Is fulltime required before HRT, or can HRT be done before fulltime? Or is this something that has no firm rule in place and is at the discretion of those with the MD or PHD behind their name?
Quote from: meatgrinder on March 29, 2011, 10:29:31 PM
Is fulltime required before HRT, or can HRT be done before fulltime? Or is this something that has no firm rule in place and is at the discretion of those with the MD or PHD behind their name?
Good question.
Of course, I'm no expert. However, my gender therapist recently told me there is no firm rule. Also, I've noticed that different people go fulltime at different points. Some go fulltime before ever being on HRT at all. Others have been on HRT for a long time, like me, and have not yet gone fulltime.
My gender counselor said that it is wise for each person to go with their own comfort level and with their own circumstances. That works for me. How about for you? Makes sense, doesn't it?
In my case, I went through a job loss and financial hassles over the holidays. So, it took a while to get established in my new job. Now, I am. Also, I haven't done any hair removal yet, again, because of circumstances. I have my for-now wife, her daughter, 3 doggies and 4 kitties depending on me for support. Also, I'm helping a few other people on the side.
Their needs come first. They cannot suffer on account of me. That's why I've delayed for so long going fulltime. Originally, I intended to do it in October 2010. Circumstances got in the way.
The good news is that I start laser beard removal in late April 2011. At that time, I'll also get a new and better wig. Finally, I'm now looking more feminine than in my avatar pic (Thanksgiving Day of 2010) and can now pass more easily.
Really, there's no hard and firm rule. Why should there be anyway? These rules are like Santa Claus meaning they are made up. It's your life. It's your circumstances. It's YOUR choice to go fulltime whenever YOU choose to.
Just my opinion. Good luck!
;) Lacey Lynne.
Thank you, great info. I'm still very new around here.
I've got no intention of going full time or even out in public presenting as F until I can look the part, glad to know I 'probably won't' be forced to.
I agree its a situation where there is no one correct way to do things. Since I identify as somewhere between genderqueer and female its also not a specifically one direction path way for me. Sorry, I wish that was easier to explain but I am still working trough the details myself. But from what I have been told I could easily go fulltime if I wanted, but I am just not there yet. I totally get what Lacey is saying, I want to make sure that things with my significant other are good and that I more slow for her as well as for my work. In time things will happen.
Overall personally I think HRT before fulltime is a better option. :P
I started HRT long before fulltime. Depending on the person, it could go ether way. I am all for the person making that decision for themselves.
Some therapists including the health service in the UK want RLT to start before HRT.
Personally I self-medicated before transitioning and before entering an official programme.
Caroline
I'm going to be having "that conversation" with the NHS soon, I'm curious to see what happens (since I don't feel comfortable about changing my clothing style until my body style is changing to fit it). And I'm again reminded of this pithy cartoon:
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.yoxi.net%2Fanitya%2Ftgd-rlt.jpg&hash=fedb588e562ae15d1e0ce8beee62f11abeca20ff)
I've been on HRT for almost 8 months and I haven't gone fulltime. I think it's really up to you and your own comfort zone. I have a lot of people that I have to interact with on a professonal level. I have decided to take my time for them and also my family since I am 44 and it would be too much of an adjustment to simply go on girl mode. Granted I am getting to the point that even in my andro stage I'm beginning to feel frustrated, but I think the slow transition has been the best route for me to take.
Again, it's about how YOU feel and what's best for YOU.
I think the hesitation about going FT starts to disappear when you are one HRT. Why? You have made the commitment, you are happy, your brain thinks a different way ( I know mine goes to Geez girl you'd look hot in highs and a mini ;Ah yes brain., I'm too old, shut up, but kiss me anyway.) But you also start to act differently. You do become more feminine in thought, and I think it is the anti-androgens that are doing it.
That to say I'm struggling.
Cindy
Quote from: carolinejeo on March 30, 2011, 04:12:20 AM
Some therapists including the health service in the UK want RLT to start before HRT.
