Susan's Place Transgender Resources

What do we think about people who don't see a mental health professional and decide to transition on their own? They learn what they need to by reading up on GID and from forums like Susan's and local support groups, and only go to health professionals for medication or surgery (presumably on an Informed Consent basis).

Please note: I am not talking about self medicating. It's dangerous to take prescription medication without a doctor's care.

I saw a psychiatrist more to sort out some of the other crap in my life.. I knew who I was and what I needed, what he helped with was the baggage I didn't want to carry around any more. I think we could all do with a little help along the way, whether it be for a GD diagnosis or just some more general support with life issues.

I think it's probably best to have a mental health professional help you sort out who you really are, but it's certainly not a requirement.

There are places in the world (and in this country) where you aren't likely to find any help and you must rely on yourself and yourself alone.

Twenty two years ago New Zealand was a medical wasteland when it came to trying to find professional help so much of my transition for the first two years was pretty much down to me.  I can remember going to a counsellor and she spent much of my appointment time nervously looking at the clock to see if it was chucking out time yet.  When I did finally see a psychiatrist she thought I might have multiple personalities, but she also admitted to me that she knew almost nothing about gender dysphoria.  Fortunately my GP had been at the leading edge of the campaign for homosexual law reform in this country when he was younger so at least he was well disposed towards me even if he was not especially knowledgeable about folk like me.
The very first GP I saw though got hold of some ancient article from the Lanclet that said (crusty voice) 'The patient should be observed in their lifestyle and general mannerisms for two years before hormones are dispensed.......'  Or some such nonsense like that anyway, but I gave him the push when he tried to come on to me and pressed his fortunately still clothed erection against my thigh.  His wife left him three months later, I wonder why?

So yes a lot of my transitioning was DIY and mistakes were made by medical folk with my meds and very little was explained to me about the risks of being on such a high dose of Permarin as I was at that time.  Nobody told me about Potassium and being on Spiro and so it went on.

Is DIY a good idea, - no, - but I didn't have much choice.  If you do have skilled and competent therapists and medical folk in your area then for heaven's sake go and see them and follow their advice.

I think it's not greatly different from self diagnosing if you have lost a leg.

To be honest, a lot of it probably depends on the person and the type of help they may or may not need. We know there are people who feel they have made a mistake in transitioning - whether they went the whole way or not. I know I felt I'd made a mistake years ago and detransitioned, but I also had a lot of other issues bottled up that needed addressing. I feel that, given the magnitude of the decision, and the irreversible damage that can be involved in surgical procedures we owe it to ourselves to make sure we are in the right frame of mind. As long as the psych or therapist isn't gatekeeping then it can be very helpful.

I was thinking that a system that proved we had gender identity dysphoria, that we don't have a mental health problem simply because we don't identify as our assigned gender, would be better. The psych process would be more for those who might indeed have issues that need to be dealt with separate from the dysphoria. And as we know, depression, suicidal thoughts, etc are generally caused by GID and can often be addressed by treating the dysphoria through transition or other appropriate means.

I am against self diagnosis in the traditional sense as you're not qualified to diagnose yourself based on symptoms you find on google or wikipedia. Also vitally, doctors dont diagnose themselves. Doctors go to the doctors like the rest of us. If they dont self diagnose when they work in the medical field then neither should anyone else who lacks their knowledge. In the case of being trans though I dont think its something anyone else can tell you. I certainly didnt need to be told. The whole 'psychiatric assessment' stuff has been a waste of time for me I just wanted to get on with it. Did absolutely nothing for me, it was all for their benefit, like proving Im really trans to them. It wasnt about it helping me to learn anything. This is a different thing to illnesses and disorders which need professional diagnosis and treatment. This is a personal sense of self type thing. We know who we are regardless of what someone says

Though there have been cases of people being wrongly diagnosed with GD and detransitioning as they were never trans to begin with, it was something else. For people who arent completely certain of who they are it would be best they do some kind of therapy first to make sure its a GD issue and not something else which could be mistaken for GD. For most of us I dont think its essential, for some of us not needed entirely. Down to the person I suppose but ultimately only we know exactly who we are and how we feel. Not everyone fits into little boxes which is what they do with checklists to 'diagnose' someone. Fit so many of the criteria then they say yes you have it. But that can exclude people who still are trans but dont fit those specific criteria. Dysphoria itself varies so much from person to person in terms of how we all experience it. That doesnt mean one is trans and the other isnt because we experience it differently. I would say a professional may be helpful for guidance but I dont think its really needed unless an individual wanted it if they were unsure themself. If we are sure then we dont need it. Its different from other things in this regard

