Susan's Place Transgender Resources

After this was discussed in another thread I felt the responses regarding the length of time (and people's opinions of it) required for HRT was pretty interesting and could use further discussion. The other thread was not specifically about this, it just kind of went in that direction, so I figured starting a new one just for this purpose would be appropriate (also the other thread has been locked so no further discussion will happen there anyhow). If someone has already done this please point me in the direction of the new thread, there are so many different forums on here that I took a peek around but didn't notice anything specifically that was current.

We were basically discussing how there is a 3 month waiting period that you are required to see a therapist during to be able to get your note for HRT and rather or not that was enough time or too much time. Some people seemed to feel it was too long as they've known about their identity for so long that more waiting just seemed to be more painful and sometimes unnecessary. Other's seemed to think an even longer waiting period should be put into place.

My personal opinion is that 3 months is good and appropriate for someone who has already been out and accepted their identity. For people who may not be out I think a longer period (not more than 6 months) should be taken. The reasons for my feelings are based mostly on personal experience of course. My therapist was a very good one, she specializes in trans related therapy to begin with and is very active in our community where I live (in the trans community specifically not the general community) so she has a really good understanding of the issues and challenges we face everyday. She also sees mostly all trans clients with some exceptions so all in all the point is she knows what the heck she is talking about and she is a supportive person, I haven ever had to deal with a therapist who pushes against transitioning or things like that at all, I'm sure that may have changed my view point on the subject.

In my therapy we covered a lot of issues that I don't commonly see come up in these discussions. We talked about not just how I felt, we discussed how it would change my relationship with the people in my life, what kind of support network I had built up. We also talked about one thing I always hear come up but I always hear it in the opposite form. We talked about money. A lot of people bring up the idea that someone may not be able to afford therapy sessions for 3 months or longer, to that I simply say, how the heck are you going to reasonably afford to transition? We discussed how well I'd be able to keep up on my hormones, how I'd be able to pay for them without health insurance and with health insurance. Rather or not my insurance would cover it. How steady my job was, what doctors I'd see and how much that would cost me. Since she had so many other clients she had a reasonable expectation of the financial aspects of transitioning. In the long run this therapy helped me a lot.

I chose to see her for a year before I got my note for hormones, mostly just due the fact that I had other issues to deal with and I had financial issues as well. Honestly she would have written me a note from the very beginning, at the time I started seeing her I had lived openly as male for 7 years and was completely out to everyone in my life. My family was supportive and were ready to deal with any potential changes I chose to make. More than anything the money was the issue that kept me waiting for HRT, my other issues were things like being bipolar and needing medication for that plus therapy for particular traumatic events from my childhood. Those issues didn't resolve that I was trans and had nothing to do with my identity, she accepted that from the beginning and never treated me like I was there for therapy just for the purpose of transitioning. She knew that was a part of why I came but that my being transsexual was not my issue, therapy would just also meet that requirement for me and get it out of the way when the time came to being physical transition.

Anyhow, long story short, my point is that I appreciated the waiting time (if I had not had other issues the 3 months would have been fine with me) because it gave us the chance to talk about the reality of my situation in aspects I had never taken into consideration. The financial discussion helped my choices a lot and in the end were very necessary.

What kind of things did other people deal with in their 3 months of therapy before HRT and how did you feel it helped you as you began transitioning physically? Would you feel differently about the waiting period if you had a therapist like I had who was open and experienced with trans clients?

Therapy ($100 per week or so) is more expensive than T, correct? So if that's all one intended to do, therapy would be a burden.

Can't speak for everyone of course but my father is the only one in my family with a car. He also works 12+ hours a day and cannot afford to take time off of work. For me, therapy is inconvenient. I had to go to my therapist and we basically talked about nothing (not trans issues, just general news and unrelated stuff etc.) because I had to get the required visits first. Two months of talking about basically nothing in therapy does nothing except waste my family's money and time. She already confirmed that she didn't see a reason not to write the letter before that.

If only therapists could decide on a case by case basis. But we can't trust people with that kind of power, can we?

Quote from: Silver on September 11, 2010, 02:43:17 PM
Therapy ($100 per week or so) is more expensive than T, correct? So if that's all one intended to do, therapy would be a burden.

Can't speak for everyone of course but my father is the only one in my family with a car. He also works 12+ hours a day and cannot afford to take time off of work. For me, therapy is inconvenient. I had to go to my therapist and we basically talked about nothing (not trans issues, just general news and unrelated stuff etc.) because I had to get the required visits first. Two months of talking about basically nothing in therapy does nothing except waste my family's money and time. She already confirmed that she didn't see a reason not to write the letter before that.

If only therapists could decide on a case by case basis. But we can't trust people with that kind of power, can we?

Where I am there are lots of therapist who work on sliding scale. The one I saw normally costs about $100 and hour, she saw me once a week for $25, when she wanted me to see her twice a week (due to my other mental health issues) she changed my fee to $15 for each visit. Some people only see their therapist every other week, some only once a month.

There are a lot of other expenses to take into consideration that are different from person to person. It costs me about $500 to get my blood work done, I had to get it done before I started and then once a month for the first 4 months. After that I had to do it every 3 months for a year, then every half a year for I don't even know how long... we are still at that point and I've been on T for 3 years lol.

If I buy my T through a local store it costs me about $120 for a vial that lasts about 4 months, then of course the additional $10 or so for needles and supplies if I do the shots myself. If I can't do the shots myself I can go to my doctor and pay $10 each week to have them do the injection once I buy the T from the pharmacy and bring it in to them.

There are also the fees just to see the doctor to begin with, which also changes from each provider.

Some communities have places that help pay for blood work or do it for a discount, some don't. Some people (like myself) have access to mail order pharmacies and can get their prescription for a lower cost. Some have to pay more for shipping than other people. Some people have to buy it at certain pharmacies for reasons like insurance or convenience.

All in all for me personally I would have spent $300 on therapy by the time I got my note had I only been going or this purpose. I then would have had to spend about $150 on my first endo appointment and then $500 for blood work. I then had to come back after they got back those results on my natural levels of freaking everything under the sun that could possibly be in my body (it feels that way sometimes lol). So there's another $150 and then about $130 for the prescription and supplies. Just to go back a month later and pay another $150 and another $500. I had to pay $1,580 to get through one month on T if you include my initial visit to even get it prescribed. Even had I been paying full price for therapy it would only have come up to $1,200 for 3 months. At my discounted cost I actually paid $300 for that 3 months.

Keep in mind my insurance covered NONE of this. They would not cover my therapy until I was with them for a year because I had other mental health issues and they considered it needed due to pre-existing conditions.

Personally, I think it is difficult to call.....I think it should not be a mandatory ... I think we should allow doctors to make the call based on their medical knowledge.

For example, when I was at the transmedical conference in St. Paul, MN.  I meet some folks who were 50+ years old and they were transitioning....I think they had a full grasp of the consequence.  Plus if your that old I don't think you need permission from someone to alter their body.  I mean seriously there is not a requirement for plastic surgery.

However, when our son told us he was trans ... we insisted on counseling...not b/c we doubted his transition but because he really hadn't experienced life and we wanted someone to ask the hard questions -- how are you going to pay, how is this going to change your life etc.  He is just 21 years old.

Now for me....I am starting to transition... and when I go see my primary care doctor I am going to ask about starting hormones....she has been my doctor for over five years & I see her at least 3-4 times a year sometimes more often.  She knows me pretty well.  She will know me far better than any therapist will get to know me in 3 months.

That being said my wife works with the primary ftm doc in town & she knows our family...she didn't require a letter for our son to start hormones...she knew that he had the support system & the knowledge -- we made him do it.  She would likely give me T too if I asked ... but I would prefer to use my primary.

I think we should trust the profession that are trained and let them decide and not have a minimum.

After waiting over 40 years already, I could have done without the year long wait  :P

You know you don't have to take hormones and transition they arn't ubiquitous facts, lord knows for me having a correctly functional endocrine system for the first time in my life really allivated alot of the pain I felt about my gender dysphora. If I had large responsibilities in my life kids or I was otherwise extremely unpassable and was enjoying my job that frankly I may loose if I were to transition right then... I might not want to transition any time soon yet under the current system I would also be denied medicines that enhance my quality of life and sanctity of my mind massively.

I think hormone blockers should be available upon request after the first session if there is some degree of confusion about there identity to alleviate some of the anxiety they might be feeling as there isn't really any long term consequences to taking them over the short run and it would provide a useful diagnostic tool to those medical professionals. Sex hormones can be provided later once a clear direction and plan for transition has been established and the ability to cope with the physical changes can be ascertained.

I don't think there should be any specific mandatory waiting period. I think that people, in general, know when they're ready to begin to change physically.

What I do think is important is that the therapist or other professional point of contact for a trans person (1) work with their client to help identify what, if anything, needs to change in their life in order for them to be able to complete a physical transition safely in a stable environment (this definitely involves coming out to important people, name changes, etc and for some people might involve securing stable housing and employment, moving out of a spouse's or parent's home, divorce, or other things), (2) help their client make those changes, and (3) make sure their client has accurate information about what exactly he or she can expect from hormones, how fast the changes may be, and how this could affect existing relationships and other life factors.

This could take some time. But it would be very little time for someone who's already out and socially transitioned, or quite a long time for someone who presents as a secret crossdresser questioning their identity. It's individual. I think the focus should be on what is accomplished in the therapy or counseling, not how many months it takes to accomplish it.

I feel that HRT should be ussed as a diagnostic tool. I KNEW 100% that I was right about my gender on the third day of DIY HRT. If I had not aquired HRT prior to everything else I couldnt have moved on. My therapist works on a slidinscale and I am paying 125$ per session. I feel that is definalty prohibitive I can bearly afford it honestly. HRT is cheep in comparison.
I am not alone in this, there are doctors who advocate HRT as a diagnostic tool.

HRT only took me a very short amount of time to verify what I have known since childhood.

My therapist made me wait 3 months before she would give me an HRT letter, but my family doctor was giving me HRT to stop me from DIY.

If I had to wait the entire 3-4 months I might not have made it. I litteraly kept pushing transition away for so long that it was transition NOW or die by the time I finaly had come out.

Maybe a one size fits all aproach is what is wrong. For some a 2 year wait would seem to be indicated and others seem to need treatment imediatly.

One thing we must remember is that medical professionals have both a moral and legal obligation to care for the mental and physical health of their patients.  To prescribe treatments based on the feelings of the patient would be fool hardy to say the least.  I know that many of us believe we know what's best for us, but lets face it we tend to wear blinders and often the wait time seems intolerable.  The way I approached this is by realizing that transition was just a period of time I needed to endure to ensure being happy with/for the rest of our lives; These things never seem to happen fast enough, but it's a small price to pay when you look at the big picture.

Steph

Quote from: Steph on September 12, 2010, 08:34:57 AMThese things never seem to happen fast enough, but it's a small price to pay when you look at the big picture.

Amen to that.  Although, when I look back on the last 3 months, the amount of progress I've made (despite a non-supportive wife) astounds me.  There are things with seemingly huge delays built in.  For instance, back in July, I went to my family doctor and asked for a referral to the Gender Identity Clinic at CAMH for assessment.  This I saw as a necessary step.  Well, I didn't hear back from them at all for 4 weeks, when I received an intake questionnaire.  At first, those four weeks seemed like forever, but by the time I got the questionnaire, I had largely stopped thinking about "When will I hear from them?", and when it did arrive, it was almost a small shock... "It's HERE!  (gulp)"  I sent it back to them on Sept. 3, and I'm told to expect a 4-week delay till I get an appointment, which will then be at least 3-4 months in the future.  All of which seems like a LONG time to wait just for an assessment appointment, but in the meantime, I can explore hair removal, cross dressing, have talks with my wife, see my therapist, etc.  There's a LOT to do during that time. 

Being 54, at first when came out to myself, I was worried I'd left it all too late.  I feel a lot better about it now.  I know my time will come.  But I do think that perhaps age should be one of the factors in deciding how quickly someone can access hormones, etc.  A 2-year wait for a 54 year old is not the same thing as a 2-year wait for a 25 year old...

Quote from: Cowboi on September 11, 2010, 02:28:12 PM
My personal opinion is that 3 months is good and appropriate for someone who has already been out and accepted their identity. For people who may not be out I think a longer period (not more than 6 months) should be taken.

