Frustration with "therapy"

[MeowMeansMeow]

Ok, so I have had four sessions now with a therapist, and they started off well enough (as they generally seem to, since a lot of the initial meetings is relief at getting stuff off your chest, and simply having a sympathetic, non-judgmental ear). But now I am stopping sessions, with this therapist at any rate. It's not that I don't like her as a person, she's fine, or that she is unfriendly, she's not, but rather I find I am honestly frustrated with this system that seems to have been constructed to "deal" with transgendered people - or at least, her interpretation of it. Let me try to explain what I mean.

I am 42 years old, and I've had these feelings of wanting to be a girl since I was a small child. I am a software developer, with a B.Sc. in computer science from one of the better universities over in the UK. I'm fairly intelligent and self aware, and I think I have a pretty good handle on self introspection and exploring my feelings about this whole gender thing. I've looked at it in some depth, in fact, over a period of decades, and one of the things I was hoping to find out once and for all during this therapy was whether my feelings of gender dysphoria were based on a sexual fetish related to transvestitism, or if there really was a deeper transsexual thing going on which would make transition a good choice for me.

The therapist encouraged me to investigate these feelings, and to try to tease out what I was feeling when I masturbated while dressed (for example). I did this, and in the last couple of weeks had a rather unexpected bonus from my brief stint trying out Propecia: My sex drive became severely reduced, to the point where I am finding it currently very difficult to even masturbate to climax - the libido just isn't there, or it isn't very strong. However the desire to be female remained, strong as ever. This told me something.

I have also, incidentally, been doing more introspection about the whole concept of dressing up as a woman, and the more analysis I do of this, the more I believe that there are separate facets here - at least three, being raw libido (as a result of having gonads), desire to dress (being obviously fetishistic at least in part), and gender dysphoria (desire to be completely female, in all respects, including surgery). I have been thinking about the whole dressing thing, and something struck me as I was driving in town the other day - I saw a girl walking her dog, and she was dressed completely nondescript, nothing particularly feminine, just long pants and top, but it was completely obvious from her body shape that this was a female. It struck me because she wasn't wearing "women's clothing", and yet was unquestionably a woman. It really began to bug me that dressing in women's clothing is a bit of a crutch (to me anyway), an incomplete facade which only gives an image of, an illusion of, being female. It's not the essence of the femininity. In fact, one of the reasons it becomes so frustrating to me, and feeling like a dead end, is that it's not real.

As a programmer, I like designing elegant systems, which are well designed from the inside and out. Dressing like a woman, while being a man, just feels like a hack. It's not a true thing, it's an illusion. So it's very unfulfilling to the part of me that wants to be a woman, complete in body and mind.

The thing is, I'm still not absolutely 100% sure in my mind that transition is the right thing for me. I know the desire is there, and I know that it's not purely sexual in nature, now. But I also know that I have both male and female aspects; I could, if I really tried, live out the rest of my days as a man. The question is, could I be happier doing it as a woman? This is a grand question, a grand experiment as well, because for me it really isn't a question of "do or die", as it seems to be for some more extreme cases. I seem to fall somewhere in the middle. As to whether this should necessarily disqualify me from making a choice to be a woman, rather than feeling compelled to be one beyond any question, is rather interesting. I think the intolerance of society has taught us to try to portray the gender issue as being one that is not a lifestyle choice, but at the risk of offending some - why shouldn't there be an element of choice for some who happen to fall in the middle? If there is a spectrum, then inevitably there will be some who fall at a point where they could honestly go one way or the other, and survive in either role (though perhaps thriving more in one or the other). Does that make their quest any less valid than the rock-solid girly girl transsexual who is 100% sure?

I look at the gender roles as being something like putting on a different sweater - it's a role we play, a thing we portray. For most people it's a natural thing that we developed (and were taught) at a very young age. To revisit it later in life is not only interesting, but jarring too - not only for us, but also for those around us. But we have to remember that at it's essence, the gender split is about roles. I don't see why we shouldn't be able to choose to play a different role if we want to. I just don't see the big deal with that, but I know I'm in a small minority there.

