Emotions = no HRT?

[Alicia91]

I was with my therapist, going over my psychological evaluation. He said that because I have too much anger and depression, I can't do HRT. I told him about my difficult childhood and what I'd put up with being teh non-sports-loving, younger child, and how I was always picked on for my size, and he said that it just couldn't be done. What's up with that? Also, are there any techniques I can use (without drugs) to lessen my depression and control my anger?

[Janet_Girl]

What I do is, if it is something that is the object of my rage, walk away.

If a person, I leave the area and calm down.  Letting it flow over me.


Janet

[LordKAT]

I know there are anger management classes. Have you tried one of those? As to anger and depression stopping HRT, that sounds off. Anger and depression are relieved by HRT for a large number of people. I have depression and what my therapist called 'anger issues' but still got my T script.

[Asfsd4214]

I was with my therapist, going over my psychological evaluation. He said that because I have too much anger and depression, I can't do HRT. I told him about my difficult childhood and what I'd put up with being teh non-sports-loving, younger child, and how I was always picked on for my size, and he said that it just couldn't be done. What's up with that? Also, are there any techniques I can use (without drugs) to lessen my depression and control my anger?

As I understand it, some therapists don't like the idea of treating GID until other mental disorders have been dealt with. I think they're concerned that gender identity problems could be related to mental disorders you have rather than being a problem in its own right, and want to rule that out before doing anything.

My first therapist told me something along those lines, she wanted to treat my depression before treating my gender issues (never mind that my depression was BECAUSE of my gender issues, or that I'd stopped being depressed BEFORE going to her). Though when I explained and demonstrated that I didn't have any other social/mental disorders not related to my gender dysphoria, she simply resorted too "well you're not a crossdresser so you can't be serious so no HRT for you.". Haven't seen her since that. 

Maybe you could try seeing a different therapist. It went though 2 before finding one that was helpful and supportive.

Or of course you could try doing it his way, try to work through your anger issues. I don't really understand why depression would predicate HRT though.

[shanetastic]

I had the same issues Ashley.  My first therapist didn't know much and wouldn't give me a recommendation because I was depressed at the time because I felt hopeless because of GID and never being able to get on hormones. It's odd how it works out.  I eventually just dumped her and moved on to another therapist and eventually everything worked out but yeah I totally hate people who do that.  However, at the same time I can see where they're coming from as they need to protect their job and interests as well.  Still sucks though. 

[gothique11]

That sounds bunk, although I can understand the idea about wanting to treat your depression.

As for the depression, if it's clinical depression you can try a small dose of an antidepressant. Probably and SSRI. For anger, there's therapy. If the anger is difficult to control, a combination of medication and therapy might help over time.

Antidepressants aren't as scary as some people think the are. It really depends on what they put you on (newer ones are better), and the type. There's different classes of anti-depressants (SSRI, TCA, SNRI,). They don't cure it, but treat it giving you a little boost so that you can move forward. You still have to do the work on them. Sometimes you have to try a couple of different ones to find the right type for you. If it's not working after 4-6 weeks or you find that you get more depressed, then it's not right and time to switch. For most people, SSRIs work (SNRI if not). SSRIs can be taken at low doses, and most provide fewer side effects than other kinds. TCA and older classes are usually not prescribed these days as a first line of treatment (they can be nasty).

Anti-depressants don't change your personality, and they don't make your feelings go away. My ex gf was scared before she tried them, and then she tried after battling with depression and trying therapy, she started. She says it's one of the best things she's done. She feels more like herself, she hasn't had any side effects, and she's been able to breathe in life, and start enabling herself to move forward. I'm now on the same one as she is, and it works very well for me, too. (Celexa) She's doing therapy still, and finding that the therapy is helping her.

Taking an anti-depressant doesn't make you weak minded, or make you less of a person. Depression is physically visible in the brain, actually, and can be very debilitating. Clinical depression and the "blues" are different, btw, and an anti-depressant isn't recommended for that. So, you're doctor will have to evaluate you and see if you have clinical depression or not.

I would talk to your therapist (or another one you find) about the issues, how they are interconnected, and make a deal that you'll work on the depression and anger with transitioning.

Getting help with your depression may help you to transition more easily, and make it over different obstacles in the process. Help with the depression may or may not need meds. Therapy is a good first step, and medications if necessary, since meds aren't candy and they won't work if you don't have clinical depression.

Good luck!