I'm in the "it depends on the individual" camp. For me, years of working through my other issues and building my level of self awareness was what it took. I have made extensive use of online peer support groups though as I knew I couldn't simply go it alone. I have problems with authority and my experiences with therapists in the past were mostly negative. I had been forced to see therapists as a youth, by my schools, and was aware that the sessions were for the school's benefit not mine. That being said, I do want to see a therapist now. I didn't need anyone to tell me I am trans or that I could transition but I do see the value in having someone to talk to while I transition. I want to come out of transition a healthier person than I went in.

I am self "diagnosed", simply never had the opportunities years ago, so I learnt to live with my condition, not even knowing what it was called, from about 4YO... But in that process I covered up and tried to be who I wasn't, if it were'nt for forums like this or more open information available in my late forties, I would have died not knowing about GID and the reality of being who I really am!

Not sure what else to add, except; these days going to therapists is easy, they can help, years ago it was not like that at all...

L Katy

How the heck can anyone here even begin to say that a therapist knows better than the person their supposed to be helping in these matters?  If you feel like you're trans, you are trans.  That's pretty much all there is to it.  You know what you feel better than any therapist; therefore, it's up to the individual to realize this stuff.  Otherwise we'd be going back to gatekeeping like they used to have...

Quote from: suzifrommd on March 27, 2015, 06:45:53 PM
What do we think about people who don't see a mental health professional and decide to transition on their own? They learn what they need to by reading up on GID and from forums like Susan's and local support groups, and only go to health professionals for medication or surgery (presumably on an Informed Consent basis).

Please note: I am not talking about self medicating. It's dangerous to take prescription medication without a doctor's care.

When a person decides to transition on their own, it does not imply they will never use the services of a mental health professionals.   When therapists are the gatekeepers for HRT and GCS, it changes the tone between the person and the therapist.  There is always that extra pressure to say certain things to get through the hoops.  I don't think it serves us well.  I like the idea of informed consent, plus as part of that offering easy to access options for therapy.  I know that is not happening at the moment, but in an ideal world I think that would work.  I would be very interested to know what treating physicians for HRT on informed consent think about the issue.

I do find it a bit ridiculous that for everything besides GCS (and sometimes HRT), you need to get the approval of a therapist(s).  For all the rest, including some very involved non-reversible surgeries, there are no hoops to jump through.  I also can't understand why a person who is on HRT, and is full time for over a year, needs to jump through the mental health hoops to have GCS.

I've noticed the ones who self diagnosis then use hrt seem to know their dysphoria better before any surgery.  The problem is getting from that self diagnosis to a dr who will help them with hrt.  I've noticed the dysphoria as in my case was resolved with hrt.  I just can't understand why a dr would make a dysphoria patient wait up to 2 years before administering hrt..  I could see higher rates in depression and suicide..  I saw a shrink on my drs request, but I could have convinced him i wanted to be a cat!  I still see him since i need to as my drs requirements. But sadly, i wouldnt send someone with real issues to him.  My councelor on the otherhand who i actually served in the same squadron when we were in, ive been seeing her weekly for years before this.  Shes not qualified, but shes awesome.  She even is working on something so she can help other tgs like me..  Around here tgs are mostly comming out of the military:) So, after my paper diagnosis, My Dr was hesitant to start my hrt out of too much literature going too many ways?  I just told him while he is learning about this, to please start monitoring my hormone levels since I've already chose my hormone  course and was already on it.  My body, my life, my choice!   He started my labs for me at least and 2 months later finally came up with a prescription that was 4x the dose I am currently taking.  He's been in his field 18 years and well liked, but just never did this.  Fortunately I sat him down and went over my issue with his prescription.  Moral of the story, don't always trust your drs either.  Always get your scripts and research everything.  Can you imagine taking 4x the normal estradiol injection dose? I'd rather argue about it than follow blindly and argue after the consequences, possibly death! 
Even research your dysphoria..  there are too many sites out there with incorrect doses and treatments, but something should make sense and line up to your treatment ..  or just ask someone undergoing the same treatment if what you are on is normal.  This site doesn't want to give out dosing for a good reason, but I hope we all can tell you if your current treatment may not be good for your health..  Last, there are different treatments, please research and know them before starting.  Not all work for all of us..  By knowing other treatments, you may be less discouraged if the current one is not to your liking.  This should be common knowledge,  just like when I started chemo, I was not going to take my drs word for it.  They maybe nice, but do you know them enough to know they are not paid to lean twards a certain prescription or treatment for money?  It happens everyday.  Sorry 10 years down the road just doesn't compare to a great life if you do it right:)

This is a complex area and one model doesn't fit.