My previous experience with Improvisational theatre taught me that you can't go into new situations knowing what will happen in advance, you just need to observe, relate and react to the other people around you, and go from there. Whenever you go up on stage with a big plot in mind, it's just too inflexible, you make decisions not based on the other people but rather on what will move your Big Plot forward. This gets boring very quickly, for everybody - who cares if you want to rob the bank or take over the town? But the instant you just live in the moment and react to what's going on, and go with the suggestions (maybe only body language) that the other players put out there, then interesting things start to happen.

My current desire is to try taking hormones, to see if the gradual changes that start to occur seem to agree with me, feel right, or if they make me feel more and more uncomfortable, in which case obviously I would stop or rethink the regimen. The idea here is that unlike surgery, the effect of hormones is not irreversible (at least at first), and if you are already a bit transgendered (which I know I am) then I'm sure I could deal with whatever semi- or permanent changes did occur.

Now I think this is some interesting stuff, but I was running into a kind of brick wall with the therapist. Her approach was that I am doing this backward - in fact first of all I should be exploring every possible aspect of what I think would happen if I were to transition to being a woman - how would I relate to the world, how would I relate to other people, how would I react to the loss of status in going from a male role to a female role, how would I deal with the increased danger in living either as openly transgendered or as a woman, etc.

I found her questions more and more frustrating, because it just seems like I am being made to jump through hoops, say certain things, think in a certain way, display certain behaviors and make certain conclusions, in order to progress through whatever process it is that she has laid out in her head. When I brought up the idea of trying out hormones, she thought this was backward, and she outright refused to write me a letter for that based on our discussions so far, because she thinks it's just premature, and I (in her words) "refuse to explore" the realities of what transition would entail for me.

Our session became a little bit contentious after that point. I was coming to realize that we were no longer on the same page at all, she had a certain picture of how this "therapy" is supposed to progress, whereas I see myself as being in control of my life, and just wanting someone qualified to help me figure out some of the more interesting aspects of the issues at hand. I can appreciate of course the thing about exploring, but it all just seems too inflexible and contrived, ignoring where I feel I am and where I want to go. I get the feeling that everywhere, trans people are forced, implicitly and explicitly, to fit themselves into boxes and say certain things and display certain behaviors simply in order to progress through this system that has been imposed upon them.

She said she thought I was, ironically, exhibiting very "male" thinking by wanting to exert my own desires so strongly, and I in turn felt that this was, ironically, a very stereotypical characterization of how a "male" vs "female" would behave. Some of the strongest minded people I've ever met have been female - they know what they want, and they don't stop until they get it, does that make them males? I don't think so. In fact, any particular attribute you care to choose can be seen every day being expressed by both men and women everywhere. As to who or how I would be in my future role as "woman", who can say? I have no idea, but since I am ok with this, she said I was being "flippant" and thus refusing to explore. Whatever.

Now I can fully understand that there is a need to eliminate real mental disorders before committing to something as radical as transition or surgery. But I am just feeling that I am being pressured, in order to progress along the path that I want for myself, to behave in a certain way that is not useful to me. It feels like play acting, not going toward the truth. How can I know what it would be like for me to relate to the world completely as a woman? It's impossible to say, just like it's impossible to say what will happen when you get up on the stage and start improvising. And I'm fine with that, it's part of growing up and just evolving, flying by the seat of your pants. I don't think I have any big underlying mental health issues that I'm avoiding, this isn't about suppression of hidden desires or whatever - in addressing this gender dysphoria I believe I'm about ten million miles beyond 99% of the population in terms of looking candidly at my "inner demons", such as they are (or aren't).  But the therapist thought all this talk of flying by the seat of my pants just means that I'm "refusing to explore", and as a result I feel we came to an impasse. What did she want me to do, imagine scenarios where I'm dressed as a woman and I have to use the bathroom? She said I was being defensive, and the discussion just went downhill from there.

