I want everyone to know that the following is not a condemnation of the process of therapy. I feel that for those who need it counseling and therapy can be very beneficial. Understand that this is a personal account and is not intended to sway anyone for or against.
I just want to vent.
So anyway, I went to the doctor to begin HRT. The doctor had no issue with recognizing the truth of my request, and was very kind. My understanding when I left that day was that if my labs checked out OK I would be prescribed medication. My labs did check out, but unfortunately the head of transgender care, who is transgender herself, 'feels it very important that I have formal counseling before starting hormones'.
Now, I understand that this comes from an experienced person, but it makes it no less a bad course of action. This is part of what I wrote in response:
>start quote
I have to say I am extremely disappointed. While I understand the 'The Standards of Care' may require counseling, I was hoping very much to be able to move forward without it.
Having to see a counselor was my biggest worry, not because of any fear of what may come out in a session, but because it represents another failure within society of the recognition of my person. For me it is just another obstacle imposed and waiting for recognition from yet another is quite frustrating.
While I still have strong emotions regarding my past and future they are in no way debilitating. I have been in the process of 'transitioning' for years, my desire to start HRT is an absolute, the decision is already made. The only thing I am missing are the medications.
I have researched and experienced first hand the emotional and physical effects of 'transitioning', and I have plenty of contact with people who have been and currently are going through the process. As a matter of fact I disagree with the term 'transitioning' as the connotation is that I am becoming 'something other' rather than finally letting my true self show. I prefer the term 'emerging'.
I will of course accept any information about the effects of the medications, but as far as being informed about the personal and societal impact, I am very well aware. I am an adult and of sound mind and did not come to this realization lightly.
While I do desire the resource of a counselor, it is for after I have have started medications and more for the purpose of being able to help others with my emotional and physical changes.
>end quote
The thing that really makes me angry is the assumption that I would not be informed, or that I have come to the conclusion due to some misconception on my part. What would have been far better would be simply asking me if I felt the need to see a therapist.
Now I have the added stress, expense and waste of time while I have to wait around for yet another person to say 'yes, you should be on HRT'. No S--- Sherlock.
ARG, ARG, ARG!
You, of course, have a right to feel your own feelings and to express your frustrations.
((HUG))
It will be okay. It really will be.
Therapy is not meant to be a challenge to your identity, nor an affront to your intelligence.
This isn't actually about you at all. And it isn't a system gone haywire.
It is what it is, and how you choose to look at it won't change the outcome, but it will impact your state of mind.
Most everybody here has complied with such requirements, and we all survived, lol..
So will you, sweetie, so will you...
((HUGS))
Missy
Are there informed consent options near you?
Thank you Missy, I know you have nothing but good wishes, and that does help.
I hope you understand though, how I look at it will change the outcome. The fact that this has happened is a wrong thing. A requirement to be fulfilled from false assumptions.
The information that most everyone has gone through a similar process only serves to prove how wrong it is, the 'argument from authority' is bad critical thinking.
My identity can't be challenged, it just is. Gravity does not ask permission. I wish people would recognize they are not the gatekeepers of reality, that free will does not depend on opinion for it's truth.
In this instance the requirement of counseling has caused far greater harm than it will provide good, for many reasons.
I will calm down after a while, but there is no method in which I will ever believe that 2+2=5.
Quote from: FTMax on February 04, 2017, 06:37:56 PM
Are there informed consent options near you?
Max, yes, that is one of the reasons I chose my health care provider. As angry as I am right now, I'm hoping this is a miscommunication and that by 'counseling' it is meant a meeting to provide me with a method of informed consent.
Veda,
I wasn't implying that the majority of us were done any wrong at all. Just the opposite, in fact...
The reality is that most all have benefitted from the process, no matter how convinced we were of the lack of necessity.
I was BORN female, with a vagina, uterus, ovaries...
Do you think I needed to be told it was okay for me to take estrogen?
I'm gonna recuse myself, lol, because you need this time to feel what you feel. And that's right, and proper. But I will say one last thing, ummm, noooo, I won't... ;-)
I hope you feel better soon. I am sorry you are upset, and disappointed, and angry...
((HUGS))
Missy
Were you clearly presenting as female for all your interactions with your health care providers?
In my personal experience, even transgender-friendly health care providers responded more positively to me when I presented as female. Back when I first talked to my doctor to ask for HRT, I presented as female the best I could. I didn't pass, but I did it anyway. I wanted them to know that I was serious about this and unafraid to be seen as who I am (although I was actually pretty afraid because I didn't pass).
I know it's totally unfair, but the effort in your presentation does matter. It is not unlike putting in the effort to putting on a suit for a job interview.
Mirya,
I did think about that, but honestly I feel for me it would have been disingenuous.
I understand what you are saying in how it is like presenting for a job interview, actually a good idea, just not for me in this instance.
Just to clarify, the doctor I saw had no problem with starting me on HRT and it was very clear to him the reason for it; it was the head of the transgender services who had the requirement, a person I have had no contact with.
(edit)
If this turns out to be due to an interdepartmental disagreement about procedure I'm going to be really P----- Off.
Frankly, I did one initial visit with a therapist, just to say i did. We went over my mindset, made sure there were no underlying problems that hrt could present issues with (I am bipolar) and got a "yup, I see no problems" I have not been back nor intemd to unless I feel I need to
Another thing that has occurred to me is that this is some form of initial vetting process; a test of my resolve by at first denying me my request and seeing how I respond.
Of course I really can't see a medical professional doing something so sophomoric...
Arg, maybe my fairy godmother will show up soon and knock some sense into people with her magic wand.
Sense of humor, slowly coming back...
Quote from: patrick1967 on February 04, 2017, 07:20:32 PM
Frankly, I did one initial visit with a therapist, just to say i did. We went over my mindset, made sure there were no underlying problems that hrt could present issues with (I am bipolar) and got a "yup, I see no problems" I have not been back nor intemd to unless I feel I need to
Thats what I'm hoping for. It's just that I had the OK and then the rug got pulled...
