Why does my therapist wants me to wait so long to start HRT?

[Iceprincess]

Ok so, I've been under psychological therapy since May 2010, but we got stuck with all the drama that happened since last october. So we're just taking back the therapy where we left it.

Now, I've been asking my therapist when will she refer me to an endo to start HRT MANY times, but the only reply I get is "when you're mentally mature and ready for it", which for me, tbh is BS. To be specific, she wants me to wait 2 years counting from the moment I started therapy with her in order to be allowed to start HRT, that's total BS!

Why is this situation happening? And, Would it be possible to go by myself with an endo and ask him to monitor and dose me, maybe by telling him I'm DIY'ing? I'm saying this because I'm in the process of starting to DIY, but I would like to have an endo by my side to monitor me WITHOUT my therapist's authorization.

Any ideas?

[blair]

Find a new therapist. The WPATH Standards of Care recommend 3 months of therapy before starting HRT, and many therapists do it sooner than that. (It was about a month and a half for me I think...) I was also lucky because my therpist was a psychiatrist so she herself was able to prescribe the meds and order the tests. 2 years is ridiculous.

[ClaireA]

That is ridic! Your profile says you're 18... Seriously, waiting two years would be a mistake.

You can try a few different options:

- Find a clinic/doctor that will do informed consent for HRT. I've never actually been to a place that does IC, but apparently they exist, and they seem to be getting more popular. Call around and see what you find out.

- Get a different therapist. Ask your therapist why SPECIFICALLY she does not want you on HRT and make sure she cuts the BS. If her reasoning is that you aren't emotionally ready for HRT, get a second opinion. If her reason is that she thinks you may not actually be TG, really consider why she is saying that, but again, get a second opinion. There is a chance that she may actually not have much experience with TG patients. Two years? Unless she can come up with a REAL, ARTICULABLE reason, find a different therapist.

- (Think long and hard about this - it is not a light decision to do this. Your therapist might actually have a good reason for not wanting you on HRT, so don't do this without serious thought and consideration) Tell your therapist that you are going to self-medicate. DO NOT SELF-MEDICATE, but let her know that you've been in therapy with her for almost a year now, and unless she gets serious about your wishes, you'll go and take care of them yourself. AGAIN, DO NOT SELF-MEDICATE. The WPATH guidelines makes provisions for allowing someone to get on HRT even with less than three months of therapy if it prevents them from self medicating, and if you let your therapist know that you are considering it, she may be more willing to get you on HRT. Again, do not actually self-medicate - it is horribly unsafe and could result in serious medical issues, including death.

Whatever way you do it, I wish you the best of luck. Don't wait any longer to get on HRT - you're young, and at your age, every day not on HRT makes a difference.

[Tamaki]

I have learned a couple of things the hard way.

First, you are in charge of your medical treatment. Not the doctor, not the therapists, not your parents (unless your a minor), not the people on this board, you are in charge. True you cant' prescribe medications or order tests and treatments but if they want to do something that you don't think is right you can say no. If they're not doing something that you think needs to be done you can persuade them or find someone else.

The other thing I've learned is that you must find the right doctor/therapist, etc. My favorite example is when my dog started to get spots on her eyes. I took her to a veterinary opthamologist (there were only two on the West Coast at the time) and she took one look at her and said she has low thyroid, go have it tested. She then charged me 1/3 the normal price. We had her tested and she was exactly right. Don't waste time with doctors/therapists that don't seem like what there knowing. Finding the right practitioner save you time money and grief.

ClaireA summed it up nicely. Go out and find what you need. The doc prescribing my hormones does informed consent, so they are out there.

Good luck!

[n00bsWithBoobs]

No therapist for me. I just asked my doctor. This isn't the path for everyone, but if you're sure, you're sure. I get why someone would go to a therapist for gender issues, but I don't get why there's such a huge deal about waiting so long for starting hormones. I can't think of one instance where someone went to counseling because they said they were transgendered and then never went on hormones.

That said, just be certain that this is what you want. From the other posts of yours that I've read, it is, but just always be good to be sure.

[Sarah B]

Hi Iceprincess

Find a new therapist. The WPATH Standards of Care recommend 3 months of therapy before starting HRT or in some cases sooner.

In addition what ClaireA says also.

You can tell your therapist (if you want to) about WPATH and say to her, I'm 18, I know what I want and you are here to help me not prevent me from achieving what I want out of life and I'm not going to have testosterone ravage my body and two years is totally ridiculous,  If you cannot and will not give me my letter then I will find the help that I need else where.

Actually run, don't walk away from your current therapist and find one that will help you.

Kind regards
Sarah B

[ClaireA]

I still can't wrap my head around this... 2 years?? Is she crazy?!

[Cindy]

Sounds very strange.

I do not know the USA conditions, but here three months of 'successful' therapy/discussion/turning up, is what is required. And the family Dr can prescribe if they feel comfortable with you and their decisions. But you do need monitoring both for levels and osteoporosis (for MtF). I don't think DIY is a good idea even though I understand completely the drive.


Cindy 

[japple]

You can tell your therapist (if you want to) about WPATH and say to her, I'm 18, I know what I want and you are here to help me not prevent me from achieving what I want out of life and I'm not going to have testosterone ravage my body and two years is totally ridiculous,  If you cannot and will not give me my letter then I will find the help that I need else where.

Ding ding.

