Therapy in different countries

[Tajgapriroda]

Hello!

I'm curious about how therapy works in different countries, in case of knowing what further possibilities there are to choose between.

I'm mostly interested in how long it takes to get an appointment at a gender therapist and how long or how many sessions it might take until HRT.

So what is it like in your countries?

From what I know about the situation in Sweden if I'm not mistaking (feel free to correct me if I'm wrong about some information).
A person first sees a psychiatrist once or twice who later sends a referral (remiss in Swedish) to one of the gender investigation teams.
I've heard that it usually takes about one year (perhaps more if there're significant doubts) until one can start Real Life Experience, which I believe seems to be a too long time.
It can also take some few months before one gets a first appointment at a psychiatrist and a gender investigations team.
It's also good to note that I'm not completly certain about these facts since I don't have direct experience with it.

Thanks in advance!

[Thessa]

I can share with you how it is handled in Austria.
It was more complicated in the past but I think the current rules are fine so far.

For example it took me less then six months to get HRT approval, which is payed by social security.
But during that time I payed Therapy, the Statement/Approval by the clinical psychologist, the psychiatrist and my therapist out of my pocket. I'm currently in the progress to get part of it refunded by social security and then by my private health insurance. We will see how much I will get back.

HRT gave me the confidence that I'm on the right track, I never believed that the right hormons can make such a big difference how you see and feel the world. 

Now I need to find the right way to live my daily life as a woman (Altagstest = Real Live Experience) and after that I can start the next round of Statement/Approval collection for GRS. If I get approved it will be payed by social security as well.
For me it will take some time, I still present most of the time as male due to some personal and business struggles I have to deal with first. I plan for two to three years until GRS.

Hair removal, FFS a.s.o. I will have to pay out of my pocket but I'm very grateful that the really costly things are covered by social security.

Here you can see a diagram of the current treatment process (in german).

[AnonyMs]

If you can pick wherever you want then Thailand's the place. Estrogen is non-prescription and standard approach is to just buy it from the pharmacy like you would asprin. I was thinking of it for a while, before I found out how easy it was in Sydney.

In Sydney I believe you visit a psych for a few sessions to get your letter. Takes maybe few moths depending on how busy they are. I didn't to that either so not completely sure.

[Shakku]

Wow, that sounds so easy about Thailand and Australia!

I'm living in Norway right now and from my understanding, it's pretty much as in Sweden, which makes me kind of desperate... Also, I'm a foreigner and don't have the nationalty  so I don't have a clue if that should come out of my empty pocket or if I will get help or refunds.

About RLE, despite being really new to all this wonderful trans world (I made my own CO about 5 days ago), it just seems so far! How am I supposed to present as female while in a masculine body? Why does it looks like a vicious circle? (I read a post about that actually: To get HRT in Norway -at least back in 2010, if anyone has something more recent I'll take it!- you need to success RLE for which HRT would help/be needed/give you confidence) I don't know what to think and even though getting hormones seems easy in some other countries, I came to understand that it would really be dangerous without the appropriate health care and check.... Oh, not to mention that I'm not native from the country I reside, let alone with the nationalty.

Any leads?

[AnonyMs]

In Sydney you don't need RLE to get HRT.

I've told my psych and endo that I have no intention of doing it, and I'm not planning on it anytime in the next few years either. I've been on HRT more than 5 years now. It made no difference to how they treated me.

Thailand's a developing country and trans-women are not actually treated very well there. I think its a bit complicated.

Personally I'd move rather than put up with the rules you're under. If you're lucky enough to have money you don't have to put up with any of this. You could even get SRS without RLE if you really wanted to.

[Thessa]

I suggest to get in touch with LGBT Organizations in Oslo like http://www.llh.no
Maybe the rules are not as bad as you suspect now.

Most likely they can also help you answer your questions and suggest a therapist and/or self help group to figure out more about yourself.

[Promethea]

Are you in Sweden? I'm moving back there in May to begin this process, so I will soon have first hand experience with this.

The first meeting with the therapist and the remiss can take longer or shorter depending on where you are. The remiss takes longer if you're not in a province with a gender clinic. That's why I'm going to Uppsala (well, there's other reasons too).

I don't think there's a requirement to wait so long to start RLE. Once in RLE they are supposed to wait two years before letting you have any type of physical treatment at all, but the good news is that most of the doctors have already realized that the protocol needs an update, and they don't wait nearly that much for non surgical stuff.

There are a few other Swedish members here, hopefully they can chime in.

I'm hoping in my case they take into account I've been full time for over a year now.

[Tajgapriroda]

From my point of view, Austria seems to be very good when it comes to therapy.
It's very nice that HRT can give one much confideence.
That diagram of the treatment process can be to a help, thanks.

At this moment, it's probable that I'll start therapy here in Sweden.

