My mom and dad think I am confused and are insisting that I see a psychiatrist rather than the therapist I am seeing.
They are trying to force it on me with guilt.
I see no reason to see a psychiatrist as I know what I am.
Ive been told I will make an ugly woman and I am crushing my family.
I personally do not like dwelling in tragedy, and to be honest I just want to keep moving forward.
Every day I feel better about the future but discussing this with them is making me very depressed and full of anxiety.
What should I do, or rather, what are your personal experiences?
If you see a therapist or a psrynk just be sure they are conversant with gender issues.
So lets just play a little mental exercise shall we...:
Would you rather live your life as an attractive man where everyone see's you as a man, or would you rather live your life as a homely woman who is seen as a woman?
:)
My immediate response to your post was "so what's wrong with being an ugly woman, anyway?" - to me, the point of living isn't to be beautiful, it's to be happy and help each other be happy (which makes people more beautiful anyway) - it sounds like your family doesn't care whether you're happy, so much as they care about how you will reflect on them as a family. To hell with that.
I know I am woman. Ive dreamed about it my whole life.
I feel for them, and understand their doubt, but I dont feel like I should play into it. However it makes me feel terribly guilty.
I guess I think your priority is to become happier, as that will have a calming effect on your family's doubts. So however you feel it's best for you to do that, go for it. You could discuss with your therapist what your family wants from you (seeing a psychiatrist) and how that makes you feel, if you haven't already.
The purpose of parenting to mammals is the thriving of their youth...It's highly inappropriate for them to be antagonistic forces upon you. :\ I think they're crushing themselves, and it's extremely shallow and low-blow for them to say that to you. If they say it again I think you should bring up there's no effective way for them to be able to be sure of that. You probably could also tell them that you've gotten comfortable with the therapist you're seeing now, and being torn away from him/her is going to make it harder to open up to the next person (the psychiatrist), which will lead to them throwing money down the drain and wasting your time. Try to stay strong, ok? ^^
I, personally, would stay away from psychiatrists. (I've fired three of them.) From my experience and anecdotal evidence I've come
across, psychiatry and GID just don't get along. For example: If you go to a psych and tell him that you're depressed because you
feel like a woman, the first thing he's going to want to do is try and cure your depression with medication and hold off on your gender
issues until you're "stable." They're gatekeepers... I've even been told by others in the mental health field that most psychs are
arrogant twirps who think they're never wrong and feel that patients have to "prove themselves worthy" to make steps forward
in their treatment.
Apparently, there is such a thing as a "gender psychiatrist" but, from what I've heard, they're more of a thing in Europe than in the US.
If your parents are concerned about credentials, try a compromise; seek out a gender therapist who's a psychologist instead of a Social
Worker. I think that you're lots better off with a female gender therapist that you're comfortable with rather than seeking out
someone with more letters after their name. How you decide, though, depends lots on where you are in transition and how old you are
(I mean, if you're under 18 and still have to listen to your parents) If the issue is just making them happy so you can maintain a relationship
with them, I'd say to go with your feelings and stay on your own course.... but if yours is a situation where your parents are going to
prevent you from moving forward, you might want to consider doing what they ask and avoid becoming adversarial.
If you need your parents support in this, think of it this way; Going to a psychiatrist and having a second medical professional diagnose
you with GID might reinforce your credibility with your folks. Yep, they think you've lost your mind and are about to ruin your life.... you may have
to spend some energy proving them wrong. Just be sure, though, that anyone you choose has experience with gender issues!!!!! I can't
overemphasize how important that is; seeing someone without experience treating gender dysphoria at your stage is a waste of your time.
only bad parents would make you feel guilty about being you. people like my mom, she's taught us all to feel guilty, now that we've grown up we realize it's her, not us, that there's something wrong with. best thing for you is to never ever do anything out of a feeling of guilt, the only right thing to do is the one that you know you won't regret. it's so much easier to deal with the consequences of your own choices than those of other people. don't give yourself reason to blame your parents in the future the way i did by not standing up to them when i should have
if you feel like your therapist is good, then that's what's good for you. your family don't know you like you do, so they shouldn't really have much of a say in the matter. if you decide to see a psychiatrist, do it on the condition that you'll continue to see your current therapist (s/he could help you from falling too deep into depression in case the psychiatrist is as crazy as your family in trying to "correct" your mind)
The decision is ultimately yours. If you are completely comfortable with your therapist, stay with her/him. However, if you think that depression is an issue, make an appt with a psychiatrist.
For me personally, I have both. I see a Ph.D. for therapy and an MD for meds. I havent had a problem with either one and in fact, both wrote me letters for surgery......but my therapist was more in tune with the standards of care. Hope this helps
Personally I have been seeing a local therapist (psychologist) for other issues to do with depression, and a Psychiatrist specialising in Gender issues who is part of a local Gender Centre. For HRT and surgery I need a Psychiatrists letters, and he is experienced in this area so I have no problems with it. He has only apparently refuse HRT in two cases, both of who had severe mental illnesses which would have led to disastrous results.
If you can find one who is a genuine specialist in GID, I would bet he will back you, leaving your family with no option but to agree with your course of action. If they are serious they would find it difficult to object if you saw the best in the field, just make sure you are doing the right thing.
Karen.
Strangely, we don't have Therapists over here in the U.K as far as gender is concerned.
Actually, there are plenty of gender therapists in the UK - i.e. therapists who have undertaken training in that specific area and who have experience working with clients with gender issues. You can find them on this website (I found my current therapist on there):
http://www.counselling-directory.org.uk/gender-identity.html (http://www.counselling-directory.org.uk/gender-identity.html)
Quote from: jillian on July 03, 2011, 10:36:21 AM
My mom and dad think I am confused and are insisting that I see a psychiatrist rather than the therapist I am seeing.
They are trying to force it on me with guilt.
I see no reason to see a psychiatrist as I know what I am.
Ive been told I will make an ugly woman and I am crushing my family.
I personally do not like dwelling in tragedy, and to be honest I just want to keep moving forward.
Every day I feel better about the future but discussing this with them is making me very depressed and full of anxiety.
What should I do, or rather, what are your personal experiences?
well, if you wanna transition, I recommend a Psychiatrist who is trained in gender studies.
Personally, I think therapist and psychiatrist is the same thing...like minister and pastor.
But if you do wanna transition, you should seek out a psychiatrist and a psychologist (or the second being a therapist who is knowledgeable in this).
The best therapist i ever had was a Psychiatrist. She wrote my srs letters. She gave me so much advice on my transition and I wouldnt be Annah today if it wasn't for her...so don't discount all Psychiatrists. Actually, I was referred to her by another Gender Psychiatrists. (There are Gender psychiatrists in the US too :) )There's just as many talented Gender Psychiatrists who knows about GID as there are Psychologists.
Hi Jillian
Where I am (Australia) we see psychiatrists who specialise in GID. There is no such thing as a therapist. When he (in my case) is happy about the mental issues, genetics, LFT etc are ok he can start to prescribe medications and talk to the other medics, we need as one medic to another.
How do we end up looking? and what does it matter?
I'll end up looking like me, and yes it matters.
There is no such thing as an ugly woman. Particularly when it is you. BTW this is an age old parental comment to put MtF off. I had it when I was 13 and most people thought, correctly, that I was female. ' Don't you want to grow to be a big strong man and have babies with a woman?' 'No I want to be a woman and have babies with a big strong man' It was a bad day :laugh:
I grew up to be 60 kilos, little facial hair, a tiny clitoris and no testicles (long story). Yep a big strong man for sure.
Cindy
Quote from: JessicaR on July 03, 2011, 03:03:41 PM
I, personally, would stay away from psychiatrists. (I've fired three of them.) From my experience and anecdotal evidence I've come across, psychiatry and GID just don't get along.
For example: If you go to a psych and tell him that you're depressed because you
feel like a woman, the first thing he's going to want to do is try and cure your depression with medication and hold off on your gender issues until you're "stable.
" They're gatekeepers... I've even been told by others in the mental health field that most psychs are arrogant twirps who think they're never wrong and feel that patients have to "prove themselves worthy" to make steps forward in their treatment.
Gosh you seem to describe my own experience in detail.
"Gate-keepers" ticking boxes. When I once sobbed he told me I was unstable and if not "corrected" it be the end of the process.
(That SOB is the ONLY gate-keeper there is at present in SA). He loves to prescribe PROZAC that's his forte, otherwise not a stitch of help or anything you'd call THERAPY.
One VERY bad experience I had to endure for one year. Once close to suicide when HRT was point blank refused after 3 month and I'm since 3 month full time RLE! Later after one year he still would not budge, like HRT that was not for him to decide. UNBELIEVABLE, what an arsehole and charging your socks off for 15min sessions.
Said 'nough, - my psychologist was like day and night compared and actually did therapy and charge for 1 hr what the other idjet charged for 15 min.
