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Are Therapists Milking the Transgender Community?

Started by Karla, May 08, 2013, 01:23:07 PM

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Karla

Following on the thread at: https://www.susans.org/forums/index.php/topic,140171.20 ...i wish to discuss the money aspect separately.

Quote from: SamB on May 08, 2013, 11:02:10 AMIn selected circumstances, it can be acceptable practice to provide hormones to patients who have not fulfilled these criteria. Examples include... and who have a history of prior hormone use.

Thanks for that... there we go.  I was on HRT for six months in 1987... and might have continued, but for a bad experience in therapy.  I'll bring that to the doctor's office.

My ability to trust has worn thin.   If it seems like i'm upset, i am.  It took two months to get an appointment with this new GP doctor.  So I started therapy right away... after a month of therapy, now the therapist says she 'wants to get to know me better' before writing a letter in time for this appointment.   

I have no desire to DIY and I'll play the system by its rules (no choice), but let's have no illusions that some of us are being milked for our hard-earned cash.

I'm not surprised that so many young people DIY, regardless of the dangers.  Fresh out of college (in today's job market), who can pay for months and months of therapy, just to get official approval for one's own life choices?

Catherine wrote, 'Transition is a MAJOR life changing event, and there's more to it than "being quite sure of what she wants"'.  Sure it is.  My life. 

Please advise.  Please remember that although i'm a newbie, i have strong opinions.  Never mistake submissive for servile, or docile.

Thanks,
Karla
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MaidofOrleans

Some milk and some genuinely are concerned. My mom is a therapist herself (family and eating disorders) and I genuinely think she cares about helping her patients and not the money, but there are some out there that will milk you for your cash. Just like in every field of work there are good and bad apples.
"For transpeople, using the right pronoun is NOT simply a 'political correctness' issue. It's core to the entire struggle transpeople go through. Using the wrong pronoun means 'I don't recognize you as who you are.' It means 'I think you're confused, delusional, or mentally I'll.'. It means 'you're not important enough for me to acknowledge your struggle.'"
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Karla

Thanks, MaidofOrleans, this makes me feel better.  :)

So i think i ought to try, 'informed consent' and use therapy as a long term discussion.  If one therapist is wasting my money, i'll find another, and another, 'til one sticks.

Sorry, i have been in a bit of... dismay... over this.

My pro-choice opinions can wait for another time.

Cheers,
Karla

Quote from: MaidofOrleans on May 08, 2013, 02:14:10 PM
Some milk and some genuinely are concerned. My mom is a therapist herself (family and eating disorders) and I genuinely think she cares about helping her patients and not the money, but there are some out there that will milk you for your cash. Just like in every field of work there are good and bad apples.
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Sammy

Right now I am thinking about changing my therapist or giving a try to another - female therapist. My main issue so far has been that here in my country we do not have any gender-specific therapists. so many of them claim that with their experience and education they can treat any situation. At the same time, I became aware that some of our general therapists have dealt with TG patients before, but they do not openly admit this, so finding out who is competent and who is not has been quite a pain in the butt. So far, I have had about 2 months of active sessions once per week but my overall feelings are that we are sort of having a general therapy, talking about my childhood, family, relations with my parents etc. Each session brings up more issues to touch upon and he keeps claiming that we still have a long journey and many areas to cover, including my sexual experience etc. But.. With each session I sort of get the feeling that we depart from TS-related stuff into some other vague psychiatric areas, which can be explored until one of us will be fed up with this. Sure, we can have this exercise for years, I have to give him the credit that he actually helped me to restore my shattered family ties with my mother to the extent that she almost seems like accepting the situation. But that is not a gender therapy. I have no idea what gender therapy is like, but what I have read here and what we are doing in his office, are two different things.
Still... today we had another therapy session, we talked about some sense of internal guilt about many things and at the end he asked me why I am not talking about HRT anymore. So I told him that I have chosen the approach of "Less talk, more action", repeatedly told him (apparently he forgot) that I got into contact with endo, did the blood tests and my HRT is bound to start in one week, and he did not seem that much interested in this. Therefore, I am not really sure that he will be able to provide sufficient support in terms of therapy, when I will be facing new issues with the HRT. I am quite sure that he will keep scaring me away, talking about how I might be perceived by others, that I will be exchanging male sexual experiences for God-knows-what which might not be even functional and it will not as functional as "real" female parts, and am I really sure I want this. Another point, which usually has the effect of internal mental facepalm for me is "Am I sure that I wont be happy to live as effeminate man? Now is 21st century and nobody would care much about how I express myself" Apparently, my attempts to explain the main difference between transwoman and effeminate man do not get much response or recognition, because we keep getting back to this from time to time. And I am spending 70 bucks for this each week. Still, he is good and experienced as the general therapist.
So, as I said, I am inclined to try out a female therapist, who happened to be my good acquaintance, but I never knew that she had degree in psych too...  And when my HRT starts, even if I dont have the therapy on a weekly basis, I suspect that I will be in a need of someone with whom I can share and talk, even if this is like once per two or three weeks only.
I also finally realised that here I do not need therapy, per se, to get the hormones - I rather needed some luck, good friends and connections, so doing the therapy has been my personal choice and despite all the above-mentioned issues and some struggle, which still goes on, I do believe that it came out better with what I got, than if I would have done this without any therapy at all.
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Donna Elvira