I don't know what the outcome of all this will be, but I do know that rather than increasing my insight into my condition, all this therapy is doing is causing me frustration and irritation, while emptying my wallet to the tune of $80 a pop. Nothing much seems to happen during these sessions for the money it's costing me, to be honest, and I really kind of resent feeling compelled to subject myself to this stuff just because some people somewhere decided that this is how it has to be done. This is my life, why can't I just live it in the way I want to, without feeling like I have to get the approval of some system that has a bunch of checkboxes to define whether you fit the criteria?

She told me outright that she wasn't going to give me any letter, and that moreover I didn't really need any letter to go to a physician and ask for hormones. So I'll go to Lyon Martin and see what they say - not demanding anything, but rather just explaining (as far as possible in the timeslot I'm allowed) what I'm about, where I am, and what I'm thinking about. As with all Improv, I'll just play it by ear.

Does this resonate with anybody? Am I being too, I don't know, judgmental about this system? I just honestly feel a bit resentful that I am being told that I need to do certain things and check off certain boxes before I am "allowed" to do something with my own body. It just doesn't sit right with me, sorry.

Thanks for reading,

Meow

[placeholdername]

I can relate to the thought process you are going through, although I ended up somewhat lucky with a therapist who doesn't try to force me into boxes.

In my opinion you are correct, in that there is a system that has been set up for 'treating' trans-people, and it seems your therapist fits into that system of seeing you as someone who needs to be 'treated'.  And so she has her expected path for how things are supposed to go, and if you don't quite fit in that path then she's not really interested in figuring out what your path is.  Ironically my therapist and I discuss some of the same things that seem so frustrating to you -- exploring what to expect as a woman if I did transition, etc., but for me it ends up being helpful because she (my therapist) doesn't have prefabricated expectations for what my answer should be.

I would recommend trying to find another therapist if that's possible -- they're all very different and sometimes it takes multiple tries to find the right one.  I got lucky on the first try (and covered under health insurance too!), but not everyone does.

[sarahb]

I absolutely agree with what you said. I, too, felt very confined by the whole therapy process. The system is way too rigid, or perhaps it could be the certain therapist, but I went to two different ones and have spoken to others beyond the individual scope and they all have a, more or less, rigid system in place that defines the process you need to take. Instead, it should be a fluid process, where you explore your feelings in whatever way necessary, be it starting HRT early or not.

The thing I have trouble comprehending is the rigid timeline of (normally) 3 months before HRT, a year before SRS, etc. Most therapists that I know and have heard of are pretty much on target with believing that this is how it needs to be. However, some of us just go about it differently. For some, exploring all the different scenarios, thinking about everything on the most deep level, and taking time to weigh each option may be best, but for others, it may not be necessary, or they may have already done it previously and just need to get it out to someone who'll listen. In those cases, the fixed process only stifles progress.

It's the same as learning in school. Some people learn visually, some people learn by writing it down, others learn by hearing it spoken. Therapy, as it is specified now, is only taking into account one way of going about this process and making the rest of the people who need to go about it differently create this facade so that they can pass the test.

I know what you mean. I had the same frustrations going through "therapy" and have one more therapist to go to for my second letter for SRS before I disavow myself from that whole broken system.

~Sarah

[myles]

I deleted my response because I thought this was in Therapy and it was in MTF.. Sorry!
Myles

[Asfsd4214]

I guess I'm going to be the voice of dissent.

I had a similar but somewhat reversed situation.

In the same way, I went through two separate therapists who had a "system" that they rigidly adhered too and expected me to jump through their hoops before they'd recommend me.

In that way I've had an almost identical experience.

