How many sessions are typically required for a letter

[Randy1980]

I'm assuming every therapist has there own guidelines the follow but I'm curious as to how many therapy sessions most of you had to go to before your therapist would write you a letter to start her... I just went today to talk to my got about starting hrt. It doesn't seem like she is going to require a lot of sessions but she is requiring me to do a phsyc evaluation to make sure there arent any other issues it's some sort of test then I will go back to see her and I'm hoping it will be that visit or maybe one more I'm hoping it doesn't end up being like 20 sessions or something

[Deborah]

Three sessions seems to be many people's experience.  The psych evaluation is pretty standard I think.  I was happy for it just to rule out my being a raving lunatic, LOL.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

[AnonyMs]

Depends on who you are seeing I think. You can get it done in one session here in Sydney. Sometimes none.

[Dena]

Many times others have received their letter in 3-4 sessions but it can be longer. I spend a couple of years with a doctor who couldn't write a letter and then another year before I got one form the second one. Yes I didn't know what I was doing and had I known, I might have got a letter sooner but that may be some sort of record for most difficult to obtain letter.

My advice to you is keep mentioning it and if the doctor delays you, make sure you understand why. There is a reason to evaluate you but you shouldn't be paying for the doctors new BMW.

[Randy1980]

Yeah I figured the phsyc evaluation was standard and 3 sessions was kind of the vibe I was getting that seems like enough sessions to know if it's right for the person. I definitely know there isn't a doubt in her mind that I amntransgender.. it does seem that it would be an easy racket for a crooked therapist to  make extra cash by requiring more sessions then necessary concidering they know that is most of our ultimate goal is to start her and we need that letter so we would keep coming until we received it

[AshleyP]

I'm assuming every therapist has there own guidelines the follow but I'm curious as to how many therapy sessions most of you had to go to before your therapist would write you a letter to start her...

I agree with Deborah; three seems to be about right. It was for me. I think it also has a lot to do with how knowledgeable your are about the aspects of HT, how confident you come across about what you want to do and how you'll deal with the social ramifications. I have a feeling your age may play into it, too.

I've seen more than a couple of posts on this site where the therapist insists on treating an underlying depression before considering HT. Also, I have a friend that went to a therapist that was interning (LPC-Int) and that seemed to drag on. From what I understood, the intern therapist has to present the info to the supervising therapist and couldn't make independent decisions. Good luck with your endeavor and let us know how it goes.

All the best,
--AshleyP

[Stevie]

 On my first visit with a therapist she said she would write the letter, I had been presenting full time as female for about three or four months months before I saw her. She said she would have to see me two more times though because Kaiser required at least three sessions, she booked me for her next available slots and I had my letter three weeks later. The harder thing was getting into see the endocrinologist that took another two months.

[Randy1980]

Yeah I have a feeling I'm looking at 3 sessions I don't think she waste time she was telling me she's had patients that have come to her from other therapist that we're 14 sessions in and still didn't have a letter she assured me she moves quick.. do they typically write the letter there or just agree to write the letter and have you come back for another session to get it?

[Deborah]

My therapist wrote the letter and then sent it directly to the endo I selected.  He did not give me a copy of it. 


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

[steph2.0]

My first therapist appointment was on May 19th at a clinic that specializes in transgender issues. I was stunned when, at the end of that first session, she agreed to write the letter.

I haven't yet asked what convinced her to go that quickly. It's possible that having my supportive wife along helped. I'd also made it a point that every stitch of clothing I wore came from the women's department, even though I'd never presented in public before. It was all pretty androgynous. Jeans, white button down top, cotton camisole that looked like a regular undershirt, white tennis shoes, a small silver necklace - and I've had a long pony tail for 20 years which I loosened up a little. That's it.

It seemed like she did most of the talking, but my wife and I must have said the right things, because on June 14th we met with the in-house endocrinologist (who is herself a transwoman), and she transmitted the scripts while we were there. I started HRT on June 21st, the first day of summer.

I think it helps to go to someone experienced with trans issues. After all the people she's seen, she can apparently tell very quickly when someone is ready. In many cases, I suspect it's the insurance companies, not the therapists, that impose the limitations.

