Susan's Place Transgender Resources

Hi  is it really nessary in all cases ? I mean if your middle aged like myself  do i need someone else to tell me how i feel, when i think about it no male is going to want to  change their body and life on a whim
To me this site with all the input and experences from others who are on the path and walked the path provides insights that no academic  could duplicate so i guess in a sense  susans place is my therapy but then i,m old enough to make my own judgements  and take note of the advise of others who have more experience.
But i guess if your battling with the decision  then some gentle guidance  would be benificial...and i guess we are all different with our life situations

Maybe...maybe not. Are you completely Ok with transition if that is what you are wanting. There is no substitute for real world discussion. Much also depends on where in the world you actually live and what standards of care are in place. I have therapy because I wanted it and not because I had too. Although having psychiatric support during transition is a pretty good idea...not mandatory but good idea.

Most places require letters before surgery or even hormones so like I said it will depend on where you are and what standards of care apply. The other part is what medical intervention of any were you planning...Hormones? Social transition, SRS.

I agree no male is going to want to change their body and life on a whim but they may try to change it unnecessarily because they don't understand why they feel they way they do and for people like that there is no peace because the problem is psychological and not physical.

If you have it completely sussed I wish you luck, go for it, but for me I wanted to ensure I wasn't missing something here so I went and continue (every 6 months) to catch up with my therapist and we chat about heaps of things Including my Transition.

Take care

Liz

Thank you for your insight Elizabeth  , well i live in Australia  i know there are all sorts of rules here about hormones and i believe they even make you live as a female for a year before any hrt etc ...,very draconian  or at least it used to be 
You are right for some it could be a psychological  problem identity  issue  and then therapy  would be very benificial...for my self i go to thailand a lot so i,m not constrained by the status quo  here in oz , i,ve already made a start as in getting hair removal , and i finally got the courage  to send shots of my self to ffs uk .....i,m dreading the results . But for me it all centers around being passable  if i can do that then my main problem will be all the people in the miniing and construction  industry  i work with , we work on projects and may not see each other for a  couple of years  afterwardsbut then again if i do a good job i  ould remain incognto  , i don,t fear their ridicule  but more their disappointment  , but then i,m not a mind reader i,m aloner in the real world outside these camps we live in , i think ive more or less set my mind on this but it centers on either being a passable female or stay as a man obviously there is some confusion  not too mention fear of making myself vulnerable ie loss of strength  and status thats how the hormones scare me as people might notice the hormonal changes
and being stuck in these camps for 4 weeks at a time  could be trying , but then again its a mark of courage  to face the unknown
But i can tell you that this urge has been pushing me for some time now strangest thing i was lieing in bed one night thinking about transitionig  and i felt this electric tingling  course through my body from my head to my toes...almost as if my body agrees with me  , i can if i have to go to thailand and completely   circumvent the west i don't  know that i would go srs but every other aspect i would change ...its like an evolution for me ...
Thanks for listening  and  the time you have given me  :)
I forgot to add i do like this body  it is a good example of a male

Different therapists have different things they like to see or have out of the way before they right letters. Hugs
Mariah

I transitioned at age 59 after discovering informed consent. I never sought out nor spoke with a therapist, I never felt the need to . Maybe if I had back in my 20's or 30's I would have transitioned long ago, but that's a subject for another time.
What I discovered during transition was that I have some very very good friends that stood by me. Two cis girlfriends in particular that I was able to talk to about anything. Without their support I probably would have had to seek out a therapist.
There are so many new (and wonderful) things happening while transitioning that you will need someone to share it all with, and sometimes you just need to vent.
So no, I don't think a therapist is a prerequisite, but I sure would keep it as an option.

Quote from: markie on August 10, 2016, 08:03:49 AM
Thank you for your insight Elizabeth  , well i live in Australia  i know there are all sorts of rules here about hormones and i believe they even make you live as a female for a year before any hrt etc ...,very draconian  or at least it used to be 

This is complete crap. There is no such requirement before HRT, except in SA where I believe 3 months therapy is still legally required. Actually, we have it pretty easy here in Australia as far as medical stuff goes. There are no jurisdictions where bathroom use is legislated. Name changes are easy... Gender Marker changes are about to become available to most.

