Quote from: Dena on February 08, 2017, 12:34:50 AM
I honestly think that you will not have any difficulties with the therapist as long as you take the appointment seriously. If you weren't transgender, my transdar would have told me a long time ago. I actually think it a pretty good deal giving the time for a few therapy visits in exchange for having your treatment paid for. If I were offered a deal like that, I would have taken it in a second and I would have been $100,000 richer today.

"transdar" that's awesome!  Very science-fictiony, "Ma'am Can you identify this alien life form?" "Yes, let me activate my transdar ray."

$100,000? Just... wow.

Back in the day, it wasn't the insurance companies setting requirements, it was the doctors and the surgeons.  Because from their perspective, cross-gendered hormones and sex-change surgeries presented a moral quandary -- how could they prescribe powerful drugs and perform irreversible surgeries while preserving their medical ethics to do no harm?  Of course I agree that we should all have the right to do what we will with our own bodies, but by the same token, no one else has to consent to provide those services on their own part.

Especially given that there are enough people out there who've suffered from their own choices, because those choices had consequences beyond understanding physiological effects and side-effects -- for there can and will be psychological consequences and social consequences, too.  And, I dunno, but I think it's reasonable for a doctor or a surgeon to say that they're not in a position to evaluate whether their patients truly understand such consequences (that they lack the training for) and ask for verification from a third party who's better able to make that evaluation. 

Now this is different -- it's not a doctor putting on the brakes, it's an insurance company.  And they have their own obligations which are on an entirely different order entirely.  They aren't just in the business of providing health care, they're in the business of making money.  And it's that which creates what I'd characterize as a true conflict of interest.  Aside from that, people starting hormones tend to escalate to more expensive procedures, and if they're going to be paying for that, it's in their financial interests to at least make sure those expenses aren't being doled out unnecessarily.  It makes financial sense, as well as ethical sense, to put in checks and balances.

It's much the same logic for something as simple as having a dermatologist check out a bump on my back -- for my insurance to cover it, I first need a referral from a primary physician.  When it comes to trans care, the referrals begin with therapists, not because this is a "mental illness" but because there are psychological and social dimensions to what we're doing; what we're doing is beyond the scope of treatments for objectively measurable medical conditions.

There's nothing "objective" going on when it comes to wanting to try cross-gender hormones.  It begins with our subjectivity. 

Quote from: Veda on February 08, 2017, 11:57:37 AM
"transdar" that's awesome!  Very science-fictiony, "Ma'am Can you identify this alien life form?" "Yes, let me activate my transdar ray."

$100,000? Just... wow.

What I paid out was between $30,000 and $40,000 but by the end of the transition, I was very well paid at about $23,000 a year. Take that money and invest it for about 34 years and it should at least triple over that time period. The right investments might have done even better.

Quote from: Dena on February 08, 2017, 09:09:52 PM
What I paid out was between $30,000 and $40,000 but by the end of the transition, I was very well paid at about $23,000 a year. Take that money and invest it for about 34 years and it should at least triple over that time period. The right investments might have done even better.

Just given the rate of inflation, if you were to put 1980's dollars to 2010's dollars that would be $95K to $125K.

It just makes me think of all the Pioneer Gals (and Guys!), and how nice it would be to have a documented history that I could put on my bookshelf...  Would you recommend 'Transgender History' by Susan Stryker?  Would that happen to be our Susan?

Different Susan but you can find our Susan's story here. As for book recommendations, others on the site will be more knowledgable about this. I haven't looked at a book on the subject for a very long time. I have been living the life and didn't even know the books existed.

Quote from: Sophia Sage on February 08, 2017, 08:55:21 PM
Back in the day, it wasn't the insurance companies setting requirements, it was the doctors and the surgeons.  Because from their perspective, cross-gendered hormones and sex-change surgeries presented a moral quandary -- how could they prescribe powerful drugs and perform irreversible surgeries while preserving their medical ethics to do no harm?  Of course I agree that we should all have the right to do what we will with our own bodies, but by the same token, no one else has to consent to provide those services on their own part.

Especially given that there are enough people out there who've suffered from their own choices, because those choices had consequences beyond understanding physiological effects and side-effects -- for there can and will be psychological consequences and social consequences, too.  And, I dunno, but I think it's reasonable for a doctor or a surgeon to say that they're not in a position to evaluate whether their patients truly understand such consequences (that they lack the training for) and ask for verification from a third party who's better able to make that evaluation. 

