Hi again! not sure if anyone remembers me haha, I posted here a while ago and I wanted to update on my situation; so I've been seeing a psychiatrist and a psychologist for a few months, both gender-specialists, who have both confirmed that I am trans (although I don't think there should need to be any "confirmation" from third persons, I'm a boy and I don't need confirmation of that fact).

Question 1: Last week I had a blood test and I have my first appointment with an endocrinologist in early September. My psychologist said that they would prescribe me T the same day if everything in the test was okay, but what if it's not? I have had anaemia in the past and I might have it now, would that prevent my getting T? I don't want to wait more months or get more unnecessary blood tests (I'm needle-phobic). And what if I have unknown problems? I mean I may as well have cancer and be dying and I just don't know yet lol.

Question 2: This probably has been asked many times before, sorry for that, but anyway, I'm asexual and it worries me a lot that I'll become sexual once I'm on T. I have never had sex, kissed, masturbated, had a "wet dream" or watched porn, I am sex-repulsed, if it were for me everyone in the world would stop having sex right now (yeah I know I should be a priest XD, I would if I could). Any reassurance from someone who's both on T and 100% asexual? Some cisguys are asexual, so logically I should be able to remain asexual as male-bodied, but since higher libido is always listed as one of the main unavoidable things T supposedly does, I worry. I mean just thinking about me having sexual thoughts makes me sick, but if it were to happen it wouldn't make me stop T either. Not sure if I would stand it for long though.

Quote from: Manny on August 01, 2014, 08:44:55 AMQuestion 1: Last week I had a blood test and I have my first appointment with an endocrinologist in early September. My psychologist said that they would prescribe me T the same day if everything in the test was okay, but what if it's not? I have had anaemia in the past and I might have it now, would that prevent my getting T? I don't want to wait more months or get more unnecessary blood tests (I'm needle-phobic). And what if I have unknown problems? I mean I may as well have cancer and be dying and I just don't know yet lol.

Well, that's the point of blood tests - to see if there's anything that's underlying that may cause complications.  There are plenty of guys with anaemia on T - but it's up to your doctor if they do find something that's worrisome and delaying you starting T isn't the same thing as not ever being able to get on T.  I know that waiting is frustrating, but we're talking about your health here.

Quote from: Manny on August 01, 2014, 08:44:55 AMQuestion 2: This probably has been asked many times before, sorry for that, but anyway, I'm asexual and it worries me a lot that I'll become sexual once I'm on T. I have never had sex, kissed, masturbated, had a "wet dream" or watched porn, I am sex-repulsed, if it were for me everyone in the world would stop having sex right now (yeah I know I should be a priest XD, I would if I could). Any reassurance from someone who's both on T and 100% asexual? Some cisguys are asexual, so logically I should be able to remain asexual as male-bodied, but since higher libido is always listed as one of the main unavoidable things T supposedly does, I worry. I mean just thinking about me having sexual thoughts makes me sick, but if it were to happen it wouldn't make me stop T either. Not sure if I would stand it for long though.

I don't understand asexuality because I'm not asexual, but my thinking is that you should have brought this worry up with your therapist.  Have you?  Because if that's a serious issue for you then you may need to think about bringing it up if it's going to cause you problems down the road. 

Your clinic/doctor might have a different opinion, but the trans clinic I go to considers anemia a non-issue for T. They said it's because going on T raises hemoglobin levels, in part due to menstrual cessation.

Not trying to question your sense of your own sexuality/lack thereof, but throwing a possibility out there to consider. Sometimes trans people are disinterested/disgusted with sex due to dysphoria, and become more comfortable with sexuality when their dysphoria is decreased. In any case, definitely something to discuss with your therapist.

If you're needle-phobic, what's your plan regarding T if you do go on it? Gels/creams? Or are you going to work on getting over the needle-phobia?

Thanks for your replies guys! Yeah I get that blood tests are meant to check if I have health problems lol, I just don't want anything to delay my starting T, and it's very possible that I may have anaemia. I just hope you're right, Blink, and T actually helps and it doesn't become a reason to delay it. But in my country, people just don't know much about gender issues, not even the so-called "professionals" so I don't trust completely whatever decision the endocrinologist makes regarding this.

