Susan's Place Transgender Resources

Community Conversation => Transsexual talk => Topic started by: KarlMars on March 09, 2016, 04:54:58 PM

Title: Questions about dysphoria diagnosis
Post by: KarlMars on March 09, 2016, 04:54:58 PM
How hard is it to get the diagnosis? I went to a therapist that was hesitant to write the note because he had seen people commit suicide after they had the gender surgery. He also wanted me to work on my borderline personality disorder. So I have never been officially diagnosed with the dysphoria.

How hard was it for you to get the recommendations for hormones? How long did it take?

If you have other mental health issues did it make it harder for you to get the diagnosis?

Please discuss.
Title: Re: Questions about dysphoria diagnosis
Post by: Deborah on March 09, 2016, 05:03:38 PM
It took me three visits which was the minimum time with that Dr.   Actually, I was diagnosed in two visits and the third visit was to discuss hormones and be approved for that.  So overall from start to finish was about four weeks because I had to space out the appointments due to finances at the time.

I didn't have any other issues that I know of.


Sapere Aude
Title: Re: Questions about dysphoria diagnosis
Post by: FTMax on March 09, 2016, 05:13:18 PM
I started hormones via informed consent and didn't get a formal diagnosis of gender dysphoria until I needed a referral for top surgery. It took 3 online visits before he wrote my letter.

I had no issues getting a diagnosis or hormones despite my previous mental health issues. All of them were related to dysphoria, and my providers had no issues seeing that.
Title: Re: Questions about dysphoria diagnosis
Post by: KarlMars on March 09, 2016, 05:24:07 PM
Quote from: FTMax on March 09, 2016, 05:13:18 PM
I started hormones via informed consent and didn't get a formal diagnosis of gender dysphoria until I needed a referral for top surgery. It took 3 online visits before he wrote my letter.

I had no issues getting a diagnosis or hormones despite my previous mental health issues. All of them were related to dysphoria, and my providers had no issues seeing that.

If you get the diagnosis, can you wait a few years before you can afford the hormones?
Title: Re: Questions about dysphoria diagnosis
Post by: FTMax on March 09, 2016, 05:37:09 PM
I am not sure. You would probably need to check with the doctor who would be prescribing the hormones. I know they prefer that surgical referrals be somewhat recent, but I'm not sure about HRT.
Title: Re: Questions about dysphoria diagnosis
Post by: AnonyMs on March 09, 2016, 06:18:37 PM
Quote from: alienbodybuilder on March 09, 2016, 04:54:58 PM
How hard is it to get the diagnosis? I went to a therapist that was hesitant to write the note because he had seen people commit suicide after they had the gender surgery.

I can't speak for the rest, but that's one of the more stupid things I've heard from a doctor. It's a whole lot more dangerous not getting treatment.
Title: Re: Questions about dysphoria diagnosis
Post by: Devlyn on March 09, 2016, 06:46:54 PM
Off topic, but may I ask which is correct? Your avatar "My status is pre T and no therapist yet."

or your post:

Quote from: alienbodybuilder on March 09, 2016, 04:54:58 PM
How hard is it to get the diagnosis? I went to a therapist that was hesitant to write the note because he had seen people commit suicide after they had the gender surgery. He also wanted me to work on my borderline personality disorder. So I have never been officially diagnosed with the dysphoria.

How hard was it for you to get the recommendations for hormones? How long did it take?

If you have other mental health issues did it make it harder for you to get the diagnosis?

Please discuss.
Title: Re: Questions about dysphoria diagnosis
Post by: Ashey on March 09, 2016, 07:03:25 PM
Thankfully it was a smooth process for me. I'd say maybe four months, going maybe twice a month, 45-60 minutes sessions. My therapist was a great guy, and actually cared. Since I went into it knowing exactly what I wanted, he understood that I didn't have any doubts or anything and just went through the motions. I talked about my feelings, my past, my goals, and he came up with a list of topics we needed to cover and got it done. Then I got my letter of recommendation to start HRT.

