When close-minded therapists turn you crazy

[Fencesitter]

- Sorry, long posting again, but I really need to rant -

Hello,

My therapist was a gentle old guy, but very old-fashioned in his view of transgenders/transsexuals. I had no other choice, the only other gender therapist in my region was well-known as being very bad at dealing with FTMs. Well spending time with him was much more a nuisance than a help, though he tried his best.  Well at least I got the letter for hormones after going through this "therapy" for about one year. And that was why I was there, so why complain?

Why I complain is - you have to deal with a system in which the therapist may be less a partner and more an antagonist. You know you want to get the hormones - he has the power to allow or deny them to you. That's annoying in itself, but when you also have to deal with a close-minded view of transsexuality, sometimes studied decades ago, then it can really become nasty.

First of all, let me say that the SoC system does not work well as a filter. I was nervous there and very aware about when he raised his eyebrow in doubt about one of my remarks, and when he nodded happily while he noted stuff. You get a learning effect quite fast, like a horse which learns to react to its master when "counting" with his hooves. Horses can't count, but they react to their masters' reactions and learn when exactly they have to stop counting, as their masters become relaxed right then.

But what really bothered me were the sometimes stupid questions. We agreed upon a 24/7 real life experience for one year without hormones, which is stupid, but he was very insisting on the no-hormone-"gender role change". Let me tell you that's ridiculous as I had no passing before hormones no matter what I tried, but my genetics hinted that it would work quite fast once on Testosterone (which it indeed did - I'm a mediterranean type). But well, the "full-time real life test" without hormones is a holy cow for most therapists in Gernany. Well I got asked silly questions in "gender therapy" before hormones:

"Do you use the male bathrooms all the time now?"
Honest answer would have been: I go to the bathroom I get pointed to as I don't want to freak out people. I also went to the closest bathroom no matter what sex at that time, and had done this occasionally before. Who cares a sh...? I had had a chronical bladder irritation for years, so gender really becomes unimportant there. At worst, you apologize towards the guys and tell them about the bladder problem, that you need to pee NOW and look demonstratively the other way round and hide your eyes demonstratively so they know you don't want to have a look at their penises. And at my workplace, people had transformed the bathrooms into unofficial unisex bathrooms long ago as you don't get your pee breaks paid there so you rush to the next free toilet. That would have been the honest answer.

But I saw him become very aware and waiting for something to write on his notepad, his body became tensed. He wasn't like that often, so I assumed this was an important question which I was not to mess up.
Well I lied at him and told him I always used male bathrooms. He asked more, I described my lies to him. I feel loyal to my company anyway, so I wouldn't tell about their toilet problem, which is illegal in Germany. Plus I really don't see why using male bathrooms before passing as male matters at all for diagnosis. So I see no moral problem here, he was just a gatekeeper. He seemed satisfied and noted down the stuff.

And then I asked him why on earth he asked me that? (I had already learned like a "counting horse" from reading body language that you first answer, then ask why the question had been asked, and without saying that you think that question's ridiculous.)

- "Well it's very important for the diagnosis, because of the RLE. You need to gather experience in your new gender role, and toilets are very very important here"

And I secretely thought WTF???

Later on, I joked with a couple of (non-trans) friends about that and we laughed aloud. In Harry Potter, there's an annoying toilet phantom in their school. Maybe there was one to be found as well in male bathrooms, telling me secrets about my gender identity. Or I could somehow figure out what maleness meens by visiting the male bathrooms and getting the esoteric "male vibrations" there. Or maybe there was something miraculous in male bathrooms' tap water helping me for the diagnosis. We all laughed a lot there. My shrink must probably have read somewhere in the shrinks' literature how important bathrooms are. Well of course they are, imagine New York City without public bathrooms, but well...

Well, at another meeting, he asked me as what I saw myself in my sexual fantasies, and fancy myself, as a male or as a female? He became very tense again, and I became the counting horse again.
But I first told him that this is very private and I considered it none of his business.
He insisted and told me that on my request why? that it was very important for the diagnosis.
Then he stared, very intensely. And I knew I had to save my ass here, as this question seemed to be central.
I fell back into the counting horse mode again and said what seemed appropriate for a transsexual. I had not been prepared to that question, so I could only guess. And ->-bleeped-<-, I did not want to get the hormones denied. No problem with thinking them over or delaying them for myself, but it would have been humiliating for me to get them denied by a "toilets-are-very-important"-shrink. I had no trust in him after the toilet experience. I would have loved to get a good differential diagnosis, but not with that guy.

"I  always feel like a male there etc." (In reality, I just try to trick out the body-mind-descrepancy with various tricks, as when I masturbate, I get "wrong" physical sensations. And the tricks I use turn me neutral or cause a lot of gender-bending fantasies of all sorts and in all directions as work-arounds for my body dysphoria, I don't love them but these fantasies at least kind of work. But all that's none of his business and I don't know if he could ever understand that.)

He seemed satisfied, smiled and noted that. My horse counting act had succeeded.

After that session, however, at home, I searched like crazy to find out what relationship sexual fantasies might have with gender identity, esp. differential diagnosis. Unfortunately, I found nothing. I'd have loved to asked him, but I couldn't cause I did not want to jeopardize the hormone prescription.

It's ridiculous, this all has been years ago, but these long forgotten situations keep on popping up in my mind, like a trauma that I still have not digested. When these memories pop up, I feel kind of ... forced, ridiculized or humiliated. I think I haven't stomached it all yet. I don't know how to put this in words. I'm sure my shrink did not do that on purpose, but honestly, the therapy damaged me more than it helped me. Before, I thought being transgendered was kind of normal, and that, yes, it was normal as well that some of these people transitioned.  About 25% of my friends have been transsexuals or transgenders since I was 20 (androgynes, bigenders etc.), without us belonging to any specific subculture or transgender community, we just met "by chance", it was just human variation. And we were a very varied bunch of people.

