Hey,
i am currently planning the technical-medical-therapeutical aspects of my transition and have run into some questions. In a nutshell: whats the best way to shop for a therapist? How do i decide what psychological school/approach is the most useful if i have neither time nor money to spend on extensive test runs?

One of the problems is, that most gender specialists where i live are quite conservative in their approach, means at least 20 years behind most u.s. specialists. Informed consent is a concept almost unheard of, at least 1 year real life test and 50 hrs psychotherapy is deemed necessary before hrt is even considerd. Its not required by law, but inofficial standard of practise. So, in the worst case you have the opportunity to waste a year and tons of cash before anything useful happens. Do i need to mention that i never was good at dealing with gatekeepers and jumping through hoops?
To make things a little more interesting i have some issues that need to be adressed apart from being transgender. On top of persistent depression and a history of deprivation not only in the gender department my main problem are survival strategies from my ,lets say, less than perfect childhood that are practically choking me now. I have dealt with my past to a point where i can look at it without developing dissociative symptoms, being overwhelmed emotionally or becoming suicidally depressed. I also begin to develop an emotional connection to my childhood self which were major steps forward. But i still have much work to do.
So, my basic plan is to work on those points with a pro who is willing and openminded to work on gender issues as well and write the letters for hrt without too much focus on creating hoops to jump through.

Aaaargh... Editing posts from cellphones is a drag.
My main question is: has anyone here experience with a similar situations or an idea which kind of therapy could work here? Thanks for any suggestion......

Hi,

You can shop for a therapist.  They are there to help you.    Most will bend if you insist.

If you want something most will do what you want.

Depression is independent of transition.   Every issue rest of world experiences we also experience.  Do get help for depression.  Sometimes some meds help.

Sometimes the best thing to do is to get lucky.

I have often used Wikipedia to find out about psychological schools/approaches, but I have never actually used that research to screen a psychotherapist because, well, I got lucky with mine.

If there is a gender center or an LGBT center near you, you might see if you can get recommendations or referrals.

See if you can find any online reviews of these people as well--it happens occasionally.

Some therapists have a website where you can find out more or drop them an e-mail.

Often, you can screen therapists on the phone--tell them you're thinking of making an appointment and you have a few questions to ask (make sure you have a few questions prepared). If you leave a couple of messages over the week and don't hear back, that might be a sign that you want to avoid that practitioner.

A few other members have narrowed down the list by posting about specific therapists here on Susan's. If anyone here has used that therapist, you can get some good feedback.

I can't recommend a particular school or approach, but some people here have more knowledge about these sorts of things.

P.S. My therapist has been in private practice for at least thirty years, and he is anything but conservative. So don't rule out a seasoned therapist just because he or she is older.

Ask other T's for recommendations that live in your area.

When you find a therapist:
1. Be honest about everything
2. Take a copy of WPATH SOC (helps if you have read it too)
3. Take a copy of your Trans-Plan, should include your budget, timeline, research, etc.
4. Take an agenda for each session of topics - refer back to item #1.
5. Execute your Trans-Plan!!!

(Yes, Type A Personality - everything has to be planned and organized)

It's your money, make the most of each session.

Checkout my video


Hope this helps,
Jamie

Thanks for your answers!

Jamiejo! I know which surgeon you're a patient of, I'm considering him highly for some facial work down the road.

And basically with therapists, I do not support a year long requirement of RLE and I strongly believe it leads to cases of suicide, a game of cat and mouse between the professional and patient. Some patients just cannot comfortably transition without some physical changes, and at the very least, I would like to see Anti-Androgens being prescribed at the beginning of RLE - they both improve many secondary male traits and give the patient a sense that some things are indeed changing (without development of female secondary traits).

If you live in a vast, conservative area, the thing to do may be to find a "pill mill" therapist (they do exist), and simply use your savings to fly to see them out of state (plane trip will cost at most $350 round trip, if you shop wisely). There are therapists out there who'll see you once or twice in one week, write you a letter, and send you on your way. There's a specific doctor in Florida who does this, and you can find his name on this board I believe. Always call ahead of time and explain the situation - doesn't hurt to add things like "I do not have the funds or resources to afford a year's time of sessions when I am already of sound health."

Also, anti-depressants do not work in most cases, I would not not fool with them, waste money on them, or give your therapist a reason to diagnose you with depression and attempt to make you not transition by loading you up with anti-depressants instead. I believe I have a link below in my signature that's sure to educate many a layman. They simply do not work if the patient is experiencing depression for a logical, scientific reason (death in the family, being a transsexual, post-traumatic stress, ect ect.) Sure, you see people popping pills all the time, but it's the fact that they don't work that keeps them doing it for 20 years. Many even become addicted to them, not because they work, but because of entirely different properties in them they create a chemical dependency in them or even a "high".

I believe Transitioning is the answer to 99% of most Trans patients' "depression" symptoms, if not %100 of them. Anti-depressants just can't erase the thought patterns that coping and Transsexualism induce - you need to cure the real-world problem to see that grey cloud finally clear.

Quote from: RhinoP on September 06, 2011, 11:19:57 AM
Jamiejo! I know which surgeon you're a patient of, I'm considering him highly for some facial work down the road.

I would like to see Anti-Androgens being prescribed at the beginning of RLE

Yes, Dr Spiegel is amazing at the procedures he and his team performs.

Anti-Androgens are generally prescribed to qualifying patients after 3 months of therapy, per WPATH Standard of Care, which is a guideline for therapists to follow.  Some therapists do make you wait longer!  I was on Anti-Androgens after two months of therapy.  The 3 month period is to flush out any other "issues".  I started HRT: Anti-Androgens (Spironlactone), Estradiol & Medroxyprogesterone all at the same time.

The 12 Month Real Life Experiences (RLE) is also a guideline of WPATH Standard of Care is for SRS or GRS.  So at the time of surgery I will have been on HRT for 18 months.  If you can show "just cause" (per my therapist) she would have reduced the 12 month period for me.  I'm okay with the 12 month period as I need to save money.

Anti-depressants "may" work if you are depressed, but have crappy side-effects.  I fully accept my GID, so no anti-depressants were required.

Jamie