....And then I found out, almost a year ago when my friend started transitioning too, that my endo didn't even need a letter. ::)
Title: Re: Questions about dysphoria diagnosis
Post by: Emileeeee on March 09, 2016, 08:54:10 PM
The first time it took about 5 years. The second time I switched therapists and told them how it was when I walked in. Had it after the second visit. I did do informed consent, but the therapist letter got me way ahead of a 2+ month waiting list.
Title: Re: Questions about dysphoria diagnosis
Post by: Kylo on March 10, 2016, 02:47:22 PM
3 psychotherapist consultations over 4 months. The third consult she said she was putting my case forward to the relevant doctor to discuss the next steps. She never actually said "I've diagnosed you transsexual" but it effectively meant as much.

I have anxiety issues, which I mentioned. And a bunch of stuff which I didn't mention. I can only assume I said enough of the right things - I've no idea how difficult or easy it is to be diagnosed except a suspicion that they have a bunch of boxes to tick on the usual signs.

She showed me the papers she'd been writing on for 3 sessions which showed all the questions she's asked me and the notes beside and there was a ton of pencil notes all over every page based on everything I'd said, so I guess there was enough for them to go on. I don't actually know how much and what you have to say to be diagnosed.
Title: Re: Questions about dysphoria diagnosis
Post by: FTMax on March 10, 2016, 03:06:13 PM
Quote from: Devlyn Marie on March 09, 2016, 06:46:54 PM
Off topic, but may I ask which is correct? Your avatar "My status is pre T and no therapist yet."

or your post:

Quote from: alienbodybuilder on March 09, 2016, 04:54:58 PM
How hard is it to get the diagnosis? I went to a therapist that was hesitant to write the note because he had seen people commit suicide after they had the gender surgery. He also wanted me to work on my borderline personality disorder. So I have never been officially diagnosed with the dysphoria.

How hard was it for you to get the recommendations for hormones? How long did it take?

If you have other mental health issues did it make it harder for you to get the diagnosis?

Please discuss.

Dev, I think his post is referencing when he had previously spoken with a therapist. Not currently.
Title: Re: Questions about dysphoria diagnosis
Post by: KarlMars on March 11, 2016, 06:28:25 AM
Quote from: AnonyMs on March 09, 2016, 06:18:37 PM
I can't speak for the rest, but that's one of the more stupid things I've heard from a doctor. It's a whole lot more dangerous not getting treatment.

He wasn't a doctor. He was a lousy therapist. I agree that it would make someone a lot more suicidal to not get treatment. I don't have the money right now to do anything yet. I'm on medicaid and disability. When I get a chance I'm going to try to get a job. I'll probably have to wait a few years at least before hormones even.
Title: Re: Questions about dysphoria diagnosis
Post by: KarlMars on March 11, 2016, 06:31:47 AM
Quote from: Devlyn Marie on March 09, 2016, 06:46:54 PM
Off topic, but may I ask which is correct? Your avatar "My status is pre T and no therapist yet."

or your post:

I am pre T and I left that therapist back in the summer of 2015. So what I meant is I didn't have a decent therapist.
Title: Re: Questions about dysphoria diagnosis
Post by: laurenb on March 13, 2016, 06:48:38 AM
I got the feeling from my therapist that her role wasn't so much to render a "diagnosis" of gender dysphoria. Her purpose was to make sure that there weren't any other issues that would seriously compound or hinder my progress toward transition (if that's what I wanted). Of course she also gives guidance and tools to deal with the GID. Actually, I don't think there even is a "diagnosis" anymore since the guidelines have changed as diagnosis implies illness. Gender identity, according to the latest DSM, is self defined (Am I right there?). Anyway, that all being said, we all got issues and I believe a good therapist is worth their weight in insurance premiums.
Title: Re: Questions about dysphoria diagnosis
Post by: Denise on March 18, 2016, 04:11:56 PM
As for how long - each (2) therapist I've seen said they were pretty sure after one visit and were definitely sure after two.  I only know that because I asked.  Which is kinda funny since it wasn't until after visiting the Medical Dr and describing to him what was going on and he stopped me and said "Bingo - that's Gender Dysphoria."  To be honest - that made me feel 100 times better knowing that I wasn't mis-self-diagnosing and the therapists just "going along for the ride."