Personally I self-medicated before transitioning and before entering an official programme.
Caroline
same :)
Quote from: meatgrinder on March 29, 2011, 10:29:31 PM
Is fulltime required before HRT, or can HRT be done before fulltime? Or is this something that has no firm rule in place and is at the discretion of those with the MD or PHD behind their name?
Hehe, full time before HRT? Heck, I was only part time right up until a few weeks before surgery.
As others have said, the timing of going full time is variable and is dependent mostly on you, but also [unfortunately] what your therapist wants to see as well. Many therapists these days get it that for successful full time one has to have been on HRT for a while. At least, those are the good therapists.
Some places require you do RLT before HRT. Personaly I think that is torture.
For me I was not willing to go full time until I had determined if hormones were for me. I did not want to live as a woman for months without knowing for sure I was a woman infact and not just in my head.
I was on HRT for 3 months before I went full time. Once I knew that HRT was indeed good for me it was obvious I needed transition.
I can not imagine sending my old male self out into the world trying to live a female life with none of the tools and all the wrong hormones running the show. That is just plain mean if you ask me.
I went fulltime about 19 months after starting HRT. I used to tell people that hormones did away with my ability to be embarrassed.
Really though, I was pretty comfortable making the switch when the time came, and the hormones had given me such a new outlook on life, and a loss of self-consiousness, that things went very well.
I did self medicate for years on and off before stopping and doing things the right way, since then it was almost a full year of real life before being officially prescribed HRT almost 6 weeks ago
Quote from: Padma on March 30, 2011, 04:21:11 AM
I'm going to be having "that conversation" with the NHS soon, I'm curious to see what happens (since I don't feel comfortable about changing my clothing style until my body style is changing to fit it). And I'm again reminded of this pithy cartoon:
Yeah, good luck with that.... :-X You might be okay if you have a understanding GP, but I don't think the GIC people would say yes if you were to ask them.
It is amazing how different countries treat this situation so different.
Medically speaking The standards of care required a 1 year real life test before HRT could be started. However in the United States many people no longer follow this rule because it is outdated. For me to get HRT I only had to do 3 months of regular therapy meetings. I think this is a much better standard than being thrown into the world as a more or less "man in a dress".
I started to transition to part time when I started HRT and over the course of 6 months I spent more and more time out as female. After being on HRT for 8 months I am more or less full time, unless it is for some medical or legal reason where as I haven't changed my name yet.
3b on the SoC quoted above means essentially that, if they follow the WPATH SoC, it is at the discretion of your therapist and Endo, either of whom can decide to be a roadblocker. How you present yourself to both of them can go a long way in determining how quickly you get that prescription, as does just the lottery of whom you happen to pick out of a hat.
The comic above is totally awesome and illustrates exactly why I think we should never be required to be full-time before HRT. I was such a mess and so fragile before I ever started therapy that I am 100% positive I wouldn't have made it through any kind of RLE before HRT requirement alive. Hell, I barely made it as it was. It is setting us up to fail and, under such guidelines, legitimate cases probably found themselves de-transitioning and going back to hating their existence, or worse.
The hormonal adjustment prior to transitioning not only improved my chances of passing, but it put me in a more stable place emotionally and mentally so that I could actually handle failing to pass without it utterly ruining me.
I was going by the older SOC, I was not sure if had been updated but I am aware no one follows the old ways anymore.
Quote from: Padma on March 30, 2011, 04:21:11 AM
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.yoxi.net%2Fanitya%2Ftgd-rlt.jpg&hash=fedb588e562ae15d1e0ce8beee62f11abeca20ff)
If you read the SoC carefully, you will see that the RLT is required for GRS but not for HRT. There's a section in Susan's Wiki about this.
That being said, I went full-time more than two years before I started hormones. (NOT by therapist's order. It was just MY way of doing it.)
My therapist didn't really direct me either way, I was more of a gatekeeper in moving forward than she was to be honest because of my extreme fears of rejection.