As for my asexuality, I doubt it's due to gender dysphoria, I mean I find both female and male genitals equally disgusting, in fact one of my worries was that I wouldn't be considered "enough" of a guy just because I didn't want bottom surgery, but that wasn't true. So I really doubt I'm asexual because of dysphoria, if that were the case I'd probably be celibate (as in, I'd want to have sex with people or feel attracted to them but I would stop myself from doing so because of my disgust of my genitals). But of course, if T does make me sexual then being celibate is the next best thing.

I haven't talked about this with my therapist because I don't trust her, I don't trust therapists in general anyway and I don't feel comfortable revealing my fears to them, especially fears concerning such private and personal things like my own sexuality. And also because I'd worry that they would tell me not to start T or they would try to "convince" me that I'm not or shouldn't be asexual (it's happened before). And even besides all that, the next time I'll see her is after I've started T (if the blood test states I'm okay) so for all these reasons, I can't talk to her about this. I can't talk to anyone so I'm just sitting here worrying over it like a moron. :/

Oh and yeah, definitely gonna be on gel haha, my therapist knows and agrees. I wouldn't be able to work over my needle phobia, like ever hahah.

Time for some toughlove, Manny.

I suspect that the anemia won't be a problem, but you weren't specific about what type you have. Have you ever been treated for it or adjusted your diet for it?

It's a good thing you can use gel or cream instead of needles, but they tend to be vastly more expensive, and a lot of guys complain about the hassle factor. Others have complained that their changes occur more slowly, but I don't know whether that's true. At some point, you might want to work on that needle phobia; I have read that such fears can be overcome if you go about it in the right way. I have also read that a lot of people don't have a full-blown phobia; they have more of a reasonable fear--it is reasonable to fear sharp things that penetrate the body.

But your sexuality and your therapist...these things seem pretty serious to me. Some people on T say that their sex drive stays the same or goes down, but the vast majority seem to have a spike, sometimes a huge spike (mine was astronomical). You can start out on a very low dose and raise it incrementally, but even a low dose can make a big difference. My doctor told me that women with a low sex drive can go on a low (female-appropriate) dose of T to restore their interest in sex, so what if you go on a substantially higher dose and are one of those people whose sex drive hits the ceiling? What if you find that you cannot function? Dealing with all of the effects of T can be quite challenging even for someone who is well prepared and doesn't have such issues. And not having a therapist you can work with on this isn't going to do you any favors.

I don't believe that all trans people need lots of therapy, and I sure as hell get the part about not trusting therapists; that's why I swore off therapy for fifteen years myself. But then I hit rock bottom and had to make a decision to go back into therapy and this time do it right--because I had quite a lot of issues to work through. But nothing like this potential land mine.

You can go on T and just "see what happens" and not confide in your therapist, but I recommend that you be better prepared than that; it sounds like your sexuality could spell trouble if you get typical results from T. If you don't trust this therapist, you can decide to take that leap of faith and start confiding in her, or you can find someone you can really trust. A truly competent therapist won't reject asexuality out of hand or tell you that you can't be trans and asexual.

I should also point out that IF you got a T letter from your therapist instead of going the informed consent route, your failure to divulge a potentially serious problem is short-sighted and probably dishonest. If you did get a letter from her, she has a professional reputation to protect, and she is counting on you to be upfront about any issues that might indicate that you should start T later, after you work through those issues. I know that you don't want any delays, but delay is sometimes the best thing. If you are doing informed consent, then this doesn't apply, of course.

That's my take on it, anyway. I just want you to get the best results possible, and I want you to be safe and happy.

Anemia is something that testosterone can help. Testosterone often raises red blood cell count. It's unlikely that you'll have an issue. It's one of those things we all worry about.

It is possible that you will still feel asexual. But! It's possible that your feelings about sex, and being asexual are related to being trans. I think some people felt uncomfortable with their bodies and with the idea of sex because they were not in the right sort of body. Should discuss that with your therapist if you haven't already.

I don't know what kind of anaemia I had (I didn't even know there are types), but yeah I took medication for 3 months until I was back to normal levels of blood cells or whatever. I think the gel is free, the whole treatment I'm getting is free but even if it's not, my parents can afford it so I'm not worried about it. I'd only take T shots if it was an absolute necessity, and I don't really mind if the effects are a bit slower, I'm just too afraid of needles to even consider that option, although I do hope you're right and that this phobia will go away over time.