I agree. It also depends a whole lot on the person, any other pre-existing issues, and where they are now in life (emotionally, economically, etc). I've been living full-time for several years prior to seeing a psychologist, so when I did for the first time, it was not a big life changing experience it is for some. The psychologist was cool, down to earth and basically told me on my second visit she would be writing me my letter as soon as the 3 month limit was over, which I was very happy to hear. No big deal. Some docs it seems, really like to stretch out and prolong the process, even when it is abundantly clear a person has GID.

Off on the deep end.....

So, I have been thinking about this topic a lot recently ...and I have come to the conclusion ... which might be way out there for most of you ... why do we care if someone changes their gender?  Why is there so much wrapped around it all?  We allow people to alter their bodies in all sorts of ways -- tattoos, body piercing, splitting tongues, plastic surgery ... personally, if someone wants to change their body why does someone else have to give approval when in so many other ways we don't monitor or control body modification.

I know some would argue that it's a life changing experience and there is a lot that goes on with it ... but seriously would anyone selectively choose to go through all that if he/she really didn't feel it necessary?  Take medications for the rest of their life?  Save up tons of money for surgies that insurance won't cover.

I don't know .. and I imagine most would disagree with me..but I just feel people should have complete control over their bodies and not be forced to get permission from another person to do it

I am with you on this one Rob.
It is not anyone elses body. Let people do as they will. If they make a bad choice such is the way of life.

My wife made this point once...
If society allows this guy to do what he has with his body without any requirement for phychiatric intervention why do I need to do so to physicaly change my gender.

http://www.google.com/imgres?imgurl=http://samdasilva.files.wordpress.com/2010/03/lizard-man.jpg&imgrefurl=http://samdasilva.wordpress.com/&usg=__eUXcMnPb28hynaas5MXEmz0MwuU=&h=1000&w=682&sz=114&hl=en&start=13&zoom=1&tbnid=N0nPZ5x_qyzOfM:&tbnh=144&tbnw=98&prev=/images%3Fq%3DLizard%2Bman%26um%3D1%26hl%3Den%26sa%3DN%26rls%3Dcom.microsoft:en-us:IE-SearchBox%26biw%3D1076%26bih%3D466%26tbs%3Disch:1&um=1&itbs=1&iact=rc&dur=533&ei=J_CMTL_jNIXSsAPs6629BA&oei=F_CMTIvNMZDmsQPVvZGmBA&esq=5&page=2&ndsp=12&ved=1t:429,r:6,s:13&tx=41&ty=83 (http://www.google.com/imgres?imgurl=http://samdasilva.files.wordpress.com/2010/03/lizard-man.jpg&imgrefurl=http://samdasilva.wordpress.com/&usg=__eUXcMnPb28hynaas5MXEmz0MwuU=&h=1000&w=682&sz=114&hl=en&start=13&zoom=1&tbnid=N0nPZ5x_qyzOfM:&tbnh=144&tbnw=98&prev=/images%3Fq%3DLizard%2Bman%26um%3D1%26hl%3Den%26sa%3DN%26rls%3Dcom.microsoft:en-us:IE-SearchBox%26biw%3D1076%26bih%3D466%26tbs%3Disch:1&um=1&itbs=1&iact=rc&dur=533&ei=J_CMTL_jNIXSsAPs6629BA&oei=F_CMTIvNMZDmsQPVvZGmBA&esq=5&page=2&ndsp=12&ved=1t:429,r:6,s:13&tx=41&ty=83)

QuoteA lot of people bring up the idea that someone may not be able to afford therapy sessions for 3 months or longer, to that I simply say, how the heck are you going to reasonably afford to transition?

On the other hand, let's say a lot of FTMs meet their therapists once a week for three months (paying full price and about the same amount that I paid) before they can get an HRT letter. Then another six months or so before they can get a top surgery letter. This sort of timeline is not at all uncommon. Sometimes it stretches on for longer.

If we go by the amount I paid (or would have paid, for things covered by insurance), the amount that they spend on therapy alone would have covered two evaluative therapy visits, the expensive initial endo visit, a round of blood work, a full year of T, a pre-op exam/blood work, and about half of top surgery.

I can't speak for the women, of course.

Quote from: Rob on September 12, 2010, 09:54:24 AM
Off on the deep end.....

So, I have been thinking about this topic a lot recently ...and I have come to the conclusion ... which might be way out there for most of you ... why do we care if someone changes their gender?  Why is there so much wrapped around it all?  We allow people to alter their bodies in all sorts of ways -- tattoos, body piercing, splitting tongues, plastic surgery ... personally, if someone wants to change their body why does someone else have to give approval when in so many other ways we don't monitor or control body modification.

I agree 100%.

Quote from: Rob on September 12, 2010, 09:54:24 AMI know some would argue that it's a life changing experience and there is a lot that goes on with it ... but seriously would anyone selectively choose to go through all that if he/she really didn't feel it necessary?  Take medications for the rest of their life?  Save up tons of money for surgies that insurance won't cover.

I don't know .. and I imagine most would disagree with me..but I just feel people should have complete control over their bodies and not be forced to get permission from another person to do it

I agree with most all of this, unless there is a pre-existing issue like depression, other mental issues, etc. that would affect a persons decision making abilities.

Quote from: Arch on September 12, 2010, 11:05:25 AM
On the other hand, let's say a lot of FTMs meet their therapists once a week for three months (paying full price and about the same amount that I paid) before they can get an HRT letter. Then another six months or so before they can get a top surgery letter. This sort of timeline is not at all uncommon. Sometimes it stretches on for longer.

If we go by the amount I paid (or would have paid, for things not covered by insurance), the amount that they spend on therapy alone would have covered two evaluative therapy visits, the expensive initial endo visit, a round of blood work, a full year of T, a pre-op exam/blood work, and about half of top surgery.

I can't speak for the women, of course.

Cost. This is another point I think many need to factor in to the whole process. You honestly don't realize how much all this is going to cost until you're in the middle of it. And some therapists as you mention, can unecessarily add to it. Not cool.

Quote from: cynthialee on September 12, 2010, 10:20:27 AM
I am with you on this one Rob.
It is not anyone elses body. Let people do as they will. If they make a bad choice such is the way of life.

We should all be free to make and learn from our own decisions, but there should definitely be a mental health screening process, and a period of time in which the patient is evaluated to ensure that what they experience really is GID.  I know that the label gets passed around when it doesn't belong, but there have been documented cases in the medical literature of patients who were gender dysphoric and thought that they had GID, but ultimately had another issue; I read a paper recently about a schizophrenic woman who wanted to live as a man, whose dysphoria cleared up after a round of antipsychotics.  I'm not saying that every trans identifying patient should try anitpsychotics, or aversion therapy, or whatever before beginning their transition, but there should definitely be an evaluation period to ensure that the patient is in the right mind to begin HRT. 

I didn't do three months of therapy before HRT. I did six. And one could easily argue that it was the equivalent of a year because I was going twice a week. But I knew after about four months (or eight, if you double again) that I needed HRT, and my therapist agreed to write me a letter at that point. Of course, I wasn't planning to actually start HRT for a couple of months. I spent that time grappling with the implications and possible future consequences of my decision.

I needed that time. I knew perfectly well after twelve or thirteen visits that I was not ready for HRT.

I like the informed consent model in theory, but not as much in practice. I honestly think that everyone should see a therapist for at least a couple of sessions. What we're doing is pretty radical, and sometimes we get so close to our problem that we cannot see clearly.

Arch - you needed the time and you knew that. I need some time - and am taking it right now - and I know that. But there's no reason to think that everyone needs the same amount of time or that the time can only start after the first therapy session. Some people like to work things out with the help of a therapist. Others, though, like to work things out in their own heads before talking to strangers about them. And some of us like to work things out entirely in our own heads, but with the occasional discussion with a professional to make sure that what we're coming up with is practical.

I think people in general know what they need, or can figure it out if their mental health point of contact asks the right questions. And if someone already has it worked out, has done their research, grappled with the implications, come out and explained to their loved ones, all the necessary stuff before even talking to a therapist, then why impose an artificial waiting period?

Quote from: kyril on September 13, 2010, 06:34:52 AM
I think people in general know what they need, or can figure it out if their mental health point of contact asks the right questions. And if someone already has it worked out, has done their research, grappled with the implications, come out and explained to their loved ones, all the necessary stuff before even talking to a therapist, then why impose an artificial waiting period?

The waiting period is a guideline only. I think that therapists should be much more aware of this than they are. But I still think that everyone should be evaluated before they start.

I know a therapist here in town who seems way too eager to be everybody's friend...this person would see a guy once and give him the letter on the second visit. While I was active in the community, the therapist did this a number of times. And a few of those guys, in MY opinion, needed real counseling before they bopped off and started HRT. They had some major issues, and from what I hear, they still do. I don't think this therapist served his/her clients well.

So I guess I feel that if you're going to do informed consent, then fire away, damn the torpedoes, take responsibility for not going the therapy route. But if you're going to do therapy, you should have at least a few sessions so that the therapist can be responsible and thorough. I don't feel that three months serves everyone equally well, but I also don't believe that a therapist should just dispense HRT letters like candy.

I think it should be up to the therapist to write the letter, and I'm pretty sure that's how it works. I started therapy July 12th and since then I've had 8 sessions, and today will be my 9th. (9th woulda been last week but he was on vacation) and I'm pretty sure I'll be getting my letter today. I ask my therapist two weeks ago when I could start hormones and he said whenever I felt ready and I told him I'm ready, I had been ready for a few weeks. So he gave me the info of this doctor at planned parenthood and I have an appointment with her on the 29th!! AHHHHHHHHHHHHH

Quote from: kyril on September 13, 2010, 06:34:52 AM
Arch - you needed the time and you knew that. I need some time - and am taking it right now - and I know that. But there's no reason to think that everyone needs the same amount of time or that the time can only start after the first therapy session. Some people like to work things out with the help of a therapist. Others, though, like to work things out in their own heads before talking to strangers about them. And some of us like to work things out entirely in our own heads, but with the occasional discussion with a professional to make sure that what we're coming up with is practical.

I think people in general know what they need, or can figure it out if their mental health point of contact asks the right questions. And if someone already has it worked out, has done their research, grappled with the implications, come out and explained to their loved ones, all the necessary stuff before even talking to a therapist, then why impose an artificial waiting period?

I just feel like I need to reiterate; there are definitely instances in which a person is mentally ill, and is not in the right state of mind to be making permanent changes to their body or life.  There are certainly situations of schizophrenic patients (mis)identifying as transgender; there are also certainly situations in which people with legitimate personality disorders have wanted to make changes to their bodies that they might regret if given treatment.  If I were a medical professional, I certainly wouldn't let a mentally ill patient say, remove all their teeth; it would be self mutilation.  Transgendered individuals changing their bodies are doing so out of a medical necessity, but done under the duress of mental disorder, the mutilation label absolutely fits. 

Quotewhy do we care if someone changes their gender?  Why is there so much wrapped around it all?

A few days ago I thought there should be like a 4 yr life expireince for ppl under 18 before  hormones. But after reading that it clicked. This reminded me of what my endo said "There are some ppl out there that think what were doing here is immoral and what he is doing is wrong". I am his first trans patient he is treating, he has other trans patients but they seem unsure they haven't requested hormones quite yet.

I don't want someone to tell me how I and what I should do to my body. who cares if Sally in georgia is getting estrogen. I understand that a 14yr old kid may not understand the consiquences and neither may there parents, but I guess who cares. If they change there mind after 5yrs of hormones and get breast surgery then that's there deal. What is the difference between a full body lift, breast implants, rhinoplasty compared to HGH and SRS. HGH and SRS are drastically improving the lives of people. I don't think anyone is gonna die from lack of breast implants. For many trans ppl it's either surgery or suicide. Hormones is your first step.

Kind of a random note, one person brought up the fact that we need to keep in mind health care providers are legally responsible for us as well. One of the issues with informed consent comes into play with the idea that there COULD be other issues.