Some of us are clear in our minds and have accepted who we are, some others may have DID which needs exploring, others need confirmation. There is also an increasing presentation of cross dressing men who are unsure if they are MtF but want to explore how they feel. Gender reassignment is problematic in this group. Why there is such an increase in this group is unclear but possibly due to internet access to such sites as Susan's enabling people to question their gender identity.

The increase in people accessing the gender clinic that I have a loose association with has blown out waiting times from a few months to 6 months plus. Which is hard for everyone involved.

The hardest group is children. In general (and yes it is in general) if a young child (4-7) starts to gender identify as opposite to GAAB then it tends to remain stable. A high proportion of 11-15's who start to identify as opposite to GAAB remain fluid and can revert back to GAAB at around 18-22, this proportion is higher in FtM than MtF. But in both groups there is a significant group who decide to revert to their GAAB and identify as homosexual and are very happy in that identity.

So my feeling is that yes there is a need for medical professional to assist us; but, and this is a major caveat, the professionals need to be properly trained professionals in the area of transgender medicine who know what they are doing.

Well having gone the self diagnosis route, and then gone on to have 30 good years, I obviously cant object. Then again I agree with Cindy one size will not fit all and my own history is decidedly odd.

In many ways I transitioned several times. My parents disapproved of enforced gendering and hence I grew up as what I believe might now be called a demi-girl, having expressed a strong gender preference for female at age 4 or 5. I was very lucky - to find a family and schools that allowed me that freedom in the 1960's in the UK was pretty unusual but I'm living proof it happened.

Then in 1976 I sought to complete the transition and came up against a lot of very unsympathetic medics with result that with puberty biting and no help, I was forced to transition to male...

Finally in 1984/5 I took matters into my own hands. I transitioned to female, I obtained medication, I obtained SRS, but I managed to do that all with very minimal medical involvement because frankly having been blocked once I wasnt in a mood to let anyone have even the slightest input to what I was doing. For me that worked, and there might be others for whom that would also be the case, but for most its probably not the right way to proceed.

As someone who has had experiences with multiple therapists, begun HRT via informed consent, and ultimately worked with a therapist to get a referral for surgery, I recognize that there is a benefit to having multiple systems available for people to transition. I would not be the person I am today had I been stuck waiting several months to start hormones, and for that reason alone I'm thankful that informed consent exists.

But I do not believe in self diagnosis. To me, only a competent medical professional can say that I have a condition. And with a complex condition like GD, I think there is value in getting a second opinion. When you think about the amount of money you will spend on transition over the course of your life, of the social stigmas and hoops you will have to work around, getting the opinion of a competent, affirming, and friendly professional is probably the least difficult thing you will do. Especially in this era when there are so many options available for decent long distance care.

I think it should fall into the category of other chronic, manageable mental health conditions. If you have seasonal depression year in and year out, you go to a doctor, discuss it, and they make a treatment plan that you follow until you feel better. Speaking with a mental health professional for GD is the same - you go in, discuss it, and make a plan to make changes until you feel better. It's no different.

Ultimately - to each their own. I'd never impede another person's transition. I'd much rather have people present and living, even if they end up feeling like they've made a mistake.

Don't we all self diagnose this thing? I mean don't we just know? I remember those thoughts since I was only 3 years old.

But I think it depends on a number of factors. Usually it's learning how to deal with all the negative crap you get from family, friends, and coworkers.

I was invited by a therapist to panel a transgender session at a community college in southern CA. Every semester, I'd go down and do her class with three other transwomen. I had not had my surgery yet. I paid for one session with her after doing three classes and she wrote me one of my letters. I also attended a group therapy thing that was free in Santa Monica hosted by Jayne Thomas. She worked as an advisor on films that involved the topic. She really liked my input in the group. I participated for a year there. I paid to see her twice to get my other letter.

Now, I saw three good church member "therapists" in Utah before I moved to California. I saw them a lot. They tried to cure me. They put me on drugs where I'd zone out and lose several hours in a day. I'd wake up in a meeting and wonder why I was there. They tried electric shock therapy and a bunch of other senseless crap. I paid them about $15k combined. What a waste of money that was.

