Who asked you?

[Hannah]

So I was sitting in a therapy session today, listening to my counselor talk and watching her watch me. Now, I have made it very clear to her that I do not consider myself mentally ill, and that if she starts treating me like I am she had better have valid points or the deals off. I don't need a pity party or a cheerleader either, so to be fair to her I think she doesn't really know how to react to me. Anyway she was talking about a new policy at the clinic that she disagreed with, then shrugged her shoulders and said "but who asked me?"

Then it occurred to me, yeah, who did ask you? How did the psychological community get so involved with us in the first place, does anyone know? I know we do have a high percentage of mental and emotional issues within our group, but considering the trauma that is our daily lives that's to be expected. As I proceed through my own coursework in psychology, I see some of the seemingly moronic things that they/we have done over the decades, and it makes me wonder how exactly this profession became our primary gatekeepers.

I don't mean to discount the value of therapy, not in the slightest, I'm just curious about the evolution of this state of affairs. As I read about things like informed consent vs. SOC, I'm drawn to wonder if in fifty years people will be rolling their eyes at referral letters the way I rolled my eyes when I found homosexuality in the dsm-3. Yes! It used to be considered a mental condition! If we aren't by default mentally ill, then what's the deal? It can't be about the desire for surgeries, because by that same logic if I wanted to get my penis enlarged, I wouldn't have to go to a single therapy session first, heck, I bet it could be covered by insurance.

[K8]

In the past I know there have been times when I lived in my own head too much and would get way off track.  I, for one, need people to talk to in order to keep me from wandering off the reservation.  I used therapy for that when things were really rough because the therapist was trained to pick the wheat from the chaff of my babble and guide me back to reality.  Now I have lots of friends to whom I can say: Is this me or is this just weird?  (Reality check.)

Many of us have lots of problems unrelated to our gender issues.  They may be worse becasue of the gender stuff, but they are side problems that aren't going to be solved by changing our genitals.  We need to work on those, too, and therapy helps with that.

Until we can wake up each morning and decide which gender we will be that day, I think we need gatekeepers.  Their job is to try to determine if this is some cockeyed idea we came up with or is it an essential part of who we are.  We don't just bow down to them and they bless us (like going up to the communion rail or something) - we work with them to discover for ourselves what it is that we really want. 

IMHO, and in my experience, the more you resist your therapist, the longer the process takes.

- Kate

[Hannah]

Yeah twenty five plus years of denial, looking at a monster in the mirror daily and constant emotional trauma certainly warrants psychotherapy if we ever want to be normal people. That's a given, but thanks for the canned therapy speech, I'll copy that down and probably use it in a paper sometime. If you don't mind of course 

My question, which I went on to answer myself about an hour after I posted (I always find the answer right after I ask for help!) was when and how psychotherapists became so intimately involved in the transition process, and from what I can gather it was with the establishing of the original soc.

[tekla]

I think to answer the original question, the reason that psychological community is so closely involved is that in the beginning they were the only medical professionals who didn't throw trans persons out the door screaming "you freak" but, rather, opened the door and say, "Come in, would you like to talk about it?"  It was though the involvement of the psychiatric community in particular that many of these services even exist today. 

[Kara]

The psychiatric community practices a pseudo-science in which there's never any clear evidence one way or the other about anything. One of the things that bugs me is that they will never put their foot down and say, "this a truism no matter what." There's always qualifiers, exceptions, etc etc, which makes me wonder why they even have the theories in the first place?

Personally, I think the psychiatric community goes about it all wrong. They do their little experiments (which are supposedly the holy grail of psychiatry) and they draw a conclusion. It doesn't matter if they're completely off base or if they're on to something, it seems to be a given that if you have a doctorate in psychiatry, you're expected to experiment and find stuff out.

I believe (and mind you, it's just a belief) that the best way to learn is to sit down and talk to people all the time. After all, the theories they cook up are pretty much useless if you can't say for sure if you're looking at the next exception. And....for what it's worth, I think Jung was full of crap. 

[Miniar]

As someone who studies psychology, albeit only as a hobby, I have to say, I completely disagree with Kara.

[K8]

thanks for the canned therapy speech, I'll copy that down and probably use it in a paper sometime. If you don't mind of course 

You're very welcome.  Anytime.

- Kate

[Alyssa M.]

As someone who studies psychology, albeit only as a hobby, I have to say, I completely disagree with Kara.

To be fair, Kara was talking about psychiatry, not psychology. I tend to trust the psychologists a lot more -- a little loopy at times, but at least not stuck on reductionist explanations for phenomena that don't have practically reducible causes.

Why are therapists so involved in the transition process? Well, there are a few answers. First, to cover the assets (so to speak) of the doctors -- don't want malpractice suits, now do we? That would be good for exactly nobody. It's just a hoop to jump through. Second, some of us do need cheerleaders at times (in extreme moderation, don't need people pushing us to transition when not transitioning would be a better option) and some of us need to work through all that baggage to be able to transition. Therapists can be nice to have around. Third, well, you don't really need to involve them all that much. Plenty of people transition sans psychologist.

[VictoriaX]

 I think its also a matter of Doctors dont like to wander outside of their element. I've seen plenty of times where a Doc is perfectly capable of handling a medical issue but instead passes that issue on to a specialist or generalist, depending on what that doctor does. So, a surgeon who might be capable of handling the surgery for SRS really doesnt want to deal with or spend the time on arranging and handling all the other factors that get involveed and would prefer you see a specialist to handle it. That pretty much leaves you with Psych MD's / therapists.

I also think Tekla is right in that they jumped on the issue first and basically own it as far as the medical community is concerned.

