Hi there,

So, as the title says, for others here in the U.K., is it possible to transition with little, or next to no gender dysphoria? The only dysphoria I really feel is facial dysphoria. I can't stand to look at my own reflection, or pictures of me. I've known now for some time that I'm generally not happy trying to live my life as I am, or have have been for the last 31 years and that I need to make some changes in order to be able to live some semblance of a normal life without the constant feeling of sadness hanging over me all the of time. When I say sadness, I mean that I'm aware that something is missing in my life. I constantly feel like I'm holding something important back, and that in doing so, I'm not reaching what I consider to be my full potential as a person. I'm a thoughtful person and have a great capacity to care for other people, but I feel that I can't quite feel normal expressing myself while I'm stuck in a male body. Every fibre of my being is telling me that I should be acting in a different way, but when I'm around other people, I'm just not able to act that way for fear of what people might say. I put a lot of thought into other people's feelings and I always have; it's made me the person I am today, hence why I'm so conflicted and somewhat reluctant to make the changes I feel are long overdue.

I know that the first step in figuring out all of this is to talk to a therapist, but I'm unsure how to approach one. I'm also currently unemployed, so money is an issue. The fact that a tharapist that deals with gender issues has probably heard all of our problems before, makes it somewhat easier to approach one, but finding one is the first hurdle I need to get over. From there, I should be able to talk things over with someone and finaly start trying to figure everything out. Back in 2012 when I first started looking online and tried to figure out what I was feeling, I looked at a couple things, such as sexuality and whether I might just be a crossdresser. Crossdressing is fun, don't get me wrong, but it doesn't "turn me on" or anything like that. Also, I feel the same way whatever I'm wearing. I've never had a girlfriend, or boyfriend, and have yet to have a sexual relationship with anyone. I've had numerous male friends over the years, but never really felt like I fit in when around them. I would consider myself to be fairly introvert but with a pretty good interlect. I've always thought of my sexuallity to be hetrosexual, but in recent years, I've started leaning more toward some sort of pan-romantic asexual, based on my previous experiences and how I feel when I'm around other people.

The last couple of times I saw my doctor, I told her that I was having some really bad thoughts, but not "actively", more conscientiously. Some of these feelings were brought about because I am unemplyed and tired of all of the "hoop jumping" I am doing to please the "Jobcentre" (who I feel don't do me much good). I more than often feel that some of these feelings exist just because I'm feeling the constant pressure of living a life I don't really want and not that I'm just depressed with being out of work. There's more to life than working, at least, that's how I look at it. I don't feel too depressed anymore about being out of work, I've learned to accept the fact that there is little to nothing I can do to change my current situation.

I just don't know anymore. It's days like this when I'm conflicted and constantly uncertain of myself that I feel really down. I'm not considering ending my life, I want to live. I just need to find out whether or not I can make these changes in my life, based on my limited ability to articulate my feelings on this subject.

Here is something I wanted to ask people on this forum. Do you suffer from a sense of uncertainty and/or indesicion when people ask you questions? I've suffered from that issue myself for as long as I can remember and was just wondering if anyone had ever got an aswer for why they felt that way when speaking to a therapist.

Thanks for reading.

Considering your employment situation, your best bet is to access the NHS to see if you can get to the root of what's troubling you, rather than trying to find a private therapist.

But as you've no doubt discovered, when you mention to your doctor that you're feeling depressed they'll do very little to help you. If you're lucky, they're most likely to send you away with a prescription for some common anti-depressants to 'try' for a while; to 'see how you feel' when you take them. If you're very lucky, they might send you for a short course of CBT.

But actual psychological counselling? Actual psychiatric assessment? Mental health treatment that's tailored to your specific needs? You're having laugh: the NHS does everything in its power to not spend money on that kind of thing if it can help it.

From what I've seen in your posts you are definitely questioning your gender, but it's possible that there's something else there too. I am not a doctor or a mental health professional, but I have spent many years struggling to get what I need out of the NHS. So my advice to you is to be very direct when speaking to your doctor. If it helps, prepare a rough script before going in so that you can rehearse what you want to say. Don't just tell them what symptoms you're having and cross your fingers that they'll suggest something useful; tell them that you want to be referred to (a psychologist, a psychiatrist, a gender clinic) because you need urgent help with your (depression, other issues, gender issues). Your doctor has a zillion patients complaining of depression, so you need to be specific about what you want if you don't want them to fob you off as 'yet another depressed unemployed person who needs some happy pills'.

Sometimes it helps your nerves if you see somebody other than your usual doctor. If you're worried about transport costs, in many cases you can get help with transport costs to & from any medical appointments you need to attend if you're unemployed and on benefits - all you need to do is to ask for it.

If you'd like to explore your gender issues, tell your GP that you're struggling with gender issues and ask them to refer you to an appropriate GIC in your area. The GIC then applies for funding from your local branch of NHS England, and they'll then offer you an appointment for an assessment. The assessment normally takes place over a minimum of three sessions, which are usually at least six weeks apart. They'll assess you to see whether you would be an appropriate candidate for transition, and if there are any other issues to be dealt with (such as depression) they'll work with your GP and other services to get those under control.

They're there to help you work out what you need to do. The last thing they want is a patient with severe regrets, so they'll work with you to figure out the right options for you.

Good luck