I am curious ...

[beckster]

Heya peeps,

Just been reading through some of the posts here in the therapy section and am confused (doesn't take much I know).  My apologies in advance if the wording of this isn't quite appropriate but am just curious about how therapy works.  Is therapy something you do for yourself to try and get things sorted in your mind, or is it a prerequisite to getting the treatment you need from your doctor ?  Or is it both ?  Is "therapy" the wrong word to use ?  And would someone be happy to say a bit more about what happens at these therapy sessions ?  As I have said, think I am just curious about the whole process as it feels like I didn't really have to do very much ...

I am in the UK so the first thing I did was make an appointment and then wait for 2 weeks to see my doctor.  He said he hadn't treated anyone such as myself before and didn't have a clue what to do for me, so suggested coming back in 2 weeks !!  When I returned he referred me to a psychologist and prescribed antidepressants.  My mum had died about 6 months earlier and I wasn't dealing with it really well, that combined with the fact I had finally managed to admit how I felt about myself was too much too cope with at the time, so he thought it was the best thing to do.  After about a 6 month wait I had my psychologist's appointment, after about 40 minutes he confirmed that mentally I was okay, lol.  I was so disappointed - I was really looking forward to going in to work and telling my boss at the time that I was nuts !!!!  Anyway, he referred me back to my doctor, so back to the doctor I went who again wasn't sure what to do next and suggested coming back in 2 weeks, which I did.  He then referred me to a specialist who I had to wait about 10 months to see.  I spent about 30 minutes with him and he basically said that I needed to come off the antidepressants, get my name changed and provide a "life story" for him.  So I had my name changed, sent him a copy of my life story and went back to my doctor who took me off the antidepressants.  After another 6 month wait I went back to see my specialist, who after another 15 minute appointment advised that he was happy with my change of name and that everything seemed to be moving along okay.  He sent me back to my doctor to start hormones and arrange sperm storage.  My doctor wasn't sure what to do so advised to come back in 2 weeks, lol - if you have seen the film "The Money Pit" then you have to laugh at the "2 weeks" thing.  I went back and he referred me to hospital for sperm storage and then prescribed hormones.  And that is pretty much it, I will be seeing the specialist in another 5 months and am intrigued to find out what he will tell me next.  It's taken an eternity to sort but that's the good old UK National Health Service for you.

So have I missed something out along the way here ?  I don't really feel like I have had "therapy" from anyone that I have been referred to by my doctor.  Or is that the good thing about therapy, can you have it without actually having realised you have had it ? They haven't really told me anything I didn't already know about myself and in the case of my specialist have only gotten me to the stage I need to be to get treatment.  The process of getting to that stage seems to have been very easy, in another 10 months I will be eligible for surgery if I decide that is what I want, at which point I go on a waiting list and go in to hospital when they tell me they are ready to operate.

So again, just for curiosity sake what is this "therapy" thing that everyone keeps talking about ?

Regards

Becky
xx

[Julie Marie]

Hi Becky,

My therapy and the therapy that is more typical in the US would go like this:
1. You choose to see a therapist to sort out issues you cannot settle for yourself.  My reason was to keep my wife happy.
2. In therapy you discuss whatever is on your mind.  If you came for TG reasons, that's usually what's discussed
3. If you feel you need to take your TG life further you discuss those issues.
4. If you want to transition you can ask for a letter to obtain hormones, usually after three months.  The letter is for the doctor to know you have been diagnosed TG.
5. The doctor does a physical and if you're physically fit, provides the hormones.  Regular checkups follow.
At your discretion you can continue therapy or not.
If you want SRS a letter from your therapist and one other are required.
Anywhere along the line you can have a name change.
Storage of sperms or eggs is entirely optional.

What you've described here would cause severe frustration, anxiety and possibly depression for me and many others I know.  It seems like an endless waiting game played out on a pinball machine.

Therapy can be used solely to discuss things you are having difficulty with, solely for the purpose of getting the necessary letters or a combination of both.  It is voluntary if you don't want to transition, mandatory if you do.  But you don't have to go regularly.

Most people view therapy as a way to resolve issues that can't be resolved otherwise or that they don't feel comfortable discussing with others.

Hope I answered some of your questions.

Julie

[Cindi Jones]

Typically, we have a lot of problems to sort out.  Some of us don't.  I know some people who have seen a therapist once or twice a week for years on end.  

I've not heard of a case like you describe, although mine was also fairly limited in the number of visits.  My phsychs figured that I was fairly level headed for the most part, so I didn't see them often.  I did have all kinds of problems in the beginning for which I was grateful for proper counsel.  But after that, I had very little.

It all depends on your doctors and you.  If you feel you are getting enough and are comfortable with your life, you may not wish to do anything about it.  But if you are having issues, you might want to seek additional help.

Cindi

[beckster]

Thanks for the speedy replies folks, I feel it makes a little more sense now !!

What you have described Julie sounds so straight forward, I know its never going to be easy but the process of what you have to do seems to make sense.

So I presume you do still see a therapist during transition/living fulltime ?