Quote from: MissGendered on February 04, 2017, 06:56:43 PM
Veda,
I wasn't implying that the majority of us were done any wrong at all. Just the opposite, in fact...
The reality is that most all have benefitted from the process, no matter how convinced we were of the lack of necessity.
I was BORN female, with a vagina, uterus, ovaries...
Do you think I needed to be told it was okay for me to take estrogen?
I'm gonna recuse myself, lol, because you need this time to feel what you feel. And that's right, and proper. But I will say one last thing, ummm, noooo, I won't... ;-)
I hope you feel better soon. I am sorry you are upset, and disappointed, and angry...
((HUGS))
Missy
I get you hon, and thanks.
Look at that, group therapy...
;)
The vetting sucks, but there are people who aren't sure this is what they want and it's to eliminate those as well as figure out how to care for you and address you.
Veda,
I am so very sorry for your difficulties. I can imagine how frustrated I would have felt.
For what it's worth, the way my informed consent happened was:
1. I sent simultaneous messages to both my primary care provider, and Transgender Services Program at Group Health with me requesting a referral for gender therapy, that I am transgender and would like to seek HRT.
2. When I saw my physician I presented female. I wore breast forms under my bra and a cute top with fashionable women's jeans.
3. I told the physician that I was in the process of seeking the gender therapist referral from the Transgender Services Program. The physician ordered the blood tests at the same time giving me a probable program of HRT.
The blood tests came back ok, and the doctor seemed ok so far. No prescription yet, just probable dosages for my information.
4.The Transgender Services Program social worker assigned to my case called me and I had a very lengthy in-depth telephone conversation with her lasting for for more than an hour and a half. She referred me to my gender therapist.
5. I had already begun seeing my therapist when I re-contacted my physician stating that I am in therapy, and that I would like a prescription for HRT now. The physician responded with my actual HRT prescription.
So for my case, very likely I had already fulfilled the criteron of having therapy before HRT because of my own course of actions.
Again, Veda,
I am so sorry for you.
I hope my own advice previously did not lead to expectations that were later not met.
Donna
Quote from: Kylo on February 04, 2017, 07:57:27 PM
The vetting sucks, but there are people who aren't sure this is what they want and it's to eliminate those as well as figure out how to care for you and address you.
Yes, I know it ultimately comes from the desire to do good, and to help protect people from making the wrong decision, but there are other methods that work better and don't cause such frustration.
Informed consent is one method that works very well and also provides a way to discover any issues without undo interference.
The simple fact is the process is long enough that one could start with only minor risk and if for some reason there are serious doubts it can stop before any permanent changes occur.
It's akin to testing edibility of new food source, you don't start by trying to figure out if you are hungry or not, that is a given. You start by tasting a small amount and seeing what your reactions are.
How will I know with certainty that HRT is the way to go? I have to start HRT to find out.
Quote from: Donna on February 04, 2017, 08:09:50 PM
Veda,
I am so very sorry for your difficulties. I can imagine how frustrated I would have felt.
For what it's worth, the way my informed consent happened was:
1. I sent simultaneous messages to both my primary care provider, and Transgender Services Program at Group Health with me requesting a referral for gender therapy, that I am transgender and would like to seek HRT.
2. When I saw my physician I presented female. I wore breast forms under my bra and a cute top with fashionable women's jeans.
3. I told the physician that I was in the process of seeking the gender therapist referral from the Transgender Services Program. The physician ordered the blood tests at the same time giving me a probable program of HRT.
The blood tests came back ok, and the doctor seemed ok so far. No prescription yet, just probable dosages for my information.
4.The Transgender Services Program social worker assigned to my case called me and I had a very lengthy in-depth telephone conversation with her lasting for for more than an hour and a half. She referred me to my gender therapist.
5. I had already begun seeing my therapist when I re-contacted my physician stating that I am in therapy, and that I would like a prescription for HRT now. The physician responded with my actual HRT prescription.
So for my case, very likely I had already fulfilled the criteron of having therapy before HRT because of my own course of actions.
Again, Veda,
I am so sorry for you.
I hope my own advice previously did not lead to expectations that were later not met.
Donna
Thanks Donna, no your advice didn't lead me to any expectations, the doctor telling me that if my labs were good I could start HRT led me to expectations. :P
I'll live, just another friken hoop to jump through, one day HRT medication may be available over the counter. One pill for boy, another for girl.
;)
I am totally with you, Veda.
I am convinced that you will eventually get to the "Promised Land" of starting HRT.
I have tears of empathy for you.
You WILL get there, Veda.
Donna
Veda,
I for one, would feel much the same as you do had this happened to me. So I think I understand somewhat how you feel and I'm sorry it is turning out this way for you.
In my case, I probably would have benefited by going though the process they appear to have in mind for you. Now I am talking of it possibly doing me good, not you, not everyone else. I am sure they have the patient's best interests in mind though it isn't the way you would have it. The disappointment of thinking your HRT was "In the bag" and having it delayed is, I'm sure, devastation and your anger is understandable.
My primary care doctor offered to refer me for therapy and I agreed. I think it may do me some good. I see a psychiatrist for the initial intake screening on the 23 rd. Given the way I started this journey, she may well think I'm nuts and need more than gender therapy.
Always the one to put the cart before the horse, and positive this is what I want, I started HRT, then told my doctor then asked for prescriptions, and now will be starting some sort of therapy, Now isn't that crazy? It's bassackwards I tells ya! Bassackwards!. Not only that, but now after the giddiness of of starting, telling the doc, getting my scripts and feeling changes happening within me. I've come down. I'm still sure this is what I want but now wondering if it is what I should be doing. Maybe its a mistake? What of my family and friends? I'm second guessing myself one minute all the while eager to continue. Sometimes I think I have to be nuts.