Cindi

The DSM V definition of gender dysphoria basically calls for self diagnosis verified by a therapist. If you say you're trans, you are absent the existence of a very few serious conditions that MIGHT mimic it. Even then it doesn't mean you're not trans, just that you have to deal with the possibly obscuring conditions to be certain.

Quote from: Dee Walker on March 28, 2015, 12:22:37 PM
The DSM V definition of gender dysphoria basically calls for self diagnosis verified by a therapist. If you say you're trans, you are absent the existence of a very few serious conditions that MIGHT mimic it. Even then it doesn't mean you're not trans, just that you have to deal with the possibly obscuring conditions to be certain.

What could possibly mimic this?  If someone feels like their in the wrong body, are we to simply invalidate that feeling if thy have other issues?

Quote from: androgynouspainter26 on March 28, 2015, 01:40:05 PM
What could possibly mimic this?  If someone feels like their in the wrong body, are we to simply invalidate that feeling if thy have other issues?

Supposedly serious stuff like schizophrenia or dissociative identity disorder.

I think dee is referring to multiple personality disorder - best guess...

Quote from: femmebutt on March 28, 2015, 02:28:26 PM
I think dee is referring to multiple personality disorder - best guess...

I am, but they don't call it that anymore.

Quote from: androgynouspainter26 on March 27, 2015, 10:31:40 PM
How the heck can anyone here even begin to say that a therapist knows better than the person their supposed to be helping in these matters?  If you feel like you're trans, you are trans.  That's pretty much all there is to it.  You know what you feel better than any therapist; therefore, it's up to the individual to realize this stuff.  Otherwise we'd be going back to gatekeeping like they used to have...

Agree totally and pretty much what I said earlier in the thread.

With all of the information available on the internet nowadays, all of the people sharing their own personal stories about why they transitioned, being able to compare symptoms, compare life experiences, and test and test your own convictions on the matter based on those stories and experiences, I think it's pretty safe to say that someone with classic gender dysphoria could probably diagnose themselves pretty easily, and in fact most of us go into transition already knowing that we need to transition, need hormones, and know whether we need surgery or not. There are plenty who are more on the fence about it who probably could benefit from some guidance to sort out their doubts and uncertainties, but most of us, probably not.

I basically did diagnose myself. A therapist was very helpful once I finally did start going to therapy, because she helped me sort out which of my life problems were likely dysphoria-related and which ones were likely general-life-issues related, but she was more help in getting through the actual process, not so much in helping me decide what I needed to do medically. I knew long before going to therapy for the first time that I was indeed trans, and that I wanted hormones, a full social transition, and SRS. She just confirmed what I already knew, and helped me rest comfortably in those convictions because I knew that a medical professional agreed with me on them.

WELL...Can someone not be both schizophrenic and trans?  I think it's a very ableist assumption that being one precludes being the other; I actually have a freiend who has schizophrenia who is currently exploring his (or possibly her) gender identity, and the two issues are completely unrealated.

Quote from: androgynouspainter26 on March 28, 2015, 04:02:29 PM
WELL...Can someone not be both schizophrenic and trans?  I think it's a very ableist assumption that being one precludes being the other; I actually have a freiend who has schizophrenia who is currently exploring his (or possibly her) gender identity, and the two issues are completely unrealated.

Don't shoot the messenger. No one asked my input on any of the DSMs, and I don't particularly agree with everything in it. Second, I didn't say no one could be both. I said that the idea was to make sure a more serious issue wasn't masking the true situation. Doctors are really concerned about not causing harm. Where would we all be if they just proscribed HRT and surgery without being sure and then later the person decided that it was a mistake and sued. None of us would be able to get what we need.

Before we get too far with this let me say that I believe we should all be able to get the treatment we need on our own say so, but too many times people have pushed for treatments of various kinds and then sued when they didn't like the results even when the treatments did just what they were supposed to. Those people ruined things for all of us.

There's a difference between gate keeping and self defense, but it can be really hard to see sometimes.

I can only speak for myself here, and say, I really needed the guidance in the end, even when I had my mind hell bent on having gender dysphoria. If not for the diagnosis then just to speak through it with someone who is hearing me, and mapping out a future plan for me in the process, whether it be to pursue HRT or otherwise. Then again, I was given the diagnosis of gender dysphoria... maybe my opinion would have changed if I was told something I don't agree with, whatever other answer that might be.

