mad at therapist...

[bree111]

I had my 2nd appointment with my therapist who is supposedly going to write my letters of recommendation for surgery. On the 1st visit, she made it seem like within 2-3 visits I would have the letter and that she does this all the time. Now on this 2nd visit, she said that it could take a few months or longer. I really have no trust in her because of this and don't feel comfortable opening up about stuff going on in my life. I think each visit, I will just insist that I am fine and need the letter. I really am fine, there are minor stresses here and there, but really the main thing is just wanting to get the surgery down below over with (mtf)

[Dena]

Welcome to Susan's Place. You hired your therapist and you have the right to fire a therapist if they aren't delivering. Have a discussion with your therapist stating what you expect. If your therapist can't give you a good reason to delay HRT, you should consider another therapist. Unfortunately I spent a good deal of money because I couldn't find another therapist to switch to but today, that shouldn't be a problem. Be assertive and good luck.

We issue to all new members the following links so you will best be able to use the web site.

Things that you should read

Site Terms of Service & Rules to Live By	Standard Terms & Definitions	Post Ranks (including when you can upload an avatar)
Reputation rules	News posting & quoting guidelines	Photo, avatars, & signature images policy

[Rowena_Ellenweorc]

Did you ask why it would take longer than you thought?  Because there could be other factors at play as to why its going to take a while longer, such as needing to be in therapy and/or on hormones for a certain amount of time, insurance is being a brat, she thinks there might be another issue that could affect it etc...

FOR EXAMPLE --
Upon reading the 'transgender policy' for my insurance I discovered things like,

Hormone treatment and/or therapy for a year (depending on what surgery you are going for)
Actual diagnosis of dysphoria by 2 medical professionals (1 if its FTM top surgery)
Determined as medically necessary to alleviate dysphoria
Determination that there aren't any other conditions that would affect surgery
and a few other things that I can't remember off the top of my head

Then of course there's the requirements that doctors doing the requirements themselves have whether you have insurance coverage or not.

Then there is of course the possibility that you misunderstood her in the first appointment.

Anyway, that's just me playing devil's advocate for a moment there.  But I totally see why you are frustrated and don't trust her.  If you've asked why and still don't understand, and still don't trust her, then its time to move on to a different therapist.  Therapy does ZERO good if you can't trust the therapist. 
I speak from personal experience.  Most of my therapists for my anxiety I did not trust AT ALL because they would throw the blame on me, when a large part of my anxiety came from my parents unrealistic expectations from me, and a large part from growing up in foster care, and a large part from just social prejudices against me my entire life.  So yeah, if you have done what you could, then move to a different therapist.

[Wednesday]

Needless to say I believe in your freedom (and right) to have surgery without any third-party consent and I support it fully.

However, I must make a plea for your therapist (and for all therapists overall). She's a professional before anything else, and if she's a good one she may have sensed something wrong (not necessarily related to transition or surgery) so IMHO it may be really worth to give her a chance and wait to see what she has to say.

Keep in mind that today most therapists are not on the gatekeeping thing, actually they're quite the opposite. So I doubt giving her a chance is going to do any harm.

She is supposed to be working in your best interest.

[bree111]

Thanks. I believe it is because in the past, I had been diagnosed with bipolar and had been in the hospital before. I should not have told her anything about my past history. Now she is getting all of my medical history. She said she just wants to do her due diligence and wants to make sure that I don't regret it. But it is a completely different tune than the first visit. I really do not have any psychiatric issues. There is really nothing to tell her besides that I want the letter and need to get the letters for the surgery. The only things stressing me out in life is the gender dysphoria and wanting to get the bottom surgery and her hesitation to write the letters. She's just adding more stress and worry. She shouldn't have even said in the first visit that it only takes a couple of visits. I have already been diagnosed with gender dysphoria. I should not have eve said anything personal. I live in the bay area California and am on medicaid.

[Dani]

bree111,

Yes, your previous diagnoses are a complicating factor. You did the right thing in being open and honest with your therapist.

One thing you might question is the accuracy of the "bipolar" label. Is it really bipolar or just extreme frustration with the gender dysphoria issues. Many of us have thought about and a few even acted on self destruction because of our gender issues.

Transition takes several years. However, a hormone letter will get you started. Hormone therapy has made a wonderful difference in reducing my gender dysphoria.

[Doreen]

I know 'gatekeeping' exists for a reason.. and some do fall through the cracks & get hrt or surgery ... that regret it later.. BUT sometimes the gatekeeping is done for their own monetary interests and not your health & safety.

I had a therapist that did this after seeing him off & on over a year... still refused to wright my surgery letters by claiming I hadn't seen him enough times to make a full evaluation.  This is what I call a con artist, not gatekeeping.