Try educating yourself in the current process and the current WPATH Standards of Care.. Be aware that going OS for all your transition-related medical needs will still likely require that you jump through the hoops of any western country - the reputable Thai surgeons will all require a letter from a shrink. Good luck paying full, non-PBS price for all your meds..

Thank you Mariah
And Thanks Charley ....thats exsactly how i feel about the way of doing it,
Thanks for the heads up kelly...im only new to this , I don't really follow rules or regulations. ...I dont intend full srs and and a thai psychiatrist will give me what ever I want ....anyway.....
As for paying full price for meds , I intend to move to thailand where medicine is cheap and easily accessible
Should I come back to Australia im pretty sure I could get pbs meds , it is so easy to get whatever you want ....depends on how persuasive you are
I guess I just dont want to be dictated or controlled  by authorities. ...

Quote from: markie on August 10, 2016, 07:32:54 PM
Thank you Mariah
And Thanks Charley ....thats exsactly how i feel about the way of doing it,
Thanks for the heads up kelly...im only new to this , I don't really follow rules or regulations. ...I dont intend full srs and and a thai psychiatrist will give me what ever I want ....anyway.....
As for paying full price for meds , I intend to move to thailand where medicine is cheap and easily accessible
Should I come back to Australia im pretty sure I could get pbs meds , it is so easy to get whatever you want ....depends on how persuasive you are
I guess I just dont want to be dictated or controlled  by authorities. ...

Where do you get this idea that people are being dictated too in Australia. I can only speak for my experience and I have not found the process overly controlling I have lots of choice of who I see apart form the initial Psych recommendation to get HRT...had to wait to see the right DR. That took 2 appointments for me, The first was to talk to me and the second was to write my letter for HRT. No problems, no issues and now I get them for $5.80 per refill

What have you heard that is so scary? I am not following any rules...I am following a chosen standard of care so I can get the best possible outcome for me and my family.

The other thing that leaps out at me is that your transition is all about being able to pass...what if you cant. Does that mean you won't Transition? Why is passing so important to you. You do realise you don't go from male to suddenly passing overnight unless you are one of the extremely lucky few who are androgynous enough to pass easily, But even then you will spend some time not passing and having to deal with it, even if its only when prepping for a procedures or simply being read. Unfortunately it is impossible to remove all traces of who we once were. For most of us the best we can hope for is to disguise our worst parts and play up our best parts. If you have stacks of money all it means is you can have many more medical procedures but that alone will not guarantee that you pass because looks alone won't do it.

What if you could find a way to still transition and not care as much about passing or would it still be non-passing = non-transitioning.

I am sure you will be able to transition without therapy I just hope you are able to achieve what you want. Is the issue with therapy about you being scared that someone might say...you are not trans enough and can't change your life...transition is not possible, thereby leaving you in misery for the rest of your days...You must have read some really scary stuff...my experience does not reflect that at all.

I am not advocating jumping through hoops for anyone I certainly didn't and won't. I am suggesting that therapy is not Jumping through hoops and its also good to know that someone with a few clues agrees with you about being Trans. It helps in those times of doubt. At some point somewhere even in Thailand you will need to get a shrink to give you at least one letter and many of the better surgeons require two.

Good Luck and I hope it works out for you

Liz

Too many questions not enough answers...
"Is the issue with therapy about you being scared that someone might say...you are not trans enough and can't change your life...transition is not possible, thereby leaving you in misery for the rest of your days..." thats close cept I would not be in misery...disappointed yes I  can be male or female but prefer the latter , and no if I couldn't pass I wouldnt do it ....I have my reasons and im not inferring anything about yourself  ...I don't like authority point blank
I'm in the process of finding myself ,to me its personal and  well it makes me laugh when I think how I would broach the subject with my doctor ...oh doc instead of testosterone can I have some female hormones please...I must admit it would  n a classic moment the look on his face , but funnily enough when I first went to get test from him he misheard me and said well we have to get government approvals for srs ....haha talk about a near miss
Yoiu are right.femimistion icannot.be achieved over night ....but it is the 21 century and one.is only limited by self.set boundaries. ..I can do anything I want and I can do it in a couple.of years if I choose
The mind is already primed its taken 45 years to realise that .changing the body is easy....amd.as.for.feminine...for.me.more likely masculine tomboy  no real major adjustment needed.
But thanks for yoir inpit ....somewhat antagonistic. ..but valuable all the same