[rejennyrated]

Wow.

Your therapist sounds like an idiot.

Seconded.

I never had therapy thank goodness as it's not something that was done in the UK in the 1970's and 1980's, but if I had come across one who said something as positively moronic as that it would almost certainly have been the last thing they said to me because I would have simply told them that in that case it was utterly pointless to continue the session, politely walked out at the end of the sentence and found a new therapist.

[Hannah]

(without drugs)

Yeah I wanted to speak up for drugs too. Celexa and Remeron have changed my life almost as much as hrt did. They have come a long way in the last ten years, it might be worth looking into. Hrt can help with anger too. I'm not saying you should cycle through therapists until you find one that tells you what you want to hear, but yeah a second opinion is definitely called for here.

Anti-depressants don't change your personality, and they don't make your feelings go away

It's true. In fact, if you don't need them the newer ones don't do a whole lot of anything so you don't really have anything to lose.

[findingreason]

It's interesting how they can sometimes want to treat somebody with GID and want all the other things to be perfect beforehand somehow....when the GID or other stuff can often being the causing it. It's unfortunate that there are more bad therapists and counselors than good ones it would seem, the good ones actually listening to their patient's needs and such, and then deciding a best course of action with them, instead of dictating their life. I'd say definitely go find another therapist, this one don't sound too terrific to me.

[Nikki]

In regard to the anger issue, workout at least twice that's recommended for the average person, daily.

Don't fret just yet, but consider that's just over one (1) hour per day. No prob. in the least.

Find the mechanized tool to facilitate it and make it happen, be it the stairstepper, treadmill, stationary bike, etc.

And the secondary (or secondary in this case, anyway) benefit is that you'll in no time be very fit.

You can't lose, Babe. Tear it up. Good luck.

[placeholdername]

I agree with finding another therapist.  Some people just have a mental block when it comes to GID -- it's so bizarre, so obviously *something* else must be wrong, and when we fix that the GID will probably go away.  Hell, that's what I told myself when I was in the teen years -- I had other major depression issues as well, and ended up going to a therapeutic boarding school (it actually helped a lot).  But even after that, I still felt the way I do, which is how I knew it was real.  But it was just as real 14 years ago.  So yeah, get another therapist, or at least a second opinion.  Is this person actually a gender therapist or just a 'regular' one?

[Miniar]

My psychologist told me the opposite..
I told him I'd previously been diagnosed with depression (though not properly, it was a preliminary diagnosis) and that I was having "some" coping issues. His response was that we should start by looking at fixing one of the major causes and see if that alleviates the emotional pain, since it's a given that the transsexual thing is at least a significantly contributing factor.

[Alicia91]

That's the kind of stuff I've been saying, but he still keeps talking about more/different drugs. Add to that I've been in counseling and therapy all my life for anger (and I might say I've come a long way from throwing chairs at people and breaking down doors), AND I forget the word, but I only have a bit of low-grade depression. Unfortunately, the guy I'm seeing was the most highly recommended therapist in my city. Plus, everywhere outside of Sioux Falls is so old fashioned, most businesses are closed on Sunday's. I just think this is all so totally bogus!

Also, I did an internet search, and there are NO LGBT therapists within 50 miles of my zip code.

[Asfsd4214]

That's the kind of stuff I've been saying, but he still keeps talking about more/different drugs. Add to that I've been in counseling and therapy all my life for anger (and I might say I've come a long way from throwing chairs at people and breaking down doors), AND I forget the word, but I only have a bit of low-grade depression. Unfortunately, the guy I'm seeing was the most highly recommended therapist in my city. Plus, everywhere outside of Sioux Falls is so old fashioned, most businesses are closed on Sunday's. I just think this is all so totally bogus!

Also, I did an internet search, and there are NO LGBT therapists within 50 miles of my zip code.

I remember that feeling. There's only one in my area and it takes months to get in to see her.

But it doesn't sound like this therapist is helping, so I'm not sure what you can do aside from finding another therapist.

He reminds me a bit of my first therapist, she seemed far more interested in focusing on my depression that I was suffering in the months before I finally went to therapy. She wanted to put me on antidepressants too.

And if he's that much like my former therapist, perhaps he intends to just keep putting up arbitrary barriers to HRT.

