Scared about therapy going in the wrong direction.

[Cairus]

Hey everyone. This is kind of a personal post, but hopefully I can get some advice regarding therapy. Alright, so I started making appointments to see a therapist about a month ago, so I've seen the guy four times, it's once a week, and costs $120 a visit. So I'm paying almost $500 a month for therapy with the only therapist in town I could find who specializes in trans/queer issues. I specifically aimed for this fellow because I needed someone experienced with writing letters and treating transsexual patients because I don't have the time to dally with a professional who is oblivious to these things. My goal is to get a letter of rec in a timely manner because if therapy goes on and on, I won't be able to continue it due to the cost.

The problem is, I opened up to him and he snaked some really personal, painful experiences I've had out of me and drew the conclusion that I have PTSD, and told me 'we're going to work on that.' Okay, so I have PTSD, fine, it needs help, I'm all for getting help with that. The thing is, if what I were going to him for were PTSD, I wouldn't have gone to him. I would've found an affordable therapist, covered by medicare. According to the Harry Benjamin thing, I need to be in therapy for like three months for the therapist to have my 'transness', 'proven' to them, right? How am I supposed to do that if the guy is obsessing over a PTSD diagnosis instead of working on confirming my GID?

I'm scared that the seriousness of a PTSD diagnosis will eclipse the need for me to have my gender issues addressed and treated with some amount of promptness. He knows now that I've been raped multiple times, and I'm terrified he's going to try to convince me that being trans is an attempt to 'escape' from that. It isn't, but as with any transperson, the only 'proof' I have that I am transsexual is my own insistence that I am. I can't afford for this to take any longer than it HAS to. I know that something like PTSD needs help, and that I shouldn't PUSH my therapist, but is there any way I can encourage him not to put my GID on the backburner?

For guys with diagnoses other than GID, how did you go about handling this? If you go in for GID but they try to treat you for some other diagnoses, how do you make sure the therapy stays on track?

[Arch]

Cairus, have you talked to him about his own criteria for the HRT letter? What does he expect from you before he will write it? Does he expect to diagnose you? Or does he want you to sort of self-diagnose? Or does he expect you to convince him that you need to transition? And how familiar is he with the SOC and current practice and all of that?

My therapist accepted me as trans from the very beginning and used male pronouns--the whole works. His goal was to get ME to come to my OWN conclusions regarding whether I needed HRT and transition.

I should add that I, too, was worried that a couple of date rapes and a childhood molestation might delay or prevent my transition. But I was identifying as male even before I was molested, and my therapist knew that.

[Cairus]

Cairus, have you talked to him about his own criteria for the HRT letter? What does he expect from you before he will write it? Does he expect to diagnose you? Or does he want you to sort of self-diagnose? Or does he expect you to convince him that you need to transition? And how familiar is he with the SOC and current practice and all of that?

My therapist accepted me as trans from the very beginning and used male pronouns--the whole works. His goal was to get ME to come to my OWN conclusions regarding whether I needed HRT and transition.

I should add that I, too, was worried that a couple of date rapes and a childhood molestation might delay or prevent my transition. But I was identifying as male even before I was molested, and my therapist knew that.

My therapist knew I identified as a transman from before I even walked in there, because I started off emailing him about it and told him up front that my motive for beginning therapy was to exact a letter for HRT. He told me he writes them, but 'that some amount of therapy is required first, of course', so here I am, in the therapy that's required first, but none of the things he seems interested in asking me about relate much to GID. I refer to myself with masculine pronouns, I don't know if he does, because he's never needed to refer to me to myself, because that would be kind of strange.

Thank you for asking me those questions though, in your first paragraph, those are things I'll write down and make a point of asking him about the next time I'm in there. There's no reason for me not to know those things, after all I am paying the man. I talk about issues that involve being trans when I need to, but he'll usually bring the subject over the something else. I think he's trying to get a laydown of my history, and seems to be under the impression that I'm doing 'okay' as far as gender identity and is more interested in finding out about 'other things', so I'm confused as to where this is supposed to be headed.

[jesse]

here are a couple of my suggestions first let me say that the therapist needs to rule out exactly what your worried about before he can write a legitamate letter. He needs to insure that the trauma you expeirenced isnt whats causing you to want to transition. only you can reassure him on that. it has to do with your responces to his questions also start making your appointments in your prefered male name if you dont already. do not allow him to refer to you as her she or any other female surname tell him you would prefer it if he would use your male name when addressing you. I would also go dressed in your true gender. if the conversations continue after about a month still linguring on ptsd tel him that you want to end that discussion and continue it under your medicaid umbrella in a second counseling session. reiterate your concern at that time about being trans and the fact that you want to start HRT. if that dosnt work pm nero theres a good online therapist that costs 100 a month that will give you what you need.
jessica

[Cairus]

here are a couple of my suggestions first let me say that the therapist needs to rule out exactly what your worried about before he can write a legitamate letter. He needs to insure that the trauma you expeirenced isnt whats causing you to want to transition. only you can reassure him on that. it has to do with your responces to his questions also start making your appointments in your prefered male name if you dont already. do not allow him to refer to you as her she or any other female surname tell him you would prefer it if he would use your male name when addressing you. I would also go dressed in your true gender. if the conversations continue after about a month still linguring on ptsd tel him that you want to end that discussion and continue it under your medicaid umbrella in a second counseling session. reiterate your concern at that time about being trans and the fact that you want to start HRT. if that dosnt work pm nero theres a good online therapist that costs 100 a month that will give you what you need.
jessica

I don't need to make appointments under my 'preferred male name' because my name is unisex- it's Alex. And he doesn't refer to me as 'her' OR 'him'- these are one on one counseling sessions, in what situation would someone say 'he's doing fine' alone in a room while talking about me? That makes no sense. And I do dress in men's clothing, always. This is not an 'on and off' thing for me, it's constant. I bind, pack, and dress in a masculine or gender neutral fashion constantly unless I am asleep or just woke up, in which case I still pack but lay off the binder. It's not like I'm going in there in a tutu signing my name 'Tiffany-chan' on any papers. If he called me a girl to my face I'd probably walk out then and there, so you're right, I should probably ask him about his view of me to make sure he doesn't actually think I'm a girl. You'd think it should go without saying, but knowing my luck I'd better ask about that, too. Thanks, Jesse.

-Edit: Also, I was considering that online gender therapist guy a while back, before I joined this forum. I tried emailing the guy, but he got aggressive with me when I didn't follow up his response quickly enough and was demanding money(we hadn't even scheduled appointments yet) via wire, which made me very nervous about it being a scam.

[jesse]

wonder if its the same person might be but i currently use him and he has been nothing but kind to me he is my second reference. ok i based my responce on the idea that you wernt full time yet most of the people i have seen on here do not present in the initial or even several months into therapy as the prefered gender to their therapy sessions. second i was refering to the way he speaks to his staff about you for instance " can you please make an appointment for next tuesday for HER" but since that is not an issue prehaps then i would channel his discussions away from the ptsd by telling him you would like to make anouther appointment for that and see what he says. If he is determined to pursue it and he is really your only option in town im not sure what you can do other then seek an online therapist or an even longer cummute.
jessica

[FlorDeLuna]

If you could go to another therapist (that would be covered by medicaid) to begin to work on your PTSD issues, you could explain to him that you do think that's important and because you can not afford to continue to see him after reaching your goals regarding your GID, you felt it was better to find someone else that you could continue with for the PTSD.  He sees that you're actually focused on resloving those issues and might be more willing to let them drop during your sessions with him.

Also- you are paying him, I would just be honest and tell him exactly what I felt.