Anyway, I had been on a low dose of T-blocker for a few months and ended up actually going full time before I started my regular HRT regimen with the proper T-blocker and Estrogen. I was full time for about two weeks before adding estrogen.
It was so strange because if you had asked me even six month ago how this would have gone I'd have guessed that I was going to be on HRT for quite a few months before actually going full time. But once I went out a couple times and realized that it wasn't a big deal, it gave me courage to just go for it. Basically I saw no reason to continue to play the boy role except on a rare occasion where it's necessary to keep certain people from knowing before they should know this about me.
So for me I did it at about the same time, but technically went full time before full HRT. And my therapist is one of those "I am here to assist" types, not the gatekeeper type so I suppose that helped me just do it when I was ready.
Quote from: Madelyn on May 18, 2011, 09:56:33 PM
But once I went out a couple times and realized that it wasn't a big deal, it gave me courage to just go for it.
I wish this could be said more often. This is a great message to those who make into such a big deal. I have a terrible time of trying to get this message across to folks.
Quote from: girl_ashley on May 18, 2011, 09:59:50 PM
I wish this could be said more often. This is a great message to those who make into such a big deal. I have a terrible time of trying to get this message across to folks.
I know. I remember how afraid I was to step foot out of the house. These are serious fears for sure.
But the thing is that if you just plan a little bit, and wear something that is appropriate, and try and look natural and nice you just probably won't have a problem. But try telling me that about a year ago and I'd have listened but still hesitated.
People, you are your own worst critic! The first time I went out it was a jean skirt, sweater, black tights, flats, and I did my hair and makeup as nicely (naturally) as I could and people totally didn't even look weird at me. I was floored, but guess what - people didn't care. I looked average enough to not draw lots of attention to myself.
A couple months ago on the first day I went full time I actually got a flat tire and had to call a service company to change it for me (wasn't going to do that in a skirt and bring all that attention to myself). It went PERFECTLY FINE. I have a Youtube vlog of the whole thing that I really wish I could share, but alas, I'm not out to a lot of extended family and friends yet so I can't post... :(
You know, I am just in awe that I waited so long to do this. You, whoever is reading this, will be too. Ashley is right!
QuoteCRITERIA FOR HORMONE TREATMENT
Eligibility Criteria. The administration of hormones is not to be lightly undertaken because of their medical and social risks. Three criteria exist.
...
3.Either:
a)A documented real-life experience of at least three months prior to the administration of hormones; or
b)A period of psychotherapy of a duration specified by the mental health professional after the initial evaluation (usually a minimum of three months).
I got my hormone letter on my second therapist visit (exactly one week after my first therapist visit), and got my prescription filled the very next day because I made the doctor's appointment the week before when my therapist told me she would give me my letter on the next visit. To make all these dates easy to remember, I started my "official" full time the same day I started HRT. 15 months later I had SRS.
It was difficult at first, but I kept in mind the overriding motivation was that I was doing this to save MYSELF and not one tiny bit for what a single other soul had to say or think about it. By 5 months I was getting "ma'amed" even in boy clothes and no makeup, but the first couple months were very hard. I think if it hadn't been for the incredible feeling of rightness in my body that HRT provided for me it would have been immeasurably harder. As it was I never questioned that it was right for me, no matter what the costs.
I think such a life changing event should be up to the individual when they feel it's right for them, whether before HRT or after. But to paraphrase a common cliche', if it were easy everybody would be doing it. I do think that period of adjustment at the beginning served to solidify my commitment to transition, because it helped me understand that if anything felt this right deep down in my soul then it
was right, no matter what I had to go through to get it. All the rest was immaterial.
Quote from: Lisbeth on May 18, 2011, 09:24:37 PM
If you read the SoC carefully, you will see that the RLT is required for GRS but not for HRT. There's a section in Susan's Wiki about this.