[Hannah]

Yeah, I actually liked Teklas thoughts, and as I've read more on the subject over the past couple days they seem to be pretty accurate. You know, I swing back and forth when it comes to therapists. On the one hand, in a couple years I'll BE one so I can't throw too many stones, but even now I've met so many up-and-coming quacks that I worry for their future clients. I once asked my psychiatrist his opinion about the helping professions being a bit off, and he got wild eyed and explained to me that everyone is a little crazy, especially therapists.

[Randy]

I always thought that it was just the nature of our condition. If modern science hasn't yet found a physical cause, they just assume we're crazy, like they did with homosexuality. And you know what happens when you assume 

[Alyx.]

I always thought that it was just the nature of our condition. If modern science hasn't yet found a physical cause, they just assume we're crazy, like they did with homosexuality. And you know what happens when you assume 

You make an ass out of u and me?

I thought they did find a physical cause.

[Inanna]

Wow!  Becca, I couldn't agree more!

I'm going full-time now, and I've never seen a therapist, and I don't plan on seeing one if I can avoid it.  I'm hoping I can find a surgeon that doesn't require letters from a therapist (in another country perhaps).  If not, I suppose I'll have no choice.

I have problems like anyone, there's no doubt.  I sometimes become sad about my past of course...  I sometimes have apprehension about my future too.  Yet these feelings are not overwhelming me in my daily life such that I can't function or need professional help, and they certainly aren't exclusively concerning my transition.  They come and go like the feelings any regular person experiences.  In fact, I think my life's challenges have allowed me extra perspective... made me more adjusted, not less.

Assuming that someone needs therapy who doesn't conform to the gender society has labeled them is simply offensive to me.   Now don't mistake me for saying therapy isn't a wonderful option to have.  It is!  If things go astray in my life, I may need it myself one day and I'm thankful I have that option.  I'm just appalled, however, that it's being forced down my throat to have access to the amenities needed to fully complete my transition with the services in my own country.

Like you I think required therapy for HRT or SRS will be looked at as backwards as the medical community's practices regarding homosexuality several decades ago.

[NicholeW.]

Anyone who goes to therpay simply to get a letter is extraordinarily short-sighted and will prolly continue to do him or herself disservices over the course of their lives.

One goes to therapy to actually work on one's internal difficulties and external problems.

And if you think the therapists are cock-eyed go live for awhile with doctors and lawyers and computer engineers, bakers, garbage-men, cops and accountants among others.

As Jimmy Buffet says "there's a little fruitcake in every one of us." Some just appear more fully baked than others. Think of therapy as the last twenty minutes of your oven time.

[Hannah]

I'm sorry, I haven't been minding this thread. I had disappeared into my bed for a few days to recover from this last term, lordy-lou it was a handful this time around. Thanks for the replies though.

It wasn't my intention to discount the value of therapy, or even to cast disparages on my own therapist. In retrospect it looks that way I suppose and I'm sorry for my lack of clarity. The thing I appreciate most about mine, living in a rural community, is that she is one of the few people, and usually the only person who I can talk to about both the wonderful and aweful things that are happening to me. On a strictly practical side, I can't imagine undergoing hormone therapy without her, much less letting someone cut into me without outside verification that I haven't lost my mind

[Ell]

That's a given, but thanks for the canned therapy speech, I'll copy that down and probably use it in a paper sometime.

i don't think Kate's response was canned. i think she was being upfront with you. also, she was just offering honest support on a support site.

there has always been a bloc of transitioners who prefer no therapy, no letters, no external help.

and a bloc who really get a lot out of therapy.

doctors are not going to remove your bits without proof that you will not come back later with regrets because:

a) some transitioners have committed suicide *after* SRS. believe it or not, lots of doctors do have consciences, and need to protect themselves.

b) some transitioners could sue, after SRS, if they weren't properly prepared to understand the psychological risks of SRS.

the therapist does indeed play a large part in managing that risk for the medical community.

-ell

[tekla]

some Several transitioners could sue have sued, and some have won, after SRS, if they weren't properly prepared to understand the psychological risks of SRS.

There, fixed it for you.

[Lori]

In the past I know there have been times when I lived in my own head too much and would get way off track.  I, for one, need people to talk to in order to keep me from wandering off the reservation.  I used therapy for that when things were really rough because the therapist was trained to pick the wheat from the chaff of my babble and guide me back to reality.  Now I have lots of friends to whom I can say: Is this me or is this just weird?  (Reality check.)

Many of us have lots of problems unrelated to our gender issues.  They may be worse becasue of the gender stuff, but they are side problems that aren't going to be solved by changing our genitals.  We need to work on those, too, and therapy helps with that.

Until we can wake up each morning and decide which gender we will be that day, I think we need gatekeepers.  Their job is to try to determine if this is some cockeyed idea we came up with or is it an essential part of who we are.  We don't just bow down to them and they bless us (like going up to the communion rail or something) - we work with them to discover for ourselves what it is that we really want. 

IMHO, and in my experience, the more you resist your therapist, the longer the process takes.

- Kate

That was well said. I know I need a therapist. My therapist may need a therapist after dealing with me. I do think some crazy people know they are crazy or at least know something is wrong with them. A therapist helps figure out what it is. I need that because something is wrong with me. I don't think being TS is wrong, I just think everything else is. I wonder though how many have turned "being ts" into a fantasy though. So I agree with the gate keeper thing.

[Lisbeth]

I thought they did find a physical cause.

The purported finding of a physical cause is 90% wishful thinking on the part of trans-people. A large amount of research remains to be done before anyone can claim physical cause as fact.