Quote from: markie on August 10, 2016, 11:11:11 PM
Too many questions not enough answers...
"Is the issue with therapy about you being scared that someone might say...you are not trans enough and can't change your life...transition is not possible, thereby leaving you in misery for the rest of your days..." thats close cept I would not be in misery...I can be male or female but prefer the latter , and no if I couldn't pass I wouldnt do it ....I have my reasons and im not inferring anything about yourself  ...I don't like authority point blank
I'm in the process of finding myself ,to me its personal and  well it makes me laugh when I think how I would broach the subject with my doctor ...oh doc instead of testosterone can I have some female hormones please...I must admit it would  n a classic moment the look on his face , but funnily enough when I first went to get test from him he misheard me and said well we have to get government approvals for srs ....haha talk about a near miss
Thanks for your input

I take no inference in anything you have said. I don't understand what you are talking about but I certainly take no inference.  I don't understand who the authority is you are talking about. The statement about the SRS doesn't make even the remotest amount of sense to me. The government has nothing to do with "approval or non approval"  of SRS You don't need govt approval even if self medicate you need Dr's assistance with the HRT to help keep you in the therapeutic range so you get enough of the good stuff. ;)

Good Luck

Liz

I had surgery in 1982 and standards were a bit more strict back then than they were now. Even then, therapy was there to help you adjust to the new life and ensure any personal issues were resolved before surgery. I was never judged to be transsexual by my doctor. Instead I was judged capable of making my own decision as the result of what I learned in therapy and my personal feelings. We are the only one who truly know what we need and if you meet with a doctor who says otherwise, you need a new doctor.

My last therapist was worth every cent I paid him in that my surgery put all the troubles from my previous life behind me. It's not many people who can restart life with a clean slate but I was one of the lucky ones who did.

Oh well I'm so electrified emotionally
that no doubt I'm bound to screw up
My last statement was a reply to kellys  post Liz
But you know maybe I will talk to my doc I believe therapy is free..its just speaking the words ..communicateing it to him , I guess it cant.hurt....oh I know what it is pride....amd awrkwardness....im on antidepressants  xnanax and weaning off that to sertraline ,social phobia per se
But thanks some times  I run off at the  mouth. ...so its good to get a reality check
Humbling though it may be ....I dont have
enough e in my system to have a crie :( umm thats meant to be humour ...but the wind has gone from my  sails
As for my comment about passability I am  a big very masculine good looking guy and I would just be ridiculed without some sort of intervention
Anyway I'm glad we had this dialogue pep talk as I will ask my doc I might have to write it on paper but I'll communicate to him  ome way or another  thanks :)

Quote from: markie on August 11, 2016, 03:55:30 AM
Oh well I'm so electrified emotionally
that no doubt I'm bound to screw up
My last statement was a reply to kellys  post Liz
But you know maybe I will talk to my doc I believe therapy is free..its just speaking the words ..communicateing it to him , I guess it cant.hurt....oh I know what it is pride....amd awrkwardness....

Only if it will help...there is no point if it doesn't. I think you could end up doing yourself an injustice by not exploring your issues thoroughly...have you considered where you fit on the Gender Spectrum...you don't have to belong in any particular category. But a knowledgeable ear whether be a Dr, therapist or good close knowledgeable friend to bounce idea's off is very handy...

Liz

No, letters are not always required. Some clinics will start hormone replacement with "informed consent". Having a history with a therapist is great for getting letters for possible future surgeries. However, definitely not required.

Quote from: markie on August 10, 2016, 07:32:54 PM
Thanks for the heads up kelly...im only new to this , I don't really follow rules or regulations. ...I dont intend full srs and and a thai psychiatrist will give me what ever I want ....anyway.....
As for paying full price for meds , I intend to move to thailand where medicine is cheap and easily accessible
Should I come back to Australia im pretty sure I could get pbs meds , it is so easy to get whatever you want ....depends on how persuasive you are
I guess I just dont want to be dictated or controlled  by authorities. ...

