In the very likely case that you have not been following my posts with huge attention, here goes a summary of my situation. Read my introductory post for a detailed history if you feel like it.

-I am a 19-year-old MTF transsexual who aims for complete transition and the highest amount of stealth possible. Thus, I do not plan to come out to any stranger unless utterly necessary.
-Despite having come out to a therapist and my mother about one year ago, nothing yet has started, not even therapy (at 70$ an hour I can't do miracles...) mainly because I was always developing connex problems - suicidal depression, compulsive eating, even weird temporary epilepsy - there was always something "more urgent" to take care of.
-I have decided about two months ago to pressure the physicians into treating me the right way.
-I have seen my psychiatrist, who cannot help me because he lacks competence in the transsexual field. He referred me to another psychiatrist who, without being specialized, knows more about the issue - TG patients from this hospital are usually sent to him.
-The psychiatrist in question has called me for an appointment on January 25th, 2011. I then HOPE to start HRT, but knowing how stubborn psychiatrists are (and after seeing him I know that one is particularly imposing), maybe I'll not even be able to do that.

You have the main aspects you need to know about me now. Now, let us continue with information I have not posted yet.

Two months ago, after getting out of a relatively uneffective group therapy, I rather childlishly decided I would not do anything but eat, sleep and lose my time until I started HRT because it was too much to bear, partly encouraged by the unappropriate combination of psychiatric medication the said group therapy had prescribed me. After a while, I ended up on the toilet bowl with scissors in one hand and my genitalia in the other. No need for a picture. Luckily, I was too afraid of damaging tissues needed for vaginoplasty to do anything.

Nevertheless, such an attempt scared me, so I went to the hospital. There, I got hospitalized and by a combination of circumstances, I stopped taking my medication even though they wanted me to. The effects were instantaneous, and after a few days I was out of the hospital.

I was now enabled to rethink the situation again, free of those drugs. While it had been clear for me forever that living as a man would never be an option, I saw the necessity of maintaining an active life for transitioning - it's not that I didn't know what I needed to do ; I was denying it.

So I decided to place some faith in the medical community. A discutable choice, but a necessary one. I don't know about English, but in French, we have a saying that means "hope makes you live". So I used that hope of very near transition to gather the energy required to move out of my mom's apartment (she kinda kicked me out for doing nothing in her basement for too long) and look for a job (which I do not have yet, but I have an interview on Monday and I hope it will work).

Notice how I said "very near". After many years, my capacity to endure my body has decreased immensely, and I think it is an accurate approximate to say I will have broken down by February if HRT is not started. I can do efforts, but there is a limit to them.

That's what I told dr R [first psychiatrist] when I saw him this week. However, he refused to do anything because he did not know enough about the issue. So basically, I have to find a job, live, and start school without starting HRT or therapy until January 25th. I don't want to look like I give up easily, but that's just not a realistic goal. I just came out of two years of falling ever lower, and I fear getting back in there.

This Tuesday, I will see my physician [family doctor], dr S. She's nicer than the psychiatrists, so I believe I may have a chance. I want to talk her into prescribing me HRT, or AT LEAST start spiro to help me get to my appointment with dr L [second psychiatrist].

It IS possible, as in my country, the only requirement for HRT is informed consent. (And "risk reduction in certain cases", whatever it means.) I now know she may prescribe even full HRT to me without any prerequisites other than her being sure of my issue.

But I will need help and preparation, because no matter how grave the situation, how urgent the problem or how big the risks, I chicken out very easily when I need to convince people. I KNOW if I don't get anything from her I'm virtually sending myself to death... Well, not death as I prefer a 100-year-long life of total unhappiness over death, but at least professional, social and psychological death.

I really need help here, help on how to convince her that the issue is real and needs to be dealt with NOW, not in two months. Do you think I should be agressive (not rude, just agressive, like "hey I need this now and blah blah") ? Do you think printing out select posts I wrote here a Susan's could help, as I express myself much better with a keyboard ?