Now this is different -- it's not a doctor putting on the brakes, it's an insurance company.  And they have their own obligations which are on an entirely different order entirely.  They aren't just in the business of providing health care, they're in the business of making money.  And it's that which creates what I'd characterize as a true conflict of interest.  Aside from that, people starting hormones tend to escalate to more expensive procedures, and if they're going to be paying for that, it's in their financial interests to at least make sure those expenses aren't being doled out unnecessarily.  It makes financial sense, as well as ethical sense, to put in checks and balances.

It's much the same logic for something as simple as having a dermatologist check out a bump on my back -- for my insurance to cover it, I first need a referral from a primary physician.  When it comes to trans care, the referrals begin with therapists, not because this is a "mental illness" but because there are psychological and social dimensions to what we're doing; what we're doing is beyond the scope of treatments for objectively measurable medical conditions.

There's nothing "objective" going on when it comes to wanting to try cross-gender hormones.  It begins with our subjectivity.

Wonderful.  'first, do no harm' and 'does it make fiscal sense'... I know I'm being reductive and I'm not going to address your post by point here, but I do wonder, is there nothing 'objective' going on?  Part of my decision making wasn't just about how I felt, it had to do with the physical aspects of how I have lived. 

I'm reminded of an old thread I was involved in regarding machine intelligence and reproduction; it had to do with the concept of adding gender to 'robots'.  My idea was based on a reductive mathematical model (game theory): That given a 'female' set that was only able to produce 'eggs' in a finite number regularly over a given time span and a 'male' set that could produce 'sperm' in a much greater quantity regularly over a much shorter period. 

Of course it was a closed model but it led me to study different methods of reproduction among various species, which led me to ponder other things:  What are the memetics of human reproduction and are there cases in which the model varies due to environmental pressure?  Given the nature of the human brain as a 'Universal Turing Machine' and the human genetic code as an 'environmentally adaptive mechanism' what is the possibility of gender variation as a method of dealing with changing environmental conditions?

OK, going to stop here, but suffice it to say I think I may have some 'objective' reasons to start HRT.

And just to be irrational, I got my shoes and they fit well, and they make my feet feel like princess feet.  Yay, new shoes!

Hi Veda,

   I have already weighed in on the delay or your HRT program due to red tape.

So I'll jump right to the Important stuff.  CONGRATS on the new shoes !!!!

   I love my shoes I have had to sadly purge or whittle down hundreds of dollars in shoes I am terrible at self control when it comes to shoes and am always running out of places to hide them. As I write this I chuckle about one pair I hid so well months ago that I am still looking for them. Sadly I need to toss a pair of black heels that are in sad shape from over use. (They actually fit) I'm currently drooling over another pair of high heels in a black and white rose print but they won't replace the black ones.

  I have a weakness for higher heeled pumps or strappy sandals, almost a fetish. Super feminine and sexy in a size 11-12. Be still my aching heart.

Lol I hope you enjoy yours as much as I do mine.

   Jeanette

Quote from: Veda on February 08, 2017, 11:38:44 PMWonderful.  'first, do no harm' and 'does it make fiscal sense'... I know I'm being reductive and I'm not going to address your post by point here, but I do wonder, is there nothing 'objective' going on?  Part of my decision making wasn't just about how I felt, it had to do with the physical aspects of how I have lived. 

The desire to change the physical aspects of how you live are still internally motivated.  As you said earlier, it's about your identity, and while that identity can't be contradicted, neither can it be confirmed.  There's nothing "objective" about identity.  It comes entirely from within.

There are significant differences between HRT and, say, getting a nose job; they are not commensurable.  A nose job isn't going to change your basic social identity -- it might reveal that you're vain, it might make you attractive, it might even correct a deviated septum (that's purely objective), but it's not going to change your social categorization.  And it's not going to change your internal chemistry.  HRT typically does both -- you'll start to grow breasts, and though that's a physical change, that particular physical change has implications for the gendering you receive and hence your social categorization.  It will change your emotions, a blatantly internal effect.  It will change your sexuality -- primarily, it reduces the sex drive, which again can have both internal and social implications. 

Personally, if your Primary Care Physician is willing to take responsibility for helping you to manage these kinds of considerations, that should be good enough -- in that respect, I agree with you wholeheartedly.  But I'd still think you'd be naive to think that an endoc is qualified to do a good job with those responsibilities.  While it's entirely possible that such considerations will be easily managed entirely on your own, by the same token you won't know until they happen, and if you realize that external help from a therapist would be of benefit you've shortchanged yourself, because that professional won't have a baseline experience with you to fully understand your process.  Much in the same way that it makes sense to take bloodwork before starting HRT. 

