Susan's Place Transgender Resources

Hello,
    I am a MTF transsexual who is about to schedule my first therapy session next week.  I was very lucky and was able to get a therapist recommendation from a local Transgender group.

    I searched around a bit on this forum about what to say / not say with ones therapist without much luck.  On a certain level I am petrified that the therapist will categorize me as something else.  I know the therapist will very much be the gatekeeper of my future, and if I have to find a different one the time with this one will have wasted.

This leaves me with the two things I have been wondering:

What do I say to the therapist?
What do I not say to the therapist?


Thank you,
Galantha

In this day and age, just be yourself. The two therapists I had, I told everything. Even seemingly 'trans violations', such as being an ftm who's bisexual and wears mascara. The more important factor is whether you know who you are or not. If you know you're trans, know you're female, it won't matter if you - god forbid, enjoy sex  :o or know what's under the hood of a car.
I think it's safe to be yourself with your therapist, and I think if you embellish to try to conform to some stereotype, you'll shortchange yourself. Your therapist can help you best, the better they know you.
Remember that this is a self diagnosis for all intents and purposes. If you're sure, your therapist will be sure.

So if you're trans, if you're a woman, say so. Be firm about it.

Whatever you choose to talk to the therapist about, do your best to be as perfectly honest with the therapist as humanly possible.

Say whatever you want. Don't be afraid of blurting out whatever. I've found therapists to be very understanding and patient with things.

Quote from: Galantha on June 21, 2009, 09:24:54 AM
What to say?

the truth

Quote from: Galantha on June 21, 2009, 09:24:54 AM
What not to say?

don't tell lies.

Just tell the truth and answer all their questions honestly, and bring up any concerns you might have. If you try to hide things or embellish the truth, you'll just be hurting yourself in the end. The therapist's job is to help you, they won't be able to help you properly if you don't tell the truth! If you need to take a little extra time getting to know the therapist and getting comfortable talking to them, then do so! It'll help you in opening up more to them in the future if you're comfortable talking to them, and will make the whole process easier!

The therapists job is to help YOU get what you need. They aren't there to judge you, or compare you to others. As long as you tell the truth, they'll be able to rule out other things faster and diagnose you properly quicker.

Hi Galantha, :icon_wave:

Welcome to our little family. Over 2500 strong. That would be one heck of a family reunion.

Feel free to post your successes/failures, Hopes/dreams.  Ask questions and seek answers. Give and receive advice.

But remember we are family here, your family now. And it is always nice to have another sister. :icon_hug:

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Quote from: Natasha on June 21, 2009, 11:42:46 AM
the truth

don't tell lies.

Ditto

Janet

How to convince a therapist that you are Schiz:

Don't show any expression. When you go into the office, be wary, and take a good, long look around the room before you sit down. Whatever you do, don't stare directly into the therapist's eyes. Instead, find things in the room to stare at. Give short, sure answers to any given question, and do not offer him any information that he doesn't request directly. And remember, if he asks a question that seems to be too personal, you should take offense over it: he is using those personal questions to probe into the unsanitary details of your private life. Giving him a piece of your mind over it will raise his respect for you.

How to get on well with a therapist:

Be open, trusting, calm, and considerate.

QuoteHow to convince a therapist that you are Schiz:

Don't show any expression. When you go into the office, be wary, and take a good, long look around the room before you sit down. Whatever you do, don't stare directly into the therapist's eyes. Instead, find things in the room to stare at. Give short, sure answers to any given question, and do not offer him any information that he doesn't request directly. And remember, if he asks a question that seems to be too personal, you should take offense over it: he is using those personal questions to probe into the unsanitary details of your private life. Giving him a piece of your mind over it will raise his respect for you.

You can start laughing, but this was far more helpful then I would like to admit.

----------------------------------

Thank you everyone who responded.  The answers have been helpful to me, even if they have been a bit obvious.

-- Galantha

+1 to what the others have said. 