That being said, I went full-time more than two years before I started hormones. (NOT by therapist's order. It was just MY way of doing it.)
This practice strikes me as so cruel, RLT before HRT. What nationalities are you girls that are going through RLT before hormones? I feel very strongly about the hormones providing confidence and not letting RLT turn into a gauntlet!
I had never heard of this, so forgive my ignorance.
I know that I'm atypical but I was on HRT (DIY) for 3 1/2 years before I started living as me (I despise the term "full time")
I had never presented as "me" in public until almost 3 years into HRT... I never would have had the confidence.
Folks can say what they want about DIY HRT but I feel like I did what I had to do.
There are lots of doctors here in the US that are prescribing HRT with, "informed consent." When I did eventually go to an MD, she continued me on almost exactly the same dosages as I had chosen myself without a therapy letter; I demonstrated an in-depth knowledge of HRT and its effects (even taught her a thing or two!) and we wound up adding progesterone. I think that there are many of us that fall into the submissive role when confronting the gatekeepers.... Do your research and gain the ability to chat about this stuff near their level. Tell them what you want and when you want it and why... have answers to their challenges ready and don't be afraid to tell them that you're no longer in need of their services..... just find another doctor. Sometimes, it's as simple as showing up for your appointments "en femme" (Ugh! I hate that term, too) and looking your best to show you're serious.
Requiring "full time" before HRT is unnecessary and tortuous. Don't jump through their hoops.
About 8 weeks ago my Doctor that I have been seeing said to me about a 'possible RLE' before he would put me on Hrt. But more recently he said that it was more of an individual choice of the person of when they chose to go Fulltime before or after going on HRT.
I said that I would prefer to take HRT first and then move onto Fulltime later when I felt the time was right. That way if I don't like the effects of HRT ( and it's highly unlikely that I won't) I can stop. But obviously stopping brings it's own problems and I won't go into that.
I said also that I would make small steps to feminize myself and slowly change my appearance and then eventually blend it into fulltime . I'm finding that I have to tell them what I want and get them to help / guide me.
My Psychiatrist seems more intent on getting me into the gay scene and meeting men for relationships / sex ::). I'll give him a bit longer before ditching the dinosaur and finding one that will actually help and guide me into transition but sorry.......going bit O/T with that one
And yeah JessicaR, would have to agree with the living as 'me' rather then the 'Fulltime' label, though I guess that is just an official phrase that everyone refers to. To me it's the beginning of the 'Real Me' and I'm sure most other girls would feel that way
The comic above says it all for SA and I think still UK!
ONE year RLE before HRT!!!!!!!!!!!!! Nuts!
To me that is plain crazy, it would have killed me to do that. Who can one I ask?
So what happens you have to find your own way around this nutty shrink enforced idea.
WPATH does not stipulate it, only 3 month on RLE and the HRT.
Yet a lot of "gate-keepers" in UK, SA, maybe Germany, Switzerland INSIST!
They are either sadists, control-freaks (like mine was) or just to scared to make a mistake, they prefer you kill yourself rather (so that problem is fixed, NO JOKE, it happens)
I go with the idea as early as possible so you can find you if you trans, cd, or what not. If not trans, mostly it puts you of E real fast when getting flaccid, and chemically castrated. It will but any normal type male off one time.
Greetings,
Axelle
The NHS guide is three months, not 1 year. Private practitioners tend to follow the 3 months psychotherapy or RLE option and even the NHS GIC's are pretty understanding of self medding people.
I went to see a private doc first and got a script, I have now transferred to the NHS with no problems. I have been on HRT for 9 months and haven't started RLE yet, although I need to fdo it now if I want the NHS to take over my script.
I know a lot of U.K based transsexual women and not very many who began RLE before HRT. Some of the older ones have a thing about 'doing it the right way' but if it was so right then other countries would do the same.
Beni76;
You need to put as much distance between you and that psyrink as you can. Trying to get you into the gay scene is not doing you any help whatsoever.