Life goes on, hey :-)
Axelle
My first reflex would be to ask, why see a psychiatrist instead of a therapist? Why can't you see both?
And most importantly, who the heck are your parents to decide that YOU need a psychiatrist? See a generalist doctor and see what that person thinks. You don't just go to a specialist doctor, especially a psychiatrist, whose role is basically to medicate mental illness cases that are hard to treat with psychotherapy alone, without an excellent reason (and ideally a referral from a doctor). Some psychiatrists even despise therapists altogether and will medicate without even trying such a thing.
Psychiatrists, in EVERY CASE, are a last resort. Do not see one without an excellent reason.
Aaaaaaand don't let yourself be influenced by your family. Take your own decisions.
Psychiatrists, in my opinion are the first resort!
If you get a gender Psychiatrist to work with you for your therapy, that will only prove to your parents further that your case is legitimate.
Psychiatrists just are not trained in negative social mental disorders. There are MANY good and wonderful gender Psychiatrists out there.
It may be because where I live, family doctors usually refer patients to specialist doctors, but in my opinion, that's where one should start. I have seen a total of 4 psychiatrists so far, one of which wanted to psychanalyze me by looking for childhood traumas before I could actually talk, another was a jerk who thought he knew every hardship in the world because he had a wheelchair and I couldn't complain, another was nice but unable to work with gender issues and the last one is very hard to understand, tends to go hard on medications and has an unfriendly attitude.
Most importantly, none of them, except the one who was uncomfortable with gender issues, did actually seem to listen to me and understand me. Or, at least, gave me the impression that they did.
My experience has lead me to believe that they are not all that great. I may have just had bad luck, though, but I am still reluctant about going to see a specialist doctor as a first step. My perception is that they prescribe and judge; they don't treat.
Did you hire a Psychiatrist that was specialized and trained in Gender Issues? Or did you picked a Psychiatrist that was a "general" psychiatrist?
When it comes to gender transformation, you need to pick a psychiatrist that has notable experience in the fields of gender studies and sexuality. Personally, I would never pick a Psychiatrist from a generic medical clinic. I shop for mine...make sure they do have the experience to help me transition.
Think of Psychiatrists and Leaders in a religious building. You would not want to go to a Roman Catholic Priest to do your Wiccan Altar Devotions and you would not go to a Rabbi to discuss your options on Karma routed reincarnation. While all these people have had some sort of training in all religions and all are credentialed to marry, preach, etc etc, you still want to find the right religious leader to your specific questions or problems. The same is true with Psychiatrists.
Or look at it in a Medical way.
If you are in dire need of Chemotherapy, you would not go to your general practitioner. You would seek out an Oncologist.
With any professional field, you want to look for someone who is specifically trained in the field of study that you are needing help from. Opening the yellow pages or calling your closest mental health provider is not the right way.
As TS roadmap states: When looking for a TS related psychiatrist, make sure you ask the following questions to the Psychiatrist:
* How many TS patients do you have?
* How many women have you recommended for surgery?
* How long have you been working with TSs?
* What is your educational background?
o Remember, one of your SRS letter writers must, according to the Standards of Care, be from a doctorate-level clinical professional: "If the first letter is from a person with a master's degree (M.A.), the second letter should be from a psychiatrist (M.D.) or a clinical psychologist (Ph.D.). If the first letter is from the patient's psychotherapist, the second letter should be from a person who has only played an evaluative role for the patient."
* What books on TS issues most influenced you?
* Have you written any books or articles on the subject?
* What got you interested in working with transsexuals?
* What is your basic philosophy about how to treat this condition?
* What is your opinion of the Harry Benjamin Standards of Care?
* What is your hourly rate?
* What length of session do you usually prefer?
* Is it possible to do longer or shorter sessions?
* How long do you usually see patients before you might OK them for hormonal therapy? SRS?
* Are you affiliated with any endocrinologists or plastic surgeons?
* Are you part of my insurance network?
* Would you be willing to classify our sessions as depression in order to meet insurance requirements?
* What are your hours?
* Do you have weekend or evening appointments?
* Do you work from your home or from an office?
QuoteIf you are in dire need of Chemotherapy, you would not go to your general practitioner.
Uhm, no, actually, that's where we disagree. You need to go to the general practitioner who will refer you in radiology to see if there's a tumor, and if it's a confirmed cancer, then you're going to be referred to an oncologist. If everyone bothered specialists directly with problems that could possibly not require them, the system would fail.
But it seems to work radically differently over where you are. You are in the US. Since you pay for everything there, whereas if you are poor you get nothing at all, if you have money, you have a lot of freedom. Here, unless you're rich AND you live in a big, big city, you don't "shop" for a physician. Most of them are in the public system. You get the one the system deems the best for you.
As for who I have seen, the three first were not gender-specialized (but I had started seeing them for something else anyway). The last one is. He's actually THE specialist around.
Quote from: Padma on July 05, 2011, 01:34:38 AM
Actually, there are plenty of gender therapists in the UK - i.e. therapists who have undertaken training in that specific area and who have experience working with clients with gender issues. You can find them on this website (I found my current therapist on there):
http://www.counselling-directory.org.uk/gender-identity.html (http://www.counselling-directory.org.uk/gender-identity.html)
I didn't know that! In my early days I went through a local psychiatrist and then six long years with psychiatrists at Charing X GIC.
Quote from: A on July 05, 2011, 11:45:25 AM
Uhm, no, actually, that's where we disagree. You need to go to the general practitioner who will refer you in radiology to see if there's a tumor, and if it's a confirmed cancer, then you're going to be referred to an oncologist. If everyone bothered specialists directly with problems that could possibly not require them, the system would fail.
But it seems to work radically differently over where you are. You are in the US. Since you pay for everything there, whereas if you are poor you get nothing at all, if you have money, you have a lot of freedom. Here, unless you're rich AND you live in a big, big city, you don't "shop" for a physician. Most of them are in the public system. You get the one the system deems the best for you.
As for who I have seen, the three first were not gender-specialized (but I had started seeing them for something else anyway). The last one is. He's actually THE specialist around.
actually, i have to disagree with you about this. I had stage three renal cancer. The only reasons why you would go to a General practitioner first if 1. You had no idea about the cancer and the GP found it and you were referred to the oncologist and 2. Some insurance carriers require you to get a referral from your GP for an Oncologist.
But no, you would not see your General Practitioner for your process of eliminating carcinoma cells from your body.
This is what I meant by comparing it to Psychiatrist. You would not see a general Psychiatrist for a gender specific issue where a general Psychiatrist may have little or no experience with.
So you can't blame all Psychiatrists for being lousy. You would need to see out a gender/sexuality educated Psychiatrist and if there is no one in your area, then you would need to seek out a Psychologist (Ph.D) educated in sexuality/gender related issues per the WPATH.
But don't discount all Psychiatrists. They are all not bad as one would think if you really look for one that can meet your needs.
How could you know about a tumor without seeing a general practitioner first? Oo
Anyway, I'm not going in the right direction here.
I am not discounting them all. Psychiatrists are useful. I just don't think they are a good first step. The gender-specialized psychiatrist in my area has not been very useful yet. Plus, a psychiatrist is a physician. It's not his job to help the person come to terms with their gender identity and treat other conditions, and psychologically support the patient towards transition, etc. The psychiatrist is there to assess, diagnose, prescribe, inform and test readiness. That is what I have been told.
My main point is that seeing a psychiatrist right away may not be the best move, unless he's very soft on the SoC requirements of readiness or the patient is quite fine in every field except gender. Perhaps my psychiatrist is special in that way, but he requires concrete, correctly presented and durable proof of very significant progress in all spheres of my life, probably until every possible cause of mental discomfort is pushed aside and he "has" to give me his approval for transition.
Until now, he has not quite helped me, except with medication for my concentration. He has been requiring things from me, simply. And if I were needing to decide, analyze my problems, understand them and get mentally ready for transition, he would not be the one to help me do so. I would have needed a therapist.
In fact, I did need to see a psychologist to 1. understand his goals and instructions and 2. learn to endure my temporary male status and live functionally regardless. I would have probably caved in without that psychologist. The psychiatrist did not think I needed it.
So perhaps I am absolutely wrong, but my experience seems to show that a psychiatrist is not really the first person one should see. I think this is even more true in the case of a trans person just discovering, accepting and understanding their state such as the topic author. Therapy is useful and even essential for many people, and I regard that as the "true" basic towards transition.
But then again, the psychiatrist is still stalling me. Perhaps when he starts moving I will change my mind.
Quote from: A on July 05, 2011, 07:39:16 PM
How could you know about a tumor without seeing a general practitioner first? Oo
Read my response...i stated you would see a general practitioner if you didn't realize one was there and the GP found it. Then you would be directed to an Oncologist who is better suited to deal with it.
QuoteAnyway, I'm not going in the right direction here.