The therapist is there to help you.  If you are not open and honest you are shortchanging yourself and probably delaying the process.  You want to find out what you need, not what the therapist needs.  The therapist is there to help you get to where you need to be.

Good luck!

- Kate

Quote from: Galantha on June 22, 2009, 02:49:12 AM
You can start laughing, but this was far more helpful then I would like to admit.

I am, but in a good way.

Your therapist will want to name one of his/her children after you if you just admit outright that you are scared out of your wits. They tend to be extremely impressed with clients who are willing to talk about their feelings. It's actually a source of frustration for them to have a client who is too concerned about saying the wrong thing or doing the wrong thing. They get a better idea of who you are and what you're about if you just go in and try to be yourself. As a result, they're a lot more likely to trust your OWN judgement regarding YOURSELF, so it makes things a lot easier on both of you.

be yourself.  you can't go wrong.  Therapists don't always see themselves as gatekeepers, and you can always get a different one if this one turns out to be an a$$hat. 

That was odd.  I called up the office of one of the two therapists recommended to me and asked to schedule a session.  The receptionist just hung up on me.  Did I violate some sort of Taboo? 

-- Galantha

Quote from: Galantha on June 22, 2009, 04:17:29 PM
That was odd.  I called up the office of one of the two therapists recommended to me and asked to schedule a session.  The receptionist just hung up on me.  Did I violate some sort of Taboo? 

-- Galantha

That's just downright rude. They're not supposed to do that. I believe it might come under discrimination.

QuoteThat's just downright rude. They're not supposed to do that. I believe it might come under discrimination.

I will definitly agree with you on the rude part.  I doubt it was discrimination, I did not tell her anything about or why.  Thinking back, it occurs to me most people are going to be referred to a therapist by their doctor.  The receptionist may have thought I was some fruitcake.

I sent the Therapist an email directly, hopefully I will hear back from her soon.

-- Galantha

Quote from: Galantha on June 22, 2009, 05:14:34 PM
I will definitly agree with you on the rude part.  I doubt it was discrimination, I did not tell her anything about or why.  Thinking back, it occurs to me most people are going to be referred to a therapist by their doctor.  The receptionist may have thought I was some fruitcake.

I sent the Therapist an email directly, hopefully I will hear back from her soon.

-- Galantha

Hanging up on someone is the same as refusing to give them service, which is the same as discrimination. Any counseling center that tried to pull that with me would have quite a problem on their hands...and the receptionist would probably be fired within the month.

Ideally, counselors/therapists etc are supposed to help people no matter what their problem and while they do have the right to refuse you service, I believe they have to give you a reason and refer you to someone else. At least, that's my understanding.

maybe you just got disconnected?
did you try calling back?  Or did the receptionist say something about a long walk and a short pier?

Quote from: Jessica L. on June 22, 2009, 07:21:31 PM
maybe you just got disconnected?
did you try calling back?  Or did the receptionist say something about a long walk and a short pier?

It is possible I was simply disconnected.  I made no attempt to call back.  I did however get a response back from the therapist to call the number I was disconnected from inorder to get cost information and schedule an appointment.  I need to go to bed soon, so I will not do that tonight.

-- Galantha

Take advantage of the experience. Try to use this small discourtesy, if it was indeed a discourtesy, to build up in your mind a more human image of this therapist. He/she is really just an ordinary person, and therapists don't really receive the highest of incomes. They are probably being hurt as much as anyone else during this economic downturn. Think about the therapist thinking the kinds of things and doing the kinds of things that any ordinary person would do. Maybe that could help tone down your anxiety a bit.

Therapists are really just like any other kind of professional: tired more often than they like, starting to feel themselves age, and maybe feeling a little disappointed that their profession isn't EXACTLY what they envisioned it would be. In light of that, it's nice to try to feel some compassion toward them, and treat them with simple, human kindness. Try to smile when you see them, and maybe make a little bit of small-talk. To a therapist, a minute or so of light-hearted chatter is worth five thousand years of hearing about someone's inner turmoil. They're bombarded with that stuff every single day, and it gets really repetitive after a while. It's easier on you and them both if you think of them as PEOPLE, flawed and confused like anyone else, rather than these sinister gatekeepers.

