Hey there, I have my first appointment with my gender therapist on the 9th. I'm really excited to go, but my mom told me that the doctor said she won't be the only doctor I need to see to get my letter for T. Which I'm confused about, because that is really the whole reason why I want to see a therapist. It sounded like she said that Dr. Stein (my therapist) will have to refer me to another doctor, who can then give possibly give me a letter. I did not know it was this complicated, and Dr.Stein is very expensive for my family, I really want to be able to get my letter as quickly as possible.

I guess my real question is, do I have to go through more than 1 therapist to get a letter? Is the entire process more complicated than I thought?
Thank you

I guess this would really all depend on laws where you live and who you're planning on getting T through. Typically, you'll need to see either an internalist/endocrinologist, I've seen a couple people go to a urologist, or an experienced general practitioner. These are usually who monitor your T levels every couple months; a gender therapist usually gives you a letter that you then take to a doctor, or sometimes a gender clinic, depending on where you're at and what's available. As far as I know, however, usually a gender therapist can prescribe a letter for T on their own, so yeah, I'm a little confused on that part if that's actually what he meant.

I'd say keep looking forward to talking to your therapist.
Not being excited, maybe just looking forward a bit.


Because you are not an adult yet it might be possible a second letter is needed.
I'd say just ask your therapist.

Its also possible its a misunderstanding and a second letter would be needed only for some surgeries.


hugs

I had an experience like that. I ended up going the informed consent route, but my original therapist did tell me she would have to refer me to someone else for a letter- she said she didn't know enough about T to be willing to write the letter. It was still good I went to her, but yeah, I would have had to get a letter from another therapist.

I live in California, I don't know what laws there are specifically about getting T unfortunately :/ . I'll definitely ask about it when I first see her, I'm just impatient and thought to ask now .

Quote from: CursedFireDean on May 30, 2015, 02:41:40 PM
I had an experience like that. I ended up going the informed consent route, but my original therapist did tell me she would have to refer me to someone else for a letter- she said she didn't know enough about T to be willing to write the letter. It was still good I went to her, but yeah, I would have had to get a letter from another therapist.

I do know that my therapist is experienced with trans issues, she's being a gender therapist for around 15 ish years, so I know that she knows what she's doing, but it's weird how I might need to see another doctor to get a letter. I think she mentioned a psychiatrist? Idk, I guess I'll see. It's just getting harder and harder to see my friends going through puberty and I'm going through the wrong one.

Thanks all

Quote from: Pizzaparty78 on May 30, 2015, 08:16:11 PM
I live in California, I don't know what laws there are specifically about getting T unfortunately :/ . I'll definitely ask about it when I first see her, I'm just impatient and thought to ask now .

I do know that my therapist is experienced with trans issues, she's being a gender therapist for around 15 ish years, so I know that she knows what she's doing, but it's weird how I might need to see another doctor to get a letter. I think she mentioned a psychiatrist? Idk, I guess I'll see. It's just getting harder and harder to see my friends going through puberty and I'm going through the wrong one.

Thanks all

*hugs*
keep on keeping on.
Well you might tell them exactly that... and that you would prefer to go on t. Maybe in a matter of fact way .
Time will pass quickly till your appointment.


hugs and wish you luck

In Colorado I had to go to a Therapist who then released me to another physician at a different clinic. Basically what happened was I had several appointments with my therapist before being diagnosed with G.I.D. Once I was diagnosed she gave me a list of physicians who worked with Transgender individuals to go to. I made an appointment with the physician and she told me I needed to be released by my therapist in order to start therapy. I got and delivered the release form to my Doctor and my therapist sent her a "T Letter".

I never received a physical copy of the Testosterone Letter from my therapist as I didn't need it. The Therapist and Physician were working together through calls and E-mails to give me the hormones I needed.

It's different for a lot of people.

If you want to avoid having to see several doctors then your best bet would be to see a Psychiatrist and not a therapist as the Psychiatrist can prescribe testosterone for you to pick up.

Quote from: Pizzaparty78 on May 30, 2015, 08:16:11 PM
I do know that my therapist is experienced with trans issues, she's being a gender therapist for around 15 ish years, so I know that she knows what she's doing,

Don't bank on this. I know a SoCal therapist who had been doing gender therapy for a long time, and she royally screwed my friend. My friend was emotionally distraught for ages afterward, and on top of it all, he never did get his top surgery letter. I wondered whether he was being a bit melodramatic until I talked to another trans guy's mother and heard their story.

I'm not trying to scare you; I just don't want you to equate experience with expertise and empathy. Just be careful until you see which way the wind blows.