Then I had to deal with this gatekeeper, a gentle man, but, well... I had never even thought about it that being transgendered might be considered pathological, that you had to go through exams to get hormones, that people judge you for sometimes silly characteristics and behaviors (like going to the men's bathroom before passing) - and that you had to prove and justify yourself for being transgendered, other than with my friends. Plus my friends never asked me such ridiculous questions. They just knew which bathroom I use means nothing about myself. Nothing. This was all so weird to me, dealing with the system. I really couldn't understand it. It was like being beamed into a culture where I was pathologized for being left-handed and had to pass exams for being allowed to write with my left hand. And then being judged as a real or non-real left-handed guy based on the fact which hand I use when I wipe my ass. By right-handed people who had written or read theories about people like me, often prejudiced or dismeaning theories, and where the ass-wiping had become a central criterium to allow left-handed people use their appropriate hand. (This analogy does not work well as left-handed people really usually their left hand for this.)

Can you relate to this?

[justmeinoz]

I'll let you know after my first therapy session next week.  I don't think I will have those srt of problems, bu thanks for the warning.

[lilacwoman]

Wasn't that counting horse named Hans?
Reminds me of a meeting at gender clinic when the shrink and a feamle therapist were asking these stupid questions. 
I was getting pretty peed off with them so when they asked another one I took a deep breath an dstarted tapping my fingers on my knee...they shut up instantly and changed the subject.

At the next meeting I did the same just to see how well trained they are and sure enough they eat oats and hay.

[Muffin]

What is the procedure in Germany for those that self medicate and then decide to go through the "right" channels?
I'm curious to see how they react to that because here in Australia when I made my first psychiatrist appointment it was a three month wait so I started self-medicating. When I got there I told him and he was ok about it and sent me for blood tests for that same day instead of making me jump threw a series of hoops first.
His concern was on my health first and foremost which was good. I'm just wondering if they frown upon that there and try and set you back for it or help you jump ahead with proceedings.

[Aidan_]

You're right, those SOC are truly a waste. Almost anyone who's TS/TG has been having it on their mind for years before seeking a therapist, and it's not a good filter. My psych does a few of the same things yours does. He asks the weirdest questions like, "In your fantasies, do you feel 'safe' having a guy on top? or do you picture a girl?" I told him the former was true, even though you don't have to feel safe just because this guy is on top of you @_@

Psychs are weird, and those SOC don't keep people from going TS who really aren't meant for it.

Best wishes to you though!

[Cruelladeville]

In the UK women are now suing GP practices....

As Doctors abused vulnerable women in power-plays....mental shenanigans...

And when these women complained the medics involved closed ranks...

As one of these chaps is now doing 18 months in prison, as he was a serial offender, and moved to another clinic before being finally caught....

Tells you all you need to know. Doctors are fallible, some bad, some indifferent and some excellent....

But in all cases it's for you to decide if you can work with them or not....

With therapists that act as gate keepers equally they might enjoy the roles they play..... so if you need to do the jumps to get through the hoops, jump yeah will!

But all of us that have been through this crap, see it very much as par for the course.....(sadly)

[Fencesitter]

Thanks for your replies!

@lilacwoman
Yes, that counting horse was called Hans. Made me smile to read how you reacted to these questions.

What is the procedure in Germany for those that self medicate and then decide to go through the "right" channels?

You get your hormones prescribed so it's a good way to avoid the nasty waiting period for hormones. However, shrinks tend to make it a lot harder and longer for you before they give you the okay for SRS. The rationale goes like this: by having taken hormones, you have already created some physical changes which you might be reluctant to reverse, thereby pushing yourself through transition before proper diagnosis has been made. Plus, it makes diagnosis much harder and requiring longer time, as hormones change you psychologically, which also pushes you towards transition.  The 24/7 every-day-life test before hormones which is necessary to assure the diagnosis has probably not been done long enough.

So you better don't tell anyone if you self-medicate unless you don't mind getting your SRS delayed, or the letters for the name change. The flaws of this rationale is that going full-time also causes lots of effects which are irreversible, social effects - you cannot go back into the closet again. And that hormones are often also used as a diagnostic tool as well and it's quite arguable whether the test really must be done BEFORE hormones.

You're right, those SOC are truly a waste. Almost anyone who's TS/TG has been having it on their mind for years before seeking a therapist, and it's not a good filter. My psych does a few of the same things yours does. He asks the weirdest questions like, "In your fantasies, do you feel 'safe' having a guy on top? or do you picture a girl?" I told him the former was true, even though you don't have to feel safe just because this guy is on top of you @_@

I don't mind them using a good filter, but, well, the filter should be... good. It can't be good as long as filtering consists of asking such stupid questions and demanding "highly important diagnostic" measures such as sending you to the right bathroom. That's not a filter, that's random stuff. There's just too many shrinks who are clueless about this topic, and that's where these silly questions come from. I was also asked a lot in detail with what leisure-time activities I had as a child. I took the pleasure to annoy my shrink by listing gender-neutral stuff at first, such as jigsaw-puzzles,  reading books, playing with the other kids on the street etc. "Did you also play with dolls?" "Did you wear your hair long or short as a kid?" "Did you fight with the boys sometimes?" Who cares, and what does that have to do with being transsexual? That's about traditional gender role stuff, not gender identity or body dysphoria. Plus I was there as an adult, not as a kid. But our German SoC demand from the shrinks that they depict your "psycho-sexual development" in detail for the letters, so they have to ask these questions.

And I don't understand your shrink's question, what does he mean by "on top"?

@Cruelladeville
The serial offender who is in prison now, what did he do? Sounds awful.

[Aidan_]

And I don't understand your shrink's question, what does he mean by "on top"?

