Susan's Place Transgender Resources

New member to this site but I have from time to time have visited.  After 44 years I have decided that I need to do something about how I've felt about myself going all the way back to about 6 years old.  Late next week I have a appointment with a therapist that specializes in transgender issues.  I'm not naive enough to think that she will ask me a series of questions and then give me formal diagnosis of suffering from gender dysphoria.  But I don't know how many sessions it will take before she does render a diagnosis.

What should I aspect and what is next step after getting the 'letter'  I'm excited but also terrified about this 1st encounter with a therapist.

Welcome to Susan's Place. Something you may not have seen but gender dysphoria is the only condition that is self diagnosed. Your therapist will not be diagnosing but instead will be confirming your diagnoses. Depending on the therapist and how open you are, this could be accomplished in 2 or three sessions.

The next step will be up to you. Some people desire additional therapy in order to deal with other issues in their life and other may move on to transitioning. You may start your transition before ever seeing a therapist and some do but many have and idea how they want events to play out and go by their own time table.

If your goal to get letters (you didn't state which) you should mention that early on. HRT letters can come pretty quick. Surgical letters may only be available after a year of RLE. If you desire a letter, you should ask your therapist what actions you need to take in order to receive the letter you are interested in.


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Thank you Dena for responding so quickly.  I believe that i would like to start HRT as soon as possible.  I do need to lose weight (but I have already been doing this for other reasons) and would like to take a wait and see approach about SRS and FFS.  I'm married going on 14 years and have a six year old boy.  My SO knows about my dressing in Fem or as she calls it Samantha mode but it has been over six years since I've dressed.  In that time I never felt a pressing arge to dress since along the way I realized that clothes don't make you a woman.  I feel like one on the inside and every time I would dress I would fell at first happy and relaxed but then reality would remind me that I still had a penis.  Which I have never liked having.   Should I go dressed to the first session or would it be better to go as I appear appear to everyone 24/7?

You should appear at your therapy session however you  will be comfortable. If Samantha has spent a fair amount of time in public, then there would be no problem with Samantha going. You will be nervous enough without adding a first public appearance to it. Once you are relaxed with the therapist, it would be a good place to first introduce Samantha.

SRS and FFS often require the year of RLE (full time) before letters are written. It's not always the case but but most of the time it is. Often people don't require FFS as estrogen can make a major changes in appearance given time.

Hello Samantha,

Dena is right on. I want to add that a letter is not the only thing to hope for from therapy. You have gone through many years and many emotions to get to where you are. A good therapist can help you sort though much of that and help you move farther into your journey with the fewest bumps and bruises. This works best when you find a therapist that you can be comfortable with and openly communicate your wants and needs.

I would like to add that while there are many folks that get their "Letter" in one or two visits, many of the protocols suggest a minimum of three months of therapy with few specifics of what that really means. Mine came after two months. I just brought this up to keep you from getting your expectations set too high.

You know that transitioning is not just getting a letter or starting hrt or........but it is a process that began when you decided to do something about choosing to experience your real identity and will continue for the rest of your life. It is a great journey, enjoy every step.

Anne

Samantha has been out in the public before (library, mall, park)  in the past and even then I didn't interact with people very often or for extended periods (always been very shy around people) so I never really developed my fem voice.  Regardless I've lived my current life and like everyone else in the world have had my share of good days and bad.  But quite literally everyday from the first time I realized that I wasn't like the other boys and since then I've felt like I was a fraud in how I presenting myself.  For years I simply thought I was a cross dresser but even dressed I never felt complete and eventually acknowledged that while it helped.  Eventually I would need to take off the clothes and wash off the makeup and when looking in the mirror afterwards I would still feel like a stranger was staring back at me.

Don't worry about having every perfect if Samantha goes. We tend to be a little rough around the edges at first and the therapist expect it. I think you have little to worry about with the therapist as it shouldn't take long for both of you to agree on your  transgender status.

Thanks for everyone's advice so far.  I'm still on the fence about how I should present myself (dressed in fem or not) when I meet her for my very first appointment.  I don't want to seem that I'm trying to hard and when I asked she didn't really respond.  I sort of feel that how I appear to her for the first time is almost like a test  (not one of those pass/fail ones)

When I met with my therapist for the first time, she never registered my dress.  She asked a few cursory questions to get things started and then we talked about life.  To this day we have never really discussed clothes and I have been seeing her for a long time.

Just go in an be you and you will do fine.

My very first session with my first therapist was with me presenting as male.  The session went well, if we call 'well' my completely falling apart with 50 years of repressed self exploding all over the office. :)

For my second session, I wore my jeans, size 8, and a teal lightweight long sleeve turtleneck, with the usual padded undergarments, and a nice Calvin Klein jacket.  When he came into the waiting area calling my male name he completely missed me.  I stood, he did a little double-take, "Oh, there you are. This way..." and I was off to my second session.  I know what I looked like...  Brrrr...