So I'm not convinced that you're being as rational as you think you are.  To me, it looks like you're reacting to what you perceive as some sort of stigma of working with a trained psychologist, and social stigma in general. 

For example, your objection to the word "transition" as something that's "othering."  While the word "emergence" is semantically nice, you're still beginning a period of transition, you're moving from one state to another -- from someone who has repressed their identity to someone who is looking to take steps to make that internal identity externalized for the rest of the world to recognize.  (It doesn't matter if the identity is on the binary, or "trans," or something completely unique and new.)  "Transition" is an apt word, and at some point it will be over.

Now, if you're concerned about the stigmatization of seeing a gender therapist, or of the word "transition," how will you react to the widespread stigmatization you'll receive as someone who's becoming visibly gender variant? 

Finally, there's the choice you made to work within the system in the first place.  You didn't seek out an informed consent clinic, for example, and you didn't self-medicate.  You worked with your insurance.  And yet you didn't realize that your insurance company would require seeing a therapist prior to getting HRT.  There's evidence of a lack of due diligence, then, on your part.  And your doctor didn't realize that either, which should also give you pause as well.

QuoteAnd just to be irrational, I got my shoes and they fit well, and they make my feet feel like princess feet.  Yay, new shoes!

There's nothing irrational about this!

Quote from: Sophia Sage on February 09, 2017, 11:43:02 AM
There's nothing "objective" about identity.  It comes entirely from within.

Finally, there's the choice you made to work within the system in the first place.  You didn't seek out an informed consent clinic, for example, and you didn't self-medicate.  You worked with your insurance.  And yet you didn't realize that your insurance company would require seeing a therapist prior to getting HRT.  There's evidence of a lack of due diligence, then, on your part.  And your doctor didn't realize that either, which should also give you pause as well.

First part: au contraire mon <amie>, Identity doesn't exist without the external.  Ceci n'est pas une pipe?  It is an effect of the pipe, so in fact is one aspect of the pipe.

Second part, I'm afraid to say that I did very strongly consider self medicating, to the point of calculating the cost of sending my own blood work to an independent lab...  and I did search out an informed consent clinic, they were full for months...

Moderator's Edit: It was brought to my attention that the original post contained a grammatical error, it has been corrected. As a note to all, if you do not know a language well enough to have the proper grammar, please use a language you are familiar with. There are too many possibilities of using the wrong gender. We all deal with enough of that in our every day lives.

Quote from: Veda on February 09, 2017, 11:59:42 AM
First part: au contraire mon <amie>, Identity doesn't exist without the external.  Ceci n'est pas une pipe?  It is an effect of the pipe, so in fact is one aspect of the pipe.

Second part, I'm afraid to say that I did very strongly consider self medicating, to the point of calculating the cost of sending my own blood work to an independent lab...  and I did search out an informed consent clinic, they were full for months...

Moderator's Edit: It was brought to my attention that the original post contained a grammatical error, it has been corrected. As a note to all, if you do not know a language well enough to have the proper grammar, please use a language you are familiar with. There are too many possibilities of using the wrong gender. We all deal with enough of that in our every day lives.

My apologies.  My use of the French colloquialism was an attempt at humor, and not in any way meant to hurt anyone.

Quote from: Sophia Sage on February 09, 2017, 11:43:02 AM
While it's entirely possible that such considerations will be easily managed entirely on your own, by the same token you won't know until they happen, and if you realize that external help from a therapist would be of benefit you've shortchanged yourself, because that professional won't have a baseline experience with you to fully understand your process.  Much in the same way that it makes sense to take bloodwork before starting HRT. 

That is it, the crux of my issue.  It is a very reasonable idea to get a baseline, but, how long does it take a therapist get a baseline?  I go see a therapist and they say to me, "I think we need have more sessions before I sign off on HRT."  How long do I have to wait for them?  I already have a baseline with myself, and the people who know me, a much better baseline than a therapist may be able to get.

Anyway, I'm going to sign off this thread as it seems to be making people upset and I just intended it as being a place for myself and others to vent.

Besides, I have new shoes to walk around in.  

Surprise!!! My girls and I don't really care about anyone's BS