This is why I think I could have benefited from doing it in the recommended order. IE Talk with my doctor, see the shrink and get the referral to gender therapy, then start HRT. I just hope she won't agree with me and confirm I'm nuts. I guess I'll find out. Meanwhile I'll continue my HRT.
I truly wish you well and hope your meeting is to get the formal go-ahead for HRT as you want. Let the anger go and see what actually transpires. It just may be another step on that road to your happy destiny.
Jeanette
Quote from: Donna on February 04, 2017, 08:31:28 PM
I am totally with you, Veda.
I am convinced that you will eventually get to the "Promised Land" of starting HRT.
I have tears of empathy for you.
You WILL get there, Veda.
Donna
Thanks hon, I will get there, just wish 'the system' wouldn't add insult to injury.
I hope not to many tears, you should save them for tears of happiness.
Of course, the quality of mercy is not strained...
Looks like you are almost two weeks now, how are you doing?
Quote from: JeanetteLW on February 04, 2017, 08:59:42 PM
Veda,
I for one would feel much the same as you do had this happened to me. So I think I understand somewhat how you feel and I'm sorry it is turning out this way for you.
In my case I probably would have benefited by going though the process they appear to have in mind for you. Now I am talking of it possibly do me good, not you not everyone else. I am sure they have the patient's be interests in mind though it isn't the way you would have it. The disappointment of thinking your HRT was "In the bag" and having it delayed is I'm sure devastation and your anger is understandable.
My primary care doctor offered to refer me for therapy and I agreed. I think it may do me some good. I see a psychiatrist for the initial intake screening on the 23 rd. Given the way I started this journey she may well think I'm nut and need more than gender therapy.
Always the one to put the cart before the horse and positive this is what I want I started HRT, then told my doctor and then asked for prescriptions, and now will be starting some sort of therapy, Now isn't that crazy? it's bassackwards I tells ya! Bassackwards!. Not only that but now after the giddiness of of starting, telling the doc, getting my scripts and feeling changes happening within me. I've come down. I'm still sure this is what I want but now wondering if it is what I should be doing. Maybe its a mistake? What of my family and friends? I'm second guessing myself one minute while eager to continue. Sometimes I think I have to be nuts.
This is why I think I could have benefited from doing it in the recommended order. IE Talk with my doctor, see the shrink and get the referral to gender therapy, then start HRT. I just hope she won't agree with me an confirm I'm nuts. I guess I'll find out. Meanwhile I'll continue my HRT.
I truly wish you well and hope your meeting is to get the formal go-ahead for HRT as you want. Let the anger go and see what actually transpires. It just maybe another step on that road to your happy destiny.
Jeanette
Thanks Jeanette. I don't think it is all that crazy, maybe a little, but an OK crazy, not an OMG crazy. I mean heck isn't it more crazy that we live in a society that doesn't recognize us as a healthy part of itself, that makes us think we are the 'bassakward' ones? Jeez, we are talking of people who can't stand a boy actually being a girl (or the opposite, or whatever), but will have no problems inbreeding to the point of genetic abnormalities and who think mono-culture is the ideal. I mean really,
biodiversity much? Anyway, I will not rant. ;)
Quote from: Veda on February 04, 2017, 09:06:06 PM
Thanks hon, I will get there, just wish 'the system' wouldn't add insult to injury.
I hope not to many tears, you should save them for tears of happiness.
Of course, the quality of mercy is not strained...
Looks like you are almost two weeks now, how are you doing?
Thanks, Veda
How am I doing?
With abut 2 weeks of HRT so far, I would have to say I am very relaxed. No big physical changes other than two things "down there" smaller, and two things "up front" seem different.
I was under the impression we live somewhat near each other, and I know of a local option for HRT where no therapy would be required (if I am correct about where I think you live). They also provided me with surgery referral letters free of charge after one visit each with a therapist and a psychiatrist they have on staff. Send me a PM if you'd like contact info and you're in my area (you can find it on my profile).
Quote from: FTMax on February 05, 2017, 09:19:44 AM
I was under the impression we live somewhat near each other, and I know of a local option for HRT where no therapy would be required (if I am correct about where I think you live). They also provided me with surgery referral letters free of charge after one visit each with a therapist and a psychiatrist they have on staff. Send me a PM if you'd like contact info and you're in my area (you can find it on my profile).
Thanks Max, I'm in the Pacific Northwest. I'm calmed down now, still very disappointed, but I'll live. I thank you for the offer, and If things don't improve with my provider I'll be contacting you.
For now I'm window shopping for the shoes I'll be getting, you can check out 'fashion' for my choices. Much like earrings, shoes make it all better.
:)
Veda,
This is to ensure you fully understand the consequences of your actions and to screen out any other mental illnesses that may confuse the issue. Please don't think I'm saying this applies to you but wouldn't you hate to take such a massive step for the wrong reason. I was offered hormone therapy in the 90s and bottled it. I regret it now and was more worried about my parents support which wasn't there.
In essence, the therapy is there to protect you or to support you. I wish you luck in whatever choice you make.
Sent from my LG-H840 using Tapatalk
I hated the thought of the "system" as well, particularly as I'm using a public one that is known for red tape and long waiting lists.
The idea of dependency on a system, on gate keepers and whether or not I would fit their criteria did make me angry and wary. But without going some back alley route there's no other way. Same as if I needed a heart transplant, I'd still have to go through their system, be on their list and jump through their hoops. We are depending on others and their technology to help us, there's no denying that.
I just figure, at least they can do these things now, and are willing to offer them here. 200 years ago it would have been a daydream, or an unsurvivable ordeal. Helps me to think of it that way. This IS cutting edge.
Quote from: Kylo on February 05, 2017, 12:51:28 PM
I hated the thought of the "system" as well, particularly as I'm using a public one that is known for red tape and long waiting lists.