I managed to find a way around it, and got hrt, gcs, everything without therapy.   25+ years later I"m a very happy girl.

[bree111]

bree111,

Yes, your previous diagnoses are a complicating factor. You did the right thing in being open and honest with your therapist.

One thing you might question is the accuracy of the "bipolar" label. Is it really bipolar or just extreme frustration with the gender dysphoria issues. Many of us have thought about and a few even acted on self destruction because of our gender issues.

Transition takes several years. However, a hormone letter will get you started. Hormone therapy has made a wonderful difference in reducing my gender dysphoria.

Thanks. You misunderstood, I was talking about letters for surgery. I have been on hormones for 10 months and they help, but the bottom area is still frustrating. And yes, it has been because of gender dysphoria

[bree111]

I know 'gatekeeping' exists for a reason.. and some do fall through the cracks & get hrt or surgery ... that regret it later.. BUT sometimes the gatekeeping is done for their own monetary interests and not your health & safety.

I had a therapist that did this after seeing him off & on over a year... still refused to wright my surgery letters by claiming I hadn't seen him enough times to make a full evaluation.  This is what I call a con artist, not gatekeeping.

I managed to find a way around it, and got hrt, gcs, everything without therapy.   25+ years later I"m a very happy girl.

Thanks for the reply. Wow, that must have been devestating. I don't think the person I am seeing is a con artist. She said everyone she sees eventually gets their letter, some just take months. The state pays for it, medicaid, and it is a clinic that she works for, so I am sure it is not anything like that. She said she just has to do her job. I will ask again on next visit, as well as see if I can see that online gender therapist for a surgety letter. thanks

[Wednesday]

Thanks for the reply. Wow, that must have been devestating. I don't think the person I am seeing is a con artist. She said everyone she sees eventually gets their letter, some just take months. The state pays for it, medicaid, and it is a clinic that she works for, so I am sure it is not anything like that. She said she just has to do her job. I will ask again on next visit, as well as see if I can see that online gender therapist for a surgety letter. thanks

Agreed with you.

As much as transgender patients are a fairly small portion of the population, plus they're not gonna spent more than 2 years in therapy (and this supposing the therapist is gonna gatekeep every single trans patient) and the bad reputation therapists still have in this community (which I'm really sure they're aware of)... Honestly I just can't see how gender therapy could look as a profitable business to them.

Guess if they were straight for the money they would have chosen a bigger, profitable (on the long term) niche, like couples.

[Rowena_Ellenweorc]

bree111,

Yes, your previous diagnoses are a complicating factor. You did the right thing in being open and honest with your therapist.

One thing you might question is the accuracy of the "bipolar" label. Is it really bipolar or just extreme frustration with the gender dysphoria issues. Many of us have thought about and a few even acted on self destruction because of our gender issues.

Transition takes several years. However, a hormone letter will get you started. Hormone therapy has made a wonderful difference in reducing my gender dysphoria.

Thanks. You misunderstood, I was talking about letters for surgery. I have been on hormones for 10 months and they help, but the bottom area is still frustrating. And yes, it has been because of gender dysphoria

Dani's point is also valid for surgery, if not more so.  If you scroll up to my previous post, I gave some reasons for this that she could be looking at.  But yes, as you said you would in a later reply do in your next visit, make sure to ask.  That bipolar dx could be what's hindering it.  Like Dani said, I too believe you did the right thing in telling her about it.  And until you have firm evidence that she DOESN'T have your best interests at heart, (which can be learned from just asking why) personally I think she means well.  She's most likely gathering evidence that you ARE safe to go ahead with surgery.

And this is coming from a person who as a rule has a hard time trusting therapists, hahahahaha

[SadieBlake]

OP, did this therapist indicate that this would be in any way a pro-forma exercise? I took nearly a year to get from telling my pshrink I would be seeking a letter to having it in my hands. Most of that was down to she didn't have prior experience with WPATH SOC or with diagnosis of gd and so we had her consult to a PhD psychologist who did specialize in gender. That second therapist did ultimately provide the necessary second (purely evaluative) letter on the basis of just 3 sessions, however at the outset she made it clear that that wasn't a given outcome - due to not having priorly written an evaluative letter.

I didn't object to this, I'm seeing my pshrink for major depression as well and we didn't spend much time on anything i could consider gatekeeping and perfectly reasonable amounts of time evaluating the importance of depression vs gender dysphoria.

Just last week we had someone on here angry about having been allowed to transition by their therapist. I think it takes time to establish a therapeutic relationship necessary for giving an evaluation and not taking that time could be seen as irresponsible.