The difference is that their system was "you have to dress (heavy emphasis on the dress) and go out and act like a woman for an indefinite period of time, or we won't recommend you, and while we're willing to talk about whatever you want, these are the rules and all the talking in the world isn't going to change them". Where as I was more than happy to talk about my issues go through things and explore my issues with them, they didn't care as far as any kind of hormone therapy was concerned.

Despite that experience though, I can't help but think maybe your therapist in this instance is right.

Therapists don't want to do anything that you might regret and be unable to come back from, hence the 3 and 12 month rules. I don't personally have a problem with these limits as long as they're applied with a degree of flexibility and sensitivity to different circumstances.

I feel like a totally hypocrite in saying this, and maybe I should, but it sounds like you genuinely aren't being cooperative with your therapist when she's making a reasonable request.

[MeowMeansMeow]

I feel like a totally hypocrite in saying this, and maybe I should, but it sounds like you genuinely aren't being cooperative with your therapist when she's making a reasonable request.

That's a reasonable position to take, I understand where you're coming from here.

However, my response is this: What if I'm right, and she's wrong? The big assumption seems to be that they know what they are doing, and we all need "treatment" for some condition. I don't necessarily buy into that framework - I tried playing along, but something just feels very wrong about it. I don't think I'm ill, and I don't think anybody else has the right to dictate to me what path I should be taking.

Also, part of me just wonders whether this whole deal about having to see them for a certain number of sessions doesn't basically boil down to "paying your dues" - yes, in terms of money. I always become a little suspicious when any treatment system says that you have to do x number of sessions, no question, before any consideration is given to "the next step". That is what Scientology does, it's what every chiropractor I've ever met does, and it seems to be what psychologists do too. Are we just cash cows, when it comes right down to it?

Sorry to be so cynical, but hey, I'm feeling pretty cynical right now...

Meow

[alexia elliot]

Hey there, I am sorry that in order to know your self you first must talk to total strangers who than in the name of science tell you who you are. Seems to me you already know the answer, and if you don't, believe me they do not know aether.. It is sort of trying to describe individual water drop in the ocean, you know it is there but how do you differentiate a drop from the rest. Others here describe our condition and the process as fluid, which it absolutely is. From the youngest I remember I was different. I then knew I do not fit the stereotype for aether. We develop at the youngest a vision to strive for, a feminine being and through all my life I dreamed about the day I would suddenly transform into it if just all the stars would align. The stars never did and they never will so the best next thing was to take the wheel and drive, hence my own hrt and therapy regimen, so to speak if it works fine, if it doesn't, fine.
After all what is there to lose, your life? Every one talks of life being precious, it is precious if it is worth loosing, other than that life is just a continuation of species nothing more nothing less, an equation. I do not encourage jumping from a cliff without a parachute or else, but given your intellect and ability to decipher information out there necessary to make an educated determination, I believe you know best the direction.

Love Alexia.

[Asfsd4214]

Hey there, I am sorry that in order to know your self you first must talk to total strangers who than in the name of science tell you who you are. Seems to me you already know the answer, and if you don't, believe me they do not know aether.. It is sort of trying to describe individual water drop in the ocean, you know it is there but how do you differentiate a drop from the rest. Others here describe our condition and the process as fluid, which it absolutely is. From the youngest I remember I was different. I then knew I do not fit the stereotype for aether. We develop at the youngest a vision to strive for, a feminine being and through all my life I dreamed about the day I would suddenly transform into it if just all the stars would align. The stars never did and they never will so the best next thing was to take the wheel and drive, hence my own hrt and therapy regimen, so to speak if it works fine, if it doesn't, fine.
After all what is there to lose, your life? Every one talks of life being precious, it is precious if it is worth loosing, other than that life is just a continuation of species nothing more nothing less, an equation. I do not encourage jumping from a cliff without a parachute or else, but given your intellect and ability to decipher information out there necessary to make an educated determination, I believe you know best the direction.

Love Alexia.

I don't think therapists (good ones anyway) will pretend to be able to tell you who you are. Their job is simply to help you find out. Which sounds like what she's trying to do.