For example someone who is mentally ill could easily do informed consent and never once bring up their mental illness, or may not have even been diagnosed. Years go by, person is unhappy with the results for whatever reason, they later get diagnosed with a mental illness. Now who is at fault? Depending upon the mental illness the doctor is. They could have gone through with HRT or SRS based upon the informed consent of someone who has a disorder that prevents them from making life changing decisions in a rational or reasonable way, having never gone through with therapy the doctor may have had zero signs this individual had any illness at all. This patient could then turn around and sue the doctor, while informed consent was obtained it was obtained from someone who may have not been (or simply could claim they weren't in) a clear state of mind.

Not all mental illnesses or emotional issues can be assessed by sitting in a room with someone for 20 minutes explaining a procedure and getting documents signed. I personally know someone who has seen doctors for years and they STILL have to change his diagnosis every few months because he is so good at hiding his issues intentionally and sometimes just unintentionally. He also happens to be trans. This guy states over and over again to any medical professional within reach that he's trans, that he's ready and now he's on hormones. In his personal life he still tells people he isn't sure. He tells mutual friends that I forced him to live as trans when we were a couple, which is very very far from the truth. Story was simple, I had a girlfriend and we got married, one day my wife told me she was trans too, I accepted this and stayed eventually the relationship ended for a mixture of reasons but not due to gender identity. Now he tells people I made him do this because I wouldn't love him if he didn't? Honestly, I loved him more when he was a woman... but that's just because I'm a straight guy lol. Personally I'm not even sure he is trans at all, his huge emotional/mental break began at the same time he chose to come out to me. It was really his mental issues that eventually drove us apart. We were together for a year with no signs of issues before he came out and then started displaying several signs of mental illness including a complete change in personality, family values, the ways he treated people both in his life and strangers... tons of craziness all at once. He is most likely schizophrenic, it runs in his family.

That is just one person. What about the stories of people who went through therapy and still ended up not making the right choice?

I think it's easy for all of us to look at our own experiences and say it should be this way or it should be that way, but the medical system and the legal system does not work that way (at least not in America). Maybe it isn't a matter of looking at people who change their bodies in other ways and saying "Hey we should be allowed to do that too!" Maybe some of them should be required to meet certain standards and guidelines as well to achieve their goal.... maybe they got what they wanted too easily and without anyone questioning why. I'm sure there are plenty of women with boob jobs who did it for reasons like self confidence who could have gotten counseling instead. I'm sure there are a million other examples of people altering their physical appearance that could have been dealt with in a reasonable manner instead of undergoing alteration surgeries that may not be reversible and may not make them happy in the end anyhow.

I think that at least some therapy is necessary, and as someone else mentioned, 3 months is a guideline not an actual requirement... a therapist can choose to not hold you to those standards. Most are aware of that, but they aren't going to admit it, they don't want to be liable for anything you make a wrong choice on because they didn't follow the standards with you as a patient.

I made the vow when I got married...'In sickness and health'.

Mental illness is a sickness. I could not leave a mate for becoming mentaly unstable.

Quote from: cynthialee on September 14, 2010, 07:33:24 AM
I made the vow when I got married...'In sickness and health'.

Mental illness is a sickness. I could not leave a mate for becoming mentaly unstable.

You don't really know what all mental instability includes so you can't honestly say that. When you marry a kind gentle person and they turn into a selfish, drug abusing, self hating person who pushes away their entire family and becomes a stranger to you then begins beating the hell out of you on a daily basis including things like throwing TELEVISIONS at you.... well your opinion might change.

By the time I got out I was flat out told by cops and my family to never ever let this person in my life again. For 4 years I tired to be his friend, always coming when he needed me, always giving him a place to stay, ensuring he had food, clothes and a roof over his head. In the end he always went back to the streets, always told me he hated me and didn't need me, threw some punches and ran away. Always letting me sit at home worrying if he was dead or alive. Manipulating every single situation in his own mind to be the victim of it rather than the person who caused it and acting as if this was the mater of fact way that it happened. When we were alone he'd apologize to me, if anyone else was present he'd cry and whine and scream until they believed I was the one who treated him so poorly.

Saying you wouldn't leave someone for being mentally ill is easy to say when you've never dealt with it. When you have a very happy childhood and life then one freaking relationship makes you capable of reading books like "A Child Called IT" and RELATING to the character because your spouse has done a lot of the same things to you.... well you may feel differently then dear.

I think that it's important to help your partner work through the bad points, but if they don't want to help themselves, how can you be expected to do it for them?  If I had a mentally ill partner who was genuinely working to get better I would stand by them, but if they were spiraling out of control and simply didn't care, or liked the volatility and hostility, I can't see myself staying.

On another note...  The medical professionals who are charged with providing for and caring for our mental and physical health have much time and money invested in this thing they do.  Why should they jeopardize that because some starry eyed individual does not have patience.  It's almost typical of todays society, the "Me Now" generation, the "I know what's best for me" crowd, the "Why is my problem not on the top of your list Mr Doctor" bunch, "Screw things up and I'll SUE your arse".  Well folks welcome to the real world, doctors need protection as well cause the rules were put in place to ensure that idiots don't die.  Sheeeesh, frig! Even after transition you're gonna have to wait for things.  I have an 8 month wait just to see my OBGYN, and that's for a regular check up.  Slow down sweeties, good things come to those who wait.

Steph

/Rant off

Quote from: Steph on September 14, 2010, 04:33:21 PM
Even after transition you're gonna have to wait for things.  I have an 8 month wait just to see my OBGYN, and that's for a regular check up.  Slow down sweeties, good things come to those who wait.

Seriously! I'm bipolar and at this point by the time my appointment with a new doctor rolls around it will have been over a 3 month wait, and that is for an appointment for a mental disorder that can prevent you from functioning in any sort of reasonable manner at all. If I mess up between now and mid October when I finally get to see someone I could loose my job or worse, so I have to watch myself and so does my partner to ensure that I stay on track until then. It isn't a simple task it's an all day long every single day concern because my meds aren't currently working so the only help I have is myself and the people in my life until I get to the doctor.

You have to wait for everything, you have to pay for everything, and rather we like it or not you even have to pay for and wait for the portions of treatment you just don't care for, desire or feel you need. It isn't always about our protection, sometimes it is about the protection of other's like the doctors and therapists. Their lively hood depends on NOT making a mistake that could cause them to loose their job or license. For me that would be enough of a reason to make everyone follow the letter of the law rather they liked it or not if I were in their shoes.

Quote from: long.897 on September 14, 2010, 02:14:12 PM
I think that it's important to help your partner work through the bad points, but if they don't want to help themselves, how can you be expected to do it for them?  If I had a mentally ill partner who was genuinely working to get better I would stand by them, but if they were spiraling out of control and simply didn't care, or liked the volatility and hostility, I can't see myself staying.

Thank you, this is the difference in between my situation and many others. My partner didn't want help, it's been 7 years since we first married and he still has never gotten help. When it seems like he is finally going to do it he uses that help for things like being diagnosed with disorders he does not have to get certain prescriptions to use to get high or sell to other people (he has a background in the medical field so he knows how to fake it to get what he wants). There has always been an alternate motive behind his cries for help, never once has he actually made any attempt to better himself or his life.

When I have tried to be his friend and have him in my life to help him he instead screws up everything I have going for me. It is literally to a point where had I not cut him out of my life I would have lost my own family, I gave up many friends when I was with him and only some am I lucky enough to be getting back now years later.

I am willing to stand by my partner but I am not willing to allow them to tear my life apart at the seams over and over again when they are not even willing to work towards getting better. No matter how much you love someone there is always one thing to remember, the first and last love is self love. In the end you are the only person you are guaranteed to have, there is a point where you have to take care of yourself and stop trying to help someone else. I almost lost everyone in my life and lost my home before I let my partner go.... looking back I can honestly say it was not worth it. He was not worth the life that I put on hold and gave up for him.

You make some big assumptions about me Cowboi.
I live with a spouse who has issues, I would not even imagine leaving over mental issues. I have been in a relationship that was downright abusive. I never left them though. I was left, I didnt do the leaving. I tried my hardest to make it work.

I stand by what I said.

Quote from: cynthialee on September 14, 2010, 08:59:02 PM
You make some big assumptions about me Cowboi.
I live with a spouse who has issues, I would not even imagine leaving over mental issues. I have been in a relationship that was downright abusive. I never left them though. I was left, I didnt do the leaving. I tried my hardest to make it work.

I stand by what I said.

Then all I can say is that is a sad way to live. Having been there myself I know how hard it can be and after having done it I would personally never choose to stay in that situation again. Either way this thread is not about abusive spouses, the original commentary was unnecessary and has only lead to a useless side conversation where neither of us are going to agree anyhow. So lets agree to disagree, I know you have to be strong to stay but I also know how much it took to get out of the situation, either path takes a strong person assuming that the person is making the choice and doesn't feel stuck. It takes a strong person to actively try to make it work, it takes a strong person to know their own limits and walk away from something that has become unhealthy for them.

Not to derail, side track or distract from the thread any further... But I'm dang curious about that cute lil' doggy in your avatar

Is it yours? have you more pic.s? I think there is a pet picture thread

I will have to look for the pet pictures thread. That is my little boy Cruiser in the avatar pic, he's an Italian Greyhound. And of course I have TONS of pictures... I am one of those my pet is my child people.

There are a lot of people who absolutely need HRT immediately, and a long mandatory waiting period could kill them.  I understand that there are apparently people here who actually felt like they could wait years and years before starting hormones, but some of us were borderline suicidal by the time we were asking for hormones.

I also think that people who desperately need HRT immediately greatly outnumber people who are confused but somehow able to hide it from therapists.  I understand wanting to make sure a few confused people don't transition when they shouldn't, because they might hurt themselves, but I don't understand taking precautions that would almost certainly cause other people to hurt themselves, which is what a mandatory waiting period does.  Besides, if someone can pretend to need HRT for three months straight, they could probably pretend for a year.

Three months is a bit too long, and I honestly, literally think that any mandatory period longer than that should be treated as a human rights abuse.  Therapists should be able to encourage patients to wait if they don't seem ready, but not require it.

If a confused person goes on HRT and realizes they didn't want it, they can stop the treatment and generally be okay.  (They'll have a deeper voice and facial hair if they were on testosterone, but us trans women manage just fine.  And if they were on estrogen for a short time, there probably won't be any major effects.  Even if they were rendered sterile, it's not that big of a deal, since they don't need fertility to live.)  Whereas if a desperate person is denied HRT and commits suicide, there's no way to reverse it.

Quote from: Mara on September 22, 2010, 09:04:50 AM
There are a lot of people who absolutely need HRT immediately, and a long mandatory waiting period could kill them.  I understand that there are apparently people here who actually felt like they could wait years and years before starting hormones, but some of us were borderline suicidal by the time we were asking for hormones.

Hi, Mara. I'm not sure what you consider "long." Or even what you mean by "immediately." Late in your post, you say that three months is too long; but it's only a recommendation, and therapists don't have to abide by that.

But therapists do have to be responsible, and they have to cover their asses a bit. If a client is borderline suicidal, then the therapist has to weigh priorities--take enough time to properly evaluate the client, but also help the client get through the rough period and not become actually suicidal. If a client is actually suicidal, then that person should probably be hospitalized, not automatically given a letter. I don't think it's a good idea for therapists to write HRT letters for a suicidal person if the therapist hasn't had a good chance to sort out the client's sanity, stability, issues, and needs. And all of that has to be evaluated case by case. While it's true that transsexuality should be largely self-diagnosed, the therapist does need to be convinced that the client knows what he or she wants, is stable enough to decide, and is ready to pursue it.

I think a lot of people forget how powerful hormones are. We tend to think, "We need to save the people who need HRT right away and might commit suicide without it. Hey, if it's wrong for you, you can just stop." What about the unstable people (and I've known a couple) who could be harmed by HRT or who are just as unstable after starting HRT and can't make good, informed choices? Can we honestly say that immediate HRT saves more people than a judicious waiting period and a bit of psychotherapy? Even if we can, is this a responsible policy overall? You talk about desperate people who are denied HRT; isn't that a separate issue? Aren't we talking about desperate people who are being asked to wait for a short period before being approved for HRT?

Perhaps informed consent should be more prevalent than it is. Then it's all on the trans person.

I guess I have several points. If you have access to informed consent, fine, go for it. But if you're going to go the therapy route (even if that's your only choice), then remember that the client isn't the only person who can be affected by the decision to start HRT. I don't think we can assume that HRT won't badly affect certain people, and I have mixed feelings about the argument that it's better for suicidal people to immediately go on HRT (that's what you seem to be saying). I think such people should be hospitalized and properly evaluated if they're that unstable.