Note this - I learned something the other day about therapists. I should have paid more attention earlier on in the process.  The letters after their name is important.

I don't really know what all these letters mean (Ed.D, LCPC, NCP, DAPA) but apparently they hold weight for insurance companies and medical doctors. But the first therapist I was seeing had these after her name: MA,  LPC, ACCHT.  Apparently that is not enough in the eyes of insurance at least.  it also means $100/hour vs $180/hour.  But as the old saying goes, you get what you pay for.  Also note some therapists will adjust their pricing based upon income. 

Also drug companies will help out too if you can't afford prescribed medications.  Consider asking a pharmacist to see if there are any discount drug programs for the specific drugs being prescribed.  Or look online at pharmaceutical web sites to find help.



Title: Re: Questions about dysphoria diagnosis
Post by: KarlMars on March 18, 2016, 10:49:41 PM
Quote from: laurenb on March 13, 2016, 06:48:38 AM
I got the feeling from my therapist that her role wasn't so much to render a "diagnosis" of gender dysphoria. Her purpose was to make sure that there weren't any other issues that would seriously compound or hinder my progress toward transition (if that's what I wanted). Of course she also gives guidance and tools to deal with the GID. Actually, I don't think there even is a "diagnosis" anymore since the guidelines have changed as diagnosis implies illness. Gender identity, according to the latest DSM, is self defined (Am I right there?). Anyway, that all being said, we all got issues and I believe a good therapist is worth their weight in insurance premiums.


Thank you very much for that good bit of information, miss. I hope that you transition is or has gone well for you.
Title: Re: Questions about dysphoria diagnosis
Post by: KarlMars on March 18, 2016, 11:09:48 PM
Quote from: pj on March 18, 2016, 04:11:56 PM
As for how long - each (2) therapist I've seen said they were pretty sure after one visit and were definitely sure after two.  I only know that because I asked.  Which is kinda funny since it wasn't until after visiting the Medical Dr and describing to him what was going on and he stopped me and said "Bingo - that's Gender Dysphoria."  To be honest - that made me feel 100 times better knowing that I wasn't mis-self-diagnosing and the therapists just "going along for the ride."

Note this - I learned something the other day about therapists. I should have paid more attention earlier on in the process.  The letters after their name is important.

I don't really know what all these letters mean (Ed.D, LCPC, NCP, DAPA) but apparently they hold weight for insurance companies and medical doctors. But the first therapist I was seeing had these after her name: MA,  LPC, ACCHT.  Apparently that is not enough in the eyes of insurance at least.  it also means $100/hour vs $180/hour.  But as the old saying goes, you get what you pay for.  Also note some therapists will adjust their pricing based upon income. 

Also drug companies will help out too if you can't afford prescribed medications.  Consider asking a pharmacist to see if there are any discount drug programs for the specific drugs being prescribed.  Or look online at pharmaceutical web sites to find help.

Thank you very much for this information and input. I am just asking for future reference. Right now I am on disability and medicaid which I doubt will cover anything. I hope someday they pass laws for medicaid to cover HRT at least. Due to my mental health issues and changing moods I must wait awhile to think about even starting hormones. In the meantime I'll have plenty of time to talk this out with a therapist.
I want to make sure I can keep at least a part time job and have some way to support myself before I consider any transition. I lack stability right now due to temporarily living with and caring for my dying grandmother and my family needs lots of help. I apologize for too much information. I don't want pity. People seem to like it when I give more information rather than type a few words around here.
Title: Re: Questions about dysphoria diagnosis
Post by: Moneyless on March 19, 2016, 03:59:42 AM
Been seeing my psychologist for about 6 months now. I would've been on T 2 months ago if I wasn't required to be 18. So basically for about 4 months, once a fortnight. He didn't question me at all, however he has two other patients my age who he refuses to write letters for also due to their mental or physical health.
Title: Re: Questions about dysphoria diagnosis
Post by: Swayallday on March 19, 2016, 05:49:45 AM
six appointments and 8 months further now.