[Cowboi]

Okay, I have to admit that I have not read all of the responses so I apologize if I am repeating anyone. Honestly I became a little disheartened with them after the first few as there is not a lot of knowledge being shared on the responsibility of the therapist. Also I am new here, so hello to everyone, for background I myself am FTM, engaged to a woman who is MTF and am in college to become a gender therapist.

I do have to admit that some people are right, it may just be a personal issue for this therapist. Everyone has different requirements or tweaks the actual requirements to fit their ideas and beliefs. Chances are this may be the real issue with your current therapist and perhaps a second opinion would be a good idea for you.

As far as the comments regarding rather or not emotional issues or mental issues are taken into consideration with HRT, they ARE. It is your therapists responsibility to ensure that every single person they recommend for HRT meets several requirements. Everything from emotional stability, a supportive environment, and the facts of rather or not someone actually is trans or will benefit from HRT (and eventually a sex change) are the things that a therapist has to be concerned with. Like I said before, each individual sees these requirements as needing to be filled in different ways, and some therapist do use these as an excuse to not have to involve themselves with the legal responsibility of the whole issue.

If your therapist is concerned that some of your gender issues may actually stem from things that happened in your past it may be something the prevents you from moving forward. I myself had to work with my previous therapist for over a year before I got my letter for HRT because I had PTSD stemming from sexual abuse as a child and teenager. While she never did believe that this made me desire to be male, she did see that it was a huge issue and wanted to at least begin working with me on it before moving forward with HRT. She expressed concern with the ideas that I needed to be able to be open and trust people in order to find support from my family and friends during such a dramatic life change. I honestly have to say I feel that she was correct in handling my therapy this way.

There were also other things to consider, even finances came into consideration (granted I do not have much in the way of income being a college student!), she did not want to put me in a situation where I may not constantly be able to undergo HRT or where it would create a stressful situation that would cause other emotional problems, this was because for me personally finances were one of my biggest issues in general and a concern over money constantly haunted everything I did at that time.

I know that it is disheartening to have to wait longer, and like I said get a second opinion in case you do have a therapist who is just giving you the run around. However there is a lot of responsibility on their shoulders that we don't often see or recognize. If they write a note for someone who down the road does not feel that HRT and a sex change was the correct route for them then a therapist runs the risk of being held responsible legally. There are concerns over things like lawsuits from families if an individual commits suicide (especially if they leave any evidence that this was due to depression stemming from their gender issues) as this can point to the therapist not taking the appropriate steps in therapy and ensure their client is emotionally capable of moving forward and dealing with the issues involved with HRT.

For the sake of not making this insanely long I am going to end it for now and allow other people the opportunity to respond. I just wanted to pass along some of the information from the other side though, maybe get people to think about the actual things we are asking from these therapists. They are putting a lot of their reputation, career, and possibly even personal well being (considering lawsuits) on their work with us and any other patient. It is something they always have to think about and take into consideration with every single patient they see for any reason.
Post Merge: January 01, 2010, 11:52:11 AM
I forgot to note as well, the person who posted before me with some therapists from Nebraska, I can give you guys a more extensive list. Megan Smith is the therapist I was seeing and she is highly recommended (not just by myself but by many people in the Omaha area who have seen her). Granted options are slim but Megan is a wonderful therapist who is capable of being very open with you about what it is she is trying to accomplish as well as any concerns she has with your therapy in general. She is also a good resource for information, she may be able to point you in the direction of a therapist closer to you if she knows of anyone in your area. Or even towards an organization or group that may have advice.

[lilacwoman]

to a shrink anger means crazyness...so when I got a little riled up at first apoointmnet with shrink he labelled me 'serious doubts about mental stability'   so best not to mention natural normal emotions and instincts with them.

[Cowboi]

to a shrink anger means crazyness...so when I got a little riled up at first apoointmnet with shrink he labelled me 'serious doubts about mental stability'   so best not to mention natural normal emotions and instincts with them.

I'd have to say you had a therapist that either sucked, or the way you were acting did not seem like an appropriate or reasonable response to whatever issues you were discussing. It may have been reasonable to you (our own feelings commonly seem okay or normal to us) but he was looking at it from an outside perspective.