Your attitude to these things sounds very similar to mine, and I've spent a lot of time looking at how to get what I want. Too much time really.

It would help if you post which city you're in as the way you go about these things will differ depending on where you are. I can give you some advice for Sydney that would make it very easy (also if you can travel to Sydney).

You don't necessarily need to live in Thailand to get access to medicines since it can be quite easy in Australia, especially if you have a bit of money. Socially Thailand should be much easier since Thai's have a very relaxed attitude to these things, but just for access to HRT I think its a waste of effort.

HRT is available in Thailand without prescription but not particularly cheap, and implants seem difficult to find (possible though I think). I by far prefer to have implants. You should also find a doctor in Thailand to help with the HRT so you don't end up with any medical problems. There's been posts about that, and there don't seem to be many of them.

Surgery in Thailand is much easier to get than most people think, but it sounds like you're aware of that anyway.

Electrolysis is difficult (but possible) to get in Thailand, since Thai's start so young they don't need it. There's been posts about that.

Facial Team are coming to Australia in December this year for consults, and they have a good reputation for FFS.

In California, I was able to start HRT without a letter...but have a therapist that wrote one up and simply left it in my file.  My doctor never asked to see it or talk with my therapist.  I have met a few people that have never seen a therapist and they are doing fine, but have to agree that having the objective ear is nice.

Quote from: ElizabethK on August 11, 2016, 04:09:37 AM
Only if it will help...there is no point if it doesn't. I think you could end up doing yourself an injustice by not exploring your issues thoroughly...have you considered where you fit on the Gender Spectrum...you don't have to belong in any particular category. But a knowledgeable ear whether be a Dr, therapist or good close knowledgeable friend to bounce idea's off is very handy...

Liz

Its a good point Liz about exploration with someone good, its funny you should mention about the gender spectrum....I've read there ia sliding scale with 100% hetro at one end and 100% homosexual at the other some people are at the extreme ends and everyone else falls somewhere between , I would assume this would apply to the gender spectrum as well, I have been doing a lot of thinking about it I know i would like to change my body, to reflect my inner self , I know I have overcompenstated  by weight training ....
Buts heres a funny thing for over 20 yrs I have had this massive guilt shame complex that I might be gay not thats theres anything wrong with that (being gay) as technically I am a female that likes woman...but anyway went I started this site and I my other research I realised I'm not and actually its this site and peoples storys and info that did it.....and.you know that guilt complex.has literally melted.away no longer do I cringe when the men in camp or wherever go on in a derogatory manner about gays etc   because I know now what i am ....transgender how far along that sliding scale I do not know yet
So thats some.pretty strong therapy. ...how many years on a couch it would have taken to realise that I can only imagine
Its utterly fantastic. ...
I have memories now of how girlish I was as a.little child my father worked away for months and my mother wanted a girl ...my sister came.along ....
Anyway my father hated me for my girly behavior and voice so I think his disapproval pushed me.under .

There is a scale for gender as well. You have male on one end and female on the other. In the middle you have non binary which can be a number of expressions depending on how the person feels about themselves. You can read about them in our WIKI  (https://www.susans.org/wiki/Transgender).

Quote from: Harley Quinn on August 14, 2016, 10:27:27 AM
No, letters are not always required. Some clinics will start hormone replacement with "informed consent". Having a history with a therapist is great for getting letters for possible future surgeries. However, definitely not required.

Well that's a good thing to hear ! And perhaps the history with a therapist is worth it for those options