He did ask me why I was dressed for the session.  I mentioned that he HAD said this was a safe space at the start of the first session, and that I felt better and thought I might communicate better as myself.  Then we dove in..

So, yes, you can go as yourself.  It's a safe space, and I guarantee that the doctor has already seen it all.  If it helps you to feel more comfortable, or to communicate better, then by all means, do it.

Quote from: SammyGirl on September 23, 2016, 04:42:27 PM

What should I aspect and what is next step after getting the 'letter'  I'm excited but also terrified about this 1st encounter with a therapist.

Congratulations on your important 1st step. I think in the months ahead you will find yourself experiencing a lot of firsts.

For example, I have my first hearing with the county judge next week to petition for my name change.  The 1st time I ever changed my name.  For many of us it is a beautiful and sometimes difficult but totally worth it journey of discovery that awaits.  A true metamorphosis is possible. My advice:  just be honest with your therapist. Find a real life trans support group. Be present. And let the magic happen.

Quote from: Michelle_P on September 25, 2016, 11:01:44 PM
The session went well, if we call 'well' my completely falling apart with 50 years of repressed self exploding all over the office.

I cried like a baby at my first intake too.  Pro tip: bring lots of tissue. (Just kidding. They're a gender therapist! They WILL have tissues.)

Actually an SRS referral can consist of primarily a q&a diagnosis, viz:

Sadly I'm an old hand at therapy. When I decided to start hrt it was just a quick appt with my PCP and then the somewhat long wait for an endocrinology appt. All I had to tell my doc was I've known for 20 years I'm trans and had discussed it extensively back then as well as for the previous 2+ years I'd been working with a psychiatrist on issues if depression as well as extensive work on being trans.

I don't fit in the gender binary and spend my days now simply not worrying about the hrt-induced changes showing and take a little time to apply makeup etc. This is also how i present for therapy. My therapist has been a rock throughout, it couldn't be more clear that she genuinely cares for me and that said, not being an expert in gender she wanted to involve someone with specific experience before writing a surgery letter for a patient not planning to pass (hence waiving RLE at least as defined by my insurance company). This was all fine in my eyes as I need a second letter for SRS anyway.

So I sought a referral and the psychologist I came up with said she'd first consult with my pshrink and then work with me if appropriate.

Those sessions came down to two sessions of me relating my history and the things I've been through in a cumulative 7 years in therapy. On the third session she opened saying "this may feel a little invasive, I'd like to ask you questions I need to form a diagnosis".

And so the substantive part of that therapy was indeed a series of questions to get to a diagnosis. I'm *not* saying treat it as a rubber stamp, a good therapist can help immeasurably with understanding ourselves.

p.s. I choose to go to therapy as I am 24/7 which is essentially non-binary, I femme up a little more on those days, wanting my therapist to see whatever the most femme Sadie does at trthis point in time.

My first visit I showed up as Anne (I had warned her before hand). I wanted her to meet me first as the person I choose to be. My second visit I went in guy mode wanting to introduce her to who I have been most of my life. All following sessions Anne showed up. How I presented my self to her did not seem to make any difference in our progress though I believe that she preferred to work with Anne, she recognized that as Anne, I was most comfortable and more open to sharing more fully. - Anne

Hi girls it's Shannon. I went as Shannon and used my passable voice and was greeted and treated as Shannon.

Congrats Shannon on stepping up and out!  The main thing is to be comfortable with the therapist so that you can better open up the little intricacies that brought you to this point.

Kaity. Thank you. It felt good to be me.  I didn't overdue my appearance but was definitely girly.  I wore basically the same thing to the Endo/GP and Therapist.  Hugs Shannon

Quote from: spx_1112 on September 28, 2016, 12:42:44 AM
Kaity. Thank you. It felt good to be me.  I didn't overdue my appearance but was definitely girly.  I wore basically the same thing to the Endo/GP and Therapist.  Hugs Shannon

Well done!  Getting your gender presentation lined up with your gender identity is like a little miracle drug.  You can feel better, and I bet you communicated better because of that.

Congratulations!

Wish me luck my appointment is tomorrow and I'm so nervous I don't know if I will be able to sleep tonight.

You will do great!  Just breathe and relax.  The appointment will be awesome.

you will be fine, be honest.. in the end your only being honest with yourself.

my appointments are right after work and well i cant go home to change and come back.. i have no car :(

You don't need luck, you will ace the appointment and be back here tomorrow telling us how great it was.

OMG!!!  I was so worried about my first appointment but after a hour session with my therapist I found myself not wanting to leave.  I decided not to dress for the occasion, maybe some other time, but I wanted to feel comfortable.  I shared my details about my past and how I've felt for as long as i can remember.  Dr Thor was very understanding and I thought the best part of the session was when she pulled what she called the 'bible' (some medical journal I can't recall the title) on GD and started to list one by one the diagnosis point of being transgendered.

Finally when the session was at a end I asked the question that has been on my mind for over forty years.  "Am I suffering from Gender Dysphoria?"  Naturally she said that while she is not ready to give me the "Letter"  which I expected she said that I'm showing many of the classical signs of being transgendered.