The idea of dependency on a system, on gate keepers and whether or not I would fit their criteria did make me angry and wary. But without going some back alley route there's no other way. Same as if I needed a heart transplant, I'd still have to go through their system, be on their list and jump through their hoops. We are depending on others and their technology to help us, there's no denying that.
I just figure, at least they can do these things now, and are willing to offer them here. 200 years ago it would have been a daydream, or an unsurvivable ordeal. Helps me to think of it that way. This IS cutting edge.
It does seem like jumping through hoops, even more it's having to fit into a cookie-cutter system. I think the biggest problem I have is having to be diagnosed with 'Gender Dysphoria' in order to receive medication. It has the stigma of 'mental disorder' which of course immediately puts a preconception on ones general mental health. Of course there are instances where that is the case, and therapy has a clear benefit, it just should not be assumed as the general diagnosis for all gender variant people.
As a matter of fact I've been thinking of how to allow for recognition without the stigma, and would love to see more accurate terms adopted within the medical community; 'Gender Variant', 'Androgynous' and 'Gynandrous', 'Polar' and 'Non-Polar'...
So I would be recognized as 'Gender Variant, Non-Polar, Androgynous'; 'Non-Polar' because I don't want SRS, 'Androgynous' because I was born with male genitalia but am actually female and Gender Variant because it recognizes who I am as a healthy and natural part of humanity.
I know it is a wordy naming convention and redefines both androgyny and gynandry, but may work in the medical community by providing a broader definition and by distancing gender identity from 'mental disorder':
I got lucky with an informed consent practice near me, so other than my initial screening as I said, i have not had to undergo extended therapy. I imagine I will feel very differently when I have to play the game to get referrals for surgery, if I find myself in a financial ane insurance situation to do so. 1 year RLE (who defines the start date) at least one if not two psych letters, and proving medical necessity. I wish that the fact that we know what we need to feel whole counted for something
Quote from: patrick1967 on February 06, 2017, 08:02:36 PM
I wish that the fact that we know what we need to feel whole counted for something
I think that it counted for a whole lot for me with my therapists, actually, Patrick. But, it does seem that no matter how certain I was about anything, at almost every milestone moving forward, the therapy process unearthed issues I had never considered, and provided a means for processing and regaining certainty. I did only go to a gender therapist the minimum required, but I quickly segued into trauma therapy to deal with my co-morbid issues. Never once was I invalidated by either process, rather empowered to heal, and embrace my potential. It is often seen as a red flag when one approaches a reasonable dialog with a professional with contempt or apparent unwavering resistant certainty. And rightly so, for truth can stand to have a bright light lit and shone upon it. When we are more invested in circumvention, the obvious question, is why? And THAT is part of what gender therapists are there for, to help us understand our motives as well as our disinclinations. The fact that co-morbid conditions are easily confused for identity issues is common knowledge in psych circles, even if not especially common. These kinds of issues, like mental illness, or buried childhood trauma, are the most likely issues to be unacknowledged, or buried, in those that seek circumvention. It is believed that it is better to slow down all transitions rather than let any one go forward based on non-gender identity causations, since these are the people at greatest risk. I think of it as being like the American ideal that it is better that 20 guilty men go free, than one innocent man be punished. But hey, like I mentioned earlier in this thread, I went through all the hoops, even though I have no Y chromosome, because I knew I had other issues (DID, incest/rape, child abuse, CPTSD), and I wasn't afraid to dig in and be sure I wasn't about to make the biggest mistake of my life.
I only profited from the process, even when it was clunky and clumsy. The truth can bear scrutiny. That is something I try to keep in mind in all aspects of my relationship to myself.
Missy
Quote from: MissGendered on February 06, 2017, 08:16:45 PM
It is often seen as a red flag when one approaches a reasonable dialog with a professional with contempt or apparent unwavering resistant certainty. And rightly so, for truth can stand to have a bright light lit and shone upon it... The truth can bear scrutiny...
Missy, I can't agree more with the second part, it equates with the quote I have 'fact destroys the lie'. Therapy for the sake of dealing with personal trauma is not just good advice, it is necessary.
The first part, resistance to therapy being a 'red flag' is something that I feel needs to be corrected, or at least understood in a different light.
I'm sure you have a firm grasp of 'Cassandra Complex'. It can take many different forms and what person can be blamed for resistance to therapy, especially when used by an 'authority' as a prerequisite to a needed treatment, and, given the fact that 'the light of truth' has been shining very clear for a very long time? I would very seriously consider the
lack of resistance to
compulsory therapy more of a 'red flag'.
I have to admit I've got a case of the 'Cassandra's', as a mater of fact I almost adopted Cassandra as my own name (I still do like 'Cassie'), but I felt it was to morose. Now when I'm feeling angry at the world I just go by 'Darth Veda' ;)
Quote from: Veda on February 07, 2017, 12:33:52 PM
The first part, resistance to therapy being a 'red flag' is something that I feel needs to be corrected, or at least understood in a different light.
Ironically, it is only through examination that such a red flag can be responsibly lowered, hun. Statistically, the overwhelming reality is that most people have very little understanding of the things that therapists do for a living. And I might add, assuming you have no unknown, or hidden reasons for therapeutic concern, by advocating loudly for a way to circumvent known effective protocols, you may be inadvertently be paving the way for those that do need examination to avoid it, and become part of the small percentage of transition regretters.
All our actions have consequences, and when our pride comes into play, we easily miss the bigger picture. As I said in my first response, "this is not about you"...
Well, maybe it might be, let's see what therapy unearths, since you will have to have real gender therapy to get anywhere past HRT. Maybe HRT will suffice, but for so many that believe that will be true, it truly doesn't. Only time will tell, hun, I would only ask and suggest you be open to the possibility of other possibilities than the ones you now envision. You just never know...