Some can decide for themselves I think, though in my case it was best for me to talk it out- not just 'be 100% certain', but to explain myself and really, really, think through it.

I always like your thought provoking posts, Suzi!

Quote from: suzifrommd on March 27, 2015, 06:45:53 PM
What do we think about people who don't see a mental health professional and decide to transition on their own? They learn what they need to by reading up on GID and from forums like Susan's...[/i]

  If a person has continual suffering and constantly fails to find ways to cope or transcend their issues one hopes they would just seek help.  But I think there are plenty of ways outside formal mental therapy a person could help themself.  In my case I have my therapist to thank for helping me to be able to confront my gender issues, but my decision to go on hrt was my own and was not made while under her care. I'd like to think if I were conflicted and struggling with that decision that I would be sensible enough to start seeing her again.

I'm sure someone could provide a link to a "things to consider before transitioning" article...

...oh wait, isn't that your point?

What I think is everyone should at least try just to make sure they are confident in proceeding with transition. However if you are so confident then by all means go forth but like any problem it is better to get a second outlook on it.

The only thing that bugs me a bit is really its all up to me to really figure it out if that makes sense. I realize GID is so variable but is there not some queues as to what it really is? My guess at this time they don't really know so we are left to our own decision with little guidance to make those choices. Maybe I am wrong or haven't gone through enough with a therapist to really figure stuff out but for me still feels as if its really just me figuring this out. I do understand though that only I can truly know my own thoughts. I had hoped there would be some traits, queues or whatever that might point me into what direction I was heading if that makes sense.

So in short at least in my experience we really do actually self diagnose but with help and guidance would be wise.

I'm changing my answer. I've seen enough dumb tattoos to realize people don't give enough weight to decisions that affect permanently changing their appearance. This is so much more than a change of appearance - this decision is something you have to live with and struggle with for a while. And all the major considerations need to be measured against the longer arc of our life's trajectory, goals, etc.

Johnny: Why do you think I should see a therapist?

Doc: I'm a bit concerned about the things you've been saying.

Johnny: Like what.

Doc: About how you're a man, always been a man, and plan on living the rest of your life as a man.

Johnny: Well, I am a man. I've always known that.

Doc: It sounds to me like you might be saying you're cisgender.

Johnny: Of course. I was born with a male body and I want to live as a man.

Doc: I really think you should talk to a therapist about this. A lot goes into deciding whether you're cisgender. It's not the sort of thing you should do on your own.

Johnny: Why not? I like being a man. I play football. I go out with girls. Why wouldn't I be cisgender.

Doc: I'm not saying you're not cis. I'm saying that you should look more carefully at it. Are you sure you don't just want an opportunity to do the things that men do? Like play football and date women. You could do those things as a woman, you know.

Johnny: But I've always wanted to be a man. Isn't that enough to know I'm cis?

Doc: You really want to be screened for a mental illness. There are a number of conditions that might make someone think they're cisgender when they're not.

Johnny: This is crazy. I'm a man. I've always been a man. I have a male body. Are you telling me I need a therapist to tell me I'm cisgender?

Doc: It's not just that. Being cisgender is hard. Cisgender people are under a lot of pressure. Cisgender men can be required to serve in the army. Cis men are under a lot of pressure to get married and have kids. And the statistics are grim. Over 90% of crime victims are cisgender. Also more than 90% of car accident victims. It can be hard to find love as a cisgender person. 50%, 50% mind you, of cisgender marriages end in divorce. Don't you think a therapist could help you deal with the difficulties involved in choosing to be cis?

Johnny: I'm not choosing to be cis. I AM cis.

Doc: Maybe. I'm just suggesting that you talk to someone before choosing that lifestyle. It's just not natural. God has given us HRT and SRS because He wants us to choose how we live. Just deciding to be cis without carefully weighing those alternatives is simply not natural. Especially since cisgender people face such a world of difficulty. I'll give you the name of one of the top gender therapists. At least tell me you'll think about seeing him.

Because gate keeping can even begin with a primary care doctor and their not giving the necessary referrals needed sometimes for insurances to cover therapy and the like you often do have to self diagnosis and even be confident in it to ensure you get the care you need. My previous primary care doctor was one of those and as a result he isn't my primary care doctor anymore as a result he handed me off to a doctor in the office who handles trans patients which worked out for the best. I have been sure all my life and much of that stems from issues that have been around since my birth. Having said some really do need to sort this out with a therapist to find out where they stand, but in truth only you and you alone can decide if your trans or not. The therapist is only their to help you sort out who you are and due to the hoops in many cases right the letters we need to get the care we need.
Mariah

Quote from: suzifrommd on March 30, 2015, 08:19:40 AM
Johnny: Why do you think I should see a therapist?