Arch, are you trying to scare me? hahah, because you're succeeding! Yeah I'm just worried about this man, I went through a very bad phase a few years ago, and sometimes I really worry I might go through that again because of the higher libido thing, but it's not like I have much of a choice. I can't trust my therapist, besides I don't even like her, we had a strong argument the last time I saw her, and I know she dislikes me too (which is not my fault, she was the one who lashed out at me for no reason), so even if I wanted to confide in her she wouldn't be keen on listening to me and empathising, I don't think. Besides, in our first session she basically dismissed my asexuality, even pitied me as she said "you have never had an orgasm?! oh, poor boy, what a shame! this is such a pity...". I don't even think she believes asexuality exists. And where I live I can't go to other therapists, she and the psychiatrist are the only ones specialised in gender issues AFAIK. I just can't with therapists, I can't stand their condescending look and their ignorance and their "I know better" attitude. Yes my therapist sent me to the endocrinologist with the T letter, does that mean I should be completely honest with her? I've told her many lies already. Thanks everyone for your answers btw, you're all very kind and helpful. But I wish someone asexual himself would comment as well and tell me his personal experience, aren't there any in this forum? I know that asexual people are a vast minority but come on, I can't be the only one here can I?

I wish I could help ya out man, really.  I'm asexual, aromantic, myself, but I'm not on T yet so :/ Soon though, I don't think it'll be too much longer before I start on a really low dose.  Depending on when you'll be starting I can keep you informed on how things go in that department, but otherwise I don't have much to give you.  I'm not really worried about it though.  Something you might look into is that there are some anti-depressants that have a side effect of essentially killing your libido - and that's why I'm not worried about it - I'm on one.  It is a hit or miss thing however, some people get that effect, others don't. Are you still seeing that psychiatrist? This would be a good one to bring up to him/her if it interests you. But I do hear you in not wanting that libido.  Just frustration abound for an ace.

I wasn't trying to scare you at all--not for the sake of JUST scaring you, anyway. But I've known a couple of guys who managed to start HRT while they had very real problems that should have been addressed first--both had serious complications later. One bypassed therapy and did informed consent, and the other guy found a therapist who was a soft touch; two or three visits, and he had his letter. That clearly wasn't enough time for him to work through his issue, and I'm pretty sure he didn't even divulge it.

While it's possible that your therapist is subliminally picking up on your untruths and responding negatively because of that, I doubt it because she did write the letter. Her dismissal of your orientation is cavalier, and her condescending attitude is inexcusable (I've seen a bunch of therapists and have never encountered condescension; there are more supportive types out there). If this therapist isn't working and you can afford to switch, then please consider doing so, even to one who doesn't specialize in gender. What if you find that you're in over your head?

In your case, I would think that gel is the way to go, actually. You have to use it every day, and the T takes time to build up in your system. You can stop or reduce your dose instantly at any time. But if you do have to stop because the sex drive is messing with you, you will likely be better off with a decent therapist supporting you.

I agree with arch. The point of therapy is to support you and help build you up, not made you sit with someone you don't like or trust and you feel you can't tell your problems to. I strongly suggest finding a different therapist if you can.
I can tell you that sex drive was my first change. I went from having virtually none to what feels like overdrive within the first three weeks, and my T levels were already high for a female bodied person. If you're really concerned and don't want anything to do with sex, I'd really recommend finding a new therapist so you'll have that support to fall back on if things get bad.
The two of you have to fit right and be able to work together. If you don't mesh, move on. Going to therapy with a person you can't trust is useless.

Quote from: Arch...you will  likely be better off with a decent therapist supporting you.

No "likely" about it, IMHO. You need to run, not walk, and get away from this therapist as soon as possible. The behavior you're describing is not OK.

Quote from: MannyI just can't with therapists, I can't stand their condescending look and their ignorance and their "I know better" attitude.

Holy Cheetos --  it sounds like you've encountered some rotten therapists.

You'd be way better off with a good therapist who doesn't specialize in gender issues but is willing to learn. As far as I'm concerned, any therapist who "dismisses" a client's issues, no matter what they are, is committing malpractice.