Missy
Quote from: MissGendered on February 07, 2017, 12:56:13 PM
And I might add, assuming you have no unknown, or hidden reasons for therapeutic concern, by advocating loudly for a way to circumvent known effective protocols, you may be inadvertently be paving the way for those that do need examination to avoid it, and become part of the small percentage of transition regretters.
Well, maybe it might be, let's see what therapy unearths, since you will have to have real gender therapy to get anywhere past HRT. Maybe HRT will suffice, but for so many that believe that will be true, it truly doesn't. Only time will tell, hun, I would only ask and suggest you be open to the possibility of other possibilities than the ones you now envision. You just never know...
The first part is an 'appeal to consequences'. While I'm open to the possibility of people 'working the test' I think there is a better method than compulsory therapy to help people come to terms with their true motivation, which is related to the second part...
The second part is a method of imparting doubt (insidious), by undermining self confidence through 'argument from a lack of contrary evidence'. A better method is to impart concepts of critical thinking such as 'Do the claimant's personal beliefs and biases drive the conclusions, or vice versa?' More here: http://rationalwiki.org/wiki/Category:Logic
One of the things I dislike about therapy is that it is highly subjective, of course there are methods employed by good therapists which counteract that subjectivity, but it is still a reason to be cautious.
Ultimately we have to face the idea that gender variation is in fact a natural phenomena, and there is every indication that it is common to all forms of sexually reproductive species. What method is best for determining if true gender variation is the prime motivator behind someone seeking HRT?
Personally, I go with a rational approach.
(edited to provide correct link)
Quote from: Veda on February 07, 2017, 02:06:20 PM
The first part is an 'appeal to consequences'. While I'm open to the possibility of people 'working the test' I think there is a better method than compulsory therapy to help people come to terms with their true motivation, which is related to the second part...
The second part is a method of imparting doubt (insidious), by undermining self confidence through 'argument from a lack of contrary evidence'. A better method is to impart concepts of critical thinking such as 'Do the claimant's personal beliefs and biases drive the conclusions, or vice versa?' More here: http://rationalwiki.org/wiki/Category:Logic
One of the things I dislike about therapy is that it is highly subjective, of course there are methods employed by good therapists which counteract that subjectivity, but it is still a reason to be cautious.
Ultimately we have to face the idea that gender variation is in fact a natural phenomena, and there is every indication that it is common to all forms of sexually reproductive species. What method is best for determining if true gender variation is the prime motivator behind someone seeking HRT?
Personally, I go with a rational approach.
(edited to provide correct link)
I don't require my intelligence to be insulted, hun. You may condescend all you want, but I will not accept it.
I'm done.
Good luck.
Quote from: MissGendered on February 07, 2017, 02:41:56 PM
I don't require my intelligence to insulted, hun. You may condescend all you want, but I will not accept it.
I'm done.
Good luck.
Not my intention to condescend and my apologies if you are offended, but I'm not going to limit my discourse on this subject.
Some things are very hard to accept and I find rationality and scientific method the best tools for finding truth.
"Arguments that appeal to ignorance rely merely on the fact that the veracity of the proposition is not disproved to arrive at a definite conclusion. These arguments fail to appreciate that the limits of one's understanding or certainty do not change what is true. They do not inform upon reality. That is, whatever the reality is, it does not "wait" upon human logic or analysis to be formulated. Reality exists at all times, and it exists independently of what is in the mind of anyone. And the true thrust of science and rational analysis is to separate preconceived notion(s) of what reality is, and to be open at all times to the observation of nature as it behaves, so as truly to discover reality."
— Duco A. Schreuder, Vision and Visual Perception
Lets just put it off to 'tough love'.
I find it hard reading this convo that there is so much taken personally. Each of us has our own path and what works best for us. Missy, you have indicated comorbid issues that make therapy a plus for you. That I can understand. For those that do not have additional issues playing into their experience, I can understand the frustration over mandatory therapy. Myself I find therapy to be a waste, both as far as cost and effectiveness. It has never been useful to me, but that is me personally. Implying that there are always additional issues under the surface that need raised and addressed seems to indicate that all of us have "problems" that need to be dealt with. Some of us are simply trans, not dealing with abuse, underlying mental issues, or other pathologies. The only issue should be "Is this individual of sound mind to make decisions about their own health care?" If I can decide without a shrinks approval to have my breasts enlarged or reduced, my nose resculpted or lipo, then these decisions should be mine as well, not gate kept
I just want to clarify again that I do not hold therapy as a negative in itself, as a matter of fact I look forward to trying it out as a method to deal with the changes I may go through after I have started HRT.
Ultimately HRT is not a magic switch where the first pill turns you into another gender, it takes time, I have the ability to stop before it causes permanent changes.
I cannot know how it will effect me until I start, and since I am a regular scientist, not a mad scientist I'm going to need outside observers to give me rational feedback.
If that rational feedback (or my own rational observations) indicate that HRT is not a good choice for me, then I will have to accept that.
No amount of therapy can prepare me for the reality of actually being on HRT, so I don't see the logic in gate-keeping.
There is however a responsibility of any medical establishment to inform about the physical effects of any medication, and I think that form of counseling should be a requirement before starting any type of medication.
There is no reason that at the time of counseling the question of therapy should not be addressed.
There is a mis conception in this thread. If you run into a therapist who is a gate keeper, you should dump them as soon as possible because they are on a power trip. A good therapist is a partner in the transition and offers a check on your thoughts. They will see the flaws in your thoughts and point them out. They will teach you what you don't know. They will speed your transition and help you deal with the problems that occur. Until you have received therapy from a good therapist, you shouldn't judge therapy off a few rumors that are circulated by people who haven't experienced therapy or who ran into a bad one.
It was only because after a good deal of digging I found one of the very few knowledgeable therapist that existed at the time that what was impossible suddenly became very possible for me. Every minute with that therapist was worth far more than I paid for it.