I feel that therapists should be responsible to their clients and sensitive to trans people but not unduly jeopardize their own career and livelihood. They should prioritize the client's needs and well-being over their own pocketbook, and they should recognize that three months is only a recommendation and is too long for some clients. And I think (along with you, I think) a lot of therapists just don't do that. But if they don't, they're too cautious, too controlling, too uneducated about trans issues, or too dogmatic about the SOC. Maybe they shouldn't be in practice at all.

I'm at the point where its been 12 months since i first went to see my G.P. I saw a gender specialist three times and have had my first assessment at the gender clinic and will have my 2nd in October. I'm 38 years old- apart from my name i have more or less been living full time since i was 17 when i first realised that there was a word for people like me. Even if you discount me getting pregnant at 19 tonprove to myself that female body equalled female i ve still been virtually full time since i was 20. Yet i come on here and find others who are in different parts of the UK and the rest of the world being given T on their 2nd appointments or after 3 visits to a therapist and while i understand that everyone is different; the fact that a time line for T hasnt even been mentioned to me is really bringing me down. While i'm really pleased for those who are getting it i'm jealous as hell. Theres even a chance i may have to do another 2 yrs RLE before i get T. I think our wishes must be taken into consideration, and this isn't anything against the younger ones; but especiaally us older ones who have had a lifetime of working things out and sorting it all out in our own heads before we go anywhere near the professionals. I know i'm ready for hormones and surgery- someone telling me ive got to wait even longer isnt really what i need

I kinda hate it but I understand why it's there. Can I wait? Maybe for about two more weeks but after that I'm pretty sure I'll go insane if I don't even have my letter...

I think it's retarded. I don't accept that I should be seen as too mentally incompetent to know what I want, I don't accept the system as it exists today, I don't accept that I should be punished for the mistakes of other, I don't accept the principle of people trying to save me from myself.

Because of that, when doctors screwed me around too much, I self medicated until they realized that their word is not the final one, which was pretty damn fast.

That's how I feel about the waiting period for HRT.

People do way too much trying to protect other people from themselves.

Quote from: Ashley4214 on September 23, 2010, 08:42:53 PM
People do way too much trying to protect other people from themselves.

I couldnt agree more!

Let me try to draw an analogous situation.

Suppose a patient visits their GP, and complains of severe, chronic pain.  The patient tells their GP that they have lived with it for years, it isn't getting better, and that if they aren't immediately treated with narcotics, they may kill themselves.  Should the GP prescribe the drugs?

It should be evaluated on a case by case basis.  There are certainly some patients who are in immediate need of narcotics, just as there are some transpatients in immediate need of hormones.  There are also, however, some patients who believe that they desperately need these drugs, but are mistaken.  It's the doctor's responsibility to prevent the patient with histrionic personality disorder from obtaining hormones just as much as it is their responsibility to keep psychologically addicted patients from receiving opioid drugs.  In either case, the prescribing doctor would be culpable for damages incurred by the patient due to their negligence. 

Should the 3 month period be a concrete rule?  I say no, but I think that it's a guideline that professionals should keep in mind when treating patients seeking hormones.  As I said, there are exceptions, and it should remain at the psychologist's discretion to determine when these cases are.  Similarly, there are some individuals who should receive a longer evaluation period, just as there are individuals receiving narcotics who should undergo stronger monitoring prior to prescription.

Protecting people from themselves is an important aspect of society, especially in the case of individuals who are potentially mentally ill.  In recent years, it seems that we've decided that everyone knows what's best for themselves; that's bull->-bleeped-<-, plain and simple.  Just as I wouldn't allow meth and crack et al. to be entirely legalized, I don't think that a patient should be allowed to walk into a doctor's office and demand a particular treatment because they've decided that it will serve them best.  These people are professionals who have gone to school for a very long time to learn how to best serve their patients, and claiming to know better than they do because you've read wikipedia, or posted on an online forum is ludicrous. 

The entire concept that someone needs to protect someone else from themselves is a form of apropriation of rights and it is also a colonialization of the body.

The idea I need to have doctors protect me from myself is absurd. What if I do screw it all up so bad I comit suicide? So what. We have too many people on the planet and some self culling would be a good idea.

Also....If we have plenty of transition disasters along the way then so be it. Gives us something to think on when we are decideing to come out or not.

I see no reason for society to be so bloody obsessed with controling our bodies and minds. It is evil.

Well if we need some "self culling" anyway, what's wrong with transfolk killing themselves because of the waiting period?

You aren't responding rationally, you're responding emotionally.  You're outraged that you don't have absolute control over what goes into your body.  Fine, but WHY, RATIONALLY?

My analogy still stands up to your response.  "The idea I need to have doctors protect me from myself is absurd."  Okay, so if I feel like some Opana or Actiq today, I should be able to go down to the pharmacy and grab a  few bottles?  Maybe I'm severely depressed, and want to enucleate; should a surgeon help me with this because it isn't right to protect me from myself?

Quote from: long.897 on September 24, 2010, 12:37:56 PM
]You aren't responding rationally, you're responding emotionally.  You're outraged that you don't have absolute control over what goes into your body.  Fine, but WHY, RATIONALLY?

I think that is definitely true, a lot of the responses are just beginning to be emotional "me" arguments. Typical of our times, "I want what I want when I want it and I want it now."

And all I can say about the whole suicide and self culling discussion is that it reminds me of a quote, "Most human beings have an infinite capacity for taking things for granted." I find the idea that we should just allow people to kill themselves disgusting.

What I feel about waiting is very different from what I think about it. 
It is entirely reasonable to ask someone who may be rushing into a situation before they are ready to wait, but my feelings are , " I want it, and I want it now!"

if the person demanding it now had a lifelong history of crossdressing and was socialising in venues where all shades of CD/TV/TG/TS were welcome then I'd be inclined to say OK start now...but if the person was a 30 something who had never crossdressed or given themselves a cross name i'd say better get some therapy first.

I should point out that these guidelines aren't in place only to protect us from ourselves; they also serve to protect other people from us. People can and do abuse hormones. This is a society, not a human archipelago.

And the self-culling remark...well, it may be right from an evolutionary/population biology standpoint, but I don't think it fits into a humanitarian context. This is a freaking support site, for chrissake.

Surely the question " how do you feel?" implies or even accepts that the answer will be emotional as feeling isn't often a rational decision? If we had been asked for our rational and logical views on the waiting times then answers may have been different? It has nothing to do wih todays society and more to do with the fact that we are all human beings and therefore all our reactions are different

Quote from: al james on September 26, 2010, 07:51:49 PM
Surely the question " how do you feel?" implies or even accepts that the answer will be emotional as feeling isn't often a rational decision? If we had been asked for our rational and logical views on the waiting times then answers may have been different? It has nothing to do wih todays society and more to do with the fact that we are all human beings and therefore all our reactions are different

"What kind of things did other people deal with in their 3 months of therapy before HRT and how did you feel it helped you as you began transitioning physically? Would you feel differently about the waiting period if you had a therapist like I had who was open and experienced with trans clients?"

I also asked those two questions that really haven't been discussed much in this thread, so if we do want to keep this going and keep it from just becoming a shoot out (don't know where shoot out came from, just random but fit somehow lol) maybe we can touch base on some of those.

For those people who are saying they wish the time period was shorter or that the time period doesn't seem necessary at all what kind of experience did you have in therapy? If your therapy had been handled differently do you think it may have changed your personal feelings on the waiting period?

Like I said in the original post my therapy was amazing, a very intelligent and supportive therapist who knew all about the struggle we deal with as transsexuals who did not require any other type of thing (as far as forcing patients to do RLE or anything like that) other than coming in, talking and touching base on how you felt and where you felt you were in the process of preparing for HRT. I know a lot of people didn't have that type of therapist, in fact I've only rarely heard other people say they had such a great experience. In the long run my opinion that they uphold the wait time for most patients instead of giving out notes right away does have a lot to do with the knowledge of how it would come back on the doctor if the wrong choice is made by the patient, having had a nice therapist who I get along well with why would I want to see her career damaged because one client couldn't wait? Obviously my opinion is based on a lot of other things, but this personal experience certainly feeds into my thoughts on the matter.

Quote from: Colleen Ireland on September 12, 2010, 09:20:38 AM

Being 54, at first when came out to myself, I was worried I'd left it all too late.  I feel a lot better about it now.  I know my time will come.  But I do think that perhaps age should be one of the factors in deciding how quickly someone can access hormones, etc.  A 2-year wait for a 54 year old is not the same thing as a 2-year wait for a 25 year old...

And it's a generational thing, too, I think, for those brought up on instant gratification.

I was almost 61 when I began counseling. ('What do you mean I'm transsexual?") and began HRT about 9 months later. SRS on my 63rd birthday. I don't recall feeling like it should have gone faster. There were lots of changes to explore during my monthly counselor visits.

At 10+ years postop, I'm pretty well satisfied with the way it all turned out.

Patience, Grasshopper.

Robyn

Quote from: Robyn on September 27, 2010, 11:07:00 PM
And it's a generational thing, too, I think, for those brought up on instant gratification.

I was almost 61 when I began counseling. ('What do you mean I'm transsexual?") and began HRT about 9 months later. SRS on my 63rd birthday. I don't recall feeling like it should have gone faster. There were lots of changes to explore during my monthly counselor visits.

At 10+ years postop, I'm pretty well satisfied with the way it all turned out.

Patience, Grasshopper.

Robyn

As someone who's under 25... I reject and am offended by your generalizations.

You can be satisfied about your circumstances all you want.... personally, I didn't wanna throw away my entire young adult and middle age life as I did my teenage life.

You can afford to be patient, you've already lived the vast majority of your life.  ::)

Quote from: lilacwoman on September 26, 2010, 11:35:45 AM
if the person demanding it now had a lifelong history of crossdressing and was socialising in venues where all shades of CD/TV/TG/TS were welcome then I'd be inclined to say OK start now...but if the person was a 30 something who had never crossdressed or given themselves a cross name i'd say better get some therapy first.

As an early 20 something who matches your description, I'd reply with exactly the thing I told my ACTUAL therapists and doctors.

This is my life, not yours, I decide what's right for me, not you.

And some of us aren't clothing fixated and don't give a crap about anything LGBT... Some of us actually feel like we're female (or male for ftms) without indulging in fetishistic activities (I have yet to encounter crossdressing in its own right that I wouldn't call fetishistic, it's my opinion, if it offends you, I'm honestly sorry for that)

Quote from: Ashley4214 on September 28, 2010, 01:20:27 AM
You can be satisfied about your circumstances all you want.... personally, I didn't wanna throw away my entire young adult and middle age life as I did my teenage life.

I certainly hope your young adult life and middle age are longer than three months...or even the nine months Robyn mentioned.  :P

Seriously, I can see that you might be annoyed if someone said that (as a young person) you were definitely brought up to expect instant gratification, but that's not quite what Robyn said. She did not say that all young people are brought up on instant gratification; she phrased it as an opinion (with "I think") and then qualified it further (with "for those brought up on instant gratification").

Quote from: Arch on September 28, 2010, 02:04:59 AM
I certainly hope your young adult life and middle age are longer than three months...or even the nine months Robyn mentioned.  :P

Seriously, I can see that you might be annoyed if someone said that (as a young person) you were definitely brought up to expect instant gratification, but that's not quite what Robyn said. She did not say that all young people are brought up on instant gratification; she phrased it as an opinion (with "I think") and then qualified it further (with "for those brought up on instant gratification").

My young life, how ever long or short it may be, is beside the point. ANY time wasted, is time I'll never see again, and its time being wasted of that period.

She in fact said "... it's a generational thing, too, I think, for those brought up on instant gratification", which implies that it's a generation brought up on instant gratification, in that context, "for those" indicates "for those of that generation".

Only she can clarify what she meant, but that's how I interpret it.

Just because an argument is bassed in emotion does not invalidate the cogency of the argument.

Emotions are real and vastly more important than just about any other reasoning.

Quote from: Arch on September 23, 2010, 12:16:44 PM
Hi, Mara. I'm not sure what you consider "long." Or even what you mean by "immediately." Late in your post, you say that three months is too long; but it's only a recommendation, and therapists don't have to abide by that.