[Marie731]

The thing is, I'm still not absolutely 100% sure in my mind that transition is the right thing for me.

Which is why you're not getting a letter.

Therapists often want a commitment. Not an experiment, not "try and see," but an absolute commitment to transition.

Yea, I know though. I had the same experience. I said the same protests. How can I know if transition is right until I try it and see how I feel?

Yea, well. I WAS WRONG. OK, I said it. But I was.

In the end, I decided to transition. No matter what. I decided that even if *I* changed my mind, I still wouldn't stop. Yea, insanity there, but I decided that the only way to "honor" this, to survive it, was to make transition *everything*. No outs. No chance to give up. Not even suicide. I'd find a way around any obstacle, any setback.

Total commitment.

Yea, I know. You're probably annoyed with me now. I would have been, had I read this back then too.

[Hannah]

She said she thought I was, ironically, exhibiting very "male" thinking

I tend to agree with her sentiment. Based on what youv'e written here, it seems like you are thinking too much with your head and might want to let your heart chime in. I liked your comment on enjoying the creation of eloquent systems and I appreciate that your'e trying to be logical and informed in your decision making process...but at the end of the day there really isn't any way for the brain to know for certain if you are going to enjoy life more in a female body until your'e in it...and once your'e in it your'e stuck there. It's purely a decision of the heart.

A few months ago I gave up. I wasn't going to transition anymore, it was just too freaking hard. I felt like a man in a dress and I couldn't see that ever changing. So I took out my earrings and cleaned off my nail polish, all the while my heart screamed at my brain to stop it, that if I did this I would be one of those 50 year old ->-bleeped-<-s crying that I should have transitioned earlier. All in all I stopped transitioning for about two hours  My brain still thinks things would be easier to just resume living as a boy, and in a way it probably would be...but my heart would bleed to death because it would not be better. I explained this to my therapist, who up until that day I had been seeing in the name of formality and she got it.

I'm not entirely sure you should change therapists just yet. I rather like that she was willing to confront your male thought patterns, and challenge you to knock it off. There's nothing wrong with thinking like a boy, youv'e been doing it for 42 years, however it just isn't going to work in this case. I can't speak for exactly what she was trying to do, but in her shoes that's the language I would have used to try and get you to stop being so rational and ignore what your mind thinks would be better and to go with what your heart thinks. Easier and better are different things, and you can't let your brain be in charge.

At the end of the day, if this is the way you want to go about it, then go for it. I went into it with the exact same attitude. She was right, if you approach a doctor with a specific regimen that you want it won't be long before it's in your hands, but if you just go to them blindly saying "make me a girl" then your luck might be a little more hit and miss. As you mentioned, hormones proved to me that I am a transexual and not some fetishist...and they also clubbed, ripped, and disembowled my male reasoning processes and all my grand plans and deadlines and schemes and structures and threw them out on the ground like the useless fish guts they were. My brain was like "oh crap this hurts I better stop" but my heart said "no". Things are getting better now, but if you go into this with the plan of quitting if you don't like it, you might be depriving yourself of what has turned out to be a beautiful, peaceful, wonderful existence. I've come into this existence the hard way, with the help of a therapist who sounds a lot like yours and it might be worth continuing to see her after you start your hrt...if you insist on starting it without her consent. They aren't particularly good at dealing with the brain, that's more in the psychiartists area. When it comes to dealing with the heart she sounds like a good one to me, so why not open up and give her a shot at helping you?

[lauren3332]

This is exactly why I am afraid of therapy.  You nailed it.  I knew things like this happened.  It's hard for me to judge what I am reading.  Exploring what if scenariios is a good thing but if you do that too much you will just go in circles.  I am just now sort of moving forward after 7 years and some more.  I got caught up in the "what if"? Is this really me? and everything else.  Imagining how real life scenarios and how they actually will go are two different things.  I got so caught up in what would happen if I did transition that I kept trying to find proofs that I was not TG in any way, then I went and tried to find proofs that was TG.  I made a thread about it.  It's not exactly the same as this but I am just trying to show what happens when you think about you go too far with exploring with what might happen.  You don't want to get stuck like that..