Hi all,
I think Patrick may be right. I think there is a possibility to take things too personally. The beauty of a forum is that we can have discussions bringing up different opinions. We don't all have to agree. Just listen with respect and if we disagree, answer with respect. It is easy if upset, to lash out, and often we hurt those around us. We are a diverse community with such a "taboo" similarity that it makes us family. At the risk of sounding very parental, one thing I told my children growing up,"You can be upset with your sister(s) but remember; sometimes, they will be the only ones there to back you up."
I find the arguments so based in logic and rational thought terribly attractive. However, this is a support site. Support is often for the irrational. It's those pesky deep seated things we try to ignore that get us into trouble. Feelings and emotions. Those are part of what therapists seem poised to help us with. We can be as rational as we like but deep down we are emotional animals. I have been very rational every step along my transition, emergence, re-birth, metamorphosis... I don't know how far mine will reach but I suspect further than I thought I would need it to. Each of those logical steps, landing, observing, reacting, re-calibrating, and mapping out the next one; led me to a place where I can cry, feel and experience more of my life than I ever could in it's rational world. I am still an engineer. I still use the scientific method and logical troubleshooting steps every day. But a year into HRT and I am still finding new benefits to the therapy I started two years ago.
I have to agree with Dena. Gate keeping is ridiculous in this day and age. However, I think there are fewer therapists who fit that description than there used to be. It's your hour, make them work for you. If they are not doing the job they should, fire them and find one who will. They are there to help you work your way through this process. I think most of them would hate being just a gate keeper.
Last thought and then you can choose what to do and move on. It is a question. Are we making too big a deal out of this? I mean, the topic title suggests we are. So either it is just a rant and maybe should be moved to the category ARGHHH!? https://www.susans.org/forums/index.php/board,34.0.html
If so, maybe this topic has gone on long enough... If not, it is an interesting discussion and one many trans activists would love in on. In that case, maybe this should be in an activism topic. To a small degree though, a lot of the natural mutations arguments are kinda preaching to the choir. Lets see what can be done outside of this closed community.
Sincerly,
Joanna
Quote from: Dena on February 07, 2017, 07:51:22 PM
There is a mis conception in this thread. If you run into a therapist who is a gate keeper, you should dump them as soon as possible because they are on a power trip. A good therapist is a partner in the transition and offers a check on your thoughts. They will see the flaws in your thoughts and point them out. They will teach you what you don't know. They will speed your transition and help you deal with the problems that occur. Until you have received therapy from a good therapist, you shouldn't judge therapy off a few rumors that are circulated by people who haven't experienced therapy or who ran into a bad one.
It was only because after a good deal of digging I found one of the very few knowledgeable therapist that existed at the time that what was impossible suddenly became very possible for me. Every minute with that therapist was worth far more than I paid for it.
All good points, the problem I'm having is not with a specific therapist, it is with my insurance provider requiring me to see a therapist before I start HRT. Unfortunately I cant just drop my insurance provider. The gate-keeping is in the form of having to have a letter from a therapist before my doctor can prescribe me any medication. My doctor has already approved my being on HRT.
Quote from: Joanna50 on February 07, 2017, 08:46:16 PM
Last thought and then you can choose what to do and move on. It is a question. Are we making too big a deal out of this? I mean, the topic title suggests we are. So either it is just a rant and maybe should be moved to the category ARGHHH!? https://www.susans.org/forums/index.php/board,34.0.html
If so, maybe this topic has gone on long enough... If not, it is an interesting discussion and one many trans activists would love in on. In that case, maybe this should be in an activism topic. To a small degree though, a lot of the natural mutations arguments are kinda preaching to the choir. Lets see what can be done outside of this closed community.
Sincerly,
Joanna
This thread it is getting out of proportion to what I intended, which wasn't quite an Arghhh!?, more of a 'wtf?'. Though, I would love some interaction from the trans activist crowd so I might start it there... I have to admit, the more I involve myself in the social and philosophical aspects of being transgender, the more I'm getting the feeling of how much further we have to go. There is so much negativity surrounding and within that it is easy to lose sight of the idea that it is actually a positive thing to be true to oneself. It's supposed to make things better darn it!
I'm going to end here and go look at my new shoes that should be in tomorrow... and try to figure out how to get that musty thrift store smell out of my new and very cute leather jacket...
I honestly think that you will not have any difficulties with the therapist as long as you take the appointment seriously. If you weren't transgender, my transdar would have told me a long time ago. I actually think it a pretty good deal giving the time for a few therapy visits in exchange for having your treatment paid for. If I were offered a deal like that, I would have taken it in a second and I would have been $100,000 richer today.
Quote from: Dena on February 08, 2017, 12:34:50 AM
I honestly think that you will not have any difficulties with the therapist as long as you take the appointment seriously. If you weren't transgender, my transdar would have told me a long time ago. I actually think it a pretty good deal giving the time for a few therapy visits in exchange for having your treatment paid for. If I were offered a deal like that, I would have taken it in a second and I would have been $100,000 richer today.
"transdar" that's awesome! Very science-fictiony, "Ma'am Can you identify this alien life form?" "Yes, let me activate my transdar ray." :)
$100,000? Just... wow.
Back in the day, it wasn't the insurance companies setting requirements, it was the doctors and the surgeons. Because from their perspective, cross-gendered hormones and sex-change surgeries presented a moral quandary -- how could they prescribe powerful drugs and perform irreversible surgeries while preserving their medical ethics to do no harm? Of course I agree that we should all have the right to do what we will with our own bodies, but by the same token, no one else has to consent to provide those services on their own part.
Especially given that there are enough people out there who've suffered from their own choices, because those choices had consequences beyond understanding physiological effects and side-effects -- for there can and will be psychological consequences and social consequences, too. And, I dunno, but I think it's reasonable for a doctor or a surgeon to say that they're not in a position to evaluate whether their patients truly understand such consequences (that they lack the training for) and ask for verification from a third party who's better able to make that evaluation.
