I mentioned in another thread that I managed to wrangle an "off the record" discussion with a worker at the local mental health facility.

while she was wonderful she did caution me that she wasn't a gender specialist and I got the impression she wasn't entirely sure what specific qualifications I had to look for, so I want to pose a two part question to the room here:

1. I thought I knew that it takes a full psychiatrist to prescribe HRT, right? My understanding was that a psychologist or some lesser degree of therapist cannot but on the other hand I was taking my younger son for some counseling a few years back and I'm relatively sure he was getting a prescription right from the hand of this man who is not a psychologist. So maybe I have this wrong so question #1 is - is there a minimum qualification I'm looking for in order to know I'm dealing with someone who can write the scripts when the time comes?

2. Is there a specific minimum qualification that the therapist needs in order for the letters required by the SOC to be valid?

Does the person have to have some specific documented specialization in gender issues or no?

I feel like if I know exactly the SORT of therapist I need I might have better luck at finding some individual closer to where I live that maybe doesn't make there work with GID widely known.





On a completely unrelated note - I got my ears pierced yesterday! It's funny how I can get excited over such normally mundane things...

I can answer the first part I think. A psychiatrist can prescribe medicine but a psychologist cannot. Once you get your degree in psychology, you then have to study up on medicine and such. It's a little ridiculous to me but anyways.

Quote from: Kara on June 21, 2009, 06:11:43 PM
I can answer the first part I think. A psychiatrist can prescribe medicine but a psychologist cannot. Once you get your degree in psychology, you then have to study up on medicine and such. It's a little ridiculous to me but anyways.

In any case, you're not really looking for a psychiatrist to prescribe HRT, unless they happen to be an endocrinologist for some reason.  HRT is not something you would want a psychiatrist to prescribe you, IMO.  A psychologist is probably your best bet, but in theory, you could find a LCSW or someone like that.  The important thing you would probably want to look for is someone who specifically has experience with transgender clients.  The only important thing if you don't go with a psychologist is that in order to have SRS, if that's what you want, I believe you'll need one of your two letters to be from someone with a PhD.

It would probably depend on your endocrinologist, but you should be fine for HRT with a letter from any therapist.  The letter my therapist gave me was specific to me, describing how long she had been seeing me, some of my history, that I identify as female, and that in her view I was a good candidate for HRT.  It was also the first document I ever had that addressed me as "Ms <last name>"

Even then, there are some endos that will give you a prescription based on you signing an informed consent form, and they may not have a hard requirement of a letter from a therapist.  It really depends on the specific doctor.

If you aren't near a city you might have some trouble finding an experienced therapist, but my psychologist is in a pretty rural area, so it doesn't mean you're totally stuck.  Good luck!

Most "gender-specialists" aren't psychiatrists at all. They are LCSWs, LSWs, LPCs and PsyDs, prolly in about that order (there may be more LSWs than LCSWs and about as many LPCs). The benefits of LSWs and LPCs is that they generally tend to cost less with absolutely as much non-school training as their doctorally-inclined colleagues and LCSWs have normally worked a bit longer than LSWs although that is not a given either as LSWs often do not do the tests for LCSW.) They do not normally prescribe medications for transitions at all.

Meds are usually prescribed by endocrinologists (very expensive to see) or GPs (less expensive.) Most endos do not work fulltime on T-issues and patients (not enough money in that) and are generally attached in some fashion to fertility-clinics (much more pay-off and a wealth of customers.)

Any shrink with half-a-brain is unlikely to prescribe anything other than psychotropics or the meds that take-the-edge-off of those. Nurse practitioners are also capable of prescribing hormones and often do in gender- LTBG-clinics for transition patients.

N~

An overview of the possibilities of getting on HRT in increasing order of desirability:

• Go out on the black market, buy pills, gobble them. Not recommended.
• Find a clinic that operates on "informed consent", see an endo, get a prescription.
• Find a general therapist, teach them about gender identity & sexual orientation, get a HRT letter, see an endo, get a prescription.
• Find an LGB therapist, teach them about gender identity, get a HRT letter, see an endo, get a prescription.
• Find a therapist versed in GID, get a HRT letter, see an endo, get a prescription.

Ok if I understand then - separating for a moment the seperate issues of HRT and recommendation letters...

RE: HRT-

I would be better served to seek out and LSW or LCSW with GID experience and/or training, and then possibly-potentially employ them for a referral to a GP or NP who can and does prescribe hormones to Trans patients and there's really no reason for a psychiatrist (probably even a bad choice) and little reason for a psychologist...

Have I summed it up fairly correctly?

Assuming all that is true...then that's the nearer term route that makes sense.

But the question remains - according to the SOC, what's the minimum qualification for a person who writes a letter for surgery?