If you are indeed a woman you have nothing in comon with gay men.
Find a proper gender therapist that can help you figure out your gender.
Quote from: Padma on March 30, 2011, 04:21:11 AM
I'm going to be having "that conversation" with the NHS soon, I'm curious to see what happens (since I don't feel comfortable about changing my clothing style until my body style is changing to fit it). And I'm again reminded of this pithy cartoon:
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.yoxi.net%2Fanitya%2Ftgd-rlt.jpg&hash=fedb588e562ae15d1e0ce8beee62f11abeca20ff)
Oh god, I hope my therapist isn't like that. >.>
Quote from: cynthialee on May 29, 2011, 06:03:25 PM
Beni76;
You need to put as much distance between you and that psyrink as you can. Trying to get you into the gay scene is not doing you any help whatsoever.
If you are indeed a woman you have nothing in comon with gay men.
Find a proper gender therapist that can help you figure out your gender.
I have really come to realise this in the last week Cinthialee, with his push for me into the gay scene. That just wouldn't be me and if I were to present as a woman as I really feel, I can't see too many if any of them being interested in me.
I feel that I have to go back to just finding my own way as in finding a network of friends instead of taking his suggestions.
As for a gender therapist, unfortunately there are none that I know of where I am and it would mean relocating several thousand miles which is just not feasible for me but I will look into that of what other possible options I have. For a start I am going to ask my Doctor to refer me to another shrink. One of my friends has all her hormones done through this Doctor so I feel comfortable knowing that he has some experience.
And some good points there Axelle, MillieB, RoadToTrista. The more and more I read on this, I really don't see myself doing or should anyone else have to do the RLE before HRT. Bit of a ramble but, it helps clear my head.
Quote from: cynthialee on May 29, 2011, 06:03:25 PM
Beni76;
You need to put as much distance between you and that psyrink as you can. Trying to get you into the gay scene is not doing you any help whatsoever.
If you are indeed a woman you have nothing in comon with gay men.
Find a proper gender therapist that can help you figure out your gender.
Coming out of the "gay scene", I told my therapist that was one of the biggest things that helped me understand my feelings - that I still participated with a social group of gay men, but I felt absolutely no connection to them otherwise...I just knew it wasn't me (being a gay man).
One caveat I would make about HRT is it's a slippery slope once you start. Pre-HRT I was 100% sure I would never transition. Just too much to lose. Once I started HRT my thinking began to change. From other friends I've talked to, this is very common. And I've seen it happen in others.
We think HRT is harmless and if it's not right for you, just stop. If you haven't come out, no harm, no foul. And you can resume your old life. But I don't believe that to be true for most people. I believe even non-TGs would be affected mentally if they were on cross-gender hormones long enough. You may not feel it right away, but hormones have as powerful effect on our minds as our bodies.
Hormones are a big part of why women act like women and men act like men.
Valerie I'm actually in Australia in a small isolated city called Darwin. Then again a lot of Australia is considered to be isolated , in thousands of kilometers not miles lol.
There are some good Gender therapists in all the other Capital cities though I'm not sure if they do consult's over the phone or with Skype. It is something I will have to look into, talking to an actual proper Gender therapist. The Psychiatrist was more so for a mental assessment for HRT and because I have anxiety issues and not much social content he thinks 12 - 18 months before HRT and I'll leave it that for him.
Quote from: Beni76 on May 30, 2011, 08:48:20 AM
Valerie I'm actually in Australia in a small isolated city called Darwin. Then again a lot of Australia is considered to be isolated , in thousands of kilometers not miles lol.
There are some good Gender therapists in all the other Capital cities though I'm not sure if they do consult's over the phone or with Skype. It is something I will have to look into, talking to an actual proper Gender therapist. The Psychiatrist was more so for a mental assessment for HRT and because I have anxiety issues and not much social content he thinks 12 - 18 months before HRT and I'll leave it that for him.