Finding a therapist you are comfortable with is very tricky and it took me 5 tries before I was successful. Obviously a lot depends on what you are going to see the therapist for. If it is to get a letter which opens the door to HRT I believe it totally skews the relationship , frequently leading the patient to tell the therapist, who is now a "gatekeeper", what one believes he/she wants to hear.
Personnally, I was looking for someone I felt comfortable actually telling the truth about my feelings, my doubts, conflicts etc.. someone I could be completely open with and who would simply help me better understand myself by asking the right questions at the right time.
In particular, with a very understanding doctor,  I had no need for therapist's letter of approval to get HRT. The issue will eventually come up for GRS but I believe it will come up naturally when the moment is ripe.
As indicated in the beginning of this post, I have found the person I was looking for and she has been remarkably present for me through a couple of very rough patches over the last year and this had nothing to do with money. She cares and it shows.
Bises
Donna 
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suzifrommd

Try to find a therapist who is a member of WPATH. The WPATH standards of care make it very explicit that it is up to the patient when to start HRT (http://www.wpath.org/documents/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf) last paragraph on page 25.

Any therapist that stands in your way is a gatekeeper and a leech.
Have you read my short story The Eve of Triumph?
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ChristyB

Over the years I have had several therapists of varying competencies. Therapists are no different than mechanics, or plumbers or any profession. There are those that are in it for business and those that are in it for the feeling they get by truly helping people. My current therapist has no gender specific experience and she was very forthcoming about that when I asked. She is pushing me to find someone to talk about gender specifics that has experience even if it means I would see her less or not at all. That speaks volumes for her professionalism. The key as mentioned is to find someone who will help you. If your current therapists isn't, simply fire them and look for another. If your car had a bad transmission and your mechanic wanted to replace the engine, would you take your car back to them?

Hope you find someone,
Christy.
Meh.
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FrancisAnn

Some are nice & some are impossible. Just find & meet new one's until you are satisfied. No need to stress on it too much, life is too short.
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Northern Jane

I have wondered about the therapy requirement and when/why it came into being.

I went through all of this between 1966 and 1974, before there was an established protocol. I found a sympathetic doctor, a gynecologist, who started me on hormones at 17 (a year below 'age of consent'). There was no surgery available then but he arranged a "psychological assessment" which he felt would be a requirement for any future surgery. The assessment was completed in one weekend. When surgery became available (1974), everything was in order.

I am not saying that I would not have benefited from counselling - there were issues of childhood abuse and PTSD that I did not deal with until years later - but I was not, at that time, patient enough to deal with anything but the major issue on my life.

It looks, to me, like the present system is more about following a prescribed path than about getting to the truth.

JMHO
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Joanna Dark

I don't think any therapist goes into gender identity disorders in order to get rich. If they did, they need to reconsider how they make life decisions. I mean transgender and transsexual persons are incredibly rare. We are like  0.2 percent of the population and that is a liberal estimate. We are probably even less. Also, due to the explosion of people identifying as trans in the last decade, they do have to be careful. I'm prob going to get flamed for saying this, but I just don't believe that every single person who identifies as trans is in need of medical intervention. For some, it can be a risky prospect. Anecdotally, consider the large number of trans women with multiple children.