He meant as in a sexual position with the 'guy on top' instead of the girl. Like classic missionary or something like that. Apparently he thought that was relevant to being TG >_>

[Asfsd4214]

What is the procedure in Germany for those that self medicate and then decide to go through the "right" channels?
I'm curious to see how they react to that because here in Australia when I made my first psychiatrist appointment it was a three month wait so I started self-medicating. When I got there I told him and he was ok about it and sent me for blood tests for that same day instead of making me jump threw a series of hoops first.
His concern was on my health first and foremost which was good. I'm just wondering if they frown upon that there and try and set you back for it or help you jump ahead with proceedings.

About half way through reading your post I actually double checked the username to make sure I wasn't reading one of my own posts and agreeing with it (something I've done before.



I love the harm reduction philosophy. Shame susans.org doesn't.

[Cruelladeville]

@ Fence....

He sexually abused patients..... while examining them!

Nice.... 

[Muffin]

However, shrinks tend to make it a lot harder and longer for you before they give you the okay for SRS.

This made me think of how the longer you are on anti-androgens the more damage you risk doing to your liver. How do German shrinks justify that?

The rationale goes like this: by having taken hormones, you have already created some physical changes which you might be reluctant to reverse, thereby pushing yourself through transition before proper diagnosis has been made.

When I first saw my psychiatrist he said the decision to go through transition is ultimately mine and that he is there to over see it and facilitate it.
I know I view this a little bit different to most as for me I just knew, I've known since I was five and the hardest part towards coming out was not dealing with my own feelings but others. Those around us also transition in a way and that to me is the part that has required the most focus. But on the other hand I understand there are some that are unsure if it's the right thing for them... but to me that is what a psychologist is for. They are optional here in Australia.. you can skip that step if you show confidence with who you are. To have a shrink that needs that much convincing to me suggests prejudice.. and letting their own opinion weigh in more than yours.

Plus, it makes diagnosis much harder and requiring longer time, as hormones change you psychologically, which also pushes you towards transition.  The 24/7 every-day-life test before hormones which is necessary to assure the diagnosis has probably not been done long enough.

Germany sounds horrible for TSs so far :-/   especially compared to Australia.  I never realised just how easy it's been here. It seems like shrinks over there are really sceptical of TSs yet here in my experience (other than a few idiot GPs) they've all understood me completely and helped virtually without question. For my SRS referral I went once and was there for 20mins. I told him I was there for my SRS referral and he said fine did you want a second copy sent straight to your surgeon? Then we talked about it for less than a few minutes and went onto something else :S
I have a spare room if you wanna move here lols

So you better don't tell anyone if you self-medicate unless you don't mind getting your SRS delayed, or the letters for the name change. The flaws of this rationale is that going full-time also causes lots of effects which are irreversible, social effects - you cannot go back into the closet again. And that hormones are often also used as a diagnostic tool as well and it's quite arguable whether the test really must be done BEFORE hormones.

That is the problem with gender identity it can be such a hard thing to determine and explain, it's like asking someone on the spot to define love in one or two sentences. It's a feeling and what you feel can't always be put into words well enough let alone in a way that will convince a sceptic. And they obviously have a piece of paper with the "correct" answers that they check you against.. which needless to say is major BS. To me gender is a vibe.... you sense it in people it's not a series of predetermined questions.. it's different in everyone as there are different locations on the gender spectrum one can be imo. blah.

I don't mind them using a good filter, but, well, the filter should be... good. It can't be good as long as filtering consists of asking such stupid questions and demanding "highly important diagnostic" measures such as sending you to the right bathroom. That's not a filter, that's random stuff. There's just too many shrinks who are clueless about this topic, and that's where these silly questions come from. I was also asked a lot in detail with what leisure-time activities I had as a child. I took the pleasure to annoy my shrink by listing gender-neutral stuff at first, such as jigsaw-puzzles,  reading books, playing with the other kids on the street etc. "Did you also play with dolls?" "Did you wear your hair long or short as a kid?" "Did you fight with the boys sometimes?" Who cares, and what does that have to do with being transsexual? That's about traditional gender role stuff, not gender identity or body dysphoria. Plus I was there as an adult, not as a kid. But our German SoC demand from the shrinks that they depict your "psycho-sexual development" in detail for the letters, so they have to ask these questions.

Who knows more about what someone feels? The person in question or the one with a bias opinion asking irrelevant questions? The fact that different countries have different methods suggest that one is more correct than the other yet I assume doctors don't want to admit that. If they really knew about it as well as most TSs then there wouldn't be any animosity.
Is Australia doing it wrong because it seems so much easier? Or are we doing it better? It would be interesting to see the success rates of different countries that use different methods and different amounts of hoops.
If the end result is happiness and a better life then it's a success and if that can be achieved with less hoops then awesome.. that is the better (smarter) way.. but I guess we have to consider other things like the system, money, liability-fear and stubborn doctors who haven't updated their medical literature since the mid 70's. :-/
*checks*.. yep room is still avail! ^___^

[lilacwoman]

These horses called shrinks were never little mixed up kids like the vast majority of we TS so of course they cannot relate to us and our need for quick transition once we have come out of the closet.

Then depending on which old horse trained them as a mirror image of itself they can only believe that anyone who doesn't want to be a horse must have deep mental problems and this can only be determined by asking questions about whether we imagine ourselves as a mare under a stallion or a stallion on a mare.

Simple really 

Out in the wild there are no stallions that fancy other stallions or mares that shack up with other mares but maybe there are a lot of stallions that wish they could wear the pretty flowing covers the jousting horses wear.  Or are those horses just transvestite?


The horse in black and white looks a little timid so obviously needs to go to a shrink to discuss getting on T to get some aggressiveness.

[Fencesitter]

Sorry this is awfully long again!

This made me think of how the longer you are on anti-androgens the more damage you risk doing to your liver. How do German shrinks justify that?

No idea. As far as I know, they are much cooler about prescribing anti-androgens to MTFs than prescribing estrogens, as estrogens "have long-term effects, changing your body a bit more into female mode, which may make you do wrong decisions too early". (Killing yourself because of anti-androgens driving you into a depression has an even more long-term result, but who cares?)