If I would go abroad for therapy, I'll probably choose a place nearby where I live. I've been thinking about Denmark since it might take shorter time to get HRT there according to this site (http://www.ft.dk/samling/20131/lovforslag/l189/bilag/3/1370669.pdf) (PDF in Danish, from 2013).
Although I'm not sure how it would work for me there since I'm not living in Denmark.
Other countries could probably also work for me, but I don't know that much about what therapy would be like there for me.

Sydney seems to sound good, but it might be a bit too far away for me.

Yes, I'm in Sweden. I luckily live very close to one of the Swedish hospitals where there is a gender investigation team.
I do have an appointment at that hospital soon with a psychiatrist because I've quite recently finished a CBT-treatment for another psychological matter. One of the points that we will talk about at that appointment is if I need some other kind of treatment from another unit. I wonder if I should tell about my gender dysphoria then.
I feel a bit nervous to tell. 

Yeah. I hope that I can speed up the process by being effective at the sessions.

Hope they'll take that into account.
There are some sites in Swedish (in at least one case with a little information in English) which provide good information about transgender treatment in Sweden, in case if you would want me to post them.

[Sebby Michelango]

You can only get treatment from the capital city in Norway, and that's in Oslo at Rikshospitalet, the hospital.
In many cases you have to go through between 1 and 2 years with gender therapists and examination. You have to go through 2 years at hormones before surgeries and you have to be castrated/sterilized to change your gender marker at passport, important papers etc. According to International Amnesty and the LGBT-activist group "Skeiv Ungdom" the system in Norway have a One size fits all model. Take everything or nothing. A trans activist in Norway called Tarald Stein got the treatment refused, and he went to private clinics. 80% of they who goes to the hospital get the treatment refused, but only 20% are allowed treatment. It's very strict because Rikshospitalet are afraid to do mistakes according to them. International Amnesty and the treatment system are very disagree with each other.

A sex correction process uses to take from 5 to 8 years. There are very few cases there are 3 years. The hospitals gender therapists decide if you're trans enough or not. Only "true transsexual" gets treatment, not non-binaries. Many talks very negative about Rikshospitalet.

[Shakku]

That's what I read and heard about the Oslo GID Clinic...
I also heard more refreshing news, such as it would be fairly easy to get your name changed in Norway!

That would be quite a reliefe to have a new name which would be officially recognised! DO you happen to know if the procedure is opened for non citizens? Do I need at least a personnummer? (I got the feeling that I will get one once I find a job....)

[Sebby Michelango]

That's what I read and heard about the Oslo GID Clinic...
I also heard more refreshing news, such as it would be fairly easy to get your name changed in Norway!

That would be quite a relief to have a new name which would be officially recognized! DO you happen to know if the procedure is opened for non citizens? Do I need at least a personal number? (I got the feeling that I will get one once I find a job....)

I've heard the national identity number says which sex you're assigned at birth. To change your gender marker in the passport and to change your number, you have to go through sterilization/castration. Without that treatment you can't change the number or the marker.

[Shakku]

I've heard the national identity number says which sex you're assigned at birth. To change your gender marker in the passport and to change your number, you have to go through sterilization/castration. Without that treatment you can't change the number or the marker.

That would be problematic, but that's targetting long term =)

I was more asking myself about a name change? As a foreigner, do you think I would have the right to change my legal name?

[Tajgapriroda]

I found this site that says how long the gender identity investigation can take in Sweden until one gets the diagnosis.
http://www.internetmedicin.se/page.aspx?id=3422 (in Swedish, under the headline Utredning)
It says that the time of the gender investigation should be individually based and it usually takes about 4 - 18 months. The time also depends on how far one has come into its own process.

I'd be glad if I could be on investigation for about 4 - 6 months until diagnosis, but I don't recall any other sites which say that the time could be that fast so I don't know how common this actually is, but one can always hope.
The article had its latest update in late august 2015.

[Promethea]

but I don't recall any other sites which say that the time could be that fast so I don't know how common this actually is, but one can always hope.

That's probably because of what I mentioned in my previous post about what the doctors actually do being ahead of what the protocol says they should do. Most sites probably just quote the protocol.

[Tajgapriroda]

I've been in the gender identity investigation (or if it's simply called gender therapy) for some time now here in Sweden, so I can share a little of what has happened so far.

My referral to the gender clinic in Stockholm was sent in the beginning of april 2016 and I got my first appointment at the clinic in the middle of august 2016. I've had some sessions now and I also asked for Androcur (an anti-androgen) which I later on got prescribed and I've been taking it for a bit more than one month now.

I have some sessions left to attend though, but I would estimate that I'll get my diagnosis and can start HRT during the spring this year if I'm not unlucky.

I'm not living full-time as female yet, but hopefully, I'll have the confidence to do so when the summer starts or earlier.