AnonyMs ...I live im wa , yes I'm a bit rebellious when it comes to perceived authority. ..I tend to just want to what I please
Yes Thailand is very laid back which why I wanted to live there the hrt would be a bonus , buts more the lifestyle I could libe as myself ...I recently started laser hair removal over there I have a few sessions to go....but hair does not look good over muscle anyway
I came across ffs uk years ago I never followed through though so recently I went to bangkok and had a thread lift done with filler before I got the ffs photo set.done
Amd.after that while in thailand I had a photo set done...its strange I told them.i wanted the photos for cosmetic surgery showed them the ffs uk photos page...they were very nice ...they only did weddings at that place but had another  shop for portraits which they opened ....so now I'm waiting on the results. ..->-bleeped-<-ting  my self that I'm goimg to look crap
I have heard of facial team and.am considering making an appointment ment in dec .....I've seen some remarkable results from surgeons across the globe , for hard cases like mine I dont know whether facial team do radical modifications. ...I have the funds to do it not flush with finance  but i could do it couldnt do it in usa though due to our $ and the high cost of surgery there though there are some . fantastic surgeons there I've worked hard ...never thought I would spend my money this way but while I apparently make an impressive man
I want to be at least within or close to that as a female

Thank you  Dena I will do that

Quote from: kaitylynn on August 14, 2016, 11:52:11 AM
In California, I was able to start HRT
without a letter...but have a therapist that wrote one up and simply left it in my file. 
My doctor never asked to see it or talk with my therapist.  I have met a few people that
have never seen a therapist and they are
doing fine, but have to agree that having
the objective ear is nice.

Good to hear ...I may just bite the bullet and find someone to talk to im not sure whether I should tell my doc or.find another...I really only see doctors to get what I want or if im ill and because of my work situation in remote sites I tend to just see anu doc available I dont have one looking after me

I needed one therapist for hormones. For surgery with Marci Bowers, she requires two letters with one from a Phd and since Marci was my chosen surgeon I saw a 2nd therapist who agreed to write a letter after two visits but wanted to see me over the course of a year which turned out to be several more visits with her.

I am by far no expert with this but it seemed that when doing research the requirement these days is set by the surgeon. Seems the two major factors are, is surgery right for the client and can the client survive the real life test. In regards to the real life test, I think the year requirement should be variable as some have been living full time and doing all the right things with the right mindset. 

Thanks karen,
  .                          What  country ? Is that year requirement pre hrt or during or post hrt ? I'm assuming it is for srs ?

Quote from: karenpayneoregon on August 16, 2016, 07:55:51 PM
I needed one therapist for hormones. For surgery with Marci Bowers, she requires two letters with one from a Phd and since Marci was my chosen surgeon I saw a 2nd therapist who agreed to write a letter after two visits but wanted to see me over the course of a year which turned out to be several more visits with her.

I am by far no expert with this but it seemed that when doing research the requirement these days is set by the surgeon. Seems the two major factors are, is surgery right for the client and can the client survive the real life test. In regards to the real life test, I think the year requirement should be variable as some have been living full time and doing all the right things with the right mindset. 

When I transitioned, the standards were a year of HRT and cross living before surgery though exceptions were made. The reason was because some people would become disturbed by the changes HRT made to their body and others might not be comfortable in the new role. Those weren't hard set standards and depending on other factors, some times the wait was shorter and some doctors wanted two years. The one I don't hear about any more was we were required to have at least half our facial hair removed before surgery as a test of our determination. As laser hair removal hadn't been invented yet, it was a real test.

Mmm that is a test alright bit unfair
But I kinda understand living for year on hrt...makes sense,  those links to before an after make me want it so bad makes.me yearn for it ...when I go on r&r I'm seeing my doctor or a.doctor and.hit them /hmm for treatment if they want me.to see a therapist I will, I don't think I need to but as liz said I might be doing myself an injustice. ...just dont want to blow my money on a . shrink so I hope its free as that money will be needed for other things

Quote from: markie on August 10, 2016, 06:50:02 AM
Hi  is it really nessary in all cases ? I mean if your middle aged like myself  do i need someone else to tell me how i feel, when i think about it no male is going to want to  change their body and life on a whim
To me this site with all the input and experences from others who are on the path and walked the path provides insights that no academic  could duplicate so i guess in a sense  susans place is my therapy but then i,m old enough to make my own judgements  and take note of the advise of others who have more experience.
But i guess if your battling with the decision  then some gentle guidance  would be benificial...and i guess we are all different with our life situations

If you have a Therapist that is versed in the ways of Transition they can be a guide and help you not make mistakes or help you around situations that you might not otherwise realize were affecting you.

