Hi guys I know that before getting T you have to see a therapist or a psychiatrist.  But what exactly happens with them?  My guess is they ask you regular questions first to see if you have any mental health problems and then they ask you about your GID?  Is it normal for them to talk with you about other aspects of your life outside of GID?

I think they also want you living as a man before they write a prescription or a letter of recommendation too, right?  Do any psychiatrists write you the prescriptions themselves or does it have to be done through an endo?  On average how long did it take people here and people you know of to get their letter/prescription?

Sorry for all the questions, I'm just kind of lacking in knowledge in this area guys. 

It really depends on what country you're in. If you're in the US, it also depends on whether you're doing this through insurance. If so, different insurance companies have different policies. If you're paying out of pocket, then...well, it depends. I've heard lots of people give different reports of what their therapists do, ask, and require.

I know a guy whose psychiatrist writes his T prescriptions, but he has major mental health issues. The guy, not the psychiatrist.

Most therapists that I've heard about do not require you to be full-time. Most trans people I've talked to get their letter and then go to an endo, unless they are doing informed consent, which does not require visits to a head doc.

The standard recommendation in the SOC is three months of therapy. Some people need more, some less. Some therapists want more, some less. Three months does not necessarily require weekly visits, either. It all depends.

Quote from: Arch on October 14, 2010, 11:31:31 AM
It really depends on what country you're in. If you're in the US, it also depends on whether you're doing this through insurance. If so, different insurance companies have different policies. If you're paying out of pocket, then...well, it depends. I've heard lots of people give different reports of what their therapists do, ask, and require.

I know a guy whose psychiatrist writes his T prescriptions, but he has major mental health issues. The guy, not the psychiatrist.

Most therapists that I've heard about do not require you to be full-time. Most trans people I've talked to get their letter and then go to an endo, unless they are doing informed consent, which does not require visits to a head doc.

The standard recommendation in the SOC is three months of therapy. Some people need more, some less. Some therapists want more, some less. Three months does not necessarily require weekly visits, either. It all depends.

Hi. Thanks.  I have a few questions though.  When it comes to informed consent, what is that exactly is that?  And can you go to any doctor to get a T prescription with informed consent with out seeing a psychiatrist and just saying you're trans? 

What about if you have a medical condition that is helped by T but doctors are wary of giving it to you because it's not an approved treatment.  Can you say you want the T anyway with informed consent with out having to say you're trans?  Sorry that's a little off topic but I have a medical condition that was VASTLY improved by a low dose testosterone treatment.  And it was the ONLY thing that worked.

About the SOC three month recommendation, is it possible in your opinion to maybe get on a low dose, even a women's dose, of T on the first visit if you explain to the psychiatrist that you have already been on a low dose T cream for a medical condition in the past and it was the only thing that helped?  Do you think it's possible they would let me start out small and then get the full dose once the three months is up?

Btw I am in the US and plan on paying out of pocket.  Don't know if that will help your answers or not, just wanted to let you know if it does. 

About getting the low dose from your therapist 1st visit, I've never heard of it happening before.. But I've not heard of it NOT happening, either. I guess that's something you'll have to ask.

My experience with therapy wasn't very typical, because my parents, though accepting, don't want me to start T. I missed my appointment in December of 09 where I WOULD have gotten my letter because I fell asleep and slept through it (D'oh!) And then my therapist had surgery so I couldn't go see her again until February 2010. When Feb came around my parents made it clear that I wasn't going to be allowed to start, even though I told them around October that I was going to (They didn't take me seriously)

So I had to wait until 6 months before transferring to VCU from my current college, which would have had me starting in March of 2011, because that's 6 months between August 2011 when I would have been transferring. They wanted to give me the time to make some changes needed (like voice, hair, muscles) so I could pass at VCU. They didn't want me to start at my current college because... I don't know really, their reasoning was for the people I already knew, but they all either knew me as male or as a transguy. And on top of all of that, I realized that I would have to stay in my college I'm in now for an extra year for complicated reasons, so I would have originally had to wait an EXTRA YEAR, ala, March 2012. (I convinced them to let me start in March 2011 anyways.)

So I waited because I love my parents and I want their approval for everything because I don't want to break any trust.

But starting this semester left me with having to re-introduce myself as male to everyone. There were so many new students that all thought I was female, it was too much to handle all at once. I went from EVERYONE knowing I was male, to only the handful of friends that had similar break periods as me. That along with having 4 hard huge project oriented classes which stressed the hell out of me, I dropped out of 3 of them, leaving only Glassblowing because when I'm in that class, all I'm thinking about is the molten glass at the end of the rod and the 2,400 degree furnace 2 feet away from me XD;;;

When I dropped out of the classes, I also told my parents that I WOULD start T. I made the decision to do whatever I needed to do to be happy and if they didn't like it, I would leave. It became apparent that I needed to do things for me, not for them. They accepted grudgingly, and I got my letter and made my appointment (which is next thursday yaaaaay)

So yeah. My wait period was a little less than a year because I wanted to be complying with my parents wishes.


My experience with therapy was not just about GID. I have severe anxiety and depression, and a lot of history with dropping out of school due to panic attacks and the like, so we talked about that alot. We talked about what kind of a role my GID played in my life, and once I was confirmed to be trans, it kinda got pushed to the background. We talked about my actual issues. Of course we discuss the GID every visit, but since everything got smoothed out, it's mostly just regular old therapy.

So basically your therapy experience will depend on your mental health. If you are a happy and functioning person, your therapist won't really need to talk to you about anything other than your transition.

I can't remember if real life experience is required for starting T. It's been a while since I read the Harry Benjamin thing, but I did have a year or more of knowing I was trans/ passing feebly as male in public before going to therapy, so I don't know. Personally I think you should try to pass as soon as you can, it's the most awesome feeling ever

Your therapist, in my experience, can't write prescriptions unless he or she is a psychiatrist. Psychologists and Social Workers just do therapy, not drugs. Plus, you'll need to go to some kind of doctor to get blood work and physicals before you start T, to make sure you're healthy and to see your hormone levels so they know what dosage to start you on. Every doctor does it different though, so that's another question to ask your therapist.

I was considering informed consent and asked about it here on the forum, but I still don't understand it fully. I know that basically you have to know all the symptoms, and you have to be aware that there are possible symptoms we don't know about yet, like long term side effects.

WOW long post! Phew! Hope I answered some questions. Basically, everyone's experience with therapy is a little different.