Quote from: Rengar on May 31, 2015, 01:44:03 AM
If you want to avoid having to see several doctors then your best bet would be to see a Psychiatrist and not a therapist as the Psychiatrist can prescribe testosterone for you to pick up.

Man, it took me and my family forever to find a therapist, and now knowing that it's faster to find a psychiatrist instead =  . I've just been hearing so much about seeing a gender therapist for the past 3 years, that I thought that this was the best way. Well, I guess I'll see where it takes me. The worst part is how expensive seeing her is. P.S. I see that you play LoL, Rengar, nice  .

Quote from: Arch on May 31, 2015, 02:10:46 AM
Don't bank on this. I know a SoCal therapist who had been doing gender therapy for a long time, and she royally screwed my friend. My friend was emotionally distraught for ages afterward, and on top of it all, he never did get his top surgery letter. I wondered whether he was being a bit melodramatic until I talked to another trans guy's mother and heard their story.

Considering that I live in SoCal, this is a bit scary, I hope that this isn't the same doctor, but I highly doubt it. Thank you for putting all this into perspective.

The therapist I'm talking about is not a Dr. Stein (nor is another therapist I've heard some bad things about). If someone at Susan's ever mentions the name of a practitioner whom I know to be questionable, I generally send a PM. I've never even heard of Dr. Stein, and I'm not sure where she is located. But if gender identity is one of her specialties, then she should be qualified and willing to refer you for T if you are stable and very clear about wanting to go that route.

Another thing to either ask during your first session or before (maybe via e-mail) is whether Dr. Stein follows the treatment guidelines issued by the World Professional Association for Transgender Health (commonly known as WPATH). These guidelines were made for trans* care, by trans* doctors, lawyers, etc. in order to eliminate a lot of the patronising behaviour often imposed upon trans patients seeking care. This can especially make acquiring T difficult, as WPATH eliminates the need to wait a year or whatever in your gender-confirming identity.

My gender therapist used WPATH and I had my letter in a number of weeks; granted, I was not diagnosed with depression or anxiety, so take my results with a grain of salt. WPATH generally recommends that other issues/medical concerns be resolved or treated <i>before</i> prescribing HRT.

Quote from: Pizzaparty78 on May 30, 2015, 08:16:11 PM
I do know that my therapist is experienced with trans issues, she's being a gender therapist for around 15 ish years, so I know that she knows what she's doing, but it's weird how I might need to see another doctor to get a letter. I think she mentioned a psychiatrist? Idk, I guess I'll see. It's just getting harder and harder to see my friends going through puberty and I'm going through the wrong one.

Yeah the first therapist I saw WAS experienced, that's why it was so annoying. She knew all about trans people, but the reason she wouldn't do the letter was she didn't know about hormone effects. I assume she was just too lazy to learn, I didn't like her or the person she wanted to refer me to.

In my experience of seeing an experienced therapist for one session when trying to get my top surgery letter she basically said "I require you to see me 6 months and that is why surgeons accept my letters". Now imagine that in the most snooty voice; is how I hear it in my head when she said it. That was followed by her not even guaranteeing me a letter after those 6 months. Yeah wasn't going to waste my time with her.

Go with your gut and be forceful to know when the soonest they will be willing to give you what you want. If they cannot give you a time frame upfront and/or try to skid around the question aka "well it depends on how the sessions go" then run far away.

Quote from: Pizzaparty78 on May 31, 2015, 02:28:56 AM
Man, it took me and my family forever to find a therapist ...


Considering that I live in SoCal, this is a bit scary, I hope that this isn't the same doctor, but I highly doubt it. Thank you for putting all this into perspective.

Here might be some alternatives, just to calm you down... you might see tht as fallback ... :
https://www.susans.org/forums/index.php?topic=187135.0

Thank you all so far, all the information you've given has been immensely helpful.

@Andrew, I'll probably ask her when I first see her, it'll definitely be a good thing to ask her. I hope she does follow those. Btw, I notice the WPATH guidelines say at least 3 months of therapy or documented real life experience, if I've been out for 2 months to my family and friends, does that count?

Quote from: CursedFireDean on May 31, 2015, 05:15:02 PM
Yeah the first therapist I saw WAS experienced, that's why it was so annoying. She knew all about trans people, but the reason she wouldn't do the letter was she didn't know about hormone effects. I assume she was just too lazy to learn, I didn't like her or the person she wanted to refer me to.

That is annoying, not that great of a therapist since she couldn't refer you, so hopefully that isn't the case with Dr. Stein. We found out about her from the LGBT center in my city, they gave us a list of Trans friendly therapists.

@Alex that doesn't sound good either, good thing you knew what to do though. I'll make sure to ask her for a time frame, and being as impatient as I am, I won't forget to ask.