By long, I mean that in some countries, the health system is run by people who apply a one-size-fits-all policy where everybody has to wait 1-2 years before starting HRT no matter what.  Years is too long, and potentially lethal.

I used three months as the example because it's the SoC rate.  A few weeks over three months would be okay, for instance.  But generally either therapists will stop their limit at three months or else they'll go into crazy ranges like 1-2 years.  (Some of these other therapists also require cruel things like years of RLE before hormones, which is tantamount to psychological torture for some people and can be extremely dangerous in some regions.)

[quote author=Ashley4214 .

And some of us aren't clothing fixated and don't give a crap about anything LGBT... Some of us actually feel like we're female (or male for ftms) without indulging in fetishistic activities (I have yet to encounter crossdressing in its own right that I wouldn't call fetishistic, it's my opinion, if it offends you, I'm honestly sorry for that)
[/quote]

crossdressing is presenting female 24/7.   So according to you every woman wearing trousers is crossdressing for fetishism?

I'm willing to bet good money on the fact that in any town in UK or US 90% of the women will be wearing clothes that are definitely womens that 98% of the men would not want to wear.  The other 98% are probly too old or rough to care.

if you don't feel the need to dress female then maybe you aren't TS but are something else that a good therapist can discover if you are honest with them.

Quote from: lilacwoman on September 26, 2010, 11:35:45 AM
if the person demanding it now had a lifelong history of crossdressing and was socialising in venues where all shades of CD/TV/TG/TS were welcome then I'd be inclined to say OK start now...but if the person was a 30 something who had never crossdressed or given themselves a cross name i'd say better get some therapy first.

What is it with you and this obsession with crossdressing?!  It's like, every single post I've seen from you in the last few days is you showing up to talk about this, and the other ones claim that all trans people crossdressed before transition, which is an outright falsehood.  Why do you keep saying it?  Are you just trying to demean everyone here who never "crossdressed"?

(Also, it's not crossdressing when transsexual people do it.  It's just dressing.  Crossdressing is what we did when we dressed based on our genitals, rather than our brains.)

Quote from: lilacwoman on September 28, 2010, 10:49:10 AM

if you don't feel the need to dress female then maybe you aren't TS but are something else that a good therapist can discover if you are honest with them.

Are you outright questioning the gender identity of people who didn't crossdress before transitioning?  Are you saying that I'm not a trans woman, but really some kind of confused man?

Considering that you've done this over and over in the past few days, I think you're actually trying to start an argument.

I am posting a rememinder of the TOS.

Quote9. If you disagree with transgender individuals, or activities which cross gender boundaries take your arguments to a more appropriate web site.

Quote10. Bashing or flaming of any individuals or groups is not acceptable behavior on this web site and will not be tolerated in the slightest for any reason.  This includes but is not limited to:

• Advocating the separation or exclusion of one or more group from under the Transgender umbrella term
• Suggesting or claiming that one segment or sub-segment of our community is more legitimate, deserving, or more real than any others

This thread is about the waiting period for HRT, not what a person has to do or has done.

Respectfully Janet... how can we properly discuss the waiting period for HRT without discussing the reasons and merits it exists and the manifestations of the waiting period? (I.e RLE before HRT, something I experienced from two therapists and dumped both within a couple sessions over, or requirements pertaining to cross dressing).

Quote from: lilacwoman on September 28, 2010, 10:49:10 AM
crossdressing is presenting female 24/7.   So according to you every woman wearing trousers is crossdressing for fetishism?

You're right that I was unclear what I meant by crossdressing.

What I said was...

And some of us aren't clothing fixated and don't give a crap about anything LGBT

and

I have yet to encounter crossdressing in its own right that I wouldn't call fetishistic

By clothing fixated I mean any abnormal degree of interest in clothing or dressing, abnormal respective of either assigned or identified gender. (As in, clothing fixation to a degree where it would be considered unusual with respect to either gender).

What I mean by crossdressing when I made that post, is fetishistic (I don't mean sexual fetishistic necessarily, I mean an obsession directly with clothing specifically) desire to dress as a certain gender for either psychological or sexual gratification.

Crossdressing is its own issue that need not accompany anything else, and I don't believe it should be taken into account when deciding if someone should be living as a different gender than assigned to them at birth. Which is basically what I was trying to say, though I was a bit angry when I wrote that post.

Quote from: lilacwoman on September 28, 2010, 10:49:10 AM
I'm willing to bet good money on the fact that in any town in UK or US 90% of the women will be wearing clothes that are definitely womens that 98% of the men would not want to wear.  The other 98% are probly too old or rough to care.

I don't think it matters what you wear, when I say crossdressing, what I was more referring too was any clothing fixation, I know I said crossdressing, simply because that's pretty much invariably how its expressed.

Quote from: lilacwoman on September 28, 2010, 10:49:10 AM
if you don't feel the need to dress female then maybe you aren't TS but are something else that a good therapist can discover if you are honest with them.

I don't need a therapist to tell me what I am, I never did, I already knew.  ;D

Quote from: Mara on September 28, 2010, 10:31:57 AM
By long, I mean that in some countries, the health system is run by people who apply a one-size-fits-all policy where everybody has to wait 1-2 years before starting HRT no matter what.  Years is too long, and potentially lethal.

Okay, I see now--and I agree--but the OP specifically asks about the SoC suggested three-month therapy period, so that's what I focused on. These other systems clearly aren't going by that.

Quote from: Ashley4214 on September 28, 2010, 03:55:50 AM
My young life, how ever long or short it may be, is beside the point. ANY time wasted, is time I'll never see again, and its time being wasted of that period.

She in fact said "... it's a generational thing, too, I think, for those brought up on instant gratification", which implies that it's a generation brought up on instant gratification, in that context, "for those" indicates "for those of that generation".

Only she can clarify what she meant, but that's how I interpret it.

It is certainly implied that younger generations tend to expect instant gratification, but that's hardly a novel observation; it's in the news on a regular basis. My point is that "for those of that generation" implies that there are also some of that generation who weren't raised on the instant gratification model.

Neither one of us lives in a completely "free" country; these systems have their advantages and disadvantages. One benefit of the three-months-of-therapy guideline is that it protects people who need to be protected. Maybe you feel that you don't need protection, but I'm sure a lot of vulnerable people who do need protection feel that they don't need it, either. If any client's word is enough, these people won't be protected, and, quite possibly, neither will those around them. Because three months is only a guideline and not a requirement, a therapist can easily say, "You don't need three months; I'll write your letter this week, and you can pick it up on Tuesday." Or, conversely, "This client has serious issues and shouldn't go on HRT yet." Unless, of course, the system is effed up--which is a somewhat different issue, as is the comparison of subsidized non-subsidized systems.

There's always informed consent in countries where it is available. Of course, you generally have to pay out of pocket for that. There's always something.

Quote from: Arch on September 28, 2010, 07:10:35 PM
It is certainly implied that younger generations tend to expect instant gratification, but that's hardly a novel observation; it's in the news on a regular basis. My point is that "for those of that generation" implies that there are also some of that generation who weren't raised on the instant gratification model.

Neither one of us lives in a completely "free" country; these systems have their advantages and disadvantages. One benefit of the three-months-of-therapy guideline is that it protects people who need to be protected. Maybe you feel that you don't need protection, but I'm sure a lot of vulnerable people who do need protection feel that they don't need it, either. If any client's word is enough, these people won't be protected, and, quite possibly, neither will those around them. Because three months is only a guideline and not a requirement, a therapist can easily say, "You don't need three months; I'll write your letter this week, and you can pick it up on Tuesday." Or, conversely, "This client has serious issues and shouldn't go on HRT yet." Unless, of course, the system is effed up--which is a somewhat different issue, as is the comparison of subsidized non-subsidized systems.

There's always informed consent in countries where it is available. Of course, you generally have to pay out of pocket for that. There's always something.

We'll have to agree to disagree, I think informed consent should be more universal.

Anyway, guess it doesn't matter now, I escaped the 3 month rule through the harm reduction loophole (was self medicating). And I don't for a moment regret it.

If we were subjecting our neighbors to sex steroids against their will, I doubt it would take 3 months for a court injunction to put a stop to it. Except it's not our neighbors that we are forcing the steroids on, it's ourselves, and HRT is the injunction.

Also, I question the authority of the whole "gatekeeper" system. Although it's easy to become enamored with our western medicine and all its marvels, if we really take a look inside it, it doesn't live up to it's hype. There are plenty of cases where physicians ignore a patient's assertions, only to learn in the end that these assertions were not only important, but critical. Ask survivors of many long-term illnesses, and they will tell you that one of the most important lessons they took away from their experience was to trust their gut and find a health care team that would do the same. That isn't a greedy "me, me, me" attitude, it's a trait that will actually increase our chances of having a positive outcome, of surviving.

Quote from: Ashley4214 on September 28, 2010, 07:23:04 PM
We'll have to agree to disagree, I think informed consent should be more universal.

Actually, I do, too--with proper emphasis on "informed." I don't believe the practitioner providing the services should just dispense hormones willy-nilly to anybody who wanders in off the streets--the provider absolutely must make sure that the patient/client seems to have the ability to truly be informed and to take responsibility for his or her actions.

In my community, I've heard that a certain person was refused hormones at the informed consent clinic because he/she was clearly not operating on all thrusters. I think this was a good move. On the other hand, the same clinic approved a couple of people whom I know to be very unstable; I was surprised that even the informed consent clinic gave them the go-ahead. One of these people apparently came close to committing suicide, or maybe he actually tried and was hospitalized (he was very vague about the details). So I worry that some clinics (maybe even the one in my city) don't screen people adequately. That's my main objection to informed consent clinics; I think they should do a good job of weeding out certain people. If someone has serious mental health issues and/or isn't quite stable, is that person capable of being fully informed and fully consenting? I say no, not necessarily. In short, I don't think "informed consent" should mean that absolutely everybody should be able to do absolutely anything, even with their own bodies.

Quote from: kelly_aus on September 28, 2010, 08:20:56 PM
I was originally against any waiting period, thinking that it was simply "gatekeeping". After having hung around here and the chat rooms, as well as other sites, I see why the SOC's call for a period of consultation with a therapist..

And remember, as has been mentioned before, that they are only guidelines.. Your therapist may decide after only a few sessions that you are ready for HRT, or may decide you need additional therapy before HRT. Just because you think you are ready, doesn't mean you really are..

I've only had 1 session with my therapist so far, but found it quite constructive. I will be going back and following through his process.

Except they're not only guidelines... many therapists consider them as rules, and they say that it requires three months minimum.

Several of the therapists I saw in the beginning had their own make believe SOC that said you have to have about a year of RLE before HRT.

I just don't have a lot or respect for any of these systems.

Quote from: Colleen Ireland on September 12, 2010, 09:20:38 AM
  But I do think that perhaps age should be one of the factors in deciding how quickly someone can access hormones, etc.  A 2-year wait for a 54 year old is not the same thing as a 2-year wait for a 25 year old...

Colleen,
While I don't think it was intentional, this comment comes off as a little dismissive of younger trans people. While a younger person may have a projected longer life as themselves (projected, not guaranteed), there are other considerations as well. For a young trans woman for instance, 2 years could mean the difference between needing FFS or not, hair transplants or not, or thousands more on her electrolysis bill.
And once that bell rings for transition, every day spent waiting is a lifetime, no matter the age.

Quote from: Nero on September 28, 2010, 09:37:45 PM
Colleen,
While I don't think it was intentional, this comment comes off as a little dismissive of younger trans people. While a younger person may have a projected longer life as themselves (projected, not guaranteed), there are other considerations as well. For a young trans woman for instance, 2 years could mean the difference between needing FFS or not, hair transplants or not, or thousands more on her electrolysis bill.
And once that bell rings for transition, every day spent waiting is a lifetime, no matter the age.

I have to agree with Nero on this, even the younger people can have very specific age related reasons to move forward. The younger you can begin the better the results.

I think a lot of what is being said isn't taking one truth into consideration, each individual is in fact an INDIVIDUAL. What is right for one person may not be what is right for the next one, or it may be exactly what is right for the next person. You never know until you take the time to get to know these people as individuals, which is exactly what therapists are supposed to be doing.