I know I view this a little bit different to most as for me I just knew, I've known since I was five and the hardest part towards coming out was not dealing with my own feelings but others. Those around us also transition in a way and that to me is the part that has required the most focus. But on the other hand I understand there are some that are unsure if it's the right thing for them... but to me that is what a psychologist is for.

Agree 100%. But it shouldn't be forced upon us, to go see a shrink for that. There's a lot of other people you can ask as well. Like your priest etc. I don't say that's the best solution, but we're adults so it would be great to treat us as such, letting us make our own choices. Plus there's a lot of body modifications you can do, face tattoos etc., which have a great social impact. Without needing letters first. That's a double standard.

They are optional here in Australia.. you can skip that step if you show confidence with who you are. To have a shrink that needs that much convincing to me suggests prejudice.. and letting their own opinion weigh in more than yours. Germany sounds horrible for TSs so far :-/   

Well that sounds great. And about Germany... German shrinks are usually not up-to-date. There's even a GIC (gender incompetence centre or whatever that means) far in the North of Germany where one of the leading shrinks of Germany, Bosinski, has a lot to say, and in the scene he's known as a shrink to avoid. Well he says that physical transition effects for FTMs is mostly based on illusions, and that mostly nothing happens there on a physical basis. Oh yeah, and FTMs are almost always only into females, point. Er, well, I've seen transmen on hormones for 5-10 years, and yes, you cannot figure out any moe they were not natal females as long as they're not undressed. I just guess that transmen avoid this guy like hell, so he doesn't ever see how testosterone long-time effects are. Otherwise, no comment... Unfortunately, this guy is very famous and has a lot to say. Well, his research upon hormones and transsexuality are very good, this I have to admit.

I never realised just how easy it's been here. It seems like shrinks over there are really sceptical of TSs yet here in my experience (other than a few idiot GPs) they've all understood me completely and helped virtually without question. For my SRS referral I went once and was there for 20mins. I told him I was there for my SRS referral and he said fine did you want a second copy sent straight to your surgeon? Then we talked about it for less than a few minutes and went onto something else :S
I have a spare room if you wanna move here lols

Well here in Germany it depends on who you deal with. Much of the psychoanalytical section is as esoteric and pseudo-scientifical as it has always been. Meaning, they tell you bull->-bleeped-<- about oedipal phase and blabla gone wrong in your childhood, making you transsexual, a disorder of your psycho-sexual development. Though the oedipal phase etc. has never been proven at all. I wouldn't mind about it, but these esoteric Sh*theads had a big say for our German Standards of Care etc. and still have a lot to say about us otherwise. It's really nasty. For transsexuals as well as for those shrinks who don't buy into this ideology but have to write up this stuff.

Unfortunately, this is the school which pinned down in the German SoC that shrinks have to describe your "psycho-sexual development" in detail. Which violates your human right for private sphere, to put it gently, as the letters have to describe it and they get sent to the health insurance companies. And these letters are usually also used for the name change here, as we need shrinks' letters for the name change. This means judges have to read about your masturbation phantasies etc. if they read through the letters - which does not respect the judges' wish for being protected from other people's privacy either.  Er, if you ever asked me whether I told the kinky stuff to my shrink - no. For exactly these reasons. I don't mind telling kinky stuff to anybody, but I don't want that stuff to be found somehwere in official files or force a conservative judge to read through that stuff - as long as I don't know he/she feels at ease reading it.

In their "academic" schools, until a couple of years ago, the psychoanalysts even mostly forbade gays and lesbians to become psychoanalysts as these people were considered to be so deranged in their pre-oedipal or whatever development that they couldn't treat other patients well. This has improved a bit meanwhile, but I still cannot take this esoteric psychoanalytical bull->-bleeped-<- serious. And I'm sure that they won't treat transsexuals with the due respect deserved to any human beings for the next couple of decades. (Sure, you may find good exceptions and great shrinks there blabla, but I just don't have any reason to put even the slightest trust into this school of thought.) I know of an MTF shrink who had applied as a visitant for an important psychoanalytical workshop/seminary about transsexuality. She was refused without any reason, and she took apply to the anti-discrimination law we have here. No reactions yet. It was THIS YEAR. 

All this would be unimportant if this pseudo-scientifical shrink school had not taken over so much power here. Their academies etc. with their bogus theories still have impact on how we get treated in future by  the law, though. One of their biggest struggles at the time is that the European Union has set up anti-discrimination directives, also about discrimination against gays & lesbians etc. So in Germany, over time, they'll either have to bend to the EU laws or declare their school of thought/academies as a "religious community" so they can keep on blocking out gays and lesbians, and I'm not even talking about trans people here. Which at least would show how unscientific this bull-->-bleeped-<- is. Haha. If you think I'm telling bull->-bleeped-<- here, feel free to ask and I can bombard you with lots of good links - most of them in German, though.

I met Sophinette Becker, one of the most important "heads" of that German esoteric shrink community, in person, a couple of years ago. It was about getting a letter for my name change. First of all, the whole trans community had been suspecting her to be transsexual herself, but nobody ever got a clue. I didn't know either after leaving her, I even tried to pin her down on her unusual forename as I had a good excuse to do that (my natal forename is close to her forename), but I got no conclusive answer after asking. Otherwise, her appearance etc. was ambiguous, might have been natal or not.