PLEASE don't take this out of context. I'm not saying that people who have children are not trans. What am saying is that if you have children and a wife and a very masculine profession AND you were legitimately happy and then all the sudden you discover you are trans when you were not before, I think therapy would be a good idea before irreversibly chemically castrating yourself and perhaps losing your ability to sexually function in a penatrative manner. Many men, like 99 percent, consider losing that ability a reason to die. Look at all the war movies were some guy euthanizes some other guy because who got shot in the balls. There is quite a few. Dead Presidents is the first that comes to mind. So, a couple months of therapy to make sure you are sure in these cases is probably a good idea. Not saying anybody this applies to isn't trans. I mean for me having sex was incredibly difficult and sometimes impossible. I don't even like touching my testicles. Nothing skeeves me out more. *shivers run down spine* Theother thing is life has been incredibly hard for me. I was very succseful before the bubble burst but it was not because of male privilege it was because my career is magazine editing and I worked as..wait for it...a fashion and beauty editor and erstwhile gossip columnist. I also covered parenting and baby features. Not exactly what every boy grows up dreaming to be. In fact, I was astounded they ever hired me. This was the best time of my life. I was really good at it and I loved all the makeup and clothes and beauty swag I got. It is prob the most female job one could have. And I was really good at it. Funny this is my mom still says I don't believe you ever showed any female side. Like, what? This also during the time where I had a girlfriend and fiance. So maybe my mom looks at that. But she should also look at the fact she had a shaved head and was very masculine. Not anymore though. In fact she dumped me when she was done with her lesbian phase as she called it. She always said I was woman with a penis lol or just plain woman. But I digress.

I know I am kind of sounding more trans then trans but it is not my intention. I know I sound like a trans elitist but I just think in some cases, not all, you shouldn't just jump right in. I do think if one wants to go the HRT route they are prob trans. But given the rate of detransition and suicide after SRS (I consider one suicide high) you want to be 100 percent sure. The other thing is and this is actually what I meant to say but I always get sidetracked, is that it is not the therapist's job to fix you. You will get out of therapy what you put in. And I have had way too many therpaists, psychologists, and psychiatrists. Know why it didn't work? Cause I refused to tell the I was trans. I just couldn't do it. And being trans is the defining characteristic of my life. It's like what they say in NA: it works if you work it! You have to put something in. IDK, I just don't think anyone goes into gender counseling to bilk trans men and women. I think the majority do it because they legitimately want to help us.

I prob shouldn't even post this as i really hope I haven't hurt anyone's feelings. And I'm really not a trans elitist I just think some people, not all, should get some counseling first if being trans only recently manifested itself. Sometimes I imagine for some people becoming a woman is prob a tragic mistake. I guess I just don't understand the high number of uber-masculine trans women. I just want to offer a different POV. Please please please don't be offended. Ack. I'm scared lol
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Joanna Dark

Quote from: muuu on May 08, 2013, 11:20:08 PM
Detransition is another thing though, but does that really happen that often?

Peer reviewed medical journals report the rate of detransition to be 31 percent from what I have heard. I don not if it is true or not but I do not believe that it is the less then 1 percent that is reported on trans web sites. It is probably somewhere in between. It is such a complex issue that it is hard to say if transition is right for a person. I mean I am 100 percent sure that I am a transsexual and have been for very long time and I'm only 30. Yet, in the last week or so I have started questioning whether or not I am making a huge mistake and this at the exact moment I am starting to pass and I have only been on HRT for 73 days. I don't know why it has sped up so fast so quick.
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Northern Jane

Quote from: muuu on May 08, 2013, 11:20:08 PM
Wouldn't those other issues be dealt with by a regular therapist, not a gender therapist?

Yes, and they were eventually.
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V M

I'm actually considering to find a new therapist at this time

I've had a few therapists over the years, non were specifically gender therapists but most had some training regarding gender issues -

One or two have been very impressive and helpful, some seemed to be 'milking it' to make a check imo and there were a couple I felt to be more harm than good

I've been working with someone who goes by another title for the past few years but is within the realm of therapy and has been more help than any 'therapist' I've ever had
The main things to remember in life are Love, Kindness, Understanding and Respect - Always make forward progress

Superficial fanny kissing friends are a dime a dozen, a TRUE FRIEND however is PRICELESS


- V M
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Sammy

What is the overall impression from our MtF audience? Are female therapists better suited to our situation than males? I know, we all communicate better with women, even if they dont know we are trans, because subconsciously they know we are the same or at least that we are different from men.
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Joanna Dark

Quote from: Sammy on May 09, 2013, 02:21:07 AM
What is the overall impression from our MtF audience? Are female therapists better suited to our situation than males? I know, we all communicate better with women, even if they dont know we are trans, because subconsciously they know we are the same or at least that we are different from men.