I am not discounting them all. Psychiatrists are useful. I just don't think they are a good first step. The gender-specialized psychiatrist in my area has not been very useful yet. Plus, a psychiatrist is a physician. It's not his job to help the person come to terms with their gender identity and treat other conditions, and psychologically support the patient towards transition, etc. The psychiatrist is there to assess, diagnose, prescribe, inform and test readiness. That is what I have been told.
This is because you had a bad experience. I thought, based on your prior experiences you stated you went to a generalized Psychiatrist and not a gender specific one. It is their job to help people with their gender issues. A Psychiatrist is a Psychologist with the power to Dispense medication.
Many Psychiatrist will also do therapy work with you. All of mine did....they weren't just there to dispense medication. If you went to a general psychiatrist where he or she knew you were also seeing another therapist for the therapy work, then yes, the Psychiatrist will just be there to give you the medication you need. If this person is your sole therapist, then the psychiatrist would also help with therapy. But you need to find one who has the background to help those transition. A psychiatrist is a wonderful first step if you can find one that will meet you needs.
QuoteMy main point is that seeing a psychiatrist right away may not be the best move, unless he's very soft on the SoC requirements of readiness or the patient is quite fine in every field except gender. Perhaps my psychiatrist is special in that way, but he requires concrete, correctly presented and durable proof of very significant progress in all spheres of my life, probably until every possible cause of mental discomfort is pushed aside and he "has" to give me his approval for transition.
Until now, he has not quite helped me, except with medication for my concentration. He has been requiring things from me, simply. And if I were needing to decide, analyze my problems, understand them and get mentally ready for transition, he would not be the one to help me do so. I would have needed a therapist.
In fact, I did need to see a psychologist to 1. understand his goals and instructions and 2. learn to endure my temporary male status and live functionally regardless. I would have probably caved in without that psychologist. The psychiatrist did not think I needed it.
So perhaps I am absolutely wrong, but my experience seems to show that a psychiatrist is not really the first person one should see. I think this is even more true in the case of a trans person just discovering, accepting and understanding their state such as the topic author. Therapy is useful and even essential for many people, and I regard that as the "true" basic towards transition.
But then again, the psychiatrist is still stalling me. Perhaps when he starts moving I will change my mind.
Then I would think you need to fire that psychiatrist and look elsewhere. Also, I do not know your mental background so I cannot comment, but I know some transwomen that have a LOT of mental issues that the transwoman swears they don't have but I can see it clearly. They say their psych is giving them hell and holding back their transition when I am thinking to myself (well, then the psych is smart!).
Now, I am not saying you have mental issues because I do not know you, but if someone comes in being depressed all the time or have really bad depressing moods, then I would be hesitant to let the person transition as fast as they want too. Again, I am not saying this is you but many transgirls I have met truthfully has a lot of mental co morbids they must sift out before the Psych will continue onward.
I recognise my "mental health" issues and do not blame him for considering them. However, I think he is doing the "useful" before the "essential", and as he is very intimidating, I cannot convince him of my advancement if I don't prepare properly.
As for firing him... As I said, this is a psychiatrist, not a secretary. I had the CHANCE to be allowed to see him. I can't "fire" him. He's the one and only specialist.
Hi Anna,
if the whole country (SA) has ONE approved "gate-keeper" so all these good questions (reply # 18) are worth zilch, nada, nothing.
You either take it or leave it.
Unless you can afford to go oversees for GRS etc.
Most folks here JUST DON'T HAVE THE MONEY (say ~US$15k for Thailand, incl. airfair, stay, etc.), and so are FORCED to go to this one and ONLY State hospital approved guy.
I've seen girls with legit "letters" approach the State hospital (Steve Biko Academic Hospital) they are all send back to go to this one and only dude.
Him being gay, I'm sorry to say, does not much help transwomen either. I speek from first hand experience - he actually does not like females as such. Surprised?
Axelle
PS: Reading what A had to say about his psychiatrist is my own exact experience. Also how much "therapy" for 15min a month will you get?! NOTHING. CAN'T BE FIRED AS HE IS THE ONLY ONE.
PPS: As I said earlier also and again as A mentioned, going to Psychologist was one day and night difference, a life saver.
PPS: That "gate-keeper" was nothing other then a point scorer and one unhealthy control-freak to boot. Like if I'd cry (the one time) he ends the session, I'm dismissed!!! He just want to see a happy cheerful woman that has no problems so he may pass you after you seen him 12 month according to the "Bejamin rules" and you may march. Takes your bucks and cheerio.
Quote from: Axelle on July 06, 2011, 01:37:41 AM
Hi Anna,
if the whole country (SA) has ONE approved "gate-keeper" so all these good questions (reply # 18) are worth zilch, nada, nothing.
You either take it or leave it.
Unless you can afford to go oversees for GRS etc.
Most folks here JUST DON'T HAVE THE MONEY (say ~US$15k for Thailand, incl. airfair, stay, etc.), and so are FORCED to go to this one and ONLY State hospital approved guy.
I've seen girls with legit "letters" approach the State hospital (Steve Biko Academic Hospital) they are all send back to go to this one and only dude.
Him being gay, I'm sorry to say, does not much help transwomen either. I speek from first hand experience - he actually does not like females as such. Surprised?
Axelle
PS: Reading what A had to say about his psychiatrist is my own exact experience. Also how much "therapy" for 15min a month will you get?! NOTHING. CAN'T BE FIRED AS HE IS THE ONLY ONE.
PPS: As I said earlier also and again as A mentioned, going to Psychologist was one day and night difference, a life saver.
PPS: That "gate-keeper" was nothing other then a point scorer and one unhealthy control-freak to boot. Like if I'd cry (the one time) he ends the session, I'm dismissed!!! He just want to see a happy cheerful woman that has no problems so he may pass you after you seen him 12 month according to the "Bejamin rules" and you may march. Takes your bucks and cheerio.
Oh, I am anything but rich. Trust me.
I make about 5000 US dollars a year and I have no medical insurance either. I also lived in an area where the closest Gender Psychologist was 3 hours away. Trust me, I had to be very resourceful.
I kept searching for a gender psychiatrist that payed on a sliding scale and I did find an awesome one. She charged me 40 dollars a session for two one hour sessions a month.
For my HRT and SRS costs, I have various churches helping me with that income. So yeah, i know how hard it can be to transition.
40 dollars a session. One-hour sessions. Two sessions a month. This is luxury, a dream. It does not exist here. Psychiatrists are busy and if you are lucky, you get one 30-minute session every two or three months. They don't have time to do things like therapy. And here, there are free psychiatrists. If you want to choose, to "shop" for one, you get one of the few private practitioners. Those charge hundreds of dollars an hour because private things are for the rich.
Here, 40 dollars an hour is what a BEGINNER, VERY CHEAP psychologist charges. Not one physician, especially a psychiatrist, will charge that low.
Hell I don't charge that low.
Quote from: A on July 06, 2011, 10:56:41 AM
40 dollars a session. One-hour sessions. Two sessions a month. This is luxury, a dream. It does not exist here. Psychiatrists are busy and if you are lucky, you get one 30-minute session every two or three months. They don't have time to do things like therapy. And here, there are free psychiatrists. If you want to choose, to "shop" for one, you get one of the few private practitioners. Those charge hundreds of dollars an hour because private things are for the rich.
Here, 40 dollars an hour is what a BEGINNER, VERY CHEAP psychologist charges. Not one physician, especially a psychiatrist, will charge that low.
have you called them and asked if they charge based on a sliding scale?
Also, my Psychiatrist is not a beginner nor is she "very cheap." She has had years of experience and she has a very good reputation. So don't think because a Psychiatrist is charitable makes them desperate or new.
Also, A, have you looked into these Psychiatrists..,there in your area:
http://www.mcgill.ca/cosum/about-us (http://www.mcgill.ca/cosum/about-us)
Quote from: Annah on July 05, 2011, 11:31:47 AM
Did you hire a Psychiatrist that was specialized and trained in Gender Issues? Or did you picked a Psychiatrist that was a "general" psychiatrist?
When it comes to gender transformation, you need to pick a psychiatrist that has notable experience in the fields of gender studies and sexuality. Personally, I would never pick a Psychiatrist from a generic medical clinic. I shop for mine...make sure they do have the experience to help me transition.
I'm glad you found such a great therapist/Psychiatrist. I've seen you post many times in favor of the present standards of care etc. I personally think it's insulting and abusive. No other elective treatment requires this sort of craziness.
The "gate keeper" I dealt with was a post op TS, so I would assume she knows about transition. She has written several books on the subject and regularly gives speeches at events etc. She also runs a TG support group. I had been living full time for over a year, had my name changed etc etc before I went to see her to get "my letter" to start HRT. Actually my Doc had prescribed spiro at HRT levels (for my blood pressure....) about a month before so I explained I liked what those were doing, that I have been full time for over a year, I'm not depressed, actually I've never been happier. According to the "standards of care" I met all the requirements for HRT before we ever talked. I had no idea what to talk about so just told her about what going full time was like and the challenges I had faced. She started telling me how my dead mother was still controlling my life and other nonsense in response O.o I babbled through multiple sessions before she finally gave in and gave me a letter, after spending hundreds of $$. I even told her "I feel like I'm fighting for your permission to do HRT" which she got all huffy about. Maybe some people have other mental problems but I think if someone has ALREADY done the "real life test" full time for over a year, has transitioned to living as a woman etc, having to see a therapist to get permission to do anything is WRONG.