Your therapist thinks you are immature.  You may be.  You're dealing with a lot of drama from your Mom and may have other things going on.  So start being mature.  Make adult decisions about your health and tell your therapist what you expect.

[Iceprincess]

My therapist keeps insisting on patience, she says I must learn to be patient and wait, which I totlly disagree with because I'm fighting a war against my body here and I'm losing it without the hormones!

[tekla]

I do not know the USA conditions,

They are irrelevant, IP lives in Guadalajara, Mexico.

[Iceprincess]

lolz

[Jenna_Nicole105]

2 years seems rather crazy to me.

Can't imagine having to wait that long, hang in there and as others have stated don't hesitate to find another therapist if you need to.

[Cruelladeville]

Back in the UK during the 1980s it too was a minefield area...within the NHS

I worked through several systems/medics and found myself over 18 months in a Kafkaesque loop...

So quit free public-health and went private, expensive- but at least got me progressing in the right direction...

Patience, nerves of steel, and a taurean bull attitude is what got me through – still does! 

[atheris]

Forget about HRT for a moment...what do you expect to happen in the future with the Real Life Experience? Two letters are required for SRS, and I'm wondering if this therapist will write the letter of recommendation. It would be a terrible thing to go through all of the requirements of the SoC only to be told that your therapist doesn't think you're ready to move forward to SRS.

It really shouldn't matter. If you've met your obligations, it's YOUR decision, not hers.

The therapist I used is on the Board of Directors of WPATH, and she gave me my letter for HRT after a few sessions. She also said she would never get in the way of someone's desire to have SRS, even if she didn't understand WHY the client wanted to go in that direction. She saw her role as an advisor and as a guide with all decisions, ultimately, to be made by the client.

My point is, I'm not sure if this therapist is going to support your future decisions or if she's going to continue to frustrate your progress. If you really DO have issues that should be addressed, you can still be started on a low dose HRT to get you started, so there are safe ways of working with you.

I'm not sure this therapist is going to be able to help you with anything, because if you have a problem you'd like to address, you'd be deterred from discussing it with this therapist out of fear that she'll use it as yet another excuse for not starting you on HRT. You need a therapist with whom you can speak freely and have a genuine rapport with. You need a therapist who will work WITH you, and who will support your decisions when they're well reasoned.

You know, you're PAYING this therapist to help you, and if she isn't doing her job and guiding you through your transition, perhaps you should find someone else.

[Iceprincess]

Actually there's something interesting: during our last session I asked her what are the issues that we'd have to address during our sessions, kinda like a program to follow, and she said "I will be the one who determines that, I don't want you to push me on it and I want you to be patient".

That kinda makes me wonder if there's something fishy...

[Epigania]

it sounds like the therapist has her reasons.  None of us are in the sessions with you and we don't know what is said, so none of us can really understand the circumstances.

With the information at hand, I agree with Japple.  She wants to see you learn and appreciate patience.  When she sees that you are mature enough to handle the responsibility of keeping your medications in check as well as feeling confident you can take the fact that HRT isn't an instant fix, but a tool on the path, she will be ready to give you the referral.

I see posts here all the time about people being depressed and suicidal because HRT didn't give them the results they expected in the time frame they expected.  She may be trying to prepare you for that possibility.

Perhaps you can compromise with her.  Ask her for a referral for Anti-Andogens in the meantime so the Testosterone effects are minimized.  She may go with that.

[Debra]

Find a new therapist. The WPATH Standards of Care recommend 3 months of therapy before starting HRT, and many therapists do it sooner than that. (It was about a month and a half for me I think...) I was also lucky because my therpist was a psychiatrist so she herself was able to prescribe the meds and order the tests. 2 years is ridiculous.

^ This. If they can't follow the WPATH standards (or be more lenient than them cuz they can be strict still) then you should probably find another therapist anyway for more than just waiting for HRT.

If he/she doesnt know about WPATH you should probably at least bring it to their immediate attention

[Iceprincess]

it sounds like the therapist has her reasons.  None of us are in the sessions with you and we don't know what is said, so none of us can really understand the circumstances.

With the information at hand, I agree with Japple.  She wants to see you learn and appreciate patience.  When she sees that you are mature enough to handle the responsibility of keeping your medications in check as well as feeling confident you can take the fact that HRT isn't an instant fix, but a tool on the path, she will be ready to give you the referral.

I see posts here all the time about people being depressed and suicidal because HRT didn't give them the results they expected in the time frame they expected.  She may be trying to prepare you for that possibility.

Perhaps you can compromise with her.  Ask her for a referral for Anti-Andogens in the meantime so the Testosterone effects are minimized.  She may go with that.

I understand that I need to learn to be patient and I do agree with it, but there's a catch in my situation...

I'm 18, in July 28th I'll be turning 19. This means that biologically speaking I still have chances of getting better results if I start HRT ASAP, which means a better feminization and transition for me.

AKA While I'm here "learning to be patient" and doing meditation about my life, my body is betraying me and masculinizing while there's nothing, NOTHING I can do to stop it thanks to my therapist's stupid reasons.

See what the problem is?

[blair]

The fact that she keeps telling you to just be patient and won't tell you the direction of the therapy it even further pushes the point that you need to find a new therapist. You are paying her to treat you, so not everything is entirely up to her. Find a new therapist and run away from this one. Don't allow someone with a gatekeeper mentality keep you from progressing in your transition.