I've always preferred female therapists for all my problems. And that's one thing I have never been short on--problems. But I think it's easier to talk to a woman about being a woman yet being born male. It's not that I think male therapists are worse; its just I think it's easier for me to communicate with women, for a variety of reasons.I've always felt this way and I've always preferred female company. In first grade, I got in so much trouble for using the girls batthroom with my friend who I convinced I was a really a girl. So I just find it nice to talk to someone about my issues and past horrors and do not mind having a therapist. I've also known  I am trans since I was 10 so I really don't need one to help me figure it out. There is nothing to figure out. I am nothing if I am not trans. But I'd rather be chromosomally XX. I used to pray when I was 7/8/9 for God to transform into a girl and to right this wrong that has been done to me. The great thing about HRT is that I no longer have dysphoria but it's still good to talk. I like talking. Today, when everyone referred to me with female pronouns was probably the best day of my life. I literally cried. It wasn't just some "Ooh that's nice." It was a spiritual experience and the culmination of a lifetime of suffering and failure. I'm really smart but barely graduated high school because of all my issues. And this is the kind of things I talk to my therapist about. And prob also about why now I am again depressed because I feel like today was fleeting and tomorrow I'll be sir'd to death and that it was a one off.
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FrancisAnn

From my experience a female therapist is much more pleasant & productive than any male "therapist". A male has no idea whatsoever about what we are truly feeling inside.
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delia_dunno

Quote from: Sammy on May 09, 2013, 02:21:07 AM
What is the overall impression from our MtF audience? Are female therapists better suited to our situation than males? I know, we all communicate better with women, even if they dont know we are trans, because subconsciously they know we are the same or at least that we are different from men.

I see a gay man whose practice is, I would guess, 95% gay men and 5% trans women. His background is in the treatment of addiction, and he treated many trans addicts in a rehab setting before opening his own shop. I am very happy. Didn't have to waste weeks developing a rapport because he knew the subset of issues I may be walking in with. I think gay men and lesbians are often a good fit for trans folk as therapists.
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Karla

Quote from: Joanna Dark on May 08, 2013, 11:36:05 PM
Peer reviewed medical journals report the rate of detransition to be 31 percent from what I have heard.
...in the last week or so I have started questioning whether or not I am making a huge mistake and this at the exact moment I am starting to pass and I have only been on HRT for 73 days. I don't know why it has sped up so fast so quick.

Joanna,

I too hit that bump, a bit over 2 months in.  Then i opened the front door, took a deep breath, felt the wind in my hair, and went out.   Is it fear?  Is it hormone fluctuations, the little doomed nuggets squirting T into the bloodstream as quickly as possible?  Do we fear the process ahead?  Fear other difficulties?  Fear becoming a second class citizen in society's eyes?   Who knows.  Be brave.

I detransitioned not at that time, but a couple of months later, due to career pressures, family pressures, and the very real possibility of becoming homeless.  I don't know where academics get their figures (following the citations suggests that they're passed around in a circle)... i simply dropped off the face of the map, as i'm sure many do.  I don't recall having received a 'why did you resign?' survey in the mail.

This is a fascinating thread, and although it was a rant, i'm glad i started it.  I have learned a lot here.

Cheers,
Karla
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FrancisAnn

Karla, Lucky Lucy.

Go forward young woman, do not look in the rear view mirrow.
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eli77

Quote from: Joanna Dark on May 08, 2013, 11:36:05 PM
Peer reviewed medical journals report the rate of detransition to be 31 percent from what I have heard. I don not if it is true or not but I do not believe that it is the less then 1 percent that is reported on trans web sites. It is probably somewhere in between. It is such a complex issue that it is hard to say if transition is right for a person. I mean I am 100 percent sure that I am a transsexual and have been for very long time and I'm only 30. Yet, in the last week or so I have started questioning whether or not I am making a huge mistake and this at the exact moment I am starting to pass and I have only been on HRT for 73 days. I don't know why it has sped up so fast so quick.

Uh... Which medical journal? Post-SRS, rates of detransition are pegged around 1% by every study that I've seen... In fact it's widely regarded as one of the surgeries with the highest rates of success. All surgeries have failure rates, just to be clear.

Also, once again, I'd like to point out that prioritizing the health of cis people over trans people is gross. If a few cis people get themselves on hormones? Well, they'll probably figure it out pretty quick. And if they don't, too bad. I'm a bit more concerned about our insane rates of suicide, depression and substance abuse than a handful of delusional, privileged cis folks. Sorry.

If this isn't the right path for you, figure that out for yourself. Making permanent physical changes to your flesh is serious stuff. Obviously. Honestly, I think it's bizarre the whole shuffling responsibility off on therapists. Yes, therapy can be a useful tool during transition, because transition is stressful as hell. But as a gatekeeper? We aren't children. We are perfectly capable of making our own decisions and taking responsibility for them.
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