To say that younger people can stand to wait longer but they have a "me, me, me" feeling about moving forward is kind of ironic in my opinion since pretty much every person who has said that is someone who is older and is also displaying the "me, me, me" attitude with their statements that while younger people can wait THEY COULDN'T wait because they are older. To me it's the same thing. You personally may actually feel that you are old enough to know best and that you have no time to waste, at the same time there could be someone out there 40 years younger than you who actually knows better and shouldn't have to waste that time either.

Being older doesn't give you an automatic pass on rather or not your actions are self serving and egotistical. To me it seems like that is basically what the "I want it now" idea is, people who are only looking out for themselves with no care of how their actions or desires could hurt those around them. Being 70 doesn't change how it will/could/did change the lives of those you love anymore than it changed the lives of people I love at 23. Being 70 doesn't make it automatically a wisdom filled well thought out idea/plan either. I've met plenty of older people who didn't have a ->-bleeped-<-ing grip on what they were doing or saying at all and were no better than teenagers I've met when it came to their ability to make choices for their lives. At the same time I've met many 14 year olds who were capable of being rational and reasonable just as we'd expect someone who is much older to be.

I see nothing wrong with the I want it now attitude if it is a reasonable thing to want.
HRT for a transsexual is reasonable.

Being FORCED to participate in a diagnosic or anyother medical ballyhoo you do not agree with is a form of submision to a rape of the soul. Just because someone MAY get harmed is not a valid reason to hold me or anyone else back from what they want. I did not want to discuss my very personal feelings and thoughts with anyone I havent decided to do so with.

(BTW: I did go the SOC route and will continue to do so. But I do not like it that my soul and body are apropriated by the medical comunity to further their goals and ideals.)

Quote from: cynthialee on September 29, 2010, 08:48:18 AM
I see nothing wrong with the I want it now attitude if it is a reasonable thing to want.
HRT for a transsexual is reasonable.

Being FORCED to participate in a diagnosic or anyother medical ballyhoo you do not agree with is a form of submision to a rape of the soul. Just because someone MAY get harmed is not a valid reason to hold me or anyone else back from what they want. I did not want to discuss my very personal feelings and thoughts with anyone I havent decided to do so with.

(BTW: I did go the SOC route and will continue to do so. But I do not like it that my soul and body are apropriated by the medical comunity to further their goals and ideals.)

Honestly, I don't get it at all. What common goal does the medical community have that is furthered by suggesting that we speak to a therapist for 3 months to ensure we are aware of the choice are making and that we are stable enough to decide for ourselves? What are they really getting out of that other than our protection as patients and their protection as medical providers? How are they harming your body or soul by ensuring that you are aware of what will happen and that you are capable of making this choice?

Everyone seems to want to overlook the facts that not all changes from HRT are reversible. What about things like potentially becoming sterile? That is not something that is reversible.

For example, in my situation I began living full time as male when I was 15 and began T when I was 23. By the end of that 8 years I was certain I did not want children and considering I lead a lifestyle of dating women exclusively I just figured that since the children would not genetically belong to both of us anyhow it wouldn't really hurt me to allow my partner to play that role. So I moved forward with HRT. I had no way of knowing then that 3 years later I would be building my life with a partner who is also transsexual, someone I could have had OUR children with, children that belonged to both of us and came from both of us genetically. At this point it is most likely (granted not for sure since we have not been tested) that neither of us can have children, now I have to live with the reality that neither my partner nor myself can have children and adoption (at least where we live) is NOT an option for trans people at all. It is a reality that for us to have children we'd have to hope for a miracle in the courts as well as uproot our lives, move away from our families, school and careers to even have a hope of being allowed to adopt. All of which may pan out to still being told no.

I never thought I'd have to deal with this issue, logically it seemed like I had the exact answer that would fit my life and allow me to make this choice later down the road. A luxury I no longer have that was taken away from me by ONE choice in life, moving forward with HRT. And I was perfectly informed and able to consent at the time that I did so.

I also don't agree with everyone pushing forward with the idea of informed consent because some people NEED HRT right away. If someone is in the immediate danger of self harm or suicide they shouldn't just be given access to medical procedures that require rational thought and clarity to consent to, they should be treated just as any other patient would be. We are not special because our depression comes from being trans. The common route for people at risk of suicide is hospitalization, to want to kill yourself is NOT rational regardless of what the reasons behind the feelings are or how easy it may be to fix/treat the situation. Not being rational, in my opinion, is a barrier to informed consent and the ability to actually consider all sides of the issue to make a choice.

Three months is not only just a SUGGESTION (something else that seems to keep being ignored but has been pointed out several times already) it's also a very very very short time period. You are definitely not missing out on a huge portion of your life by waiting a quarter of one year to begin treatment. If you are suicidal being hospitalized for part (if not all) of that waiting period would probably be a good thing for you anyhow. Even if your depression will go away with treatment you will have learned healthy ways to deal with depression if it visits again in your lifetime, those coping skills will definitely come in handy at some point in life for someone who obviously does not have them and needs to learn them to begin with.

I waited 8 years (I certainly don't think everyone should wait that long, just happens to be my number) by doing so I was allowed several opportunities to learn about all of the ways this would change my life. It also allowed a period of time for the people who are important in my life to adjust to the changes I would be facing, they are prepared to assist me, stand by me and support me through this entire experience. I also know that I will not loose any of the people who are in my life because of this choice, a luxury and comfort not all of us have but that many could have had if they ever allowed that opportunity to be present for the people they cared for. True for some of us no amount of time would have changed the people we lost, but it would have allowed for the time to deal with the reality of the loss and the reasons behind it in a healthy way.

I was sterile long before I started HRT.

If I would have waited 1 more day to start HRT when I did (1 month after coming out of the closet I lived in for 32 years) I would have likely shot myself instead. So 3 months to me would have been an eternity.

Quote from: cynthialee on September 29, 2010, 07:58:51 PM
I was sterile long before I started HRT.

If I would have waited 1 more day to start HRT when I did (1 month after coming out of the closet I lived in for 32 years) I would have likely shot myself instead. So 3 months to me would have been an eternity.

Which actually just circles around to one of my points, people who are in immediate danger of self harm or suicide should be hospitalized. In a hospital you would not have been able to (nor had the option to) shoot yourself. Suicide/self harm is now an impossibility and therapy can continue to get you on HRT while you are in a safe environment protected from the one person who was actually your enemy from the beginning, yourself.

Additionally I have to ask (this is a long thread so I'm not really into reading back through everything) but aren't you the same person who asked why people should be protected from themselves? If so you just answered your own question. Someone needed to protect you from yourself because you are a worthwhile, intelligent, individual who (from every post I've seen of yours on here) has people around that you love and care for deeply who would have taken their own life. In my opinion everything you are is worth protecting, even if the only danger is yourself.

That makes no sense.
I was the one who saved my own ass. I ordered the HRT myself. I told no one I was suicidal. How could anyone have hospitalized me when I was so good at hideing my self hatred?

My waiting period is already way past 3 months. I guess it is because I am so young and my psychologist wants to be extra sure this is the right thing for me. She is a very good psychologist and very experienced with Transgender patients. I am having a very hard time waiting though..... I wanted to start HRT 2 months ago. Would it be reasonable for me to give her a timeline of when I would like to begin my HRT?
Do you all think starting HRT this coming up March/April and then adjusting over the summer so I can go full time when I go back to school in the fall would be reasonable?

Quote from: cynthialee on September 30, 2010, 06:53:35 AM
That makes no sense.
I was the one who saved my own ass. I ordered the HRT myself. I told no one I was suicidal. How could anyone have hospitalized me when I was so good at hideing my self hatred?

While your experience is valid I don't feel that someone who didn't actually go through the appropriate channels can outweigh the opinions and thoughts of those who did. The point is still valid, but I don't think it's as strong of one in a discussion like this.

Consider if you had gone through therapy and you had talked about your suicidal feelings, how could things have worked differently? How could that have changed your experience and in turn changed your opinion on the 3 month suggested waiting period for HRT?

If you don't admit to your problems no one can help you, obviously. And if you don't allow them the chance to help you then you really shouldn't step up to the plate and critic the standards. It's similar to never trying a certain food because you are sure you won't like it, if you did try it you might find it isn't as bad as you thought. True, you may still not like the food, but you can't really judge that it's horrible or not without actually taking a taste. I know that is a pretty loose comparison, but just the first one that came to mind for an example :)

If you'd gone to therapy and received appropriate care and help your opinion on the waiting period may be much different than it is currently.

Quote from: Christine Snider on September 30, 2010, 10:55:09 AM
My waiting period is already way past 3 months. I guess it is because I am so young and my psychologist wants to be extra sure this is the right thing for me. She is a very good psychologist and very experienced with Transgender patients. I am having a very hard time waiting though..... I wanted to start HRT 2 months ago. Would it be reasonable for me to give her a timeline of when I would like to begin my HRT?
Do you all think starting HRT this coming up March/April and then adjusting over the summer so I can go full time when I go back to school in the fall would be reasonable?

It sounds very reasonable, I'd say to definitely broach the subject with her. If your psychologist is even half as good as my therapist you will at least learn why they are making you wait longer. With my therapist the only reason she waited was because I never asked after 3 months. I asked when I was ready and she gave me the note the same day :)  Sometimes they are waiting on us, and other times if we just bring it up we can discuss a time line like you mentioned and have something set up that we know we are working towards, which can help a lot.

The fact that there was a waiting period at all was my impetious to self medicate.

Quote from: cynthialee on September 30, 2010, 01:14:58 PM
The fact that there was a waiting period at all was my impetious to self medicate.

Haha, sorry, I redid my post :P

I realized how crappy and emotional I was in my first response, my apologize. I actually was just going to add on to it and apologize then but hoped that maybe it had not been read yet lol. My wording was really rude, so I tried to rethink what I was saying and present it in a more appropriate way :)

Quote from: cynthialee on September 30, 2010, 01:14:58 PM
The fact that there was a waiting period at all was my impetious to self medicate.

As an actual response to this statement I just have to say once again that the waiting period is only a suggestion not a requirement. You allowed the waiting period to push you into handling things your own way, did you at least pursue therapy first and were told you'd have to wait? Also if you did why didn't you bring up your feelings of suicide then? It is what therapy is intended for after all, a chance to talk about how you feel. Some therapist have actually pushed through suicidal patients because they are aware of the dangers, rather than choosing hospitalization or additional therapy some doctors allow HRT right away when presented with a case like yours.

I did pursue therapy. The first go around (this time, not counting my 20's) after I went to the local comunity mental health I said I had gender issues and they showed me the door.
I then found the SOC, and I read it of course and I saw the waiting period and I couldnt wait. I got ahold of HRT as fast as I could. When I saw my doctor a couple months later he freaked and gave me a proper prescription and ordered some tests. (after being forced to by my wife and my HIV care case manager.)

I knew I would get HRT from my doctor due to the harm reduction clause in the SOC.

Before I even saw my doctor and landed the transsexual bomb on him I had found a gender therapist and I have been seeing her for a year now.

apology acepted

Quote from: cynthialee on September 29, 2010, 08:48:18 AM

Being FORCED to participate in a diagnosic or anyother medical ballyhoo you do not agree with is a form of submision to a rape of the soul. Just because someone MAY get harmed is not a valid reason to hold me or anyone else back from what they want. I did not want to discuss my very personal feelings and thoughts with anyone I havent decided to do so with.

Thank you!  I have never been able to write about this topic, without feeling outraged.  Nobody has the right to make me get their permission to be myself.

I am a woman.  Period.  My mental competency is not automatically subject to question, with the burden of proof put upon me, because I have this birth defect.

You want your doctors' help/advice/approval/permission... fine.  You go and get it.  You don't have the right to tell me I need it because you do.  Every person who posted in favor of mandatory hoop jumping - How did you feel when you were a child and had to put on a sweater because your mother was cold?  Did it make you feel loved?  Well, when you do it to me today, it makes me feel insulted that you think I am a child.

What is the surcharge supposed to be to get a license to be trans?  What are the closing costs?  How dare WPATH want to milk me like a money-cow?

If society has an interest in protecting itself from people making bad decisions, where are the therapists' letters, doctor's notes and permission slips requirements to have sex, get married or have a child?  Can you imagine a doctor telling a woman that she can't have a child until she quits smoking and loses weight?  Or a three-month waiting period and two therapists' letters to get married.  No, Ms Prom Queen, you will need some more counseling before I will sign off and allow you to have sex.