Well, whatever - she addressed me as a male, which is nice. But I knew from her publications that she referred to FTMs as females, even after their operations etc. So I mentioned that to her, told her I found it polite that she addressed me well, but did not think much of it due to her publications. And she can go on addressing me as a male for politeness, but can also harshly adress me as a female as at least that would be honest as I know her publications. Well she answered with a psycho gibberish which I cannot replicate here and did not understand then, and said something like becoming transsexual is a creative solution to otherwise unsolvable problems. () Plus she asked me a lot of questions about eating disorders, whether I had been anorexic etc. (I was a little bit chubby then, but not obese). Er, no. I tend to eat too much in a hurry when I'm having hypoglycemia (lack of sugar in your metabolism) as I'm hungry as hell then, trembling, hungry as a wolf, but that's a metabolism disorder, not an eating disorder, I have pre-diabetes, and this I told her. Well I also had stopped eating almost anything for about one week after watching a report about how animals are treated in Europe and did not stomach that well. But that was just one week.

And I also told her about having eaten badly for two or three month after my metabolism suddenly changed and my hungriness was not always hypoglycemia any more but just normal hunger and I did not know that feeling before as normal hunger was like nothing to me compared to hypoglycemic attacks, so I tended to ignore it instead of eating then. But I had gotten it under control with the great therapist I had then. He happened to have been working in a psychosomatic clinic before, and had dealt with anorexic patients etc. He told me I was not anorexic or anything, but had to learn to understand the normal "hunger" feeling other than the wolfish hypoglycemic hunger attacks, which are much stronger and can even cause cannibalistic thoughts. (Yeah, twice or thrice, during hypoglycemic attacks, in my thoughts, I had slized up the arm of my colleague when I saw it, and had thrown the slizes into a pan. Sounds psychopathic as hell, but it's normal if you're suffering from a hypoglycemic attack.) Well and he was great for that and I learned how to deal with "normal" hunger. Best coincidance ever. This I told her and she accepted it.

I also asked her, why these questions? And she told me, she had found out, lots of anorexic FTMs did not do well by getting hormones and stuff, so giving the okay for all that was difficult in these cases and had to be thought over well and given more time. Wow, I had a metabolism disorder, but no anorexia at all, never had anorexia, so no problems with that gatekeeper. Since then, I also knew why Becker was known as "the shrink you can go to, unless you suffer(ed) from anorexia". Okay. I told her this bluntly and added that maybe some of the anorexics avoid her once they know about this rumor, probably the more clever ones. And that this means that she does not get statistically typical anorexic people any more, but just the cases who don't gather enough information in advance - i. e. people with less education, less scepticism, less survival skills when it comes to find out helpful support groups etc. than the average person. Which means since rumor got round that the was a difficult gatekeeper for anorexic FTMs, she might get exactly those cases in her office, who are less skilled at "survival" and getting their minds through the system - so that her cases are not representative for all anorexic FTMs anymore. Which means her observance on these cases will not be representative either any more.

She replied to me with a kind of bitter smile, saying, yes, she knows about these mechanisms/problems, and these are very bad for the concerned persons, if hormones/surgery are not good for them, but she hopes other shrinks will take care of that as well and delay physical treatment until the case is clear. Er well... wasn't quite the answer I'd have liked to hear. Well, since knowing about this new pit-fall, if I were not only transsexual, but also anorexic, I'd never tell about my eating disorder to anybody, so  I don't get the necessary health care delayed or jeopardized. Yes, that's contra-productive in my opinion. She published her findings in Germany, and lots of shrinks here read it, so the news got round. I don't mind getting examined more thoroughly if your body dysphoria might be in context of your anorexic dysphoria, but I don't think it will work to make it difficult on everybody who's anorexic. It will just raise the gatekeeper-patient barrier higher and decrease the degree of honesty.

That is the problem with gender identity it can be such a hard thing to determine and explain, it's like asking someone on the spot to define love in one or two sentences. It's a feeling and what you feel can't always be put into words well enough let alone in a way that will convince a sceptic. And they obviously have a piece of paper with the "correct" answers that they check you against.. which needless to say is major BS. To me gender is a vibe.... you sense it in people it's not a series of predetermined questions.. it's different in everyone as there are different locations on the gender spectrum one can be imo. blah.

I get what you mean here. Completely. And well, not being able to answer such questions on the spot well... doesn't mean you're not transsexual. Just means you cannot put this stuff into words easily.

Who knows more about what someone feels? The person in question or the one with a bias opinion asking irrelevant questions? The fact that different countries have different methods suggest that one is more correct than the other yet I assume doctors don't want to admit that. If they really knew about it as well as most TSs then there wouldn't be any animosity.

The best example of that is the German holy cow of "one year real-life experience without hormones". It's absolutely silly for those folks who don't pass well before hormones but will pass well once on hormones. And forces them to either ridiculouse themselves unnecessarily, or to lie to their shrinks. In much of German literature about that topic, you read that this silly test is absolutely necessary for diagnosis, should be done at least one year before you prescrive hormenes blabla, with the exception maybe of people black-mailing you into prescribing them hormones as otherwise they'd kill themselves, which shows how pathological many trans people tend to be blabla..., some of their books from 2 or 3 years ago even pretend that NOWADAYS, the International SoC request that pre-hormone-test though this has not been true any more since 2001 or something and it's easy to read that up. And they still use this bogus argumentation to back-up this typically German request of the real-life experience before hormones. Wow - that's either transphobia or free-willing stupidity.


I think German professionals are just too lazy or bad in English to read up recent English publications, or too proud to admit that they've made wrong emphasis for decades, and that they don't respect their patients enough to listen to them - complaints about the forced RLE before hormones are even documented in the German SoC, and the German Soc says that such complaints should be ignored. Well, so much about respect and hierarchies and cooperations. Throughout German literature you can read explicitely that patients object to this non-hormone-test but that these objections should be ignored, as well as the patients' complaints about being submitted to ridicule unnecessarily etc. Well, yes, Germans are no Nazis any more, but they haven't learned much since then when it comes to authorities and hierarchies. I don't object to SM-like scenarios and master-slave-relationships, but I really prefer to get involved with them on a voluntary basis. Thank you.