The only thing I really want some of you to see is that this issue is not being looked at in any way that reflects the responsibility and thought that a therapist has to put into their sessions and choices. Yes, some therapist are just bad at their job, or are just trying to pawn you off on someone else. Others are actually very good, and to label them as idiots or say their choices are stupid just because you do not agree with their assessment is not only out of line but often incorrect. As people it is natural for us not to see the fault in our own actions and feelings, it is also normal to feel that anyone who is judging you in a personal manner can't possibly understand or know what you are going through and therefore is talking out of their ass. The truth is though that it is not only our views that matter, and often times they are right and we just don't want to see it. Hell it took me years of therapy to accept that I was in fact bipolar and that my emotional reactions to things did not actually make sense or were to severe for the circumstances.

On the note of anger though there is plenty of therapy out there that specializes in those issues. My mother underwent a few months of anger management therapy, it made a huge difference in the ways she reacts to things and her happiness and well being in general. It does not work for everyone, but remember there are tons of different therapists with different techniques and chances are one will actually work for you specifically. My mother has been in and out of therapy for years before she took anger management. I myself went through several therapists before I found one that I was able to work on my bipolar with and actually accept it and begin medication. Sometimes you have to shop around

[cynthialee]

You can get medicaly prescribed and monitored HRT with out a letter. It is rather simple. Put your doctor on the hot seat. It is a simple childish move and it goes like this...."if you wont prescribe my HRT I will get hormones off the internet and DIY."
Not that you would actually do it but the strong worded statement that you will puts the doctor on a tight spot ethically. It is unethical to not precribe a regimine of HRT if the possibility that you will go it alone exists.
You won't be good friends with your doctor for awhile but it will get you on HRT whilst you are searching for a better therapist.
Anyway I pulled that move and I got my HRT. My doctor was visably pissed off. But because I am HIV+ he can not drop me as a client. I am a medicare case and he is my HIV specialist who also happens to be a qualified endocrinologist.
Just saying what I did to get hormones without doing it DIY. Which no one should do for all the reasons we always talk about.
Forcing a doctor to provide HRT without a letter is definatly circumnavigating to SOC so keep that in mind.

[Asfsd4214]

You can get medicaly prescribed and monitored HRT with out a letter. It is rather simple. Put your doctor on the hot seat. It is a simple childish move and it goes like this...."if you wont prescribe my HRT I will get hormones off the internet and DIY."
Not that you would actually do it but the strong worded statement that you will puts the doctor on a tight spot ethically. It is unethical to not precribe a regimine of HRT if the possibility that you will go it alone exists.
You won't be good friends with your doctor for awhile but it will get you on HRT whilst you are searching for a better therapist.
Anyway I pulled that move and I got my HRT. My doctor was visably pissed off. But because I am HIV+ he can not drop me as a client. I am a medicare case and he is my HIV specialist who also happens to be a qualified endocrinologist.
Just saying what I did to get hormones without doing it DIY. Which no one should do for all the reasons we always talk about.
Forcing a doctor to provide HRT without a letter is definatly circumnavigating to SOC so keep that in mind.

Yeah I tried that trick, my doctor simply said if I did that she would stop seeing me. 

Except I wasn't bluffing.

[Cowboi]

Not that you would actually do it but the strong worded statement that you will puts the doctor on a tight spot ethically. It is unethical to not precribe a regimine of HRT if the possibility that you will go it alone exists.

It is not against the code of ethics to not prescribe HRT because your patient insists they will do it illegally on their own. It does push some doctors and therapists but don't make the mistake of believing that is why they bend to their patients will. The doctor could make your situation even worse due to a bluff like that. They can ethically drop you as a client because you are not following your treatment plan, they can make your treatment plan even more severe (ie more visits to them, other support groups, outpatient or even inpatient hospitalization) under the belief that you will endanger yourself physically and emotionally.

Believe me, I myself was a very difficult client about many things, when I wouldn't take medicine for being bipolar I ended up a contract that I had to see my therapist twice a week, I could not cancel or be late for any appointments, I had to undergo outpatient group therapy at a hospital every single day for the entire day for a whole month, I had to take all medicines prescribed to me as directed and if I did not do these things she would drop me as a client. Which she did, because I would not go to the hospital outpatient group (it was freaking scary!). In the end this created more problems, my endo wouldn't see me unless I found a new therapist, but after I began actually taking my medicine no therapist wanted to see me because they said there was nothing wrong with me (irony of this situation was not lost on me). Luckily after bouncing through about 6 therapists in half a years time my endo went with their choice that therapy was not a necessary route for me. However I am on constant watch, if my blood levels don't come back normal or if I am acting depressed or out of sorts I MUST go back to therapy or no more HRT for me.