Doc: I'm a bit concerned about the things you've been saying...

<3 so good!

NOPE NOPE NOPE NOPE. (for certain people)

I think if you feel intrinsically wrong, you will identify it yourself. Most (if not all) here knew they were some form of transgender, however dysphoria can be different for different people. Mine came in bursts. Id get one maybe once a fortnight where id just curl up and cry/eat and try and figure out what is wrong with me. whereas i know people can be literally stuck in their room afraid to come out.

If you feel wrong you go to a doctor or look it up online. The amount of times ive looked up illnesses online only to conclude ive got cancer and about 7 weeks left to live is ridiculous.  And a GP who usually doesnt know you on a 121 basis ie knows you only by looking at a file cant really decide or question you upon the matter.

I personally despise tumblr (although ive made a few amazing friends on there). And the amount of kids that had assumed they were trans was ridiculous, id say about 80-90% werent and thats because they 'transitioned' back. Im not joking being transgender was a TREND on tumblr. Those that decided to go back had assumed that because they didnt like a certain type of clothing, usually a skirt. mentally linked it with everything female. note this trend was for FtMs not MtFs.

By the time you are 15/16 you know a lot of things but not everything, and certainly not yourself. I assumed i was transgender at that age and fortunately i was correct but not everyone is. Past the age of 18/21 do whatever the hell you so please, it is your life and you should be able to figure out whats wrong with you, however if you make the wrong assumption dont sue others for trying to help you.

depression and schizophrenia can be misdiagnosed as GID if you do it online and by yourself. I think a therapist's diagnosis, with open questions should be the way forward, as multiple choice can be manipulated by those wanting attention.

Quote from: suzifrommd on March 30, 2015, 08:19:40 AM
Johnny: Why do you think I should see a therapist?

Doc: I'm a bit concerned about the things you've been saying.

Johnny: Like what.

Doc: About how you're a man, always been a man, and plan on living the rest of your life as a man.

Johnny: Well, I am a man. I've always known that.

Doc: It sounds to me like you might be saying you're cisgender.

Johnny: Of course. I was born with a male body and I want to live as a man.

Doc: I really think you should talk to a therapist about this. A lot goes into deciding whether you're cisgender. It's not the sort of thing you should do on your own.

Johnny: Why not? I like being a man. I play football. I go out with girls. Why wouldn't I be cisgender.

Doc: I'm not saying you're not cis. I'm saying that you should look more carefully at it. Are you sure you don't just want an opportunity to do the things that men do? Like play football and date women. You could do those things as a woman, you know.

Johnny: But I've always wanted to be a man. Isn't that enough to know I'm cis?

Doc: You really want to be screened for a mental illness. There are a number of conditions that might make someone think they're cisgender when they're not.

Johnny: This is crazy. I'm a man. I've always been a man. I have a male body. Are you telling me I need a therapist to tell me I'm cisgender?

Doc: It's not just that. Being cisgender is hard. Cisgender people are under a lot of pressure. Cisgender men can be required to serve in the army. Cis men are under a lot of pressure to get married and have kids. And the statistics are grim. Over 90% of crime victims are cisgender. Also more than 90% of car accident victims. It can be hard to find love as a cisgender person. 50%, 50% mind you, of cisgender marriages end in divorce. Don't you think a therapist could help you deal with the difficulties involved in choosing to be cis?

Johnny: I'm not choosing to be cis. I AM cis.

Doc: Maybe. I'm just suggesting that you talk to someone before choosing that lifestyle. It's just not natural. God has given us HRT and SRS because He wants us to choose how we live. Just deciding to be cis without carefully weighing those alternatives is simply not natural. Especially since cisgender people face such a world of difficulty. I'll give you the name of one of the top gender therapists. At least tell me you'll think about seeing him.

Thanks for that fun alternate reality check Suzi!! ;D ;D ;D ;D

I really don't think of realizing that I was transgender as "self-diagnosing." For me anyway, it is a question of identity, not an illness. In the absence of confounding issues that generally prevent clear thinking, I don't see how anyone can diagnose this for someone else.