It seems like your therapist to some extent is watching out for her more than you.  She is hesitant to give you the go ahead because if you regret doing this then you might come back and sue her or something and she does not want to be liable. 

I see this a lot from just having cerebral palsy.  I went and took steps to try to get my drivers license and they said I had to do a clinical evaluation to make sure I was suitable enough to even get in a vehicle and then when I did the driving evaluation with the specialized person.  They said they were going to pass me and then medical review board said I couldn't get my learners permit because the driving instructor said that I didn't pay attention enough.  I will admit i probably need more field time then your average person but since CP affects the brain they were just covering their butt.

Another time I was at college.  I need extra time on tests because I am just slow at finishing, not because I don't know the material so I go over to this building that allows me extra time.  One time I couldn't get a ride over to the building and asked them if they could do something to help me out and they said it was not their responsibility or problem. 

I realize that none of those two stories helps you at all, but the moral of the story is, it's their house and their rules.  It sucks  but that is the way it is.  I would suggest you do a couple more sessions "her way" and see how it goes.  If you know you have done what she has asked you too and still are not satisfied, then I would move on to another therapist. 

Sorrry for being no help at all.  Hugs

[tekla]

Therapy is not like a custom kitchen, you're not there to buy a predetermined desired result.

[Nero]

If I may just chime in here, I sympathize with you. I get so frustrated in therapy, and I usually end up telling them what I'm going to talk about and what they're wasting their time on.

But in this instance, I think giving your therapist what she wants may be useful for you. It sounds like she's trying to make sure you understand what you'd be getting yourself into with a life as a woman. So often we're so miserable in our birth sex role, life as our true gender looks all rosy. And we've got to know that we're prepared for the reality of life as a woman (or man in my case). When you transition, you don't change, but the world around you seems to. Everything you do looks different to people through the 'man' lens. And vice versa. It sounds like she just needs to see that you're prepared for that.
And if transition is on the table, the realities of daily life as a female need to be explored and reconciled to.

[Alyssa M.]

First, you don't need to be 100% sure you're going to transition to get hormones in accordance with SoC guidelines.

Second, if all you want is hormones -- great, get hormones. It sounds like you're going to do that. So ... what's the problem?

Third -- four sessions? Seriously? That's not exactly a long time. I sure would write anyone a letter after four sessions if I were a therapist. You're 42? And you can't wait just a few months? Hey, that's fine -- see point 2.

Fourth (this is the big one): Why are you in therapy? Do you need therapy? Do you need help confronting all the crazy stuff that can come up when you're considering whether to transition? Do you need someone to ask pointed questions about issues you might not have considered, or about ones that you have considered but didn't really have at the front of your mind? It sounds like you could use all of that stuff, and you might consider taking her advice. If she asks you something, answer the damn question! If she suggests something, at least consider doing it. Therapy is a two-way street -- if you don't answer her questions, how is she supposed to know what's going on with you? How do you think it's supposed to work?

I'm not there, so I can't judge who's in the right, and it really doesn't matter. You can't control what she does, so forget it. The question is how you can work with that, and whether it's worth it. And it doesn't sound like you've tried very hard.

[Dawn D.]

Hi Meow!

I'd like to say, "Therapy is a crap shoot. You get a good one or you get a bad one". But, then I can't really say that because I was fortunate enough to know I have a good one. And, she is the only one I've seen thus far.

I am saddened that you're not happy with yours. However, from what you describe in her requests, it's very similar in approach to what my experience has been. I've been seeing my therapist now for well over two years. In that time, I went through many of the same emotions and thought processes that you have enumerated. Frustration, concern for costs, questioning the need and so on.