By the way, as a transsexual, I count myself very lucky. You know, my problems are relatively easy to fix compared to someone who suffers from some terrible mood disorder. I'm very fortunate compared to most people who would go in to see a therapist. When I get my license, I might focus on GID for just that reason: I think it would give me a lot more job satisfaction than other concentrations.

The therapist I mentioned responded back to me, and then called me on the phone.  She referred me up the chain to another person who is running a program for interns, who cannot bill hours out.  She felt I would be best served if I gave this person a call, and see if I could get therapy through this program.

As I am rather strapped for cash, I am thinking I should go for it.  I need to go to bed to get some sleep before work, so not going to call the guy tonight.

-- Galantha

Hi Galantha,

It sounds like a good start.  You don't have to stay with the same therapist all through the process.  (I'm on my third.)  It sounds like you can get started figuring things out with this one for free.

Regardless of what you are doing it can be hard to get started.  Starting therapy (counseling) can be a bit scary, but if you click with the therapist even a little will find it very worthwhile.

Good luck.

- Kate

If you go to a therapist with all your issues resolved, with a sober sense of purpose, completely open to the therapist but without hysterics or use of Kleenex, you will get all the recommendation letters that you need but with snotty comments that "male socialization" has left you without the ability to express your emotions.

Well, I had my first session with the intern and her superviser.

1. I did look at the floor to much
2. I was very open
3. They do have reason to believe I am a nutcase
4. I do not believe they are inclinded to deny my HRT request in three months

They are looking to meet with me weekly and have scheduled there of.  I was under the impression that this was normally done monthly.  I am not sure wether to be alarmed, or to suspect they are just trying to get the intern her hours in.

-- Galantha

Looking at the floor is okay
Being open is good
Nutcase?  Would you elaborate?
Good!  An HRT letter is a good thing. 

I saw my therapist weekly for the first month or two, and decreased to a monthly frequency after that.  I wouldn't be worried, it's just a good way to take care of a lot of the past history and details that they want to get out of the way. 

Quote from: Jessica L. on July 09, 2009, 06:32:01 PM
Looking at the floor is okay
Being open is good
Nutcase?  Would you elaborate?
Good!  An HRT letter is a good thing. 

I saw my therapist weekly for the first month or two, and decreased to a monthly frequency after that.  I wouldn't be worried, it's just a good way to take care of a lot of the past history and details that they want to get out of the way.

1. I admitted to having suicidal thoughts in the past
2. I admitted to having been depressed (a red flag to deny HRT in my research)

-- Galantha

---

Post Merge: July 13, 2009, 02:06:38 PM

---

On the flip side, I realized today I had mislead the therapists (intern + senior supervisor) on the standards of care internationaly vs the US.  Specifically I had indicated you do not have to live 1 year in role with the international standard, where as with the US you do.  It turns how you do with both on further research. 

I sent an email of apology to them, but I wonder how this will effect future sessions.  I was very positive and adminate on this item, and I suspect this turn of events will not make me look good for one thing.

-- Galantha

Quote from: Galantha on July 09, 2009, 07:12:31 PM

1. I admitted to having suicidal thoughts in the past
2. I admitted to having been depressed (a red flag to deny HRT in my research)

I admitted both of those to my therapist, too.  It's not necessarily an automatic block to HRT.  It depends on the therapist. 

Quote from: Galantha on July 09, 2009, 07:12:31 PM
On the flip side, I realized today I had mislead the therapists (intern + senior supervisor) on the standards of care internationaly vs the US.  Specifically I had indicated you do not have to live 1 year in role with the international standard, where as with the US you do.  It turns how you do with both on further research. 

I'm not sure what you mean about living 1 year in role, but I thought you were talking about HRT.  SOC according to wpath.org (http://wpath.org/Documents2/socv6.pdf) states 3 months in RLE, or a recommended period of psychotherapy of 3 months, prior to being started on HRT.  Or were you talking about SRS (1 year according to wpath.org).  If you're going through an insurance company, or public health service for SRS, they can make you wait longer, but that's not an international standard or guideline. 