Being TG isn't a "mental disorder" IMHO, anymore than being Gay is. Us being in the dsm iv is NOT something we should want or stand for, yet some people seem to embrace it. They used to have Gay and Lesbians as a mental disorder but they finally got themselves taken out and we should be as well.
I think the TS's who LIKE this being called a mental disorder have convinced themselves "I am not TG, I am a female who was born with a birth defect". Even in that case it's not a mental disorder. Or want to believe that they lack any free will about this, "Don't judge me, this is a medical problem like cancer or some other disease". That they refuse to just say "I am happier living as a woman, end of story". I honestly do NOT want people to pity me for having some "uncontrollable disease", they simple have to accept I am happier living as a woman. God doesn't make mistakes and I was intended to be this way. No excuses needed.
Maybe at one point it helped a VERY few people get GRS paid for by insurance early on being classified as a metal disorder, so it was medically necessary to correct. But those days are over. Now it's treated like a boob job or any other elective surgery by insurance. The only thing that might be covered is this unnecessary therapy O.o Being in the DSM just complicates everything and creates a situation where perfectly sane people are subjected to mental therapy because it is ASSUMED anyone who want to live the opposite of their birth gender clearly must have a mental problem, i.e. must be crazy! These rules were written by cisgendered people, just like it was straight people that included Gays and Lesbians in this same diagnosis years ago.
We -should- be fighting against this being considered a mental disorder but instead it seems many people embrace this, which I really just don't understand at all. All these treatments we desire should be set up under informed consent and have someone (the doctor should be able to do the following) go over in detail that we understand what we are doing, the possible problems that could arise and that we are of sound mind when we agree to this. I can get FFS by this model, which is going to change my appearance more than HRT ever would. Why do I need to be diagnosed as having a mental disorder for one but not for the other?
No one here charges on a sliding scale. Either you charge, either you don't. If you're charitable, you go on the public system and get paid less on top of having an unpleasant work schedule. If you're greedy, you open a clinic and charge a fortune.
As for MUSIC, it states they are public, so they don't charge but and you need a referral and a long wait (and to live close to them) to see them. Plus, they are in my province, but still a 6-hour drive away... But thank you for trying.
Also, I did not mean your psychiatrist was cheap in the sense of "bad". It's just cheap in the sense of unexpensive. As for new people, well, it is true that here, the only people who charge less are usually younger and have yet to have a reputation. Plus, private psychiatrists here are a rarity, and most of them, if not all, charge a fortune.
Stephe: The reason for GID to be in DSM is to give doctors a reason to help us. If it's not a (mental or not) problem, they won't treat us, end of story, let alone operate us to alter perfectly working organs, which is basically against Hippocrates' thing. You can't just remove this from the DSM. You must find WHAT it is, else it won't be treated because if it's in no medical book, it's not a medical problem and thus will not be treated. Plus, being a transsexual alone is detrimental to an individual's life, contrarily to being homosexual.
Homosexuals were removed from the DSM because they simply did not required any help. We do. The whole basic concept of transsexualism is to wish to be the other sex physically and REQUIRES a medical intervention.
It is not comparable in any way to homosexuality in that regard.
I think this has gone a little off topic. Some are luckier than others. I personally had a terrible time and delayed a lot because I couldn't burden my mom with my costs, but I ended up finding a community sexuality center that even subsidized my therapy sessions for 15$ a week (30 min drive). Actuallly, I lived for another while in a city where there was a trans clinic providing endocrinology, bloodwork and hormones for free. It was a bit chaotic and hormones ran out and regimens were a bit odd but you could really just buy those out of pocket without much burden. Those places were not easy to find!
I almost graduate in psychology myself. The standard view is that psychiatrists take medication-oriented approaches. The practice of medicine is pretty conservative so it can be hard to find someone willing to help you- and more often than not people leave with psych meds after a couple of sessions. Neither the meds nor therapies are guaranteed to work for a given x problem, and there's tons of skilled intelligent people in both fields. The best advice in my opinion is what has already been said. If possible, pick someone with previous experience on this. I wouldn't rush towards a psychiatrist like that.
If you ask me, my therapy didn't do a thing except me talking my lifestories to an awestruck therapist. I would've gone straight to hormones (which you can do if you really really really really don't need therapy), but you have to be really careful. Some problems are bigger than others.
Quote from: A on July 06, 2011, 05:53:29 PM
Stephe: The reason for GID to be in DSM is to give doctors a reason to help us. If it's not a (mental or not) problem, they won't treat us, end of story, let alone operate us to alter perfectly working organs, which is basically against Hippocrates' thing. You can't just remove this from the DSM.
So they can do boob jobs and all sorts of radical plastic surgery that isn't solving any sort of disorder but they can't modify -our- bodies for what reason??
In the past they would remove the female uterus on a regular basis without their being any life threatening reason to do so. In my own case they wanted to remove my gall bladder because "there is a chance it could cause you problems in the future". There are more than a few docs who will do an orch without demanding a bunch of hoops to be jumped through, why is going further so much of a difference. Oh yeah "OMG you can't cut off their dick!!!"? lol
They can give a female breast implants but some docs do require a shrinks letter to do the same if the person is male. Doesn't that strike you as a bit odd? I had one electrolysis place say they refuse to remove male facial hair without a GID diagnosis but do it regularly on females without question. That's just crazy.
Basically all we are asking for is cosmetic surgery. I don't feel I should have to admit to -them- "yes I'm crazy so please deal with this before I kill myself" to have this work done. YMMV
Quote from: A on July 05, 2011, 07:39:16 PM
How could you know about a tumor without seeing a general practitioner first? Oo
Anyway, I'm not going in the right direction here.
I am not discounting them all. Psychiatrists are useful. I just don't think they are a good first step. The gender-specialized psychiatrist in my area has not been very useful yet. Plus, a psychiatrist is a physician. It's not his job to help the person come to terms with their gender identity and treat other conditions, and psychologically support the patient towards transition, etc. The psychiatrist is there to assess, diagnose, prescribe, inform and test readiness. That is what I have been told.
My main point is that seeing a psychiatrist right away may not be the best move, unless he's very soft on the SoC requirements of readiness or the patient is quite fine in every field except gender. Perhaps my psychiatrist is special in that way, but he requires concrete, correctly presented and durable proof of very significant progress in all spheres of my life, probably until every possible cause of mental discomfort is pushed aside and he "has" to give me his approval for transition.
Until now, he has not quite helped me, except with medication for my concentration. He has been requiring things from me, simply. And if I were needing to decide, analyze my problems, understand them and get mentally ready for transition, he would not be the one to help me do so. I would have needed a therapist.
In fact, I did need to see a psychologist to 1. understand his goals and instructions and 2. learn to endure my temporary male status and live functionally regardless. I would have probably caved in without that psychologist. The psychiatrist did not think I needed it.
So perhaps I am absolutely wrong, but my experience seems to show that a psychiatrist is not really the first person one should see. I think this is even more true in the case of a trans person just discovering, accepting and understanding their state such as the topic author. Therapy is useful and even essential for many people, and I regard that as the "true" basic towards transition.
But then again, the psychiatrist is still stalling me. Perhaps when he starts moving I will change my mind.
well, it's very possible for an emergency medicine physician to pick something up during a trip to the ER? Or, possibly a radiologist picking something up during diagnostic testing?
Quote from: Stephe on July 06, 2011, 04:09:00 PM
I'm glad you found such a great therapist/Psychiatrist. I've seen you post many times in favor of the present standards of care etc. I personally think it's insulting and abusive. No other elective treatment requires this sort of craziness.
The "gate keeper" I dealt with was a post op TS, so I would assume she knows about transition. She has written several books on the subject and regularly gives speeches at events etc. She also runs a TG support group. I had been living full time for over a year, had my name changed etc etc before I went to see her to get "my letter" to start HRT. Actually my Doc had prescribed spiro at HRT levels (for my blood pressure....) about a month before so I explained I liked what those were doing, that I have been full time for over a year, I'm not depressed, actually I've never been happier. According to the "standards of care" I met all the requirements for HRT before we ever talked. I had no idea what to talk about so just told her about what going full time was like and the challenges I had faced. She started telling me how my dead mother was still controlling my life and other nonsense in response O.o I babbled through multiple sessions before she finally gave in and gave me a letter, after spending hundreds of $$. I even told her "I feel like I'm fighting for your permission to do HRT" which she got all huffy about. Maybe some people have other mental problems but I think if someone has ALREADY done the "real life test" full time for over a year, has transitioned to living as a woman etc, having to see a therapist to get permission to do anything is WRONG.