Stephanie

[Anne Blake]

I approached my therapist a bit differently. My wife and I met with her and my request was for, if possible, her to "Fix" me so that I could live happily as a CIS guy or to do what was necessary for me to begin hrt. By the end of the first session she let us know that I was clearly transgender and we went from there. I continued to clearly state the objective was to gain access to hrt and we got it done in 3 or 4 sessions. The total window from first session to pills in mouth took about 3 months, primarily due to both my therapist as well as my OB/GYN taking vacations at inopportune times.

When it was time for GCS letters, the first one took 4 sessions and the second letter took 3 sessions and all of that probably took less time than getting to hrt.

[Dena]

As useful as this site is for the transitioner, it will not fully replace a therapist. I think occasional visits are a good thing if for no other reason than it gives you a person knowledgeable about your transition to write your letter for GCS. In addition, should problems occur during your transition that you are unable to resolve, a therapist can help with that as well. You don't need to see one every week but maybe once a month will be sufficient.

[Lucy Ross]

I went to a therapist with an MA, who specializes in trans issues.  Purely on my own initiative I wrote out an autobiography covering what I thought was pertinent to my case, I wanted to save time, not forget anything important, and also help in my case my minor speech impediment manifested itself.  The session went OK; at the end I asked about starting HRT, and was told it would take 8 sessions for a letter.  Did the autobio help?  Indeed it already had - I was down from the usual 16.  That seemed really ad hoc.  A transwoman I met later told me various unsavory things the therapist had done in her instance, giving out her contact information to other clients, for instance.  This woman is a solid corporate professional and I'm surprised she didn't seek legal action against the therapist for breach of confidentiality. 

The therapist did point out to me that I can always go the informed consent route, which I did on Tuesday, obtaining HRT meds in one day.  I'll contact the transwoman's personal therapist in a few minutes here though, I'd still like an outside opinion on who I am.  But if you have an IC clinic around you can do a run around of therapy, if so desired.  There are tons of threads on this site covering this topic. 

[Sarah_P]

Mine was 3 sessions. She was actually going to write it for me on the 2nd one (which was also the first time I went out as Sarah in public!), but she had to stick to her 3 session policy. I was shocked when she told me that she rarely ever hears from most of her trans clients again after getting the letter! I'm sure I'm going to need someone to talk to during my transition.

[MissKairi]

To my utter surprise it took one meeting.
It didn't happen on the meeting but afterwards when i harassed them about my sanity via email.

Now I'm not saying do that but... Haha

Considering each uk meeting can take up to a year!!!! You have to do something

[BreeD]

To share a personal experience, rather than one based on requirements (I am US based), I saw my therapist for around 5 months (every 2 weeks roughly) before going to my GP and asking to start low-dose hormones.  My GP didn't require a letter.  Sadly she is moving and I am working on finding a new DR. 

[yuna]

I got my letter after 2 sessions.


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[Maddie86]

I went into therapy not knowing what to expect, I didn't know about this board back then. I decided back in February that I finally needed to transition (I originally intended on starting hormones in september, but my weight loss went so well that I moved it up to my bday in July), then in mid march I got ahold of a therapist who specializes in trans issues and I got an appointment with her within a week. the first session was about an hour and a half and I started seeing her once every two weeks. I think it was on my 3rd session that she said she was going to write my assessment and approve me for hormones, and then our sessions became less frequent. our last session was at the end of may and she said we didn't even need to schedule another one at the time, but now that I'm starting HRT on monday I think I'm going to set up an appointment with her for mid august. I'm pretty early in my transition, I know I will need her in the future for approval on other things, but for now it's pretty easy going. The doctor I saw said that the letter she wrote for me was really nice, I didn't get to see it but that makes me really happy!

[DawnOday]

Yeah I have a feeling I'm looking at 3 sessions I don't think she waste time she was telling me she's had patients that have come to her from other therapist that we're 14 sessions in and still didn't have a letter she assured me she moves quick.. do they typically write the letter there or just agree to write the letter and have you come back for another session to get it?

I received my letter on the third visit. From beginning to starting HRT took about two months. I have Kaiser.

[Tommi]

I went through the VA and got a letter with 1 session, and prescribed hormones the following week ( already had an endo appointment). I was already in the system with endo and psych for servive connected issues, so i was not completely new to them. Psych mainly made sure i understood that hrt can cause permanent changes, and i had realistic expectations

--
"You do realize, this means you get to do character creation & the newbie zone all over again? "