What I found to date though was that, every time she would question me in how I was going to handle this or handle that, I couldn't give her a specific answer and she accepted that. What if's are just that. What if's! There is no right answer in them. There is no wrong answer either. However, what you might find, as I know I did, was, as I approached the thought in my own mind; most of the time I could place myself in these hypothetical situations and derive a plausible solution to them. Ultimately it really helped (me anyway) to be prepared for the semi-ultimate; going full time. And, actually I learned a lot about myself that I never even knew. That was a good thing!

My willingness to "explore" also aided in my relationship with my wife to the extent that our staying together from first knowledge, and the heartbreak that occurred, and winding our way completely through transition, was a major goal. Lucky as I have been, we're still together and planning the rest of our lives that way. 

Utilizing my therapist as a conduit to hormones was not a goal of mine (hell, at first I didn't even want to take hormones!). Neither was full time a goal. Neither was SRS. But, each of us has our own reason for exploring who we are. The methods we choose can be as varied as well. What I was really after initially, was a way to cope with the desire to express my feminine side in dressing and personal interactions without wanting to off myself. As it turned out the latter was the easy part. Coping is what wasn't possible (for me) without being able to be in the public eye, so to speak. And, all of that wasn't possible without playing "what if's".

Meow, perhaps you might reconsider, perhaps not. Yet, one therapist does not make the whole process useless. Keep trying. It's a long road. It doesn't have to be rushed. But, then again, you sound as though you are clear in your position about your feminine feelings. For you and others like you, I wish there was a 'short cut'. Sadly, there doesn't seem to be. I completely agree with your assessment that unless a therapist can show an initial suspicion of some disorder other than being transgender or transexual (which is not a disorder), them making you qualify yourself as being either one is ridiculous. For the vast majority of us the only thing we suffer from mentally, is being depressed. But, that is really a result of our own initial short comings in understanding who we are and why we are. Probably in the majority of the cases such as myself, depression can be readily and successfully attended to in a timely fashion.

The type of frustration that you feel with therapy is a primary factor as well in making attempts at removing GID from the DSM. Will that effort be successful and will it help or hurt us if it is? God only, knows. I tend to fall on the side of taking it out, to the extent that it should not be listed as any type of philia(sp). However, rather it should be listed as a medical condition that once suspected to exist in the patient, you are then referred to a "gender identity" specializing doctor. Which will, in my thinking, open up direct medical access for GID. It would be a much shorter process and much less convoluted.

Whatever your decisions come to be, I hope you find solutions that work for you.


Dawn   

[Ms Jessica]

Of the responses you've gotten so far, I think I mostly agree with Nero *waves*

To expand on that, I think both you and the therapist are right: you shouldn't have to follow a pre-determined set of rules or feel like you're being made to jump through hoops, but there's really two things happening in your therapeutic dyad: you want to explore your gender identity and your therapist is trying to follow the SOC in recommending you for HRT.  For those that are 'afraid' of bad therapy experiences, it's important to understand what's happening.  If you go in to a therapist and demand a letter for hormones, you have to demonstrate eligibility and readiness under the SOC, and some of that includes considering the impact of transition. 

I think now that we have that baseline understanding of where the two of you are coming from, I see that you really need (and want) to explore your gender identity, and what you want to do.  Exploring the ideas of gender as social construct is a really useful thing to do, although maybe not *directly* related to whether you'll transition.  It's more like background research for an acting job. 

One of my therapists gave me a stack of books to read when I had been seeing him for a month or two, and while some of them weren't very helpful directly, they really helped me deconstruct societal notions of gender, but at the same time I realized that a gender role is not the same thing as one's internal gender identity, what Julia Serano calls "subconscious sex". 

For your therapist, there's definitely an element of her expecting you to follow some rules, but they're not arbitrary rules that she made up on the spot.  In fact, it sounds a lot like my gender therapist, and I'd conclude that she's just following the SOC, which is a good thing.  It's *very* important to evaluate whether you want to transition, how it will impact you, and your life, and what might happen if you lose your job, or your privileged status in society.  And there's definitely an element of covering her own ass.  If you go on hormones and decide that it's the wrong decision, she has to be protected.   