Oh, and I FULLY AND COMPLETELY understand about needing to start T as soon as possible. Lots of us get to the point where further delays further endanger us. If a heightened sex drive were a less common experience and if your asexuality were expressed differently, I would be less concerned--but still concerned. Ya gotta take care of yourself, Manny. You can usually get good support on Susan's, but we're no substitute for a truly caring and competent therapist who really listens to you and takes you seriously and sees you on a regular basis.

TW: Rape, attempted suicide and negligent therapists (if that counts)

Hello Manny,

I am aromantic asexual, originally identified as FTM and have been on T for four years.

Pre-T, I had no interest in sex because I felt indifferent to my genitals. I had not touched or looked at them until I was 18, a therapist suggested I masturbate in order to tell if I enjoy touching them as a female or not. Even though I wish I had ignored their suggestions because in the deepest of my heart, I did not want to touch myself in that manner, I'm not going to lie, masturbation and orgasms from it have helped me a lot in terms of relieving stress.

The same therapist suggested I have sex with others to see if I enjoy it as a female or not. Sex with others have been less than satisfactory. I have not been able to experience arousal towards others, much less orgasm. Due to my distress of this, of not being "normal" (I later learned this was asexuality), I took up drinking and confided in a "friend", this "friend" whom I trusted, told me in my drunken state that he found transsexuals attractive and he then proceeded to coerce me into sex.

After the rape, I could not even masturbate which was frustrating because what was once a stress-reliever was now a living nightmare. I became repulsed by my genitals, every time I would attempt to masturbate, I found myself floating on the ceiling more than once. Over the years, I no longer dissociate and no longer view my genitals as repulsive. Since identifying as non-binary, I experience dysphoria towards my genitals because I would like neither female nor male genitals - this is unrelated to the rape.

Therapists... I've had my bad share of them. I've had the therapist I mentioned above, the one who suggested I masturbate and have sex with others, he would always make the subject go back to my sexuality - he thought my sexual identity was the issue and as a result, I felt violated by the questions he asked. He would ask, "If you masturbate to blow-job videos, shouldn't you vision yourself as a female in that video, not the male?" He was very sexually explicit and it made me uncomfortable but since my mother had found him, she thought he was wonderful because he was getting to the "bottom of the issue" and she was pleased he was not "encouraging" me to transition. The therapist did not understand that my gender identity lies in the male spectrum and he was quite insistent that I should be enjoying myself sexually as a female, not as a male.

When I was suicidal, I begged him that I needed outside help (as in being committed to a psych ward) because I was afraid that if I went home after the session without getting help, that I would kill myself. He asked me if I needed the hospital, I said yes, I do. I was in tears as I answered him! He paused for a moment and simply changed the subject and said he would see me next session, telling me to "hang in there". I could not believe that my cries for help went ignored. Later that night, I had attempted to drown myself twice, nearly succeeding the second time but the thought of dying with an misaligned body, being buried as a female with a female name at the funeral kept me fighting to stay alive. I did not want to leave this world without at least trying to achieve the correct body.

One session, he would tell me that I looked feminine and that was the final straw - as someone who identified as male and trying as hard as I can to hide the female parts of myself because I dislike them, having that fact thrown in my face is a HUGE NO-NO! I told him right away that I don't want to see him anymore, he looked very puzzled and even dared to quirk an eyebrow like, "Really? I just complimented you though." I broke down crying in the car ride home. I was inconsolable. My parents didn't understand, rolled their eyes when I told them what he said and they told me to, "Get over it."

The first psychiatrist I saw, she had been known to write letters for people who would like to transition. She was very strict and the first meeting I had with her, she told me I sounded like a textbook talking in regards to my gender identity, which was untrue as I had told her my personal experiences about being depressed during puberty because I did not want breasts growing or periods. She was insistent on treating my depression with anti-depressants, even though I had told her repeatedly that my depression is because my body isn't correct. You cannot fix the symptoms of depression and hope that the root problem will magically go away. The anti-depressants made the depression worse and I became suicidal. My parents and I agreed not to see that psychiatrist again because she was trying to fix me with medication instead of therapy.

