New member to this site but I have from time to time have visited.  After 44 years I have decided that I need to do something about how I've felt about myself going all the way back to about 6 years old.  Late next week I have a appointment with a therapist that specializes in transgender issues.  I'm not naive enough to think that she will ask me a series of questions and then give me formal diagnosis of suffering from gender dysphoria.  But I don't know how many sessions it will take before she does render a diagnosis.

What should I aspect and what is next step after getting the 'letter'  I'm excited but also terrified about this 1st encounter with a therapist.

Welcome to Susan's Place. Something you may not have seen but gender dysphoria is the only condition that is self diagnosed. Your therapist will not be diagnosing but instead will be confirming your diagnoses. Depending on the therapist and how open you are, this could be accomplished in 2 or three sessions.

The next step will be up to you. Some people desire additional therapy in order to deal with other issues in their life and other may move on to transitioning. You may start your transition before ever seeing a therapist and some do but many have and idea how they want events to play out and go by their own time table.

If your goal to get letters (you didn't state which) you should mention that early on. HRT letters can come pretty quick. Surgical letters may only be available after a year of RLE. If you desire a letter, you should ask your therapist what actions you need to take in order to receive the letter you are interested in.


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Thank you Dena for responding so quickly.  I believe that i would like to start HRT as soon as possible.  I do need to lose weight (but I have already been doing this for other reasons) and would like to take a wait and see approach about SRS and FFS.  I'm married going on 14 years and have a six year old boy.  My SO knows about my dressing in Fem or as she calls it Samantha mode but it has been over six years since I've dressed.  In that time I never felt a pressing arge to dress since along the way I realized that clothes don't make you a woman.  I feel like one on the inside and every time I would dress I would fell at first happy and relaxed but then reality would remind me that I still had a penis.  Which I have never liked having.   Should I go dressed to the first session or would it be better to go as I appear appear to everyone 24/7?

You should appear at your therapy session however you  will be comfortable. If Samantha has spent a fair amount of time in public, then there would be no problem with Samantha going. You will be nervous enough without adding a first public appearance to it. Once you are relaxed with the therapist, it would be a good place to first introduce Samantha.

SRS and FFS often require the year of RLE (full time) before letters are written. It's not always the case but but most of the time it is. Often people don't require FFS as estrogen can make a major changes in appearance given time.

Hello Samantha,

Dena is right on. I want to add that a letter is not the only thing to hope for from therapy. You have gone through many years and many emotions to get to where you are. A good therapist can help you sort though much of that and help you move farther into your journey with the fewest bumps and bruises. This works best when you find a therapist that you can be comfortable with and openly communicate your wants and needs.

I would like to add that while there are many folks that get their "Letter" in one or two visits, many of the protocols suggest a minimum of three months of therapy with few specifics of what that really means. Mine came after two months. I just brought this up to keep you from getting your expectations set too high.

You know that transitioning is not just getting a letter or starting hrt or........but it is a process that began when you decided to do something about choosing to experience your real identity and will continue for the rest of your life. It is a great journey, enjoy every step.

Anne

Samantha has been out in the public before (library, mall, park)  in the past and even then I didn't interact with people very often or for extended periods (always been very shy around people) so I never really developed my fem voice.  Regardless I've lived my current life and like everyone else in the world have had my share of good days and bad.  But quite literally everyday from the first time I realized that I wasn't like the other boys and since then I've felt like I was a fraud in how I presenting myself.  For years I simply thought I was a cross dresser but even dressed I never felt complete and eventually acknowledged that while it helped.  Eventually I would need to take off the clothes and wash off the makeup and when looking in the mirror afterwards I would still feel like a stranger was staring back at me.

Don't worry about having every perfect if Samantha goes. We tend to be a little rough around the edges at first and the therapist expect it. I think you have little to worry about with the therapist as it shouldn't take long for both of you to agree on your  transgender status.

Thanks for everyone's advice so far.  I'm still on the fence about how I should present myself (dressed in fem or not) when I meet her for my very first appointment.  I don't want to seem that I'm trying to hard and when I asked she didn't really respond.  I sort of feel that how I appear to her for the first time is almost like a test  (not one of those pass/fail ones)

When I met with my therapist for the first time, she never registered my dress.  She asked a few cursory questions to get things started and then we talked about life.  To this day we have never really discussed clothes and I have been seeing her for a long time.

Just go in an be you and you will do fine.

My very first session with my first therapist was with me presenting as male.  The session went well, if we call 'well' my completely falling apart with 50 years of repressed self exploding all over the office.