What I mean, for example, is that hormones aren't entirely reversible, and as a wise woman on this very forum once advised me, "Don't start taking hormones unless you want to go full time."  It's not like growing breasts is an entirely reversible procedure, and it's not like that's going to be the only change in your body, either.  You can hide breasts with baggy clothes and sports bras, but hormones will redistribute body fat, etc etc. and you're going to look drastically different than you do now, and you can't hide it, at least not completely.   

Consider, for example, if you do start appearing more androgynous, that you could potentially have problems at work.  You have to figure out what you're going to do if you lose your job, or your family, your loved ones, your home.  I hope those things don't happen to you, but it's best to have at least considered your options in case of one of those terrible events.  Discrimination against trans people is still legal in 38 of 50 states, and that's not a good thing, especially in a bad economy.  It's not bad that your therapist is trying to get you to think about those things. 

I think that you need to examine the things and ideas that you're exploring, but it also sounds to me like your therapist is doing the right thing, just that she's on a different approach than you are.  She's trying to get you to jump through the SOC hoops so that she can give you a therapy letter.  It doesn't sound like she's trying to be a bitch to you, or tell you who you are, make you follow her arbitrary rules or anything like that.   

I'm not trying to tell you your business, but it doesn't sound to me like you've demonstrated readiness for hormones to your therapist, and that's not an assessment of whether you're really ready or not, just that she's not going to think you are. 
Post Merge: January 06, 2010, 04:47:12 PM
BTW, if any of that came off as bitchy, chalk it up to the internet being a less than perfect medium for communication.  I really don't think you're doing anything wrong, it just seems to me that you're going at this from a different direction than your therapist is, and that's the source of the conflict. 

[Nero]

Of the responses you've gotten so far, I think I mostly agree with Nero *waves*

*Waves back* 

[MaggieB]

From what I read, one of your major concerns is whether your desires are from transsexuality or a sexual fetish. Taking hormones will probably answer that question because your libido will drop away very quickly. Then you can see what it feels like to go out dressed with a vastly reduced sexual component.  Then again, if you don't want to do that, you probably have your answer.

When I have dealt with therapists, four of them, one thing I realized was that they are looking for a level of confidence in your gender identity. I was certain so things went fast for me. All four were decent therapists and I changed partly because of family pressures. I didn't really go to see them for help, just to get the darn letters.

Maggie

[nmason]

Yes I share the same frustrations after my first session on Wednesday.
I felt like I stuffed up completely. I get the feeling from his body language and lack of feedback that he doesn't really believe me. I am still in a very male looking body trying to convince another male that I am trans. I too feel like I should be on hrt but I have taken the advice from these forums and my psychiatrist not to self medicate.
So I share your frustrations with our therapists.  Keep going and see if things get better, I am going to continue and when I get to the end and I am still not happy, I will seek a second opinion.
Like others here have said they have very strict guidelines and several organizations here have got into big trouble accepting some that have transitioned to srs state and ended up suing because they had bad outcomes. 

[Kay Henderson]

Is it fair to say that a therapist who hasn't gone through the transition process him/herself or at least suffered with GID is not as well-equipped to understand us as we are to understand ourselves?

I know the SOC requires gatekeepers, and that's one of the hoops we have to jump through to get to where we need to be.  But I'll put my 68 years of life experience and 16 years of intense study up against any academic credentials.  The one time I had some sessions with a clinical psychologist, it was my own choice to do so as part of my quest to sort out what was going on in my mind.  We got along very well, but in short order she realized that I knew far more about the subject than she did.  She saw me both "dressed" and not, and she pronounced me one of the most well-adjusted patients she ever had.

I don't think anyone who isn't faced every day with doubts about his or her gender can truly know what we are experiencing.