Being TG isn't a "mental disorder" IMHO, anymore than being Gay is. Us being in the dsm iv is NOT something we should want or stand for, yet some people seem to embrace it. They used to have Gay and Lesbians as a mental disorder but they finally got themselves taken out and we should be as well.
I think the TS's who LIKE this being called a mental disorder have convinced themselves "I am not TG, I am a female who was born with a birth defect". Even in that case it's not a mental disorder. Or want to believe that they lack any free will about this, "Don't judge me, this is a medical problem like cancer or some other disease". That they refuse to just say "I am happier living as a woman, end of story". I honestly do NOT want people to pity me for having some "uncontrollable disease", they simple have to accept I am happier living as a woman. God doesn't make mistakes and I was intended to be this way. No excuses needed.
Maybe at one point it helped a VERY few people get GRS paid for by insurance early on being classified as a metal disorder, so it was medically necessary to correct. But those days are over. Now it's treated like a boob job or any other elective surgery by insurance. The only thing that might be covered is this unnecessary therapy O.o Being in the DSM just complicates everything and creates a situation where perfectly sane people are subjected to mental therapy because it is ASSUMED anyone who want to live the opposite of their birth gender clearly must have a mental problem, i.e. must be crazy! These rules were written by cisgendered people, just like it was straight people that included Gays and Lesbians in this same diagnosis years ago.
We -should- be fighting against this being considered a mental disorder but instead it seems many people embrace this, which I really just don't understand at all. All these treatments we desire should be set up under informed consent and have someone (the doctor should be able to do the following) go over in detail that we understand what we are doing, the possible problems that could arise and that we are of sound mind when we agree to this. I can get FFS by this model, which is going to change my appearance more than HRT ever would. Why do I need to be diagnosed as having a mental disorder for one but not for the other?
I do not ever recall posting how much i love the standards of care...if you can link some of my posts where I said I am for the standards of care or that i declared we are a mental disorder, then I would love to see it.
While i do not love the standards of care and hug it to bed every night, I have no quarrels against it. If it goes away or if it stays, I could really care less. I guess that would make me in the middle of it all. With that said, I think the standards of care actually helps weed out those who are truly suffering from GID and those with a multi personality disorder. Hate me if you must, but I met a lot of men and women who thought they were trans and it ended up being something else entirely other than trans related issues in their lives. If it wasn't for WPATH, then you would have quite a lot of people who were mentally disabled claiming to be transgender and getting all kinds of surgeries and HRT.....if that happened, then try to convince the public that TG isn't a mental disorder because it would certainly look like it. WPATH, at least tries to make sure you are sane to go through with the procedure. If you were cleared for HRT or SRS (if you desire it) then congratulations, you are sane by medical standards. I am aware that TG is listed as a mental disorder and just like the gay and lesbian mental disorder in the 60,70, and 80s, it will take education to the masses to get ours taking out of the DSM as well.
Then again, I heard of doctors who prolong therapy to milk all the money they can...hence, it is a neutral subject for me. It depends on many different factors whether Standards of Care is successful or not, and it usually boils down to person to person,
For me, I did enjoy my therapist. I could not transition by myself and I could not do this on my own. If you could do all of this by yourself, then good for you.
My point in this thread is try not to bash all Psychiatrists....because all Psychiatrists being useless is simply a false statement.
Quote from: Stephe on July 06, 2011, 10:35:26 PM
So they can do boob jobs and all sorts of radical plastic surgery that isn't solving any sort of disorder but they can't modify -our- bodies for what reason??
In the past they would remove the female uterus on a regular basis without their being any life threatening reason to do so. In my own case they wanted to remove my gall bladder because "there is a chance it could cause you problems in the future". There are more than a few docs who will do an orch without demanding a bunch of hoops to be jumped through, why is going further so much of a difference. Oh yeah "OMG you can't cut off their dick!!!"? lol
They can give a female breast implants but some docs do require a shrinks letter to do the same if the person is male. Doesn't that strike you as a bit odd? I had one electrolysis place say they refuse to remove male facial hair without a GID diagnosis but do it regularly on females without question. That's just crazy.
Basically all we are asking for is cosmetic surgery. I don't feel I should have to admit to -them- "yes I'm crazy so please deal with this before I kill myself" to have this work done. YMMV
there are ethical reasons why the docs do it. personally, I'd want a doc that adheres to the WPATH requirements and recommendations regarding the letters
and another thing about WPATH...if they were to to take it out of the DSM, then sooo many companies in the US that covers SRS will rescend the surgery benefits because it would go from a "surgery to enhance the well being of an individual" to a cosmetic surgery.
Over a dozen companies a year are picking up SRS in their costs because they see it as a necessity for their employees transition. If it is taken out of the DSM language then that "necessity" is no longer there and would be regarded like FFS.
If you worked for a company that currently offers SRS benefits, then I am sure you would be looking at it in a WHOLE new light.
They do not refuse hair removal to men. Many cisgendered men undergo this either because their skin is too sensitive to shave, they are tired of doing it or their job requires a hairless face more than what they can achieve with shaving (for example, someone with a very, very heavy and dark beard in the army sometimes gets scolded because they look like they have not shaved even when they did).
As for denying breast augmentation, it is possible that they do deny it. But here, anyone can have this and no letter is required whatsoever.
SRS, though, is another story. It implies the destruction/modification of healthy organs without a medical reason. One of physicians' primary guideline is "do no harm" and, without a medical reason, they should not do something that would harm the patient more than it will help them. Without any diagnosis (without a problem), however, medically speaking, SRS is removing the patient's fertility and, to some extent, removing some possibilities from them. Medicine is an exact science, and for a problem requiring a medical intervention that have some negative consequences on one's health, a diagnosis is required, end of story.
And until we know better, transsexualism is a condition that causes a generally high degree of discomfort and requires a medical intervention for its effects to be negated, partially or entirely. And no physical anomaly has been found. Therefore, unless another cause is identified, it is a mental disorder.
You can't remove the diagnosis from the DSM altogether. If you do, no invasive/organ-damaging/destructive surgery - namely SRS - will be performed, as in medicine's eyes, if there is no diagnosis, there is no (medical) problem, thus no treatment is required, and there is no justification for damaging the body. If you decide it's not a mental illness, you have to state exactly what it is, or else it's like you declare it's not a problem and individuals with it have absolutely no need for a physician whatsoever, like homosexuals, which is false.
The issue here is not whether it is a "mental" disorder, it's that it's an innate problem that cannot be classified as physical unless some breaking evidence is found, as every bodily system works well, and therefore falls in the mental disorder category unless it fits elsewhere.
Theorically, this does not apply to breast augmentation, as no definite harm is done to the body in the procedure and the body keeps all of its functions intact. The person is merely exposed to consented, limited risks, and this does not justify its being blocked. If it did, all purely cosmetic interventions would be blocked.
Apart from that, if no diagnosis justifies an intervention such as SRS, it will logically be regarded as facultative and purely cosmetic, just like botox injections. This poses serious insurance issues.
Hi all,
I had mentioned MY "gate-keeper" (SA) earlier on and finally took a more close look at his last report I requested. (First one was just a load of rambling, quite pathetic and embarrassing for him, IMHO)
You may recall I'd asked the SBAH "gender team" at that meeting to consider "inversion" rather then colon-section (turns out they not experienced so simply refused, and send my hiking... either have your belly cut 12" and shut up, or you too old, etc.)
Following all this I then got "GIDNOS" (Gender Identity Disorder Not Otherwise Specified) pinned on in the 2nd letter by this guy... because: I was *not enough cross-dressing* and *had insufficient fantasies* at an earlier age, sort of in my 30s and 40s? and that I was *too old* (64)
Told them they can stick it in "file 13" (rubbish bin).
Before that altercation at the hospital about not wanting their only "policy-procedure" offered, "colon-section" I was his guys best transitioner! How thing can change, eh.
Having had spend some quality sessions with my psychologist (in parallel with the psychiatrist, I had an inkling) none of these funnies, GIDNOS, etc. came up what so ever.
Any one to comment?
Axelle
Quote from: Axelle on July 07, 2011, 12:20:14 AM
Hi all,
Before that altercation at the hospital about not wanting their only "policy-procedure" offered, "colon-section" I was his guys best transitioner! How thing can change, eh.
Any one to comment?
Axelle
This parallels my experience. First session was short and seemed pleasant. She said something like "I think your ready for HRT" near the end but no letter forth coming. She set up another visit. During this second one I mentioned that I feel like -I have to get her permission to do this- and suddenly the whole thing changed. She became short and almost to the point of being rude. They ask us to speak our minds but then punish us if we say something they don't like. Honestly, it felt like I was back in grade school. They have a -very- limited viewpoint on what is the "correct" behavior from a transgendered person and we are as varied as the population is. Some people don't realize they have gender issues till later in life. They have been there, they just didn't recognize them for whatever reason. Being a gender variant 20 years ago was NOT something that was openly tolerated or accepted.