Therapists can be enormously helpful in doing this, but their role really ought to be to provide support. In my case, therapy absolutely helped me come to grips with feelings I'd been suppressing for decades. But I never once discussed these issues with my therapist until the day I started a session by telling him that I was transgender. The help I got was in terms of understanding myself, trusting my feelings, and trusting others enough to be able to come out.

(Note: with regard to the "confounding issues" I refer to, I don't believe and I don't think it's been suggested that one cannot be both transgender and have a serious mental illness, or that a mental illness ought to be a contraindication to medical treatments. But in that case, I think some extra care should be taken to see that independent illnesses are being treated and that the person is in a state to understand what is going on.)

Quote from: jeni on March 30, 2015, 01:49:10 PM
(Note: with regard to the "confounding issues" I refer to, I don't believe and I don't think it's been suggested that one cannot be both transgender and have a serious mental illness, or that a mental illness ought to be a contraindication to medical treatments. But in that case, I think some extra care should be taken to see that independent illnesses are being treated and that the person is in a state to understand what is going on.)

The WPATH SoC's do require that other issues are 'well managed', but don't prevent someone from moving forward if they are..

I was diagnosed with gd by a panel of stuffed animals, it was unanimous with the cow abstaining...

Firstly the DSM V no longer lists it as a "disorder" and hence there is, from a medical POV technically and strictly speaking nothing to diagnose.

Secondly while the WHO ICD10 still has it listed, it will soon be updated and is likely to also remove the "disorder" element.

Thirdly even while there is a disorder listed, there is no formal diagnostic test beyond observation of a persons affect and apparent mental state pre and post transition. Thus there is no magic wand that any doctor (or maybe even I as a future clinician) could wave to make a diagnosis on someone else's behalf.

In essence this becomes a diagnosis of exclusion. You rule out everything else, then treat empirically and watch to see if the patient improves.

Thus while I agree that some profeesional guidance is often going to be beneficial, its not always completely indispensible. As for mistaking depression or schizophrenia for this, while I can see where that fear might come from, it's actually less common than you might imagine. Those conditions have unmistakable hall marks of their own, although in the case of depression its not an uncommon comorbitity to find with GID.

Quote from: kelly_aus on March 30, 2015, 03:54:32 PM
The WPATH SoC's do require that other issues are 'well managed', but don't prevent someone from moving forward if they are..

Yeah, that was the phrasing I was thinking about. I think it's a good principle, not just for treating GD but really for any significant change.

True, Rejennyrated, DSM V doesn't list being transgender, as is only right. It does list gender dysphoria, which is a good thing or insurance companies would list ALL of our treatments as medically unnecessary. Managing a psych rehab I saw almost as many truly mentally ill people who occasionally self described as transgender with absolutely no other indicators and a tendency to recant frequently as I saw people who were definitely transgender. Some of our clients tended to jump on whatever bandwagon was current. Which is why I didn't discuss my own condition with them. Near as I can see the rules exist for three reasons. To protect seriously Ill people from doing things they'll quickly regret, to help people who are transgender through a very trying time in their lives, and to protect doctors from lawsuits.

Sadly, many people working in the mental health field tend to pathologize unusual but healthy conditions. They see being gay or trans, among other things, as symptoms of deeper illness rather than outlying healthy behavior. I suspect that had a bit to do with my recent job loss, but I have no proof and we're not a protected minority in NY anyway.

I guess I was vague a bit in my previous post. Exactly what I meant was to get another opinion to weed out any other problems and protect yourself (big decision after all) as well of course against lawsuits.

Suzi that was a very clarifying outlook and yes it did make me think there are some that just know.

For some like myself I am still questioning this (less so as I learn) and that at least speaking to another person helps figure things out and that is the important part. A just to make sure measure besides the gatekeeping shizzle. It may not necessarily have to be a professional it could be your sibling/friend whomever you trust and even if they don't understand might be able to help you figure it out if indeed you need help figuring it out.

But having to see someone to at least make sure the choice is right it is good to find someone who know what they are talking about to figure out the next step. Disclaimer not all therapist know either.

For those that truly know it should be a just a speed bump however in reality it seems its more of a pain in the ... that isn't necessary. Really if a good therapist sees you are truly confident that you are indeed trans then they should be there to provide information on how to proceed without hinderances but that damn reality is that is not that case for some. But like I am saying a good therapist might help you discover that maybe you should think on it more.

In order to start HRT, I had to see a therapist, because informed consent did not exist then. Also, I don't think that someone else can tell you if you are transgender or not; it's something deeply personal that only you can determine. 