Yes that makes sense i'm going to start looking for with that experience
Can't hurt.....thanks :)

Found a female therapist
210 $45mins ..ouch
But I found this group who can help with referrals etc
http://www.livingproud.org.au

Thanks for steering me.in the right direction and taking.the time :)

Quote from: markie on August 16, 2016, 10:43:49 PM
Thanks karen,
  .                          What  country ? Is that year requirement pre hrt or during or post hrt ? I'm assuming it is for srs ?

I'm in the USA where the requirement was for one year and strictly adhered to for many years but as my therapist indicated the rule had been in recent times open to the therapist for the time spent with the real life test. For me she saw me every couple of months. Right from the start she said I was without question a candidate for gender reassignment surgery but had written letters for Marci Bowers before and drew from prior clients.

I also will note that with a recent male to female I have been assisting in recent weeks was able to have gender reassignment surgery without a PHd. She is low income and it appears to me the rules were very much relaxed for her. Just goes to show how rules can be done for different people.

Its good that the prerequisites  are being relaxed   in the beginning  of my post i menrion the year trial ...it was so long i heard about in fact before the internet  and being ignorant i assumed  it was still in force...i thought it used to be the same way here in australia ....the reall life test is maybe unfair if the person is not on hrt or has been ....i suppose its okay if you have that feminine  look but the thought of myself doing something like that without hrt ....is harrowing mind you theres nothimg remotely  feminine  looking about me
Hence my intrest in ffs
Thanks Karen

Quote from: markie on August 17, 2016, 02:32:32 AM
Yes that makes sense i'm going to start looking for with that experience
Can't hurt.....thanks :)

I went to 6 before I found mine.  She wasn't cheerleader, rah rah rahing me into action, she was understanding, guiding, calm.  She encourages me to go where I'm happy.  The pic I have up?  Is 2 years in the making.  I would NEVER have been able to post a pic of me, then.  Today?  I can't stop smiling.  I got a good Endo Doc,a  plan, I know where I'm going and I know I'm not on a timeline, I'm on a journey.  She's a guide, and a valued one at that.

Yes I can see its not prerequisite but can be important. ..I had some online counselling
Last night very basic I think the most portant thing that was communicated to me was that I need help of other people as I can't do this by myself. ..I understand that now  and  I now know the organisation here in wa to contact trans/health wa and theres  also a list of online counselers on this site which is good for me.
.being a worker on remote sites
So I will contact them and see what they
I think for me the transition is not the block
But trying to dig myself out from under this male ego and that is where a therapist will be good , everynow I get thoughts coming through that have been repressed
Thanks   CaRenaetx

Unfortunately it still is fairly important at this point to have a therapist. The thought of people actually ending up in the wrong body is horrifying for people to accept and so the sociopolitical climate influences our care and how it works.

Transsexuality is still incorrectly viewed as some kind of mental problem by low information individuals which is delaying the evolution of our care, from how we navigate the system right down to the techniques that are used. Policy makers in politics and mental medical doctor associations are afraid of their potential backlash so things have always been awfully slow to change. For example, SRS was developed in Germany in the 1930s and has evolved little since. As for the system, we're still required to talk to a mental healthcare provider about our medical needs in order to receive care - something that almost no other medical or physical problems require.

I've recently come to the conclusion of all of that and IMO this is it: Therapists are largely necessary for the time being to access medical care. Without them it severely limits your options for medicine and surgery. The average therapist has absolutely no idea how transsexuality works and none of them have the professional expertise in treating anything transgender related. Dosages of hormones? Your primary care doctor and pharmacist. FFS? Your plastic surgeon. SRS? Your urologist/plastic surgeon. Just don't forget that your relationship with a therapist, conserning solely transgender issues, is a formality.

Yes I agree I'm a bit more informed now ,
and yes , I would think imformed transgender therapists would be thin on the ground.....I dont know what the waiting time is in perth Australia but hopefully not to long ..I wonder if over seas therapist's would hold any weight with australian doc, sthough I did use my test results from thailand to get on male hrt but that was aprivate script,
If I'm to do this right I will need access to an endo to get me started  and for that I'll need a referral from a.doc and then for that I'll need one from a therapist
Transgender face a lot of blocks
Put up by ignorant people I think
Thanks for the info :)