I saw a therapist who basically told me my asexuality isn't real, that if I can masturbate in private but cannot orgasm with another person, it must be anxiety related. I have been with numerous sexual partners and I have never been riddled with anxiety. To have anxiety that switches pleasure off implies that I have the ability to experience pleasure in the the first place with the sexual partner. How can I get anxiety over something that doesn't exist in my body? The pleasure isn't there, the attraction to the other person isn't there. I don't care for having sex with another person, it doesn't interest me and it never will. I was this way before the rape and it has remained the same after.

The second psychiatrist who is my current psychiatrist was also another person who was able to write letters for those interested in transitioning. After telling him of my experiences with other therapists, he agreed that anti-depressants would not help me, and unlike all the others, he actually listened to me. The others appeared to have selective hearing, only heard what they wanted to hear and discarded the rest as insignificant. He did not push me on my sexuality (or lack there of), if I was not interested in dating or having sex and said so, he simply nodded, accepted it and carried onto the next subject. It was WONDERFUL to have someone who finally respected me for who I am! He was very kind and noticed if I looked tense, he would crack a joke to get me to relax and commented that I don't have to worry about answering questions correctly, just to think of these sessions as chats with a friend.

Thanks to him, I went from being depressed, self-harming, drinking heavily to being stable, content, no cutting and no heavy drinking for at least four years now.

T did heighten my sex drive in the beginning and within a year or so, it had stabilized back to normal (normal is low for me), similar to pre-T. HRT did not magically create any attraction to others. My lack of attraction has remained constant before and after T, I have been this way ever since before puberty, it's something I believe is ingrained into who I am. I have tried to change myself and force myself to to be "normal" but it has resulted in misery. Once I accepted myself, I felt a weight lifted off my shoulders.

Finding a therapist who understands and respect you as an individual is very important. Sexual orientation can be fluid at times but for me, it has stayed the same through both first and second puberty, only having a steady increase in libido that eventually returned back down to its normal state.

Sorry this is long! I hope at least some of it is able to help you. 

Kind regards,

Jacey

Evan, I may start T in early September. Do please let me know if/when you do, even if it's just to compare experiences. What you say about antidepressants, that really sounds hopeful. I was thinking, even if I have a higher sex drive, if I can't stand it then I can do something about it without necessarily stopping T, like what you said, taking antidepressants (even though I don't think I'm depressed), or lowering my T dose, right? I don't know, I may talk to my psychiatrist about it, she's a better professional than my therapist, and I've had no problem with her. The problem is that I see her a lot less and only for a short time since she isn't my therapist. The next time I'll see her in a one-on-one session will be in November I think.

Arch, well I got myself the T letter in my second visit hahah. I didn't think that was bad? It's better than having to wait months with pointless talk until I can get HRT. What you guys say about me finding another therapist, I think you're right, but it's just so difficult to find a good one. In my country people know so little about gender issues, I'm sure that I couldn't find one not specialized in gender that would understand and support me. I went to several of the normal therapists and they certainly didn't have a clue about this, and I've had very bad experiences as a result, they telling me that I had a "sexual disorder", or that I should just accept myself as I was born a girl and should just suck it up and live with it, or that I can't be asexual and forced me to choose a gender etc. But still, I guess I gotta try, I mean what if you guys are right and the higher libido effect or other ones make me feel so bad that I need to talk to someone but can't? Tysilio, yeah I should stop seeing my therapist, but since the whole process is a "program" I have no choice, in September I gotta see her again, regardless of whether I find another therapist or not. Luckily, money is not an issue.

Wow EchelonHunt, those therapists you had were ->-bleeped-<-s, wtf? I've had terrible therapists myself as I said, but not THAT bad. I'm sorry for everything that has happened to you, it just sounds horrible. But I'm glad that you finally found a good one, who doesn't judge you for being asexual or trans. I also know very well what it feels like to be so depressed and suicidal, and I wish I had had the support of a good therapist, but due to my personal experience, I have this distrust in all therapists in general, it's like I see their condescending look and I'm done. Just done. But I realize there are good ones, like the one you have now, and that they can be very helpful. I also feel relieved that you remain asexual. Even if your sex drive heightened a bit, it went back to normal and that's hopeful. I could be okay with this if it happened to me, I think. A few months of suffering, rest of my life being a guy and ace. Thanks for sharing your experience man, thanks everyone. I'm actually surprised of all the help I got, I don't know what to say! I'll definitely update on my situation again in September-October if I finally get on T. As the higher sex drive seems to happen very early, in the first month or so, I'll probably know by then whether T has that effect on me or not and whether I can stand it and can talk to someone about it.