Please help ! I'm on the right way with my life and I might just get a hotel receptionnist job soon - fingers crossed. But this life is requiring huge self-denial and problem-fighting efforts, and my mental gauge of being able to stand it is depleting dangerously fast, and with all my experiences, I don't think anything but actual APPROPRIATE treatment allowing me to be myself can fill it back. Past that, maybe I'll be beyond saving...

One will have to put on an easy, informed face. You do not want to appear frantic, hysterical, or as a fanatic. As much as it may excite you to finally get your sanity back (or lose it depending on how you look at it), one must keep their expressions down. Physicians read the body language and analyze your responses down to the last word. Run through your arguments and be prepared to defend them logically. Be prepared to answer exactly why you want HRT in the simplest way possible (I know, kinda hard to do).

Overall, you want to present a well-informed, learned person to the physician you see. Showing that you know exactly what you're going to sign yourself up for will encourage the official to put you on some form of HRT faster.

As Aidan suggests, everything can be taken out of context.

Keep calm and say what it is you want. Don't make threats against yourself. Stick to the point and make a decent case.

But whatever happens, however good or porblematic is may be, try to remain patient. We are in this together. Many of us had to wait and many of us didn't get there.

Just try to work the system.

My greatest fear is that I won't be able to express what I need clearly enough for her to truly understand them. But it has always been easier for me to type out stuff than to say it. What do you think about printing out some posts [while making sure no "compromising" info about anyone else is in them] from Susan's, such as my introductory post and this one ? Do you think it could help ?

Quote from: A on November 06, 2010, 02:49:07 PM
My greatest fear is that I won't be able to express what I need clearly enough for her to truly understand them. But it has always been easier for me to type out stuff than to say it. What do you think about printing out some posts [while making sure no "compromising" info about anyone else is in them] from Susan's, such as my introductory post and this one ? Do you think it could help ?

You may try. This involves some skill with acting and perception, but imagine yourself as the physician. Your job (in this scenario) is to make sure no one that doesn't need HRT gets it. You are to keep this person (you) from getting HRT unless you feel they absolutely need it. It is your job. If you fail it and you make a bad call, you could lose your job (maybe that's extreme but you get it). Put on their mask and think about what they would want and ask. Voice it out loud if you need to.

By getting an idea of what a physician is looking for, you can contour your arguments around that. Every physician is different, but there is a general idea behind it. Practice in front of a mirror (I know this is REALLY cheesy >_>) and just take a few hours to really organize your thoughts. Writing them out helps too. Do whatever you feel you must do to prepare. However, don't overdo it. You want to be natural, so don't rehearse a paragraph or something Just be very clear with yourself what you want, why you want it, and be ready for whatever they might say (this goes back to roleplaying as the doctor) in response to your reasoning.

Also, just a common trap I've heard around the board is when a physician asks, "So you want to become a woman?" The incorrect answer is, "Yes." The correct answer is, "No, I already am one. I just lost the coin toss in heaven and got born in a male body." (You don't need to use that joke but I think adding some humor shows that you're comfortable.)

Write it all down in a short, respectful letter and then either give it to your doctor or read it out loud. Make it as complete as you can but as concise as possible. One page only--you don't want it to go on forever. You can have notes for yourself, and you can practice in advance, as Aidan_ suggests, but I suggest a letter for the physician.

If the doctor asks you why a letter, you can explain that this is an important issue, a lot depends on it, and you want to make sure you say everything you need to say.

I was just going to suggest you practice in front of a mirror. But Aidan thought of it first.

I do it all the time. I can rant and gass on the web till th cows come home but freeze up when I meet people. By practicing in front of my favourite mirror, which is in the hall, I can get what I want to say, worked out in my mind. I also can imagine what sort of things might be said and work our responses.

OK, it's pretty crazy. But who said you had to be sane to be normal?

Quote from: spacial on November 06, 2010, 03:31:58 PM
I was just going to suggest you practice in front of a mirror. But Aidan thought of it first.

I do it all the time. I can rant and gass on the web till th cows come home but freeze up when I meet people. By practicing in front of my favourite mirror, which is in the hall, I can get what I want to say, worked out in my mind. I also can imagine what sort of things might be said and work our responses.

OK, it's pretty crazy. But who said you had to be sane to be normal?

And who said being normal means you're sane?