Quote from: Rob on September 12, 2010, 09:54:24 AM
Off on the deep end.....

So, I have been thinking about this topic a lot recently ...and I have come to the conclusion ... which might be way out there for most of you ... why do we care if someone changes their gender?  Why is there so much wrapped around it all?  We allow people to alter their bodies in all sorts of ways -- tattoos, body piercing, splitting tongues, plastic surgery ... personally, if someone wants to change their body why does someone else have to give approval when in so many other ways we don't monitor or control body modification.

I know some would argue that it's a life changing experience and there is a lot that goes on with it ... but seriously would anyone selectively choose to go through all that if he/she really didn't feel it necessary?  Take medications for the rest of their life?  Save up tons of money for surgies that insurance won't cover.

I don't know .. and I imagine most would disagree with me..but I just feel people should have complete control over their bodies and not be forced to get permission from another person to do it

I agree with this.

I find it a bit disconcerting that there are so many prerequisites to transitioning, whereas people are free to alter their bodies drastically in just about any other way as long as they have the means to pay for it.  I think a waiting period for any significant and permanent change to one's body is a good idea.  But the waiting period should be a recommendation, not a a rule.  And the length of the recommended wait should vary depending on the procedure and the individual's situation.

Quote from: cynthialee on September 30, 2010, 01:55:49 PM
I knew I would get HRT from my doctor due to the harm reduction clause in the SOC.

This is exactly the type of loop hole in the SOC that people have been bringing up from the beginning. There ARE ways to get around the 3 month period, which is just a suggested time period to begin with. The fact that we can get around it when/if necessary is actually one of the reasons why it is absurd to argue against it with some of the points that people have brought up. Suicidal? Well your story is an exact example of how one can get through quicker by understanding and knowing the SOC. It isn't the only way to get through but it is one way. The thing about the SOC that I think a lot of people are overlooking in this conversation is that it is not a for sure 100% it must be treated exactly this way for every single case scenario.

Quote from: GinaDouglas on September 30, 2010, 02:05:54 PM
I am a woman.  Period.  My mental competency is not automatically subject to question, with the burden of proof put upon me, because I have this birth defect.

Sadly in our society your mental competency is automatically subject to question in almost every scenario. Rather you are on trial for murder or just don't fit into what society feels is "normal" (such as wanting to undergo irreversible physical changes to your gender) your competency is questioned. It isn't as if we transsexuals are the only people to face such issues. The fact that it isn't questioned in other circumstances doesn't make it right not to question us, it actually means it is probably best to question EVERYONE. Rather you are a cis woman who wants breast implants because you think it will raise your self image, a transsexual who wants HRT and SRS or someone who wants an abortion therapy can assist with ALL of these issues. Don't you think it would be better for a woman to learn her self worth without having to enlarge her breasts to make her feel better about herself? Wouldn't it be great if someone actually talked about all of their options with a therapist before we just allowed them to have an abortion? It would certainly help deal with the consequences of both actions. While it should not be REQUIRED it should definitely be heavily suggested, just as the 3 month waiting period for us to get HRT is only heavily suggested and not required.

Quote from: GinaDouglas on September 30, 2010, 02:05:54 PM
You want your doctors' help/advice/approval/permission... fine.  You go and get it.  You don't have the right to tell me I need it because you do.  Every person who posted in favor of mandatory hoop jumping - How did you feel when you were a child and had to put on a sweater because your mother was cold?  Did it make you feel loved?  Well, when you do it to me today, it makes me feel insulted that you think I am a child.

Um, I guess we are on a totally different page here because YES I did feel loved when my mother tried to take care of me. That is her job, she's my MOTHER. When she made me wear a sweater as a child I might not have always liked it but I probably didn't get sick as often as I would have had I just been allowed to act as I chose to. Probably kept me from getting bronchitis or catching pneumonia a few times in my life. If I didn't like it did that matter in comparison to my health and well being? Not at all. I'd rather my mother care that I stay healthy and safe than to just allow me to run around like an idiot and catch my death outside in the cold.

If your mother telling you to put on a sweater just makes you feel like a child try to remember one thing, no matter how old you may be you will always be her child. She will always love you and try to give you advice, try to care for you and sometimes she will just ->-bleeped-<-ing annoy the crap out of you with her suggestions. Does that mean she isn't doing it out of love and you should feel insulted? Not at all. The fact that it is insulting to you is perhaps a personal issue you actually need to think about more. It certainly never insulted me that my mother loved me. In my opinion I'd be one ungrateful little brat of an adult if it did upset me or insult me that my mother cared.

Cynthialee: I just read your signature and actually feel that it can apply really well to this situation.

For anyone who hasn't noticed this is her signature:
So it is said that if you know your enemies and know yourself, you can win a hundred battles without a single loss.
If you only know yourself, but not your opponent, you may win or may lose.
If you know neither yourself nor your enemy, you will always endanger yourself.
Sun Tsu 'The art of War'


You knew yourself and you took the time to know your enemy as well (the SOC in this case) by doing so you found the loophole that was necessary for you and you won by getting what you needed. If you did not know the terms of the SOC your battle for HRT would have been up in the air, it could have gone either way, you may have to wait 3 months or longer or you may have won from the beginning because you did happen to be a competent person who was sure of what they needed and had to do. It's the last phrase that we have to recognize as being important, those who are not competent know neither themselves (meaning they may or may not benefit from HRT depending upon rather or not being trans is actually their issue, exactly what the SOC is created to find out) or their enemies (once again the SOC for this scenario)... that is why they are most likely to endanger themselves without proper supervision and therapy.

So if you apply the this theory from Sun Tsu to this scenario it supports the SOC guidelines.

Nice take on it. Apt.

For me the enemy is GID. I think I have a pretty good understanding by now.

Also I use a quote from a general so I see it daily and I am reminded of the male world I came from and how much of a battle it was just surviving as a male was for me and how much I hate it.

Quote from: cynthialee on September 30, 2010, 04:39:04 PM
Nice take on it. Apt.

For me the enemy is GID. I think I have a pretty good understanding by now.

Also I use a quote from a general so I see it daily and I am reminded of the male world I came from and how much of a battle it was just surviving as a male was for me and how much I hate it.

Bwahaha, at least I'm not the only one who does stuff like that :P

It's strangely harder to find quotes that remind that being a woman sucked but I do like to keep an eye out for anything involving Paris Hilton... she always makes me feel better about being a guy lol.

Quote from: Cowboi on September 30, 2010, 03:59:42 PM
The fact that it isn't questioned in other circumstances doesn't make it right not to question us, it actually means it is probably best to question EVERYONE. Rather you are a cis woman who wants breast implants because you think it will raise your self image, a transsexual who wants HRT and SRS or someone who wants an abortion therapy can assist with ALL of these issues. Don't you think it would be better for a woman to learn her self worth without having to enlarge her breasts to make her feel better about herself? Wouldn't it be great if someone actually talked about all of their options with a therapist before we just allowed them to have an abortion? It would certainly help deal with the consequences of both actions.

If it's not required of other people, but is required of me; that's discrimination bordering on tyranny.  And no, no and no to your rhetoricals.  It's called freedom.

Quote from: Cowboi on September 30, 2010, 03:59:42 PM
Um, I guess we are on a totally different page here because YES I did feel loved when my mother tried to take care of me. That is her job, she's my MOTHER.

Oops, you fell into a rhetorical trap there.  Yeah, it's ok for my mother to make me put on a sweater, because she's my mother.  But the government and WPATH are not my mother.

While the waiting period to get on hormones might be "optional" - all the hoop jumping is not optional.  You still need the same letters, and still have to jump through the same hoops to do something non-optional like legally change your gender and identification, not to mention any kind of surgery.

I like the freedom angle Gina.

It is a total matter of freedom.

I figure that the way to deal with us is to just give us what we ask for, get us to sign release forms and wash their hands of responsibility for our actions.

Quote from: GinaDouglas on September 30, 2010, 05:11:34 PM
Oops, you fell into a rhetorical trap there.  Yeah, it's ok for my mother to make me put on a sweater, because she's my mother.  But the government and WPATH are not my mother.

I fail to see where I fell into any trap. I said I agree with my mother protecting me, I also stated that I think we should protect other people who want to do other things to their bodies as well. I would have only fallen into a "trap" had I NOT supported protection in both instances. Also rhetoric does not apply to this at all, rhetoric is merely being able to communicate and write efficiently, which we both did, everyone on this thread has. At it's best it can be used to mean writing and speaking in a persuasive manner, which I did.

You are talking about two issues that are completely different, only common thing between them is someone telling you what you should do but the differences between a mother telling a child to wear a sweater and doctors saying you need to talk to a therapist before changing your gender are so vast that you can't use them the way you are. Just because I don't think my congressman should tell me to wear a sweater when it's cold out doesn't mean I can't think they shouldn't allow people to just do whatever they want to their bodies, two totally separate issues with two completely different results. Plus I can take the sweater off, I can't just go back to having a vagina and functioning ovaries.

If people were given freedom, actually given freedom to act and do whatever they pleased there would be a hell of a lot of things happening that NONE of us would agree with. In this one instance you support freedom because it backs up what you want to see happen, it backs your personal belief to be able to do what you personally want to do in this one instance. Just because you want it doesn't make it right, just because YOU can make the choice for yourself and are capable doesn't mean everyone can or should. These rules were never made with specific individuals in mind, they were made with EVERY individual in mind.

Besides we live in America, nothing is really free here, we just like to pretend it is because it sounds nice... freedom is the American dream and it's a dream because it doesn't actually exist.

This isn't about YOU having the choice to take HRT this is about everyone having the choice to go through HRT, that would include anyone who is not mentally stable, anyone who may think it is the right path and not even actually be trans, every single person who may not medically/physically be able to handle it, etc. It would do you a world of good to look beyond your own back porch and actually acknowledge that not EVERYONE is YOU.

I have come across only a small number of people who have transitioned and regreted it.
Cisgender people do not just willy nilly decide to transition.
If the HRT doesnt drive them nutz then the social aspects will give them GID they didnt have in the first place. Transition itself weeds out alot of the non trans folks. If a cisgender person makes it all the way to SRS, they are going to have gid for sure then but it is very unlikely. Yes it happens but the process itself separates the seed from the chaff in most cases.

I think it's a logical comparison.  Other people telling me what hoops I have to jump through is like my mother making me put on a sweater when she is cold.  It's wrong on two counts.  Big Brother WPATH is not my mother, and I am not a child.

I can understand the need for guidelines on waiting times for HRT: i could even understand a minimum waiting time- what i am struggling with at the moment ( and this is speaking solely for me and from a UK point of view) is why there is such a discrepancy on the RLE and whether you get hormones during the RLE or not. The guidelines the clinic i am at gives out is that women have to complete a one year RLE but will be given HRT after 3 months. Men have to do a 2 year RLE and will be given T at the END of those two years. Now i'm still playing the waiting game of seeing the psychiatrists and as its thro the NHS i just nod and smile so Ive no way of knowing if these guidelines are adhered to. But then i read that someone else is prescribed T after their second visit to a clinic. I know everyone is an individual and as such any medication or treatment should be adapted to that individual but why is there such a wide discrepancy?

by

Quote from: Sada on September 30, 2010, 09:55:10 PM
I completely disagree with you on this one as a matter of fact I find it insulting for therapy to be mandatory.....but a therapist that is a not a TS will never understand what you are going through.

Yep.  That is right on the money.  Trying to get a therapist to understand is an impossible and agonizing task.

Quote from: cynthialee on September 29, 2010, 08:48:18 AM
I see nothing wrong with the I want it now attitude if it is a reasonable thing to want.
HRT for a transsexual is reasonable.

Being FORCED to participate in a diagnosic or anyother medical ballyhoo you do not agree with is a form of submision to a rape of the soul. Just because someone MAY get harmed is not a valid reason to hold me or anyone else back from what they want. I did not want to discuss my very personal feelings and thoughts with anyone I havent decided to do so with.

(BTW: I did go the SOC route and will continue to do so. But I do not like it that my soul and body are apropriated by the medical comunity to further their goals and ideals.)

I just have to respond to the bolded point, because it's absolutely ridiculous.