Good luck, Manny. I hope it goes smoothly for you.

Manny, you are in a tough spot and no mistake. I understand your situation a little better now. I suggest that you try to see the psychiatrist before you start T--also keep the November appointment if you can, or reschedule it to a month after you start T.

For the rest, can you evaluate therapists by talking to them on the phone? I would suggest a form letter, but you might not get a lot of responses that way.

I feel that under "ordinary" circumstances (holy Ned, what is normal for trans people?), a T letter after a few sessions isn't a problem. Heck, informed consent in my area involves no therapists at all. But I do object when the client holds back important information that might have had a significant bearing on the therapist's or doctor's course of action. As I said, I saw a couple of guys really tank because they refused to seek help for their existing issues.

I should add that some clients don't have the expertise or even good sense to know when something might be a problem. You have clearly thought about your situation, and I'm willing to admit that it's quite possible that you've simply done the best you could under the circumstances--I'm no expert, just another trans man. In the end, that's what a lot of us have to do--the best that we can. Transition tends to have bumps in the road--they come up even when you do everything "right." Just line up your resources, proceed with caution, and keep coming to Susan's.

It's really worth trying to get to a point where you can trust your therapist and prescribing physician enough to help them provide decent care. It sounds like that's mostly going okay for you though.

I forgot about antidepressants. I can definitely vouch for the libido-suppressing effects they can have. Prozac flattened my sex drive more than any others I've used.

Quote from: Felix on August 02, 2014, 05:21:38 PM
It's really worth trying to get to a point where you can trust your therapist and prescribing physician enough to help them provide decent care. It sounds like that's mostly going okay for you though.

I forgot about antidepressants. I can definitely vouch for the libido-suppressing effects they can have. Prozac flattened my sex drive more than any others I've used.

I don't like the sound of this therapist, but maybe he can educate her. On the other hand, if she's a gender specialist, then why should he be the one educating her? He might as well start out with someone new! (Okay, that might be more work, but no therapist should behave the way he says she's behaving.)

I never tried Prozac, but I did try Paxil, another SSRI. My sex drive stayed the same, but I couldn't achieve orgasm to save my life. Nearly drove me mad, and this was back when my libido wasn't much to write home about.

Quote from: Manny on August 01, 2014, 08:44:55 AM

Question 2: This probably has been asked many times before, sorry for that, but anyway, I'm asexual and it worries me a lot that I'll become sexual once I'm on T. I have never had sex, kissed, masturbated, had a "wet dream" or watched porn, I am sex-repulsed, if it were for me everyone in the world would stop having sex right now (yeah I know I should be a priest XD, I would if I could). Any reassurance from someone who's both on T and 100% asexual? Some cisguys are asexual, so logically I should be able to remain asexual as male-bodied, but since higher libido is always listed as one of the main unavoidable things T supposedly does, I worry. I mean just thinking about me having sexual thoughts makes me sick, but if it were to happen it wouldn't make me stop T either. Not sure if I would stand it for long though.

Hi Manny, I am also a libidoless sex repulsed asexual as well as aromantic.  I was kind of worried about this prior starting T but not as much as my other unwanted side effects from it simply because sex just didn't exist in my mind at all to begin with. I mean I don't think I would have even knew what that act was if it wasn't for the damn media.
Anyways, good thing that  I am the same way currently. I've been on T for 3 or 4 months now (I lost track due to stopping and restarting) and I am on a low gel dose. I chose this version because I can actually control how much I want to take.  Plus, its the cheapest.

My suggestion would be not to think about it because if you were on T and worry about anything sexual, it may trigger this fear and may produce a libido. This is my experience from thinking about my other fears that I face in my life.
If I was in your situation, I wouldn't tell that ignorant therapist about it.  I too faced similar comments and questions regarding my own asexuality and it sickened me so much now that I even hate the word therapist.

I can't say I was completely asexual before T but I was mostly and definitely repulsed by sex. My libido has definitely gone up. It can happen. You need to be prepared for that.

I'm curious, what would happen if you stopped being asexual?