Now this is different -- it's not a doctor putting on the brakes, it's an insurance company. And they have their own obligations which are on an entirely different order entirely. They aren't just in the business of providing health care, they're in the business of making money. And it's that which creates what I'd characterize as a true conflict of interest. Aside from that, people starting hormones tend to escalate to more expensive procedures, and if they're going to be paying for that, it's in their financial interests to at least make sure those expenses aren't being doled out unnecessarily. It makes financial sense, as well as ethical sense, to put in checks and balances.
It's much the same logic for something as simple as having a dermatologist check out a bump on my back -- for my insurance to cover it, I first need a referral from a primary physician. When it comes to trans care, the referrals begin with therapists, not because this is a "mental illness" but because there are psychological and social dimensions to what we're doing; what we're doing is beyond the scope of treatments for objectively measurable medical conditions.
There's nothing "objective" going on when it comes to wanting to try cross-gender hormones. It begins with our subjectivity.
Quote from: Veda on February 08, 2017, 11:57:37 AM
"transdar" that's awesome! Very science-fictiony, "Ma'am Can you identify this alien life form?" "Yes, let me activate my transdar ray." :)
$100,000? Just... wow.
What I paid out was between $30,000 and $40,000 but by the end of the transition, I was very well paid at about $23,000 a year. Take that money and invest it for about 34 years and it should at least triple over that time period. The right investments might have done even better.
Quote from: Dena on February 08, 2017, 09:09:52 PM
What I paid out was between $30,000 and $40,000 but by the end of the transition, I was very well paid at about $23,000 a year. Take that money and invest it for about 34 years and it should at least triple over that time period. The right investments might have done even better.
Just given the rate of inflation, if you were to put 1980's dollars to 2010's dollars that would be $95K to $125K.
It just makes me think of all the Pioneer Gals (and Guys!), and how nice it would be to have a documented history that I could put on my bookshelf... Would you recommend 'Transgender History' by Susan Stryker? Would that happen to be our Susan?
Different Susan but you can find our Susan's story here (https://www.susans.org/susan-larsons-bio/). As for book recommendations, others on the site will be more knowledgable about this. I haven't looked at a book on the subject for a very long time. I have been living the life and didn't even know the books existed.
Quote from: Sophia Sage on February 08, 2017, 08:55:21 PM
Back in the day, it wasn't the insurance companies setting requirements, it was the doctors and the surgeons. Because from their perspective, cross-gendered hormones and sex-change surgeries presented a moral quandary -- how could they prescribe powerful drugs and perform irreversible surgeries while preserving their medical ethics to do no harm? Of course I agree that we should all have the right to do what we will with our own bodies, but by the same token, no one else has to consent to provide those services on their own part.
Especially given that there are enough people out there who've suffered from their own choices, because those choices had consequences beyond understanding physiological effects and side-effects -- for there can and will be psychological consequences and social consequences, too. And, I dunno, but I think it's reasonable for a doctor or a surgeon to say that they're not in a position to evaluate whether their patients truly understand such consequences (that they lack the training for) and ask for verification from a third party who's better able to make that evaluation.
Now this is different -- it's not a doctor putting on the brakes, it's an insurance company. And they have their own obligations which are on an entirely different order entirely. They aren't just in the business of providing health care, they're in the business of making money. And it's that which creates what I'd characterize as a true conflict of interest. Aside from that, people starting hormones tend to escalate to more expensive procedures, and if they're going to be paying for that, it's in their financial interests to at least make sure those expenses aren't being doled out unnecessarily. It makes financial sense, as well as ethical sense, to put in checks and balances.
It's much the same logic for something as simple as having a dermatologist check out a bump on my back -- for my insurance to cover it, I first need a referral from a primary physician. When it comes to trans care, the referrals begin with therapists, not because this is a "mental illness" but because there are psychological and social dimensions to what we're doing; what we're doing is beyond the scope of treatments for objectively measurable medical conditions.
There's nothing "objective" going on when it comes to wanting to try cross-gender hormones. It begins with our subjectivity.
Wonderful. 'first, do no harm' and 'does it make fiscal sense'... I know I'm being reductive and I'm not going to address your post by point here, but I do wonder, is there nothing 'objective' going on? Part of my decision making wasn't just about how I felt, it had to do with the physical aspects of how I have lived.
I'm reminded of an old thread I was involved in regarding machine intelligence and reproduction; it had to do with the concept of adding gender to 'robots'. My idea was based on a reductive mathematical model (game theory): That given a 'female' set that was only able to produce 'eggs' in a finite number regularly over a given time span and a 'male' set that could produce 'sperm' in a much greater quantity regularly over a much shorter period.
Of course it was a closed model but it led me to study different methods of reproduction among various species, which led me to ponder other things: What are the memetics of human reproduction and are there cases in which the model varies due to environmental pressure? Given the nature of the human brain as a 'Universal Turing Machine' and the human genetic code as an 'environmentally adaptive mechanism' what is the possibility of gender variation as a method of dealing with changing environmental conditions?
OK, going to stop here, but suffice it to say I think I may have some 'objective' reasons to start HRT.
And just to be irrational, I got my shoes and they fit well, and they make my feet feel like princess feet. Yay, new shoes!
Hi Veda,
I have already weighed in on the delay or your HRT program due to red tape.
So I'll jump right to the Important stuff. CONGRATS on the new shoes !!!!
I love my shoes I have had to sadly purge or whittle down hundreds of dollars in shoes I am terrible at self control when it comes to shoes and am always running out of places to hide them. As I write this I chuckle about one pair I hid so well months ago that I am still looking for them. Sadly I need to toss a pair of black heels that are in sad shape from over use. (They actually fit) I'm currently drooling over another pair of high heels in a black and white rose print but they won't replace the black ones.
