After talking to some other guys, I've found out a few things. Having been on testosterone at all, is certainly not a requirement for top surgery (though it sounds as though some surgeons and therapists have their own guidelines for this).
And that there are some therapists who use HRT as a sort of affirmation process, with the notion that hormones aren't permanent like surgery.
But, after 6 months of T, I'm likely to have masculine features which ARE permanent.
Whereas with top surgery, I'll only be changing one area of my body, after 6 months of T, I'll have irreversible changes all over my whole body - voice, body hair, genital changes - all of these are permanent and said to happen WAY before 6 months, 1 to 2 months, more like.
So, I don't know what to do.
She all but promised me an HRT letter in 3 months. So should I just stick with her, and then if she refuses to write a surgery letter, find someone else?
How hard would that be? The surgeon I'm looking at has something on his site along the lines of "...letter from a therapist with a long-term and meaningful relationship with the patient."
I'm not sure how to interpret that, does that mean I'd have to start all over with another therapist and get a "long-term and meaningful relationship" with the new one first?

Also, it's clear that most therapists do not require FtMs to have 6 months of T prior to surgery.
At this point, I'm unsure whether she's requiring it or not. Should I just find someone else, particularly since I REALLY felt uncomfortable with her anyway? But, my goal is to get these letters, not to make friends, so does that matter?

Quote from: Nero on January 04, 2007, 12:09:10 PM
After talking to some other guys, I've found out a few things. Having been on testosterone at all, is certainly not a requirement for top surgery (though it sounds as though some surgeons and therapists have their own guidelines for this).
And that there are some therapists who use HRT as a sort of affirmation process, with the notion that hormones aren't permanent like surgery.
But, after 6 months of T, I'm likely to have masculine features which ARE permanent.
Whereas with top surgery, I'll only be changing one area of my body, after 6 months of T, I'll have irreversible changes all over my whole body - voice, body hair, genital changes - all of these are permanent and said to happen WAY before 6 months, 1 to 2 months, more like.
So, I don't know what to do.
She all but promised me an HRT letter in 3 months. So should I just stick with her, and then if she refuses to write a surgery letter, find someone else?
How hard would that be? The surgeon I'm looking at has something on his site along the lines of "...letter from a therapist with a long-term and meaningful relationship with the patient."
I'm not sure how to interpret that, does that mean I'd have to start all over with another therapist and get a "long-term and meaningful relationship" with the new one first?

Also, it's clear that most therapists do not require FtMs to have 6 months of T prior to surgery.
At this point, I'm unsure whether she's requiring it or not. Should I just find someone else, particularly since I REALLY felt uncomfortable with her anyway? But, my goal is to get these letters, not to make friends, so does that matter?

Firstly Nero I have to say that I'm not that familiar with the FtM side of our community, but having said that I think that you should probably stick with your current therapist unless there is a real problem between the two of you.  Firstly your therapist has to be professional and stick to the guidelines he/she is comfortable with.  We sometimes forget that the goal of therapy is to determine that in fact you are TS (despite the fact you already know this in your own mind), and that we are ready for HRT, transition, RLT or what ever else.  Therapy should not be entered into in order to get HRT and letters etc.  For it it is then frustration and impatience will undoubtedly follow, may be as in your case.

Remember that the therapist's credentials are on the line as well, for a misdiagnosis can have devastating consequences for the therapist as well.  Additionally it is hard to say how long this all takes before letters and HRT is granted as each patient is different.  It may take one person a couple of sessions and others many sessions especially if the patient displays or indicates other psychosis.

Yep it can be frustrating but it comes down to you and how you feel with your therapist.  If there's a problem and therapists are abundant then go for a change but beware that you are not shopping for a diagnosis, cause you never know it may not be there.

Steph

Hi Nero,

                Allowing someone to have their body irreversibly surgically altered is a big responsibility for a therapist.  A good therapist will expect a person to display a need for these changes over time rather than just one point in time. The therapist will also weigh the patients willingness to undergo all normal reassignment procedures.  Any hesitation will be seen as less than complete resolve in the patient. If you are a special case (such as not wanting HRT) then the therapist may want to extend the timeline to be certain in their mind the surgery is necessary and the correct solution. Changing doctors may make a difference but just as likely may not. Taking a few months to be sure this is the correct path seems harsh now but in the context of your whole life it may be time well spent.  I wish you the very best.




beth

Nero,

This post seems contradictory. *If* you are transitioning, does the order matter? I'd agree that T is a less draconian first step to a masectomy. I would tend to agree with this COA.

Secondly, you and you alone must determine "What you should do." Asking for advice is fine, asking for instruction is not.

Bri

Quote from: Brianna on January 04, 2007, 01:16:47 PM

Asking for advice is fine,

Bri

That's what I'm doing.

Hum, not comfortable with the therapist is a fairly good reason to look at the situation just in and of itself. If you cannot establish a meaningful rapport with the therapist it is generally unlikely they will be much use to you as you will probably not 'open up' to them.. in theory anyway.

From what I see you are unique Nero, that, by the way, is in my option a good thing. However, like I, it means you need to find a therapist who will take the effort to understand you and your wants and concerns rather than using a 'this is how it is done' approach.

So with that said, I think I would suggest speaking to the therapist and pointing out that although you are a man you do NOT want the majority of the things associated with HRT, and in essence 6 months HRT is akin to a death sentence. Meh, ok fine I am dramatic but I do tend to say things as I see them.

In essence if she can't deal with the thought of wanting just voice changes and top surgery then find another. Odds are she can deal, especially if she is, in fact, experienced. But, in my opinion that is NOT a given.