Times have changed a lot and I'm happy for future generations that this will be easier for them to deal with. But until we change this whole "Standards of care" crap to informed consent, this gatekeeper problem is going to continue..
Quote from: Annah on July 06, 2011, 10:52:07 PM
I do not ever recall posting how much i love the standards of care...if you can link some of my posts where I said I am for the standards of care or that i declared we are a mental disorder, then I would love to see it.
While i do not love the standards of care and hug it to bed every night, I have no quarrels against it. If it goes away or if it stays, I could really care less. I guess that would make me in the middle of it all. With that said, I think the standards of care actually helps weed out those who are truly suffering from GID and those with a multi personality disorder. Hate me if you must, but I met a lot of men and women who thought they were trans and it ended up being something else entirely other than trans related issues in their lives.
Define "a lot"? I don't know a lot of transgendered people, much less a lot who thought they were trans but had something else.There are VERY few people who actually have MPD. This is the same excuse the medical community uses for continuing their behavior. Your arguments here are strongly defending the WPATH.
If someone can't transition without a therapist, no problem, go see one. Some people can't leave their house without therapy, doesn't mean I should have to have therapy for ME to leave mine. The fact YOU needed the help of a therapist to do this is meaningless to this discussion.
BTW you asked for past example of your support of DSM, I saw this and seemed to be a pattern of support for the continuation of this nonsense. Again maybe you can share the "MANY PLACES" that cover this now? It's my understanding at least in the US it is almost universally NOT covered by any insurance plans anymore.
https://www.susans.org/forums/index.php/topic,100760.msg750474.html#msg750474 (https://www.susans.org/forums/index.php/topic,100760.msg750474.html#msg750474)
""They do not refuse hair removal to men.""
The first place I went for a consultation told me they won't do it without a therapist letter and they also said they do a lot of trans women and "know about this". Actually they had a lot of positive feedback online from various transwomen as being a good place to go and were "understanding". I guess you can call me a liar if you'd like :P I can only post from my personal experience.
""SRS, though, is another story. It implies the destruction/modification of healthy organs without a medical reason. One of physicians' primary guideline is "do no harm" and, without a medical reason, they should not do something that would harm the patient more than it will help them. Without any diagnosis (without a problem), however, medically speaking, SRS is removing the patient's fertility and, to some extent, removing some possibilities from them.""
So please explain how having a vasectomy or a tubal ligation doesn't fit this same description? I can freely go have a invasive procedure to make me sterile (informed consent) but require extensive therapy and be declared "having a mental disorder" letter to do this another way?
""Theorically, this does not apply to breast augmentation, as no definite harm is done to the body in the procedure and the body keeps all of its functions intact. The person is merely exposed to consented, limited risks, and this does not justify its being blocked. If it did, all purely cosmetic interventions would be blocked.""
But again, the same WPATH nonsense is applied. And MANY women would argue your "no definite harm is done to the body in the procedure" point. And how does HRT not fit "The person is merely exposed to consented, limited risks" yet it has this same WPATH nonsense blocking it as well.
""Apart from that, if no diagnosis justifies an intervention such as SRS, it will logically be regarded as facultative and purely cosmetic, just like botox injections. This poses serious insurance issues.""
So who exactly in the USA still covers SRS under health insurance today?
http://www.tsroadmap.com/reality/insurance.html (http://www.tsroadmap.com/reality/insurance.html)
"This is usually the hardest to get covered. Many policies specifically exclude SRS.
A little background: SRS was routinely covered in the US until a couple of medical articles came out in the late 1970's showing high suicide rates among post-operative women. This came at the same time a couple of prominent gender clinics were closed, notably Johns Hopkins.
The insurance companies pounced on these events as a chance to decry the procedure as elective, cosmetic, or experimental."
Quote from: Stephe on July 07, 2011, 11:45:16 AM
Define "a lot"? I don't know a lot of transgendered people, much less a lot who thought they were trans but had something else.
I do lectures/guest speaking on human sexuality and human gender studies and I would say about 30% of people who labeled themselves as "transsexual" told me that through therapy they realized they had other issues that were creating a secondary characteristic of transsexualism. And when they started their transition they were just as sure of it as you are as sure of yourself. You say, "fine, let those who need therapy get it but still take it out" well, many of these people would have never sought out therapy to transition and then their true underlying issues would have never surfaced until it was too late.
To me, 30% is a lot of people if WPATH did not exist to have had genital reconstruction surgery.
WPATH is not some major evil organization designed to suppress us. True, there are some therapist and doctors who "milk" the system and abuse it but WPATH is designed to help us ease into this transition.
You may brag that you can do this all by yourself and that is your right, but do not dismiss the other men and women who really need the support group and guidance to get them there.
Quote from: Stephe on July 07, 2011, 12:14:22 PM
So who exactly in the USA still covers SRS under health insurance today?
http://www.tsroadmap.com/reality/insurance.html (http://www.tsroadmap.com/reality/insurance.html)
"This is usually the hardest to get covered. Many policies specifically exclude SRS.
TSroadmap is antiquated. Andrea's srs insurance page hasn't been updated in 5 years.
Here are companies today that includes SRS:
Coca Cola
Campbells Soup
Walt Disney
State of Conn. Teacher Association
The Government of Louisana
HRC
Johnson and Johnson
Aetna Insurance (private plan)
AmeriHealth
Anthem Blue Cross Blue Shield
Blue Cross Blue Shield for:
Massachusetts
Minnesota
Michigan
Ameriprise Financial Inc
Avaya Inc.
Barclays Capital
Bingham McCutchen LLP
Booz Allen Hamilton Inc.
Cardinal Health Inc.
Chrysler LLC
Cisco Systems Inc.
Clifford Chance US LLP
Covington & Burling LLP
Cummins Inc.Deloitte LLP
Deutsche Bank
Diageo North America
DLA Piper
E. I. du Pont de Nemours and Co. (DuPont)
Eastman Kodak Co.
Ernst & Young LLP
Exelon Corp.
Faegre & Benson LLP
Food Lion LLC
Ford Motor Co.
Fried, Frank, Haris, Shriver & Jacobson LLP
Genentech Inc.
General Motors Corp.
Google Inc.
Herman Miller Inc.
Intel Cigna
International Business Machines Corp. (IBM)
Katten Muchin Rosenman LLP
Kimpton Hotel & Restaurant Group Inc.
Kirkland & Ellis LLP
KPMG LLP
Kraft Foods Inc.
Latham & Watkins LLP
Littler Mendelson PC
Marsh & McLennan Companies Inc.
McGraw-Hill Companies Inc., The
Microsoft Corp.
Morrison & Foerster LLP
Nike Inc.
Northern Trust Corp.
PG&E Corp.
Pillsbury Winthrop Shaw Pittman LLP
Replacements Ltd.
Robins, Kaplan, Miller & Ciresi LLP
Shearman & Sterling LLP
Sonnenschein, Nath & Rosenthal LLP
Sun Microsystems Inc.
Sutherland Asbill & Brennan LLP
White & Case LLP
Yahoo! Inc.
Cigna Private plan
Emblem Health
HealthNet
Health Partners (Minnesota)
Medica
University of Pennsylvania
Penn State
Goldman Sachs
Bank of America
City and County of San Francisco
IBM
AmEx
AT&T
Wells Fargo
Eastman Kodak
Sears
Morgan Stanley
Price Waterhouse
State Farm
New York Life Insurance
Angell Palmer and Dodge Law Firm
City of Berkley
And about 40 more companies are thinking about adding srs to their policies in Jan of 2012...so give me a few more months and Ill expand that list for you.
You take WPATH out of DSM and all these companies will have to take SRS out of their policies.
Quote from: Stephe on July 07, 2011, 12:14:22 PM
The insurance companies pounced on these events as a chance to decry the procedure as elective, cosmetic, or experimental."
If you get want you want by taking WPATH out of the picture, then the insurance companies dreams will come true to have it as elective, cosmetic, or experimental.
Quote from: Stephe on July 07, 2011, 11:45:16 AM
Again maybe you can share the "MANY PLACES" that cover this now? It's my understanding at least in the US it is almost universally NOT covered by any insurance plans anymore.
You are incorrect.
About your experiences with refusal of procedures, SRS excluded, on you, it is not about the SoC. It's about a bad interpretation of them by local legislators and/or enterprises. In a court, they would have no valid argument against you, unless your place's law is badly written.
About vasectomy, it is contraception and the only thing it deprives the patient of is the ability to procreate, without affecting hormone production or sexual capacity or posing serious risks. Physicians do not consider they do arm this way, as accidental procreation could end up in avortion or a bad life for a child. Plus, a vasectomy is (even though people don't usually do it) theorically reversible. It's just cutting a couple tubes.