Quote from: Laura_7 on May 31, 2015, 06:22:59 PM
Here might be some alternatives, just to calm you down... you might see tht as fallback ... :
https://www.susans.org/forums/index.php?topic=187135.0

That is awesome, thank you. If Dr. Stein doesn't work out, I'll probably try looking into some of them, and considering some of them are around $100 cheaper, my parents will probably approve as well.

I apologize for the long post, but another question, since I'm under 18, if I were to start T, would I need blockers as well with it? Will it also make it more difficult to get a letter considering I am younger? Thanks again

Quote from: Pizzaparty78 on May 31, 2015, 06:53:13 PMThat is awesome, thank you. If Dr. Stein doesn't work out, I'll probably try looking into some of them, and considering some of them are around $100 cheaper, my parents will probably approve as well.

*Cough*

If you don't mind my asking, exactly how much does she charge per session? My therapist costs $150 per session, but he has thirty-odd years of experience (and many years of experience with trans people), so he might be a bit on the expensive side. He also offered me a reduced rate for a couple of years because he knew I couldn't afford him otherwise. I was recently looking into another therapist nearby who claims to help with gender identity, and he apparently charges $120 per hour. So you might try someone else on the center's list. Of course, your city might be pricier than mine.

Also, does the LGBT center offer counseling? Mine usually has a waiting list that becomes particularly lengthy as summer approaches (I guess the interns take summers off). I'm not sure how good the counseling is, but the fee was something like $20 or $25 in 2008. I was calling in late July and would have had to wait a few months, so I opted for my current therapist. (At the time, his fee was $135, which I could afford because I was still with my ex.)

If finances are that important, you might want to look around a bit more.

Quote from: Arch on May 31, 2015, 07:13:27 PM
*Cough*

If you don't mind my asking, exactly how much does she charge per session? My therapist costs $150 per session, but he has thirty-odd years of experience (and many years of experience with trans people), so he might be a bit on the expensive side. He also offered me a reduced rate for a couple of years because he knew I couldn't afford him otherwise. I was recently looking into another therapist nearby who claims to help with gender identity, and he apparently charges $120 per hour. So you might try someone else on the center's list. Of course, your city might be pricier than mine.

Also, does the LGBT center offer counseling? Mine usually has a waiting list that becomes particularly lengthy as summer approaches (I guess the interns take summers off). I'm not sure how good the counseling is, but the fee was something like $20 or $25 in 2008. I was calling in late July and would have had to wait a few months, so I opted for my current therapist. (At the time, his fee was $135, which I could afford because I was still with my ex.)

If finances are that important, you might want to look around a bit more.

Dr. Stein charges $180 a session, but she lowered it to $150 for my family. My mom went through the list and called up most of the people on it, Dr. Stein was the only one who had room in her schedule, was nearby, and responded.

When I emailed The Center (As it's called), asking about their counselling services, they responded with this list. I guess they don't directly offer counselling, but refer you to one of the therapists. Or maybe I just missed it. So if they do, and it's $20-$25 like it was near you, that'd be a lot better. Although finances are important, my family is willing to try Dr. Stein and see how things go. Although, if we could find a better alternative, I'll let my parents know.

Quote from: Pizzaparty78 on May 31, 2015, 06:53:13 PM
I apologize for the long post, but another question, since I'm under 18, if I were to start T, would I need blockers as well with it? Will it also make it more difficult to get a letter considering I am younger? Thanks again

As far as I know, with ftm people t is enough, it drives down the estro, so you need either t or blockers. But you might talk that also through with your endo.

If you are 100% wanting T and your parents are 100% on board with you and you don't need actual therapy and if an endo nearby accepts Dr. Graham's letters this might be a way to go http://gendertherapist.com/ No hassle, letter is guaranteed.

This is what I ended up doing for my top surgery letter, several others here have used him as well.

Thanks Laura, from what I've heard, it seems blockers are pretty pricey, so it'd be nice if I wouldnt have to use them in the future.

Quote from: Alexthecat on May 31, 2015, 07:30:59 PM
If you are 100% wanting T and your parents are 100% on board with you and you don't need actual therapy and if an endo nearby accepts Dr. Graham's letters this might be a way to go http://gendertherapist.com/ No hassle, letter is guaranteed.

This is what I ended up doing for my top surgery letter, several others here have used him as well.

While I'm 100%, I'm not sure about my parents. If I were to go through with Dr. Graham, which seems to be the easiest way, I'll have to find and contact an endo and then talk to them. That sure would be simple though if that endo accepted Dr. Graham's letter. I'll have to keep him in mind, thank you.