Is Australia doing it wrong because it seems so much easier? Or are we doing it better? It would be interesting to see the success rates of different countries that use different methods and different amounts of hoops.
If the end result is happiness and a better life then it's a success and if that can be achieved with less hoops then awesome.. that is the better (smarter) way.. but I guess we have to consider other things like the system, money, liability-fear and stubborn doctors who haven't updated their medical literature since the mid 70's. :-/
*checks*.. yep room is still avail! ^___^

Such studies would be awesome. Well and yes, docs who are not up-to-date but stubborn are not good. Well lots of questions my shrink asked me seemed to me like he had learned that from some 70ies literature - about MTFs. And then asked me about it, just reversing the genders.

[Lisa]

Hi,

New here, well I have been reading the forum for a while, but thought is was about time I started participating.

I am 23 and from Denmark but currently living in a remote-ish part of Australia.


Anyway,
I have had heaps of these weird questions, like.

Are you attracted to yourself?
Had to say no to that cause when I see myself in the mirror I mostly start picking out all the things that are wrong, well lately I have been trying to focus on the short list of things that actually look right. But still, when I see myself in the mirror the first thing that comes to mind certainly isn't "What a hot guy".
So after this "NO" in a questioning voice accompanied by a puzzled face, the psychiatrist felt the need to explain that almost all transsexuals find their pre transition bodies attractive and would quite like to meet them.
This seemed off the planed weird to me at the time, still does, but I cant stop wondering how many (if any) really feel that way?


Was going to put down more examples of questions here but I have hit a blank.


I gave him the benefit of the doubt because he was great at helping me get over being depressed, but over the last few months I have been convinced that he just don't understand this at all.

I have been wearing women's clothing for about 5 month now, started out mixing it slowly and the last two months I haven't been wearing men's clothing at all, well except for underwear and socks, but is low on money so that will have to wait a bit. Now I didn't tell the shrink this as I thought he would notice first time and when he didn't I just got curious of how far I could go before he would notice, I mean he would be looking for it wouldn't he?
Actually nobody has noticed, or if they have just not mentioned it. Then again I just wear jeans, t-shirts, polo shirts and occasional cargo pants. Have just been trying to only buy stuff that I can wear every day and at work as money is a bit short at the moment.

Anyway back to the shrink story...
So this guy wants me to built up muscle and gain weight before we can even talk more about my transition and how I feel about it all. This is kind of one of the reasons I haven't really told him what I am doing about it, cause he haven't really given me a chance. Sure I don't mind gaining like 5-10 kg as that would put me right in the middle of the normal weight range, I am currently 2 kg under weight, but if I am going to do that then I want it to go to the right places and not just some ugly belly blob. The GP is not really concerned about my weight at all, as I have been stable on it for years.
Now last time I went to see him I wore a red tee with an anarchist logo on it and some jeans, I thought it looked quite nice. He just made fun of how it made me look even more skinny, how I was the smallest anarchist he had ever seen and that I seriously needed to build up my arm mussels. Normally I wear a polo shirt when I go see him and I didn't really think it would make much of a difference in how I look as both are short sleeved and shows my arms anyway. Oh well, it did cheer me up a bit when I stoped by my mums place later in the afternoon and she commented on how those jeans looked good on me. I am not out to her yet.


Didn't mean to write such a wall when I started but it all just kind of flowed out.

Can't resist, just one more thing...
Ok, so this is a bit off topic but just have to share it.
I went and got new shoes yesterday, like my first pair of women's shoes, just everyday shoes, maybe a bit androgen, but still, it was from the women's section of the shoe store, and they look nice with the jeans.
The sales guy was like really nice and chatty, made me feel happy for the rest of the day.

[tekla]

And Americans complain, bitch, moan and all that because here you more or less just buy that diagnosis.

[shiinee]

Well, since knowing about this new pit-fall, if I were not only transsexual, but also anorexic, I'd never tell about my eating disorder to anybody, so  I don't get the necessary health care delayed or jeopardized.... I don't mind getting examined more thoroughly if your body dysphoria might be in context of your anorexic dysphoria, but I don't think it will work to make it difficult on everybody who's anorexic. It will just raise the gatekeeper-patient barrier higher and decrease the degree of honesty.

That doesn't surprise me as far as the typical treatment of eating-disordered people.  We get a lot of the same forms of disrespect from our doctors as trans people (though this might just be my perception because I am both).  Generally doctors concentrate on restoring our bodies to a healthy weight, without any regard to our mental health until we are physically at the place they want us.  Our personal thoughts and opinions are discounted, and we get hit with all sorts of manipulation tactics like

"You are hurting yourself so much for no reason"
"Stop thinking/talking like that because it doesn't help"
"Trust me, you just don't know what you really want"
"You got a chance to control your own life, but you blew it"

In the best known hospitals for eating disorders the accepted treatment is to take away all choice from the patient's life, put them on a forced meal plan and gradually "reward" them if they comply by restoring their privileges, possessions, and freedoms.  Of course the anorexic plays the good patient, fakes wholehearted commitment to the meal plan, and then goes right back to starving as soon as no one is looking.  The relapse rate is up around 50%. 

Sure, some people with eating disorders are just shallow types who really don't care about anything except their weight.  But I don't think that's as common as our doctors would have you think.  Like any other form of self-injury an eating disorder develops as a coping mechanism to deal with high stress, loss of control, or a pre-existing emotional problem. 

From my perspective it's disrespectful and intolerant treatment disguised as caring and healing, just the same as clueless doctors give to trans people.  Concentrating on our unnatural desires for our own bodies, delegitimizing/invalidating our identities, twisting our arms until we agree to appear normal, while the issue that caused our behavior never gets addressed.  I have heard the exact same things with regard to my eating disorder and my gender identity - that I am a pitiful lost girl, who can't stop hating herself. 

Needless to say it interferes drastically with your transition (or any personal goals) and causes people to see you as a mentally ill patient, not a sane person dealing with their problems in an unhealthy way.  Basically it is taken as an excuse to treat you like less of a human being. 