I don't know about the US, but quite a few countries worldwide spend tax money on this, and they certainly wouldn't if it were not medically justified.
Quote from: A on July 06, 2011, 11:50:33 PM
And until we know better, transsexualism is a condition that causes a generally high degree of discomfort and requires a medical intervention for its effects to be negated, partially or entirely. And no physical anomaly has been found. Therefore, unless another cause is identified, it is a mental disorder.
actually, physical anomaly has been found in several studies. just look up "causes of transsexualism" on wikipedia, the references seem to be good in that article. the anomalies that have been found suggest that transsexualism might be a form of intersex rather than a mental disorder, as the brain and genes are physical and measurable parts of the body
Quote from: explorer on July 07, 2011, 03:04:37 PM
actually, physical anomaly has been found in several studies. just look up "causes of transsexualism" on wikipedia, the references seem to be good in that article. the anomalies that have been found suggest that transsexualism might be a form of intersex rather than a mental disorder, as the brain and genes are physical and measurable parts of the body
The articles and studies are great but they need a lot more research and work for it to be considered conclusive by various Medical Journals.
However, the research looks promising.
Now, to play devil's advocate (I have to...Im a Divinity student LOL):
Let's say these studies become conclusive and proof for a physical inheritance trait among transsexuals. Now, what would happen to the person who calls themselves transsexual, are firmly convinced they are transsexual and just know beyond a shadow of a doubt they are transsexual. What if these tests are done on that person and it shows, physically, they have no transsexual traits that were considered standard by those physical tests?
Would she still be considered transsexual?
Would her insurance company still pay for her treatments?
In that case, Annah, it would mean the studies were not as conclusive as they were supposed to be, and if enough cases appear, more studies will have to be done because the found cause was not obviously the only one, OR another "illness" that causes similar symptoms will have to be identified, or the person may have another problem, which will have to be identified.
@annah: thank you for writing that. i'm thinking the same thing myself actually, it's just such pain to write it out, and you even did it better than i could do..
it would be a shame if they became conclusive proof, but i think they should still at least be taken as an indicator that there may be biological causes for ->-bleeped-<-, and that this therefor needs to be studied by more than just psychologists in order to find the best possible medical treatment for all the different variations, and not only those who are strictly transsexual and in need of full srs (as the situation is in many countries). and perhaps also be classified as something other than a mental disorder (but still something that might have to be treated medically)
Anna,
good information but the US is not the rest of the world where some of us happen to live also. Yet WPATH is for the rest of the world, and it manifold interpretations also due to the differing country's laws.
I do see your *local* (US) argument, yet NOT ONE single company in SA would pay for gender therapy neither does ANY of the medical aid providers. Period. IT IS ALL DUMPED INTO THE SAME SLOT AS e.g. BA, cosmetic surgery...
BTW, Europe is even more tight wrapped then SA – or fancy like to have 3 years RLE with no HRT? Be my guest, honey!
Food for thought,
Axelle
Sorry one more though, please indulge me.
If things are so great in the US with so many companies, and medical health care providers paying for SRS and HRT ---- how come that about 80% of "us" are pre- or non-op and so many stating they can't afford the $$$?
Somehow that doesn't fit. Or are all those unemployed or working for the wrong companies, having the wrong medical provider, hey?
Companies used to ask females if they were pregnant before they got the job --- now they'll ask if you are pre- or non-op by any chance...? Be interesting to follow this lot.
Axelle
Quote from: Axelle on July 08, 2011, 01:45:57 AM
Sorry one more though, please indulge me.
If things are so great in the US with so many companies, and medical health care providers paying for SRS and HRT ---- how come that about 80% of "us" are pre- or non-op and so many stating they can't afford the $$$?
Somehow that doesn't fit. Or are all those unemployed or working for the wrong companies, having the wrong medical provider, hey?
Companies used to ask females if they were pregnant before they got the job --- now they'll ask if you are pre- or non-op by any chance...? Be interesting to follow this lot.
Axelle
Personally, I'm going to Thailand and have paid out of pocket for everything. I wouldn't say things are great in the US but there is definitely and increasing level of tolerance and understanding which is why more and more are offering selective procedures under healthcare plans
Axelle, many companies may pay for SRS, but you have to keep in mind that most Americans (was it 80%? I need to see Sicko again) have no insurance whatsoever, and even though I know little about it, I SERIOUSLY doubt the new state insurance covers this. And most health insurance companies, if not all, will constantly try to avoid covering something they should be covering by invoking weird reasons. I saw a woman who would have died of her cancer because of her insurance company if a bank had not lent her the money to pay for treatment. (The same movie.)
Thanks for that insight A.
It puts some of the earlier comments into perspective.
Also if I recall if all was quite so good as it came across in favour of WPATH et al, then Anna would not have her church to ask for donations, or would she?
I mean: so much for this gender insurance cover in your part of the world.
In ours (SA) we know exactly where we stand: YOU GET NOTHING, and ALL expenses, ALL, be out of pocket.
Exception? One only SA state hospital were you are used as a cancer training object, have to wait for years (3 or more), a protocol that takes 3 years or longer to complete, one off-putting visual result (oh my, have seen the original), a misplaced urethra (too far forward), a scar running from hipbone to hipbone, followed by never receding abdominal swelling, and a clit like an 8 year old boy's sticking out in an unremitting erection for ever, plus a stapled together sigmoid colon (staples stay inside you for ever) --- to boot 1 year plus gate-keeper interrogations with some idiot of a psych that dislike females. Plus additional interrogations at the gender team meetings preceding each of the 3 step ops involved. Welcome to the real world.
Hey, girls --- I would not have it. So got kicked out.
Anyone out there that likes to shout HERE may put their hand up --- its for free!
Get what you pay for... yep.
Gosh golly,
Axelle
Quote from: Axelle on July 08, 2011, 01:45:57 AM
Sorry one more though, please indulge me.
If things are so great in the US with so many companies, and medical health care providers paying for SRS and HRT ---- how come that about 80% of "us" are pre- or non-op and so many stating they can't afford the $$$?
Somehow that doesn't fit. Or are all those unemployed or working for the wrong companies, having the wrong medical provider, hey?
Companies used to ask females if they were pregnant before they got the job --- now they'll ask if you are pre- or non-op by any chance...? Be interesting to follow this lot.
Axelle
1. She asked about US companies. SO I provided information pertaining to US companies. Given time I can provide companies in other countries as well. However, since the question was directed at the United States, I provided the US list.
Furthermore, a lot of countries are global and the SRS benefits do extend to those outside of the US
2. Also your quote here:
QuoteIf things are so great in the US with so many companies, and medical health care providers paying for SRS and HRT ---- how come that about 80% of "us" are pre- or non-op and so many stating they can't afford the $$$?
Because so many of the transgender people have NO idea where to look to get these services. Take Stephe for example. She was convinced that SRS coverage was universally not possible to be accepted in the US and their companies. I, in turn, showed a vast list of companies in the US that does have SRS and HRT in their policies.
So to answer your questions, how come that about 80% of "us" are pre on non op and so many stating they can't afford the money is because:
1. (not to sound rude) But they haven't been resourceful. Many of us just complain a lot without really being proactive. TS just assume no one will pay for it so then they just give up. I showed over 70 companies that accepts SRS...there are hundreds more that I do not know about and there are 40 more in the next four months that are adding it to their policies. People assuming there is no places to get coverages are just assuming.
My graduate degree is pretty much being paid for because I am transgender. I am getting my M.Div/Ph.D because I looked and found two scholarships that gives money to people who identify as transgender. I am sure many TS would have thought it was impossible to get a scholarship for being TS....much less going to a Seminary with it.
I have churches raising money for my Sexual Reassignment Surgery. Again, I am sure many TS would never thought to look for a church for help when it came to SRS.
So my answer is "resourcefulness"
Many girls don't know because they do not look. Again, outside of the US, I do not know, but the question was directed at the US so I had answered it within the realm of the US
Wow, Annah, you are very special. You should become a professional counselor. I personally didn't think it was possible to get such things. I was convinced the US was a hell where you cannot be taken care of if you cut your finger or study past high school unless you have a fortune because both cost just this, a fortune.
You are a magnificent example of surviving in an hostile land.
Quote from: A on July 08, 2011, 07:32:12 PM
Wow, Annah, you are very special. You should become a professional counselor. I personally didn't think it was possible to get such things. I was convinced the US was a hell where you cannot be taken care of if you cut your finger or study past high school unless you have a fortune because both cost just this, a fortune.
You are a magnificent example of surviving in an hostile land.
that's not true at all. Many many Americans have insurance thru their employers. Those who have retired have Medicare (insurance for the retired and disabled), all of the states have Medicaid, which is insurance coverage for the poor. American hospital emergency rooms cannot deny you treatment if you have the inability to pay.
The problem lies within the coverage of SRS and transgender care to which Annah has done the research to show which employers offer transgender health care in their coverage. There is not a healthcare crisis in the United States, there is a healthcare "cost" crises.