I have a weakness for higher heeled pumps or strappy sandals, almost a fetish. Super feminine and sexy in a size 11-12. Be still my aching heart.
Lol I hope you enjoy yours as much as I do mine.
Jeanette
Quote from: Veda on February 08, 2017, 11:38:44 PMWonderful. 'first, do no harm' and 'does it make fiscal sense'... I know I'm being reductive and I'm not going to address your post by point here, but I do wonder, is there nothing 'objective' going on? Part of my decision making wasn't just about how I felt, it had to do with the physical aspects of how I have lived.
The desire to change the physical aspects of how you live are still internally motivated. As you said earlier, it's about your identity, and while that identity can't be contradicted, neither can it be confirmed. There's nothing "objective" about identity. It comes entirely from within.
There are significant differences between HRT and, say, getting a nose job; they are not commensurable. A nose job isn't going to change your basic social identity -- it might reveal that you're vain, it might make you attractive, it might even correct a deviated septum (that's purely objective), but it's not going to change your social categorization. And it's not going to change your internal chemistry. HRT typically does both -- you'll start to grow breasts, and though that's a physical change, that particular physical change has implications for the gendering you receive and hence your social categorization. It will change your emotions, a blatantly internal effect. It will change your sexuality -- primarily, it reduces the sex drive, which again can have both internal and social implications.
Personally, if your Primary Care Physician is willing to take responsibility for helping you to manage these kinds of considerations, that
should be good enough -- in that respect, I agree with you wholeheartedly. But I'd still think you'd be naive to think that an endoc is qualified to do a good job with those responsibilities. While it's entirely possible that such considerations will be easily managed entirely on your own, by the same token you won't know until they happen, and if you realize that external help from a therapist would be of benefit you've shortchanged yourself, because that professional won't have a baseline experience with you to fully understand your process. Much in the same way that it makes sense to take bloodwork before starting HRT.
So I'm not convinced that you're being as rational as you think you are. To me, it looks like you're reacting to what you perceive as some sort of stigma of working with a trained psychologist, and social stigma in general.
For example, your objection to the word "transition" as something that's "othering." While the word "emergence" is semantically nice, you're still beginning a period of transition, you're moving from one state to another -- from someone who has repressed their identity to someone who is looking to take steps to make that internal identity externalized for the rest of the world to recognize. (It doesn't matter if the identity is on the binary, or "trans," or something completely unique and new.) "Transition" is an apt word, and at some point it will be over.
Now, if you're concerned about the stigmatization of seeing a gender therapist, or of the word "transition," how will you react to the widespread stigmatization you'll receive as someone who's becoming visibly gender variant?
Finally, there's the choice
you made to work within the system in the first place. You didn't seek out an informed consent clinic, for example, and you didn't self-medicate. You worked with your insurance. And yet you didn't realize that your insurance company would require seeing a therapist prior to getting HRT. There's evidence of a lack of due diligence, then, on your part. And your doctor didn't realize that either, which should also give you pause as well.
QuoteAnd just to be irrational, I got my shoes and they fit well, and they make my feet feel like princess feet. Yay, new shoes!
There's nothing irrational about this!
Quote from: Sophia Sage on February 09, 2017, 11:43:02 AM
There's nothing "objective" about identity. It comes entirely from within.
Finally, there's the choice you made to work within the system in the first place. You didn't seek out an informed consent clinic, for example, and you didn't self-medicate. You worked with your insurance. And yet you didn't realize that your insurance company would require seeing a therapist prior to getting HRT. There's evidence of a lack of due diligence, then, on your part. And your doctor didn't realize that either, which should also give you pause as well.
First part: au contraire mon
<amie>, Identity doesn't exist without the external. Ceci n'est pas une pipe? It is an effect of the pipe, so in fact is one aspect of the pipe. ;)
Second part, I'm afraid to say that I did very strongly consider self medicating, to the point of calculating the cost of sending my own blood work to an independent lab... and I did search out an informed consent clinic, they were full for months...
Moderator's Edit: It was brought to my attention that the original post contained a grammatical error, it has been corrected. As a note to all, if you do not know a language well enough to have the proper grammar, please use a language you are familiar with. There are too many possibilities of using the wrong gender. We all deal with enough of that in our every day lives.
Quote from: Veda on February 09, 2017, 11:59:42 AM
First part: au contraire mon <amie>, Identity doesn't exist without the external. Ceci n'est pas une pipe? It is an effect of the pipe, so in fact is one aspect of the pipe. ;)
Second part, I'm afraid to say that I did very strongly consider self medicating, to the point of calculating the cost of sending my own blood work to an independent lab... and I did search out an informed consent clinic, they were full for months...
Moderator's Edit: It was brought to my attention that the original post contained a grammatical error, it has been corrected. As a note to all, if you do not know a language well enough to have the proper grammar, please use a language you are familiar with. There are too many possibilities of using the wrong gender. We all deal with enough of that in our every day lives.
My apologies. My use of the French colloquialism was an attempt at humor, and not in any way meant to hurt anyone.
Quote from: Sophia Sage on February 09, 2017, 11:43:02 AM
While it's entirely possible that such considerations will be easily managed entirely on your own, by the same token you won't know until they happen, and if you realize that external help from a therapist would be of benefit you've shortchanged yourself, because that professional won't have a baseline experience with you to fully understand your process. Much in the same way that it makes sense to take bloodwork before starting HRT.
That is it, the crux of my issue. It is a very reasonable idea to get a baseline, but, how long does it take a therapist get a baseline? I go see a therapist and they say to me, "I think we need have more sessions before I sign off on HRT." How long do I have to wait for them? I already have a baseline with myself, and the people who know me, a much better baseline than a therapist may be able to get.
Anyway, I'm going to sign off this thread as it seems to be making people upset and I just intended it as being a place for myself and others to vent.
Besides, I have new shoes to walk around in. :)
Surprise!!! My girls and I don't really care about anyone's BS