That's not necessarily a wrong line of thinking for your therapist. In not so many words WPATH standards want the therapist to rule out all other causes of crossgender identification as part of the therapy process. Plenty of people (children and adults, children especially) have thought all their social probelms (anxieties), etc. would be solved "if only I were a girl". That can be true, but not always. Therefore its important to rule out the other factors first.
I agree that co-morbid issues need to be ruled out, but making a woman wait 12-18 months after her bell rings (I hate that term, need a new one) to get HRT is torture.
Personaly I think that in many cases HRT can be ussed as a litmus test. This of course should be a patient call not the psychs call.
Quote from: cynthialee on May 30, 2011, 03:41:24 PM
I agree that co-morbid issues need to be ruled out, but making a woman wait 12-18 months after her bell rings (I hate that term, need a new one) to get HRT is torture.
Personaly I think that in many cases HRT can be ussed as a litmus test. This of course should be a patient call not the psychs call.
The therapist works for you, not the other way around. I would agree forcing someone to wait, unnecessarily, is wrong. Though plenty of people complain that their therapist won't "let" them start HRT, in part when their refusal to work on other issues is why the therapist is concerned about them starting HRT (but never actually said they were forbidden from HRT). Some people, fence sitters, also hid beind that line of reasoning. That they'd transtion, if only...when in reality they're fearing transition.
Well that is a good point that other underlying issues can make you think that if I came out as a girl then that would just fix everything. But if you don't get those issues treated first and then you did become a girl and you still had those issues ,then you could just become a jumbled mess. I think I understand what you mean and it is right.
I have just come from an appointment with that said Psych. He said that I have to work on my social issues and actually have something to offer to people in order for them to have an interest in me. Mainly because I am somewhat introverted, shy, quiet.
Secondly I asked him if there would be an issue with him if my other Doctor prescribed Androcur to me to block the Testosterone. I said that I wanted it to reduce some of the masculine effects, reduce body hair, ect before eventually reaching HRT. His reply was that is a very dangerous drug and that it has little or no effect after puberty and I felt he wouldn't give an actual answer, just groaning and shaking his head. He also said that I have to work on the way I present myself such as way I talk, posture, express myself as women don't do it how you do. He used a word but I have forgotten, might come to me later.
He also said that HRT will do little if anything for you and most of these things you have to do yourself.
I am finding that I am not finding myself comfortable to talk to him, to express my self and yes again take previous advice and find someone else. I guess a lot of this is in my head and I need someone I can feel comfortable with explain all.
I apologize to if I have hijacked this thread or turned myself into a rant machine but, it is good to get advice from others with more experience. And just let me know if I am over reacting
My therapist said about just the opposite about AAs, that by themselves they can produce some limited feminization; but at least greatly reduce the masculinizing effects of testosterone (even after puberty). It sounds like your therapist has a rather uneducated view on the effects of androgens (that he believes they some how magicallly stop working after puberty - I mean how else do you explain sex drive, etc) AND his saying you need to be more feminine in your presentation really is some sort of gatekeeperish attitude. I wonder what silly pre-requisite for HRT he'll put in front of you next.
I would definitely get a new therapist if I were you.
I was fulltime WELL before hrt. And I didn't pass worth a damn. But you know what? I was ****ing happy, and that is all that matters. And that is all that matters to you too. If you can be happy just on hrt but being fulltime would amke you feel like **** then dont. Otherwise just thats okay and have fun because you are all that you need to be happy.
Beni,
That dude is full of shiite.
Drop him like a hot potato and when you do, write him a long winded letter describing in great detail the limits of his inteligence and lack of basic understanding of HRT drugs. He doesn't know squat.
I obviously took another route. If I didn't then I would still be waiting on HRT now if I would still be here at all... I don't have time for those professional idiots, They are too scared of begin wrong in the diagnosis, The current system is a failure if you want my opinion they don't have the grit or balls to help anyone. Really you need to take care of yourself.