Quote from: A on July 08, 2011, 07:32:12 PM
Wow, Annah, you are very special. You should become a professional counselor. I personally didn't think it was possible to get such things. I was convinced the US was a hell where you cannot be taken care of if you cut your finger or study past high school unless you have a fortune because both cost just this, a fortune.
You are a magnificent example of surviving in an hostile land.
Im kinda a glass half full girl. While I do realize there are many negative things going on in the US, I also recognize there are so many opportunities here. The key is to just research the hell out of everything.
If I just made my decisions by other trans who told me life was horrible and I would end up being homeless or a prostitute, I have no idea where I would have ended up.
But I refused to listen to those point.
I looked everywhere to find whatever I could to make the system best work for me. I learned a long time ago that vetting frustrations on a website, may be therapeutic at first, may still not change the situation you are in.
You just gotta go out there an explore your options. They are out there.
Quote from: Annah on July 08, 2011, 11:38:43 AM
Because so many of the transgender people have NO idea where to look to get these services. Take Stephe for example. She was convinced that SRS coverage was universally not possible to be accepted in the US and their companies. I, in turn, showed a vast list of companies in the US that does have SRS and HRT in their policies.
You gave no reference for this "vast list" or this made up "30% of people I have seen say they have other issues for wanting to transition".
Vast? This list is maybe 0.001% of the companies in the US. And just because this is "In their policy" doesn't mean they won't try to find a way NOT to pay for it. I have been there with a life threatening illness I ended up paying out of pocket that should have been covered. They let people die who are covered for cancer treatment etc daily using nonsense reasons. I highly doubt they are going to pay for this non life threatening surgery on a regular basis.
I also find it comical you are talking about how great it is for this to be called a mental disorder but are asking for your church to pay for this non life threatening procedure for YOU. How many homeless people etc are going to sleep out on the street or go hungry because you are asking these churches to pay this -elective- procedure for you? You should be ashamed of yourself. Save and work for this yourself. Don't ask you others to pay for this by asking for them to have pity on you.. Or is this why you are so pro DSM, you are working the "mental disorder" angle to get these church people to pay for YOUR needs? Pathetic....
Quote from: Stephe on July 14, 2011, 09:40:51 AM
You gave no reference for this "vast list" or this made up "30% of people I have seen say they have other issues for wanting to transition".
Vast? This list is maybe 0.001% of the companies in the US. And just because this is "In their policy" doesn't mean they won't try to find a way NOT to pay for it. I have been there with a life threatening illness I ended up paying out of pocket that should have been covered. They let people die who are covered for cancer treatment etc daily using nonsense reasons. I highly doubt they are going to pay for this non life threatening surgery on a regular basis.
Stephe
You are simply set on being argumentative. Any response I give you will, in turn, find something depressing or wrong with it.
You said there are no companies in the US that provided SRS and that it is Universally not covered in the US. I stated you were in error in that regard and now you are wanting sources? And then you say it's 0.001%? 22% of Major US Corporate companies offer SRS. Quite a contrast from 0.001% Many of the companies I listed ARE huge.
Here's my source: call up the companys' human resource dept and ask them yourself. Google the company. Do your own research. Ill point you in the right direction and provide you a free link:
http://www.huffingtonpost.com/2011/02/22/transgender-surgery-cover_n_826385.html (http://www.huffingtonpost.com/2011/02/22/transgender-surgery-cover_n_826385.html)
Also they will give srs...they wont have srs on their policy just to deny trans people? Come now.
And my advice: stop complaining and attacking me and start being proactive.
QuoteI also find it comical you are talking about how great it is for this to be called a mental disorder but are asking for your church to pay for this non life threatening procedure for YOU. How many homeless people etc are going to sleep out on the street or go hungry because you are asking these churches to pay this -elective- procedure for you? You should be ashamed of yourself. Save and work for this yourself. Don't ask you others to pay for this by asking for them to have pity on you.. Or is this why you are so pro DSM, you are working the "mental disorder" angle to get these church people to pay for YOUR needs? Pathetic....
Again, this approach will not work on me.
As a pastor and a seminarian student we do a lot for the homeless people. On countless occasions we have opened our campus up for the homeless to find shelter during the cold nights. How many colleges can you say do the same?
Our church has food ministries, soup kitchens, financial assistance, and counseling for the homeless.
Our entire ministry does not focus on just the homeless. We minister to the sick, we minister to those who need surgeries, we minister to children, to teenagers, to adults, to senior citizens. We minister in Hospice. We minister to Straight men and women. We minister to gays and lesbians and transgender people.
We have outreaches and ministries that reaches out and touch everyone in our community. To focus on just one set of people will give a disservice to everyone else. Charity and hope comes in all shapes and sizes...not only just in shelter and soup.
Pretending that I am some horrible person ripping monies away from a starving family is a very taactless way of getting back at me. It didn't work. However, I am sure there is something else evil, malign, or incorrect that I said you can take the opportunity to jump on.
My advice to you is to just get over this thread (it was a week old since the last response). It is one thing to disagree with someone. It is an entirely different situation when you resort to childish and immature acts to attack the person you disagree with.
Lets try to keep personal insults out of this discussion. Debate the topic, not each other. We don't have to agree with each post, but we do have to be respectful to each other and the site.
22% companies? That is huge! I didn't know this! I guess I overestimated the US in terms of hell a bit.
(Though I think Stephe is right about this; Sicko said so too with quite a few examples: even in life-threatening diseases, those companies have an unpleasant tendency to refuse coverage as much as possible and have the patients fight for coverage even when they deserve it, invoking hardly logical motives. I think even people whose company covers SRS must have quite a hard time actually getting coverage, perhaps eventually requiring a lawsuit that would cost a fortune, much like the surgery would have in the first place...)
A bit off-topic:
Whoa, I am deeply surprised by the power the church has over in the US!
Quote from: A on July 14, 2011, 07:42:01 PM
22% companies? That is huge! I didn't know this! I guess I overestimated the US in terms of hell a bit.
(Though I think Stephe is right about this; Sicko said so too with quite a few examples: even in life-threatening diseases, those companies have an unpleasant tendency to refuse coverage as much as possible and have the patients fight for coverage even when they deserve it, invoking hardly logical motives. I think even people whose company covers SRS must have quite a hard time actually getting coverage, perhaps eventually requiring a lawsuit that would cost a fortune, much like the surgery would have in the first place...)
A bit off-topic:
Whoa, I am deeply surprised by the power the church has over in the US!
A company has to go through a LOT of red tape, education, and awareness programs to allow Sexual Reassignment Surgery on their health care benefit plans. All that work coupled with the fact that a very small minority of people will even be asking for SRS tells me I doubt the company will give you the run around for wanting to have it done. They are not going to go through all that work to deny the few trans (compared to all their other employees) they have.
Yes, the Church does have a lot of power in the U.S. Sadly, many fundamentalist churches (conservative) have power of much of the conservative political movement here. The conservative church is largely responsible for many of the anti same sex marriage rhetoric.
However, I am part of the progressive (liberal) church. We do all the charity that conservatives do but we don't judge or condemn people. Many progressive churches are working very closely with LGBT activist groups, social justice groups, etc etc as well as feeding the hungry and clothing the poor.
Unfortunately, many US citizens who do not go to church are not aware of the more progressive churches because the Conservative churches usually have a big voice (.ie., Pat Roberston, Jerry Falwell, etc). The good news is that the Progressive churches are getting stronger and they are fighting back against the social injustices the Conservative churches has done "in the name of God."
I may be thinking of too much bad things here, but I would tend to believe that they would definitely do such things to save money. I hope I am wrong, though...
About churches: Whoa, this is big. I am still shocked. But well, I guess this should be expected from a country that says "In God we trust".
Quote from: A on July 14, 2011, 09:37:09 PM
I may be thinking of too much bad things here, but I would tend to believe that they would definitely do such things to save money. I hope I am wrong, though...
If the company had hundreds of people go out for SRS every year then I could see your point. But usually companies do not have a ton of trans people wanting srs. If they had twenty a year I would be surprised.
Also, the company does not pay for the SRS. The companies pay to have the SRS included in its medical package. For example, if someone has SRS, the insurance company will not flip them a bill. If 50 went out for srs, the insurance company will not flip the company the bills. The Companies pay a set amount before hand to have it covered.
When the insurance companies raise their rates it is because a lot of employees has had surgery or whatever. The ration between trans people having srs and employees having knee surgery, hernias, or anything else is very vast.
The Human Rights Campaign has a worksheet on their website to show companies that they really pay very little extra to have SRS included into their policies....this has been the driving force behind why more and more companies are adding it....it really doesn't cost a whole lot more to have it. Now, if the company had thousands of trans who want srs then it could be costly, but the ratio of trans wanting srs in a company is at a level where it wont make much of a difference in the policy costs.
(I used to be a Medical Disability Manager....I know quite a bit about how US insurance policies work).