Quote from: kittenpower on March 30, 2015, 08:41:40 PM
Also, I don't think that someone else can tell you if you are transgender or not; it's something deeply personal that only you can determine.

I'm with you 100%, KP. I would take it further.

One of the most egregious examples of cisgender privilege is that cisgender people are assumed competent to choose their gender presentation.

No one says to a cisgender person they should see a therapist before deciding to live as the gender they know they are. That was the point of the ridiculous scenario I posted earlier in the thread (https://www.susans.org/forums/index.php/topic,185543.msg1652249.html#msg1652249).

However, transgender people are assumed to be unable to figure out how we want to live and to deal with living that way without clinical help.

The underlying assumption is that we are less competent than our cisgender counterparts and therefore need to be helped along and protected from making bad decisions.

I have no problem with a trans person (or cis person) seeing a therapist when they think they need one. But IMO the mindset that trans people in general should see a therapist before they transition is paternalistic and patronizing.

That scenario is classic and was so well done you could literally see it happening. I agree we need to get to the point that they understand were competent to make decisions in regards to our gender too.
Mariah

Quote from: suzifrommd on April 03, 2015, 09:45:33 AM
I'm with you 100%, KP. I would take it further.

One of the most egregious examples of cisgender privilege is that cisgender people are assumed competent to choose their gender presentation.

No one says to a cisgender person they should see a therapist before deciding to live as the gender they know they are. That was the point of the ridiculous scenario I posted earlier in the thread (https://www.susans.org/forums/index.php/topic,185543.msg1652249.html#msg1652249).

However, transgender people are assumed to be unable to figure out how we want to live and to deal with living that way without clinical help.

The underlying assumption is that we are less competent than our cisgender counterparts and therefore need to be helped along and protected from making bad decisions.

I have no problem with a trans person (or cis person) seeing a therapist when they think they need one. But IMO the mindset that trans people in general should see a therapist before they transition is paternalistic and patronizing.

Quote from: suzifrommd on April 03, 2015, 09:45:33 AM
However, transgender people are assumed to be unable to figure out how we want to live and to deal with living that way without clinical help.

The underlying assumption is that we are less competent than our cisgender counterparts and therefore need to be helped along and protected from making bad decisions.

The thing that bugs me most about that is that the entire idea that the decision might be "bad" stems from everyone else being uncomfortable with our gender identity. If it weren't for that, speaking at least for myself, there would never have been any of the internal conflict that led to this being a difficult decision. It's always been really obvious to me what I wanted to be, but it was really really hard to face the prospect of telling that to other people because it's assumed they'll have a problem with it.

Suzi, your scenario of Johnny and his doctor examining his cis-gender issues really made me smile.  Thanks for that :)

When I started to question myself about my gender identity I was seeing a therapist, I talked about this with her but, since the reason of my therapy was other gender identity and we were already working on so many other issues, she said we could explore that later. Sadly she couldn't see me anymore and I couldn't bring up the topic again. My next therapist after her... I never really liked her and when I talked about gender matters to her she almost said to me "no, you're not trans!". I stoped seeing her after a few weeks and decided I would take care of this myself.
I have, I've done some research about what being ftm or transmasculine is, about gender dysphoria and all that. I'm sure now that I am non-binary and I did that with no help of therapy (at least not direct therapy as I read some articles wroten by certified gender therapists).
However, I would like to take therapy later on the future, it's scary since I don't want to face the same expirience with my other therapist and I don't think a lot of people know what non-binary is. One of the reasons why I think my last therapist discarded GID on me was because I said "I don't feel neither man or woman" and she probably had never heard of that before...
I don't think a professional diagnosis is as much as a requariment to be transgender, but for some people, like myself, maybe talking it outloud with a professional helps, if the professioal is actually good knows about the matter, of course!

Quote from: Carrie Liz on March 28, 2015, 03:36:12 PM
With all of the information available on the internet nowadays, all of the people sharing their own personal stories about why they transitioned, being able to compare symptoms, compare life experiences, and test and test your own convictions on the matter based on those stories and experiences, I think it's pretty safe to say that someone with classic gender dysphoria could probably diagnose themselves pretty easily, and in fact most of us go into transition already knowing that we need to transition, need hormones, and know whether we need surgery or not. There are plenty who are more on the fence about it who probably could benefit from some guidance to sort out their doubts and uncertainties, but most of us, probably not.

I was going to say the same thing (thank you for managing to do it much more articulately than I ever could). I totally agree with you.