no step further  >:(
Title: Re: Questions about dysphoria diagnosis
Post by: WorkingOnThomas on March 21, 2016, 10:08:36 AM
It took months to get my referral, but that's the norm at the clinic I go to. And now there's a long wait to see the endo.
Title: Re: Questions about dysphoria diagnosis
Post by: Felix on April 09, 2016, 01:21:26 PM
Sorry this is way late, but it's not archived so I hope I'm not breaking any rules.

I was never diagnosed with gender dysphoria. I did have pre-existing mental illness, so I asked my regular therapist for a hormone letter. She had been seeing me once a week for years and we had discussed gender issues a lot so I felt like she'd be happy to help me become a whole person. She said yes when I asked but the following week she told me that her agency "doesn't do that." I felt betrayed and I got angry and asked for the contact information for her supervisor. I told her not giving me a letter was just weird transphobic bureaucratic theism, and she talked to her boss and her boss told her to write the letter. She gave me the letter and told me never to come back because their other clients were christians and it wouldn't be safe for people like me to be there. I had actually cared a lot about the people there. They were my friends. My kid was friends with their kids. She didn't even give me the dignity of calling me transgender. She thought I was a confused lesbian and that's what she told people. The letter she gave me was ridiculous. It was very bold and clear about how I was a good woman who wants to someday be a man. Luckily my physician had also been seeing me for awhile so she only needed the letter as a formality.
Title: Re: Questions about dysphoria diagnosis
Post by: KarlMars on April 09, 2016, 06:11:00 PM
Quote from: Felix on April 09, 2016, 01:21:26 PM
Sorry this is way late, but it's not archived so I hope I'm not breaking any rules.

I was never diagnosed with gender dysphoria. I did have pre-existing mental illness, so I asked my regular therapist for a hormone letter. She had been seeing me once a week for years and we had discussed gender issues a lot so I felt like she'd be happy to help me become a whole person. She said yes when I asked but the following week she told me that her agency "doesn't do that." I felt betrayed and I got angry and asked for the contact information for her supervisor. I told her not giving me a letter was just weird transphobic bureaucratic theism, and she talked to her boss and her boss told her to write the letter. She gave me the letter and told me never to come back because their other clients were christians and it wouldn't be safe for people like me to be there. I had actually cared a lot about the people there. They were my friends. My kid was friends with their kids. She didn't even give me the dignity of calling me transgender. She thought I was a confused lesbian and that's what she told people. The letter she gave me was ridiculous. It was very bold and clear about how I was a good woman who wants to someday be a man. Luckily my physician had also been seeing me for awhile so she only needed the letter as a formality.

I'm sorry to hear all that has happened to you, Felix. I have mental health problems too, and a psychiatrist and mental health case manager. They're going to set me up with a trans friendly therapist, and they don't seem bigoted at all. I had a therapist that was independent of their agency before, and he was not nice to me.

A local transman who's my friend said that all he did was get a referral from his primary care doctor (I use the same doctor's office as him) to the endo right here in town and that the endo is descent. I may not even need a therapist's referral, but I'd like to get the therapist anyway.
Title: Re: Questions about dysphoria diagnosis
Post by: AnxietyDisord3r on April 10, 2016, 09:09:56 AM
Quote from: AnonyMs on March 09, 2016, 06:18:37 PM
I can't speak for the rest, but that's one of the more stupid things I've heard from a doctor. It's a whole lot more dangerous not getting treatment.

When I was reading WHIPPING GIRL, Serano said that pointing to trans peoples' depression and suicides post transition was a way that transphobic doctors would dismiss trans peoples' agency and identities, as if societal oppression didn't play a LARGE role in their problems post transition.

This is a typical move to push down and oppress marginalized groups even more.