And its interesting what you touch on about the name change as I pretty much had to get mine done and start living fulltime before I started hormones.  It sound like you would have had the option to start hormones, then arrange a name change and go fulltime when you wanted ?

To be honest with you both, when I look back at the last few years there have been all the usual hurdles I am sure we all face.  Admitting to yourself how you feel and having the courage to do something about it for one.  Telling friends and family was another for me as I know it probably is for all of us.  The only one that came close to nearly breaking me completely was the waiting game you mention, there were so many times I nearly gave up, not just on getting treatment but on life completely which when I think back is such a sad thing to say.  But as Cindi mentions, if the specialists/therapists you are seeing think you are level headed enough then maybe you don't need to be seeing anyone as often as other people might need to.  I can honestly say that I don't regret any of choices I have made, I still have issues with things in life, but hey, we all do and that just life, but I have never felt as comfortable with myself as I do at the moment.

It does make more sense though to be able to go straight to a therapist/specialist straightaway who can help you sort things out !!

Becky
xx

[tinkerbell]

Hi Becky,

Well, in my case, I have to see my therapist on a regular basis (at least once a month), for I'm still pre-op and she is one of the doctors who is providing one of the letters for my GRS.  Even after surgery, I plan to visit her, for we have become very good friends over the years and also because she treats me for other things.  

tinkerbell

[Ricki]

I had a good therapist he moved out of the area few years ago he was very good and very $$'y...........
Hi becky and good luck with your changes!
The xperts above answered you very quickly, nothing slow on this turbulent site, the professionals are always at console reading to help!
Ricki

[Buffy]

Hi Becky,

Having gone through the system in the UK and now being 4 years post op, I have a few comments on your original post.

The UK system is very different from the rest of the World and we have the NHS of course which will (given the right circumstances) treat people diagnosed with GID.

MY GP initially declined to treat me, but I sat with him and went through a number of downloads from the internet before the practice management committee decided that I could be given treatment.

Within two weeks I had a referal letter for a consultation with a Physchiatrist at a Gender Identity Centre (GIC) and also had counselloring sessions arranged with the local Primary Care Trust (PCT) counsellor (For alleged Suicidal help). He also arranged for me to have speach therapy on the NHS.

I went through Leicester GIC and did this on a Private basis, but many GIC's are also linked to an NHS hospital, although those PCT's that don't will normally refer to Charring Cross in London.

At my first meeting, I was asked to produce my Life Story (20 pages in total) and describe my earliest thoughts, feelins, emotions, sexuality and to undertake various physchological tests to see if I had any underlying Mental disorders !

The aim of the Physchiatrist role is to diagnose GID as a result of  determining that NO other underlying mental conditions exist (such as Schizophrenia).

I left that meeting with a Private Prescription for Hormones, which my GP converted to an NHS prescription and to my joy I still use the NHS Hormone route (6 months for $13 can't be bad) despite living outside the UK for 3 years now.

I was offered therapy and counselloring as part of my treatment, but refused after the first session as the guy who was assigned to me was more of a hindrence than a help.

On my second visit to my Shrink, I went with a plan for transition and a list of dates that I was working towards, which includied telling significant others, work, name change by deed poll, date for RLT and planned FFS and SRS dates.

I left that meeting with a letter confirming GID and supporting my legal name change (which I photocopied) and sent to the DVLC, Passport agency etc.

I Changed my legal name on May 1st and a month later with a new passport was in Thailand having FFS, 12 months later I returned to Thailand for SRS.

I was 110% sure in what I was doing, how I was going to do it , but both my shrink and (short lived) Therapist both said that the majority of people they saw where confused, scared, frightened and at times desperate, which I fully understand and therapy, counselloring MUST be a key part of the process, before moving forward.

We have to accept ourselves above and foremost to go through the process and that includes whatever help is available at the time.

My only gripe with both my shrink and therapists was they where telling me what I felt, what I was going through emotionally... where I was the expert in that.

Buffy

(Another Becky by the way)

[Jenny]

Becky,

Being in the UK too, I was a bit confused about all these references to "therapy" also, so I did a little digging around.

It appears that therapy is a stage recommended in the standards of care, but one that the NHS does not really acknowledge - presumably for cost reasons.

The emphasis here seems to be on self-diagnosis, with psychiatrists more interested in ruling out other possible mental illnesses to ensure that the person presenting to them is competent to make assertions about their gender experiences etc.

After that, it's almost as though they'll provide the minimum required medical help (hormones, surgery, maybe speech therapy if you are lucky), and require a two year "real life experience" in order to try and ensure anyone that transition is not right for has plenty of time to change their mind.

It's also worth noting that (as with many things with the NHS) that it is something of a postcode lottery - where you live will determine largely what funding is available for you to access for different things.

This lack of therapy is a real problem for someone like myself, but it is easy to knock the system rather than focussing on the positives (I wonder how many of our American friends would love to be able to access state funded GRS, for example).

[beckster]

Hey peeps, sorry it's taken a while to reply but things have been up the wall the last few days.

