therapy and starting HRT I started to lift out of the severe depression I have been in for my whole life. To cope I had been shutting down and essentially numbing myself. I soon started to experience good moods. Oddly, I also started occasionally plunging deeper(since I was removing the numbing). Seeing this before I did, my therapist acted and put me(almost against my will) on anti-depressants. I am now evened out. I still have the good but a negative experience doesn't plunge me into so extreme a depression. Without continued contact, she could not have seen that.

Good luck.

With warmth,

Joanna

[Tasha_]

My therapist is genderfluid, offered me a letter straight away.... I told them thank you, I will take you up on that when I am ready. They ask me about how I feel about my transition, how I handle relationships as I come out (contractor owner of construction company) at work, to employees and so forth. What is helping me is just leasing the conversation. The last session I had I asked about resources for children because I know one with an understanding parent. And at the end of the session she led me to a personality test. The test told me about me, and confirmed her "evaluation" of my personality, and gave me more confidence. YOU are the key in your relationship with your therapist, if they are understanding and willing to learn, and you like them and feel safe talking to them, just talk.

They also got me into a trans-friendly primary care physician's office. So, you never know what else can come from a relationship. Just follow your heart when it comes to therapy!!!

Hope this helps!!!!