Can't wait for my next appointment.  Though I still have a long road to travel yet I can can say that I'm a woman!!

Thanks everyone for your support.

Samantha

Hello Samantha,

I just love to hear the excitement in your words. We have all gone through it and we know that nothing we could say would calm you down before your first appointment. But hearing your realization that you are on the right path is joy to our ears. And, it just keeps getting better. There will be times of frustration, times when nothing is going quickly enough and sometimes when it just seems to be going too fast. Enjoy the ride and keep remembering that you own every step. And please keep letting us in on your progress.

Anne

Anne

I feel like I'm on cloud nine right now, but thanks you for reminding me that I need to keep my feet mostly on ground.  "If life were easy than what would be the point of living?" Just a old saying from my deceased grand mother.  It just feels so good to talk to someone about my GD face to face and not feel ashamed of who I am.  I do feel bad that after over twelve years or marriage to my best friend and the mother of my child I couldn't tell her.  She has known of my dressing in fem for nearly as long as we have been married and were still together.

Still in was a very good day,  here is hoping that there are more good days versus the bad

Samantha

well i got the best advice from my parents.. well 2 pieces really that i hold dear.

1.) Whats the worst that can happen? and then what will you do about it.

2.) What are you willing to give up to get what you need?

no matter what may come in the future, good or bad you will succeed. dont fear the bad, you are strong enough to make it thru it all.

I'm about 5 sessions into therapy.  The first one was mostly recounting my personal circumstances and history as wll as that of my fairly crazy family as a kid.

Sessions 2-3 were a massive catharsis, much like Michelle_P described.  So much so in planned weekly session 2 that my therapist scheduled another session for the day to follow.  I barely slept the night after the second session anticipating the third.  After the third, I was emotionally exhausted went home and collapsed in bed for a 12 hour night's sleep.  I can't tell you how much my life has improved just having this stuff out on the table finally for analysis and discussion.  Just the process of moving forward toward addressing gender issues has made all the difference even thought ti is still unclear to me what the ultimate solution will be for me.

Therapy is so important to understanding your internal state and  forming a rational plan to move forward.  Stick with it.  The goal is not simply to get the coveted letters for HRT, GRS, etc. even if you are absolutely sure of your transgender status and need to transition.

Steph

My first appointment with Dr Thor went very well and have already set up another appointment with her for this upcoming Friday.  Does anybody have any suggestion on the frequency of counseling sessions?  I was thinking that every other week perhaps.

Since I'm just starting what can I expect from the other sessions to follow.  I was very fortunate to find someone that specializes in transgender issues and doesn't overlook the spiritual side of GD.

Quote from: SammyGirl on October 02, 2016, 03:54:52 PM
My first appointment with Dr Thor went very well and have already set up another appointment with her for this upcoming Friday.  Does anybody have any suggestion on the frequency of counseling sessions?  I was thinking that every other week perhaps.

Since I'm just starting what can I expect from the other sessions to follow.  I was very fortunate to find someone that specializes in transgender issues and doesn't overlook the spiritual side of GD.

Frequency of appt is typically a week, but times may vary. In my opinion you are wise to take account of spirituality and it is great your therapist looks at the spiritual side too. You are not the sum of your chromosomes and as second wave feminists pointed out: biology is not destiny.

We are on the verge of a new wave: Gender Liberation. Best wishes on your path forward. If there was one unasked for piece of advice, journal after each session, even if it's only a short sentence or phrase. Many of us find the changes we undergo are worth recording. insights worth remembering.

I would agree with a week at first until your issues have been pretty well addressed and then talk with your therapist about how often you should receive therapy. If the therapist feels you still have issues to addressed it would be best to deal with them now so your letters won't be delayed in the future.

Frequency varies according to individual needs.  I am at about a month or two between face to face sessions anymore, but I can contact Lynn (my primary therapist) through skype or messaging at any time.  I have been at this a while...Lynn and I came to a point where the frequency of IRL meeting could be spread out some.  We also know that things come up and she is always available to 'emergency sessions'.

Go at the frequency your therapist suggests at first and then see how you feel.  As you begin to acclimate to who you are uncovering, you will likely find that you can shift things accordingly.

I start therapy on January 5, for the first time.
I do not need it for "the letter", because I already have informed consent from my physician to start HRT.
However I want this to have someone to talk to about marital issues. My wife and I do have a wonderful marriage, and she has known for decades about the fact that I cross dress. She wishes my need to be a woman would just go away. We are deeply in love and I do not want to lose this love if I go to her and press my case that I simply must transition.

So, I am looking forward to therapy not to validate myself as a transgender woman who really wants HRT, an orchiectomy, and full transition. No, I want therapy to help me guide myself to make the best choice that is both healthy for me, and at the same time my wife may be able to live with.

My fantasy: a Wife and Wife marriage instead of a Husband and Wife marriage.