Thanks you all again for the replies, I can't believe things seem so different in the UK - isn't the NHS such an interesting thing ?  There are times I could honestly say you can't get better treatment anywhere, if you are in an accident or have a heart attack for example then there are no problems as you will get all the treatment you need.  However in the case of what most of us on this forum need to be treated for it seems completely different or at least it seems like more a battle to get the treatment you need.  It interesting though as should the "postcode lottery" as Jenny puts it really determine what funding you can have ?  Why is someone who lives 2 miles away from me entitled to receive treatment I am not ? Such a strange way of doing things but that is probably a topic for another day !!

Sounds like things went reasonably quick for you Buffy, I also went through Leicester and must admit they have been fab, it's just a shame the whole process made it take so long for me to actually get there.  But as both yourself and Jenny explain the focus seems to lean heavily on making sure there are no other mental issues that are making you think/feel that you need treatment for something you don't ?  And I know exactly where you are coming from with being told how you are going to feel, at one point I felt like asking the shrinks/therapists/specialists to write down how I am going to feel and I will make sure I do so for next time I come back to them, lol. 

At the end of the day though, the only expenses I have had are travel costs and prescriptions costs for my hormones, surgery is there at the end of the two year life experience if I really want it, so yes you cant really complain too much.  Just feels as though there should be a little more support in place for anyone that needs it ?

Becky

xx

[Terri Gene]

 Hello Becky,  I've never been to a psychiatrist in the UK, but they should be pretty much like the ones here in the United States.   Most of all, they want you to think and consider WHY you want to change your gender and tell them the reason.  For talk, they simply want to hear your side of how and why things are going on, to give insight into your character and your goals in life.  And importantly, they need to understand how much you want the gender change.

There is no particular verbatium followed, its just talking and getting to know you and what you expect from life after surgery.  If they understand transsexualism and what it is about, then it helps them to help you.  Just follow the therapyst dialog and talk about your real feelings.

Just talk about how you feel and why, nothing to it, but remember, he is recording everything important.

Terri

[beckster]

Heya Terri,

I think they do pretty much achieve what you have talked around and maybe it is just a case of chilling out and going along with whatever crops up whilst you are talking.  My next appointment isnt until May I think, but at least I have got my head around what I want with the SRS side of things so think we will have quite a lot to talk around.

Becky

xx

[Terri Gene]

 

I have got my head around what I want with the SRS side of things

I dunno about this exactly.  For me at least, there wasn't much to figure out, I just had to sort out my nerves as to how I would live in the normal world, and that took me all my life.  SRS won't do anything for you but make you feel comfortable with you own body, both to yourself and other people.  All problems will still be there and you will run into new ones due to the Gender switch.  All in all, the only thing for me was coping with the rest of the world with it all.

A psychiatrist in Redwood City, Dr. Dea asked me WHY I wanted to be a woman at our first appointment, and I couldn't answer her question, it took me totally off guard.  She got into a little bit of heat with me and told me that I would tell her what she wanted to know or never come back to her.   She told me to come back in a week and be prepared to talk to her.

Can't really explain why I couldn't answer her question, just that it was a little deep for me.  There was no choice or reason, it was simply my entire mental concept, and had been all my life.  I could not associate why anyone would want to change their gender status, it was simply the only right thing i could do and I had already started in full time and all my rugs had been pulled out from under my feet.

Dr. Dea and I talked for a couple sessions and she put me on Prems snd Spiro and seemed to get along ok from then on, and she pulled all the weight she could with my doctors about me being on HRT because of my medical condition at the time.  She even fought it out for me to have an Bilateral Orchiectomy paid for by my insurance.

All I know is that I am fine with things these days and people I don't know don't seem to notice anything.

To me, SRS was/is nothing but a mental adjustment to living life, little or nothing more.

Terri

[beckster]

Heya Hon,

Sounds like we have similiar feelings on this from what you have said.  The part I couldn't quite figure out was why I would want it !!  I am pretty happy with where things are at the moment, the living full time side of things is going okay, hormones seem okay and I am bascially getting on with life.  However, the conclusion I came to was pretty much what you have said about SRS making you feel comfortable with your own body.  Is it just the final thing to do once you have reached the right point in your life ?  Suppose it must be a little different for everyone ?

Lol, doctors and their deep probing questions, why you feel the way you do can be such a hard one to explain at times.  But it sounds like she has been really supportive which is the main thing !!

Becky
xx

[LynnER]

Theripy.........

First visit to my new theripist. "Oh, I know Im crazy, but thats not the issue here" and a nice laugh after that.
My current theripist says that Im extreemly levelheaded and dont really need her help for the most part...  Pretty much all I do is call her and say "Hey,  I need this or that" and its done.   Granted on my first visit we went over allot of stuff... I also took what estimates into a coppy of my life story.<something I did on my own, not cuz I was told to>  When I left her office that day she told me to call her when I found a doctor to take care of monitoring for HRT and she would write and diliver the letter... I asked her when my next appointment should be and she shruged and told me to set up an appointment when ever I really need to talk or if I needed something, elsewise not to waste my money paying her when I could be saveing it for the future.   My theripist so rocks