Suppose that you had a schizophrenic patient who didn't believe that they were schizophrenic.  They don't agree with the diagnosis, and think that they're healthy; it's SOCIETY that has the problem.  The fact that they don't like the prospect, or don't believe that they're ill doesn't change the facts of the matter; whether I believe I'm sick or not, the facts are the facts.

On a semi-related bit, the continued opinion that you know yourself, and therefore know better than your doctor is driving me crazy.  These people with MDs, PhDs, etc have spent more than a decade in school training to recognise symptoms of disease; a gender therapist has devoted a good deal of time to learning how to properly diagnosis gender identity disorder, and to run a differential diagnosis to properly look for other issues; schizotypical disorders, histrionic personality disorder, fetishism, ETC.  There are a lot of reasons that someone who is MENTALLY ILL might seek treatment, and they cannot offer proper informed consent.  Not everyone who seeks HRT is mentally ill, but a significant enough proportion are that guidelines need to be in place to protect them. 

Suppose you have abdominal pains, and you read on wikipedia about the symptoms of a burst appendix.  You're CONVINCED that that's what's going on, and you go to the ER, demanding surgery immediately.  The trained and qualified doctor performs a quick exam, and says that she doesn't think that your appendix has ruptured; the symptoms are more indicative of colitis.

This nice doctor has 10+ years of training; you've read about abdominal pain on wikipedia, and have come to your own (different) conclusion.  Do you demand the surgery?  Do you see a black market medical "professional" to remove the appendix outside of the mainstream system?  Why are you willing (assuming you are, if you aren't you should seek professional mental help) to believe the ER doc, but not the gender identity specialists?

bye

Quote from: long.897 on September 30, 2010, 11:39:41 PM
This nice doctor has 10+ years of training; you've read about abdominal pain on wikipedia, and have come to your own (different) conclusion.  Do you demand the surgery?  Do you see a black market medical "professional" to remove the appendix outside of the mainstream system?  Why are you willing (assuming you are, if you aren't you should seek professional mental help) to believe the ER doc, but not the gender identity specialists?

Because GID is not abdominal pain, and a lifetime of research is not reading Wikipedia.  Your analogy is inapt.

Quote from: Sada on October 01, 2010, 01:40:00 AM
long.897 YOU ARE SO WRONG I DO NOT KNOW WHERE TO BEGIN !!! :( You actually think because a doctor went to school that makes them competent ? Because if that is your case then where have all the malpractice suits come from !!! What about all those derms popping out accutane ??? They went to med school, but yet there is the evidence of their sage wisdom. . . I mean if you have an illness since it is your problem you will be more inclined to resolve it, because your the one living with it not the doctor ~ thier the ones making money off of it. An BTW schizophrenia is a neuropsychiatric disorder, but when they just finished their studies of the PET scans of a control group it clearly showed without a doubt physiology is abnormal. So does that make it a neurosurgeon's domain more then psychiatric disorder, or does it fall in a geneticist field? The oath is not to harm. An I do not see them making a women who want 38KKK sized breasts have therapy for that procedure. The doctors in Cali probably do more over stuffed boos every day without a thought. Not to mention there was no therapy for Brian Zembic who after losing a bet got breasts (look up that)! The problem is we are a minority an easy mark to push around. Hopefully rather then bickering we will unite and have our voice heard loud and clear to change these archaic practices and join the 21st century accepted and cherished by society.  ;)

                                                                           http://www.accutanelawsuit.net/ (http://www.accutanelawsuit.net/)

Your post is littered with logical fallacies, and the organizational structure makes my head hurt.  I'll try to address each point in bullet.

QuoteYou actually think because a doctor went to school that makes them competent ? Because if that is your case then where have all the malpractice suits come from !!!

There isn't a professional alive in any field who has not, or will not one day make a mistake.  Doctors go through extensive training in learning to identify and treat disease, and are the most competent individuals available to do so.  Sometimes they screw up during surgery, sometimes they make mistakes with drug interactions; it happens.  A computer scientist who's completed a PhD in the field might screw up a reference while coding.  A physicist might forget to account for a variable.  Making that mistake doesn't mean that your average Joe Nobody off the street could perform in that field at the level that they could.

QuoteWhat about all those derms popping out accutane ??? They went to med school, but yet there is the evidence of their sage wisdom. . . I mean if you have an illness since it is your problem you will be more inclined to resolve it, because your the one living with it not the doctor ~ thier the ones making money off of it.

Do you mean to say that doctors prolong the illness of their patients to drain their wallets?  I hope not, I'd hate to think that you're an idiot.  I don't know everything about the Accutane case, so I won't get into it too much, but it's my understanding that it was similar to Thalidomide in that the drug company failed to test it under sufficient circumstances.  That is in NO WAY the doctor's fault.  A doctor needs to be as knowledgeable as possible about drugs and treatments prescribed, but if the drug company fails to release information about potential side effects, the doctor cannot be held responsible for not knowing about them. 

If I'm mistaken, and the drug companies did release information about side effects, then the lawsuits are frivolous.  All drugs have risks; some drugs have worse risks than others.  You wouldn't sue the makers of Olanzapine for drug-induced diabetes; they clearly warn that it's a potential side effect, and doctors weigh the pros and cons accordingly. 

QuoteAn BTW schizophrenia is a neuropsychiatric disorder, but when they just finished their studies of the PET scans of a control group it clearly showed without a doubt physiology is abnormal. So does that make it a neurosurgeon's domain more then psychiatric disorder, or does it fall in a geneticist field? The oath is not to harm.

I have no idea what you mean here.  Why would it be a neurosurgeon's concern?  There isn't a neurosurgery to correct schizophrenia.  Is it a geneticist's domain?  Not yet, but it is a question for researchers in genetics.  There's a familial pattern of inheritance in schizophrenia, so identifying risk factor genes would be a major breakthrough.  It's worth noting that psychiatrists also treat conditions that can be confirmed with medical tests; I feel like you were trying to convey that a psychiatrist's sole focus is psychological, uncomfirmable conditions.  If I may offer an example, psychiatrists commonly treat sleep disorders; many of these disorders can be confirmed with a simple EEG.

The oath bit seems like you wanted to include it somewhere, and didn't know where.  It doesn't pertain to the information beforehand, or after.  It's just...there.

QuoteAn I do not see them making a women who want 38KKK sized breasts have therapy for that procedure. The doctors in Cali probably do more over stuffed boos every day without a thought. Not to mention there was no therapy for Brian Zembic who after losing a bet got breasts (look up that)!

I don't know if they DO offer them therapy, but they should.  Women who are that uncomfortable with their breasts likely have an underlying psychological problem; Body Dysmorphic Disorder, or Histrionic Personality Disorder are very likely.  As for smaller surgeries (e.g. removing a mole,) you have to admit that they aren't exactly drastic.  HRT and GCS will completely rework who you are, both physically and mentally.  Localized, small things don't have nearly the same effect on your life.

The Brian Zembic case is just silly, and the doctor who performed the surgery should be reviewed by the regulatory body.  What I said about localized surgeries still stands, but boob jobs are just a bit over the line, in my personal opinion.  I'm reading now, it actually sounds like he had a surgeon build up a big gambling debt against him.  The surgeon paid the multi-thousand dollar debt off with the surgery.  Not exactly like he walked into Johns Hopkins and had it done. 

QuoteThe problem is we are a minority an easy mark to push around. Hopefully rather then bickering we will unite and have our voice heard loud and clear to change these archaic practices and join the 21st century accepted and cherished by society.  ;)

There are definitely some doctors out there who, for ideological concerns, don't support transgendered people.  Luckily, there are plenty of resources available to utilize to avoid these providers.  I've seen plenty of lists of "good" gender therapists, and they can typically recommend a supportive medical network to assist you.  I feel like you're victimizing yourself to some degree.  Not everyone wants to push transpeople around.  I'd say more people are tolerant than aren't; it's just a case of that vocal 10%. 

Quote from: GinaDouglas on October 01, 2010, 02:17:07 AM
Because GID is not abdominal pain, and a lifetime of research is not reading Wikipedia.  Your analogy is inapt.

You're still examining yourself through tinted glasses.  Would someone with GID come to a different conclusion in regard to their ailment than a fetishist?  I went to a transgroup and met a girl who didn't want to live as a woman full time; what she thought would be ideal is if there were some pill that would make her 100% female sometimes, (particularly for clubbing and sex,) and then another to make her 100% male.  HRT and GCS would not be a good option for her, and a properly trained therapist would recognise this, and treat accordingly.

It's not my job to pay for other people's ignorance.  Whether it's a dumbass ->-bleeped-<- you met in a group, or one you see in a mirror.

Quote from: long.897 on October 01, 2010, 03:07:19 AM
You're still examining yourself through tinted glasses.  Would someone with GID come to a different conclusion in regard to their ailment than a fetishist?  I went to a transgroup and met a girl who didn't want to live as a woman full time; what she thought would be ideal is if there were some pill that would make her 100% female sometimes, (particularly for clubbing and sex,) and then another to make her 100% male.  HRT and GCS would not be a good option for her, and a properly trained therapist would recognise this, and treat accordingly.

Everywhere I have ever been. My experience is that 80% of professionals in any given field actually don't know very much. Probably because the education system sucks and they learn most of what they end up knowing after they get hired.

Quote from: al jamesI know everyone is an individual and as such any medication or treatment should be adapted to that individual but why is there such a wide discrepancy?

that long wait seems nonsensical but you can use it as a legal cudgel by honestly doing RLE and after 2 years requesting a GRC and new Birth Cert and then legally you are in a serious Human Rights issue about one department of the Gov't - GRC  making you legally male but the other dept - NHS or perhaps really just your PCT - refusing you the natural rights of a man.
Lots of UK TS are going this route.

Such blind faith in the profesional world borders on pathology.

Personally what I don't like is a one size fits all approach. Medicine is a very individual art which MUST take account of individual differences.

I think doctors and patients need to be free to exercise their judgement.

Some people clearly do benefit from a period of contemplation, others don't. The doctor and patient should be allowed to make their own informed decisions and, yes, in some instances informed consent is definitely the way to go. In my case it would have prevented me taking matters into my own hands over HRT and thereby putting my health at risk

Ironically informed consent was the basis on which I was allowed to cut my RLE from the normal length down to just over 6 months, and over 25 years later, and after a successful postop life, it would be VERY a brave, or even positively suicidally foolish, person indeed who tried to tell me that this decision was a mistake!

We are all different. Don't be mislead, the SOC are actually guidelines and NOT rules! So the day any doctor starts treating them as rules, they have ceased to practice medicine and instead mistakenly begun practicing law!

I used to be a strong advocate for mandatory psychiatric gatekeeping for HRT and surgery.  I know when I finally caved and started transitioning, I felt like I was going crazy, but I now think that was because I had the same prejudices about transitioners as the rest of society at large.

Meanwhile, I've observed a lot of needless gatekeeping over the years, where others have been held back for years before finally finding a therapist willing to help instead of hinder them.  And I've also seen people turn back during the process.  Not one of them had any kind of surgery, irreversible or otherwise.  I know there have been some very rare cases where people had GRS and regretted it, and some of those even had long term HRT and even other surgery first, like implants and FFS.  But that happened in spite of the SOC, not because the SOC were bypassed.  Do we really know that the incidences of regretted GRS would be greatly more frequent without the psychiatric gatekeeping?

I think it would be interesting to have control groups, where one group does traditional SOC under psychiatric supervision, and the other is not psychiatrically supervised and just has to have HRT and some kind of reversible surgery before having GRS.  I think that there would not be much benefit to the psychiatric supervision requirement, and any such benefit would certainly be outweighed by the harm done to those who were held back and had an antagonistic relationship with their psychiatric supervisor. 

So I think it would be better to let people have HRT with just endo supervision, and the GRS surgeon can treat them if thay have obvious HRT development and some other kind of elective, transition-related  surgery they didn't regret.  The requirment for psychiatric supervision seems like a result of stigma that transitioners are suspect as crazy, and that's the only reason we still have that requirement.  I mean, sure there are a few people who are schizophrenic and will seek to transition because that condition is not treated, but those people are really easy to spot.  We don't need the type of gatekeeping that is currently in place, and I think it does more harm than good.

Quote from: cynthialee on October 01, 2010, 07:57:56 AM
Such blind faith in the profesional world borders on pathology.

It's no different than any priesthood, going back to the beginning of time.  The nearsighted lead the blind.