Hey Everyone!

I am still around, and bringing a small update. I haven't really had much to say since my last post, which was a bit depressive.

Things are moving forward pretty slowly here. One huge thing that happened, was my husband coming around to all of this. Like, he actually is kind of accepting it. He isn't happy about it of course, but he also has started to accept that it is going to happen, and he can't change it. He even talked about us remaining friends and maybe even roommates, because he misses me. While we would only be able to be friends, due to him being heterosexual, it made me feel a lot better.

Since that happened, I have been wondering if I should start HRT soon. Not soon soon, but maybe beginning of next year. I want to lose some weight first before I start, and prepare myself mentally, it is a huge leap. So my question here is... how do I bring this up to my therapist?

My next appointment is on Halloween. We haven't really discussed it at all. This will be my fifth appointment. She knows I want to get on T, as I have mentioned it when I am talking, but we haven't talked about her role in that. We've really talked mostly about my issues with my husband, separation, my overall heath, me trying to get a job, taking care of my kids, etc. We obviously have talked about my gender dysphoria, but it hasn't been able to be the central issue thanks to everything else that has gone on. She introduced me to a support group here, or gave me the information for them anyway, and I will be going to my first meeting next month. So she is on board with helping me with gender dyphoria.

Does anyone have any advice on how to bring this up? I feel like I have missed my chance and am now really nervous.

My experience was similar. We talked about all sorts of things. I finally asked, what the proper procedure was to get a letter clearing me for HRT.

Simple as that. Of course to me it was like everything else in this whole process, a HUGE deal. However, in retrospect, no big thing.

Please others add advice. Just my experience.

With warmth,

Joanna

Your post made me think why I decided to seek help from a therapist in the first place. Aside from some practical reasons (Insurance coverage for HRT and surgery) there have been two reasons: my general depression and anxiety and to discuss my plans on moving forward with an outsider, which is part of a commitment I made to my wife.

So far we have covered a lot of ground work and I want to get through a few more sessions but then I am planning to bring up the topic of HRT again and see.

Working with a therapist requires a good level of opening up and I think the more open you are the better the results will be.

So - just bring up the topic, ask if he/she knows an endo in your area and if she would be willing to support you by writing the letter. He/she may ask for a few more sessions depending on her assessment but bringing it up will give the opportunity to talk about it.

I don't know hink you have waisted any time. Transition is unfortunately a slow process... many of us would wish it would be different....

I will repeat what has been said already. Be open with your intentions. Restate that your intention is to begin hrt and ask your therapist what will be involved to get "The Letter". I brought it up in our third or fourth session, not directly but just sort of beat around the bush about it and nothing happened. At the two month mark I just asked what more she would need to see or understand in order to recommend my starting hrt. That was all it took. I had the letter the next day. Good luck.

Anne

The six times I've gone to therapy since 1980 I chickened out and told them I was stressed. This time I opened up from the start. Three visits later she was writing a letter after suggesting I go on HRT. I never dreamed it could happen because of my heart disease. If I did I would have started years ago. I can be happy with the rest of my life or I can dwell on the past and what might have been.  I am so fortunate how this has played out. This morning I explained to my cardiac nurse as we hadn't seen each other for about a year and I'll be darn If she didn't  give me a hug and tell me how happy she was for me. Tomorrow I get to explain to my cardiologist who is the coolest guy. That there have been some changes since the last time we met six months ago.

If you have her email address, consider sending something ahead of time.

"Hey there,

I know we hadn't discussed it yet, but since things have been going so well for me I've been thinking more seriously about trying to start HRT sooner rather than later. I was wondering if you knew any general practitioners or endocrinologists locally here that I could follow up with? Can't wait to speak more at our next session."

Doesn't have to be much more than that. It puts it firmly out there that this is the next step you're looking to tackle. If you don't have her email, you can bring it up in person the same way. I'd maybe bring a full list of all local primary care doctors and endocrinologists with you to your session and ask her to look over the list and see if she knows anyone that would be able to see you. Then she'll likely get the hint. If it's a specialist that she directs you to, that's an easy way to ask - "My insurance requires a referral in order to see a specialist. Can you give me that?"

Quote from: Anne Blake on October 25, 2016, 03:44:15 PM
I will repeat what has been said already. Be open with your intentions. Restate that your intention is to begin hrt and ask your therapist what will be involved to get "The Letter". I brought it up in our third or fourth session, not directly but just sort of beat around the bush about it and nothing happened. At the two month mark I just asked what more she would need to see or understand in order to recommend my starting hrt. That was all it took. I had the letter the next day. Good luck.

Anne

This.

"I'd like to start HRT after the new year, when can I get a letter from you to present to my doctor?"

I think the fact it's something being planned for in advance -- rather than "I need HRT right NOW!1!!" -- tends to be appreciated by the gatekeepers.

ETA: Also what FTMax said.

Thank you so much everyone! As usual you gave me great advice. Now to bring it up and see how it goes on Monday.

With my therapist, I usually say at the beginning of a session what I want to talk about that session, so when I want to talk about gender, I just say, "I want to talk about my gender issues today."  You should bring up your desire to medically transition as part of that conversation: your therapist probably already expects you to eventually do that.