For my second session, I wore my jeans, size 8, and a teal lightweight long sleeve turtleneck, with the usual padded undergarments, and a nice Calvin Klein jacket.  When he came into the waiting area calling my male name he completely missed me.  I stood, he did a little double-take, "Oh, there you are. This way..." and I was off to my second session.  I know what I looked like...  Brrrr...

He did ask me why I was dressed for the session.  I mentioned that he HAD said this was a safe space at the start of the first session, and that I felt better and thought I might communicate better as myself.  Then we dove in..

So, yes, you can go as yourself.  It's a safe space, and I guarantee that the doctor has already seen it all.  If it helps you to feel more comfortable, or to communicate better, then by all means, do it.

Quote from: SammyGirl on September 23, 2016, 04:42:27 PM

What should I aspect and what is next step after getting the 'letter'  I'm excited but also terrified about this 1st encounter with a therapist.

Congratulations on your important 1st step. I think in the months ahead you will find yourself experiencing a lot of firsts.

For example, I have my first hearing with the county judge next week to petition for my name change.  The 1st time I ever changed my name.  For many of us it is a beautiful and sometimes difficult but totally worth it journey of discovery that awaits.  A true metamorphosis is possible. My advice:  just be honest with your therapist. Find a real life trans support group. Be present. And let the magic happen.

Quote from: Michelle_P on September 25, 2016, 11:01:44 PM
The session went well, if we call 'well' my completely falling apart with 50 years of repressed self exploding all over the office.

I cried like a baby at my first intake too.  Pro tip: bring lots of tissue. (Just kidding. They're a gender therapist! They WILL have tissues.)

Actually an SRS referral can consist of primarily a q&a diagnosis, viz:

Sadly I'm an old hand at therapy. When I decided to start hrt it was just a quick appt with my PCP and then the somewhat long wait for an endocrinology appt. All I had to tell my doc was I've known for 20 years I'm trans and had discussed it extensively back then as well as for the previous 2+ years I'd been working with a psychiatrist on issues if depression as well as extensive work on being trans.

I don't fit in the gender binary and spend my days now simply not worrying about the hrt-induced changes showing and take a little time to apply makeup etc. This is also how i present for therapy. My therapist has been a rock throughout, it couldn't be more clear that she genuinely cares for me and that said, not being an expert in gender she wanted to involve someone with specific experience before writing a surgery letter for a patient not planning to pass (hence waiving RLE at least as defined by my insurance company). This was all fine in my eyes as I need a second letter for SRS anyway.

So I sought a referral and the psychologist I came up with said she'd first consult with my pshrink and then work with me if appropriate.

Those sessions came down to two sessions of me relating my history and the things I've been through in a cumulative 7 years in therapy. On the third session she opened saying "this may feel a little invasive, I'd like to ask you questions I need to form a diagnosis".

And so the substantive part of that therapy was indeed a series of questions to get to a diagnosis. I'm *not* saying treat it as a rubber stamp, a good therapist can help immeasurably with understanding ourselves.

p.s. I choose to go to therapy as I am 24/7 which is essentially non-binary, I femme up a little more on those days, wanting my therapist to see whatever the most femme Sadie does at trthis point in time.

My first visit I showed up as Anne (I had warned her before hand). I wanted her to meet me first as the person I choose to be. My second visit I went in guy mode wanting to introduce her to who I have been most of my life. All following sessions Anne showed up. How I presented my self to her did not seem to make any difference in our progress though I believe that she preferred to work with Anne, she recognized that as Anne, I was most comfortable and more open to sharing more fully. - Anne

Hi girls it's Shannon. I went as Shannon and used my passable voice and was greeted and treated as Shannon.

Congrats Shannon on stepping up and out!  The main thing is to be comfortable with the therapist so that you can better open up the little intricacies that brought you to this point.

Kaity. Thank you. It felt good to be me.  I didn't overdue my appearance but was definitely girly.  I wore basically the same thing to the Endo/GP and Therapist.  Hugs Shannon

Quote from: spx_1112 on September 28, 2016, 12:42:44 AM
Kaity. Thank you. It felt good to be me.  I didn't overdue my appearance but was definitely girly.  I wore basically the same thing to the Endo/GP and Therapist.  Hugs Shannon

Well done!  Getting your gender presentation lined up with your gender identity is like a little miracle drug.  You can feel better, and I bet you communicated better because of that.

Congratulations!

Wish me luck my appointment is tomorrow and I'm so nervous I don't know if I will be able to sleep tonight.

You will do great!  Just breathe and relax.  The appointment will be awesome.

you will be fine, be honest.. in the end your only being honest with yourself.

my appointments are right after work and well i cant go home to change and come back.. i have no car