Or am I just totally misunderstanding you?

Quote from: Jessica L. on July 13, 2009, 02:31:45 PM
I admitted both of those to my therapist, too.  It's not necessarily an automatic block to HRT.  It depends on the therapist. 

I'm not sure what you mean about living 1 year in role, but I thought you were talking about HRT.  SOC according to wpath.org (http://wpath.org/Documents2/socv6.pdf) states 3 months in RLE, or a recommended period of psychotherapy of 3 months, prior to being started on HRT.  Or were you talking about SRS (1 year according to wpath.org).  If you're going through an insurance company, or public health service for SRS, they can make you wait longer, but that's not an international standard or guideline. 

Or am I just totally misunderstanding you?

I did not provide proper context for my post.  I have been working myself up with foolish thoughts of them not trusting me now. 

I was refering to 1 year in role for SRS.  Specifically, if I remember right 1 year of in role time + 1 year of HRT + 2 letters are required for SRS?  (I plan to go to Thailand as I have no expectation my insurance would ever cover it, but that is a long ways down the road).  I had specifically and strongly indicated to them the international rules did not require 1 year of real life experance for SRS.

I am under the impression you do not have to live at all in role for HRT, just three months of therapy. 

I wouldn't stress too much about them not trusting you.  You've only been (presumably) one or two times, yes?  That's hardly enough time to develop much rapport with your therapist, so give it a chance to work out. 

IIRC, it's one year RLE for SRS.  The year of HRT can be concurrent, AFAICT.  2 letters also sounds right.  If you plan to go to Thailand, I'm not sure if all surgeons there require the letters/1 year RLE, though I suppose that's different than saying the standard doesn't apply.  It would probably be more correct to say that not everyone follows the wpath SOC. 

You may not have made a statement of absolute or complete fact, but as I said, there are people that don't follow the SOC.  Couple that with the fact that everyone makes a mistake at sometime, and it's maybe not so bad.  Your willingness to own up to your mistake is probably a good thing in the long run, and not a bad one. 

I hope it all works out.  Let us know!

Quote from: Galantha on July 13, 2009, 02:43:54 PM
...  I have been working myself up with foolish thoughts of them not trusting me now. 

Yes, worrying unnecessarily and "working yourself up" is always contra-indicated no matter what the situation is: therapy, police stop, bad fish at a restaurant, hernia repair or mowing the lawn.

Emotion is fine, but "working myself up" should be re-trained to something like "working with what's there and what I actually know." :)

QuoteI was refering to 1 year in role for SRS.  Specifically, if I remember right 1 year of in role time + 1 year of HRT + 2 letters are required for SRS?  (I plan to go to Thailand as I have no expectation my insurance would ever cover it, but that is a long ways down the road).  I had specifically and strongly indicated to them the international rules did not require 1 year of real life experance for SRS.

TBH, it's not your job to give them such info and it would certainly be poor of them to not do their own research. So, you made a mistake. Ever drop a book while walking to class or arrived late for a party? About the same thing. They won't "dock" you for that.

As for your earlier worry about depression. It's not a worry. most TSes are depressed to some extent for a lot of our lives prior to being post-transition. Par for the course.

A clinical depression, quite different, would be a reason to withhold both hrt and delay srs. In fact, you may well need to be in a psych-unit with that as SI usually becomes acute in such states.

Delaying hrt because there does appear to be some evidence that estrogen-rich humans are more likely to be depressed than are T-rich humans. But once the depression relents and you're normally depressed or not depressed hrt would be able to resume or start.

It's also not a good idea to go into surgery while in a clinical depression. Most people get post-op depressions anyhow. And your surgery will work better if you feel good overall when having it and afterwards.

QuoteI am under the impression you do not have to live at all in role for HRT, just three months of therapy.

Thst impression is correct.

Nichole