[kyril]

I think a line needs to be drawn with eating disorders. Some anorexic patients really are so physically sick and in such bad condition that it's (a) absolutely critical that they get some nutrition and calories right away just to be sure they'll survive and remain conscious long enough to get some benefit from therapy, and (b) absolutely unreasonable to expect them to make serious progress in therapy, or even make reasoned decisions, because starvation beyond a certain level has effects on brain chemistry and judgment as well as on the body.

But you can be below normal weight - significantly so - and still be physically and mentally functional. You have to be quite severely underweight for there to be any short-term danger; being mildly to moderately underweight poses long-term threats to your health, but not short-term ones. It's ridiculous and stupid to demand that a patient reach normal weight before his/her autonomy can be respected and s/he can be treated as a partner in the treatment process. Doctors should be able to distinguish between patients whose eating disorder is an immediate physical threat to their survival and those whose disorder is a psychologocal condition with long-term physical health repercussions, and treat the two groups accordingly (moving patients from the first group into the second as appropriate).

And just in general denying patients' autonomy just creates a counterproductive, adversarial relationship, where patients have an incentive to cheat and lie and manipulate. It's stupid. The same can be said for trans treatment protocols like Fencesitter describes. Any time you have an adversarial relationship between teacher and student, therapist and client, doctor and patient, you've created a lack of trust and an incentive to be dishonest.

[shiinee]

Kyril, you say it like it is, not as OMG BIASED RANT as me thanks.  I do think there is a point where someone with an eating disorder can't function because their health has degraded so significantly, and making their decisions for them may be the only possibility in that situation.  Still I suspect that doctors show greater respect for the autonomy of someone who is physically and mentally incapable for other reasons. 

[Fencesitter]

I have had heaps of these weird questions, like.

Are you attracted to yourself?
Had to say no to that cause when I see myself in the mirror I mostly start picking out all the things that are wrong, well lately I have been trying to focus on the short list of things that actually look right. But still, when I see myself in the mirror the first thing that comes to mind certainly isn't "What a hot guy".
So after this "NO" in a questioning voice accompanied by a puzzled face, the psychiatrist felt the need to explain that almost all transsexuals find their pre transition bodies attractive and would quite like to meet them.

WTF??? Pre-transition, you can find yourself objectively either attractive or non-attractive when looking in the mirror, no matter if that person represents you or not. I thought I looked very cute or sexy or serious in the mirror with certain clothes, hair-dos etc., and just unattractive and ugly with other ones. But none of the mirror images was me. It was not just fooling myself, I got hit on a lot with some stylings and not at all with others.

I have been wearing women's clothing for about 5 month now, started out mixing it slowly and the last two months I haven't been wearing men's clothing at all, well except for underwear and socks, but is low on money so that will have to wait a bit. Now I didn't tell the shrink this as I thought he would notice first time and when he didn't I just got curious of how far I could go before he would notice, I mean he would be looking for it wouldn't he?

No idea, just let me tell you, I did the same stuff with my underwear. I'm very stingy and use up anything until it falls apart. I'm sure I still have some female stuff somewhere in my cupboard.

I don't know that much about anorexia as I've never had a real eating disorder, but let me tell you, I know plenty of people who are a bit underweight and always were. Some of them have just a crazy metabolism, they can eat whatever they want without gaining weight. If your bit of underweight has been stable for the last couple of years, I'd just say it's nature. People come in all shapes and weights. It often runs in the family. Anorexia is in the brain and in what preoccupies you, it's not in the numbers on your scale. Maybe you're anorexic, maybe not. It's the mindset that counts there, and the preoccupation.

I don't know how you look, but if you're just another skinny person, I don't see the point of your therapist trying to normalize you. It's not nice as well making fun of how you look, there's lots of skinny persons out there. You might have an eating disorder, I don't know you, but you might as well be perfectly normal and just have a crazy metabolism. Sometimes, this runs in families. Or a lack of whatever vitamin or metal in you.(I'd get that checked up, though, if possible)
Nice to hear about your new shoes, I hope you feel comfortable in them.

@shiinee
I've seen a few reports about anorexic people, and what you tell me confirms me in what I saw there.
As far as I know, anorexic people (and even people starving without wanting to) may reach a grade where it becomes difficult for them to eat. Many concentration camp survivors exhibited these traits as well after being freed. Plus students from a scientific "starvation" study in the 50ies or 60ies ended up like that, they ate not enough for a couple of months and did not want to eat enough any more even after the study had finished. Something happens to their instincts, brain, metabolism... I don't know exactly. So for these cases, it may be okay to force people to eat until the brain functions normally again, with enough fuel to run on.

On the other hand, lots of the treatments I have seen on TV wouldn't work for me if I were anorexic, as I'm kind of a rebel, and the treatments are very shallow and authoritarian. And as far as I see, a big problem for many anorexic people is: they see themselves in the mirror as fat, but are very thin. You cannot just talk that out of someone. Autoritarian advances don't help there either. Taking photographs of the people and showing them to them seems to work better.

I've seen a report about a clinic where they forced them to eat fast food to gain weight - hamburgers, french fries with mayonnaise, fried fish sticks etc. and they had no food choice and had to eat up the mayonnaise etc., had to eat all up like little kids. The food was unhealthy high-calory food, which is okay for starved people as a first aid, but I think does not work well for anorexics. Not enough veggies, vitamines etc. And you cannot fool anorexics there, they know lots about food and KNOW when something's not healthy and unhealthy stuff gets forced on them. Not just "too fatty" (starved people need fat), but unhealthy in terms of vitamins etc. as well.

Lots of people in Europe wouldn't eat that stuff at all, and some would have a hard time stomaching that food, and many others would find it disgusting as it's just too fat. Even I could only eat that up if I'm in the right mood and sometimes have trouble stomaching this stuff, though I'm a renowned trash can for food and eat almost anything. Even German "Hausmannskost" (houseman's food), that is, German traditional food for hard-working people, would be much healthier, it's like Polish, Russian etc. traditional winter season cuisine. Sausage soups, lentil soups, marinated beef, roulades, herring marinated in cream, etc. All that served with potatoes, delicious German bread, Spätzle (Southwest-German pasta) or great bread dumplings, cooked red cabbage, sauerkraut, various radishes or salads. Many calories, very fatty, but great & tasty if it's well cooked and balanced, and vitamines galore (apart from Vitamin C). I think it is awful to force certain foods upon people in anorexia clinics, they oughta have the choice between two or three different menues at least, different styles. I'm sure even traditional German winter meals would work better for anorexics than this mayonnaise fast food trash (added with oranges, apples etc. the vitamin intake for German winter food might be okay).

Sounds weird? Prepared by a good cook, German food is delicious, believe me, though it's no Haute Cuisine. Our sausages and bread are much better than the US standard. I went to the USA (Boston, New York) and well, yes, it's no comparison. I was shocked. I spent two days walking around generally, but also looking desperately for decent bread until I found an acceptable bakery in the Italian quarter (wonderful, tasty white bread: Ciabatta - but still no good wholemeal bread). The USA are great for lots of things, but not for bread and sausages. I'd surely have a very hard time in a US-american anorexic clinic.

I don't even want to know how such an anorexic clinic's fast food program would have been for, e. g. a Japanese immigrant. Undigestable.

I also think anorexia is connected to a self-control issue in many cases. You cannot deal with it in an artificial environment where people force you to eat certain things. Once out of the program, you'll fall back into old habits.

And I've also experienced other people having no understanding at all for anorexic people. They don't seem to understand that it's difficult to them to eat high-caloric food. And I think it's awful that anorexics are often treated as sub-humans, not taken seriously, asked to "just eat more" etc. Also, I'm not sure if it's a good idea to treat anorexics in a program which is basically about their weight. It won't help them focus away from that topic.

I've never had anorexia, but developed a kind of pseudo-anorexia for a while cause I have a metabolism disorder. I often fall into hypoglycemic attacks, making me instantly hungry like a wolf, really trembling for hunger, and occasionally even causing cannibalistic thoughts (seriously! my colleague's arm cut into slizes and frizzling in a pan... yes I have these thoughts when I suffer such attacks). But my metabolism changed for a while, so I did not have these attacks for months. Hunger, for me, before, had always been = horrible hypoglycemic attacks, as it was always like that.

I'd never been used to interpret normal hunger feelings as "hunger" since my teenage years, and so just ignored them and did not eat then. So after the change of metabolism I suddenly had a hard time eating and lost a lot of weight, even got underweight. Had a good therapist then, though for other problems, and just "hijacked" him for treating this. Thanks God, he had been working at a clinic for eating disorders and adapted his know-how to my atypical case and got me out of trouble in just 2-3 few months. But that was not a "genuine" eating disorder I had, not with a deeply psychological motivation, it was just an action-reaction problem on a primitive level which came up after my metabolism had become a bit more normal. However, without him, I don't know if I would have gotten out of trouble I faced then.

And just in general denying patients' autonomy just creates a counterproductive, adversarial relationship, where patients have an incentive to cheat and lie and manipulate. It's stupid. The same can be said for trans treatment protocols like Fencesitter describes. Any time you have an adversarial relationship between teacher and student, therapist and client, doctor and patient, you've created a lack of trust and an incentive to be dishonest.

This, yes!!!!

[Lisa]

WTF??? Pre-transition, you can find yourself objectively either attractive or non-attractive when looking in the mirror, no matter if that person represents you or not. I thought I looked very cute or sexy or serious in the mirror with certain clothes, hair-dos etc., and just unattractive and ugly with other ones. But none of the mirror images was me. It was not just fooling myself, I got hit on a lot with some stylings and not at all with others.

I don't think I can really be objective about it.
I can set my hair and wear nice clothes so that I look good and guys at the gay bars/night clubs are attracted to me, but I still would not say that I am attracted to myself, that just does not work with the way I think.
Maybe I am getting too much in to semantics, and the shrink really just meant if I thought I looked good. Which would have been a not terrible at the time and quite ok at the moment.
Oh well, on the bright side as laser is reducing the shadow my face is starting to look a lot better.

I don't know that much about anorexia as I've never had a real eating disorder, but let me tell you, I know plenty of people who are a bit underweight and always were. Some of them have just a crazy metabolism, they can eat whatever they want without gaining weight. If your bit of underweight has been stable for the last couple of years, I'd just say it's nature. People come in all shapes and weights. It often runs in the family. Anorexia is in the brain and in what preoccupies you, it's not in the numbers on your scale. Maybe you're anorexic, maybe not. It's the mindset that counts there, and the preoccupation.

I don't know how you look, but if you're just another skinny person, I don't see the point of your therapist trying to normalize you. It's not nice as well making fun of how you look, there's lots of skinny persons out there. You might have an eating disorder, I don't know you, but you might as well be perfectly normal and just have a crazy metabolism. Sometimes, this runs in families. Or a lack of whatever vitamin or metal in you.(I'd get that checked up, though, if possible)
Nice to hear about your new shoes, I hope you feel comfortable in them.

Some times when I am really absorbed in something I can forget to eat, like I will look at the time and suddenly realise that I should really have got something to eat 3 hours earlier. I am sure that if the shrink thought I had a serious eating problem then I would be on a holiday of free accommodation and catering rather than posting to this forum.


I don't know, seeing this psychiatrist is like, sometimes I feel it has been good and helped me out and other times I go away from the sessions thinking he is a complete prick.


Anyway, had all the "sex" questions. What is you're fantasies, how many men/women have you slept with, how did it feel, etc...
All stuff I kind of don't want to share with him.


It is just so frustrating that he wants me to build my body up to that of an average guy, just to see if it would make me feel better.