Quote from: Steph on September 13, 2011, 07:36:14 AM
To be fair Cori you have not revealed how your therapy sessions have progressed or what you have said in these sessions, the number of sessions you've had (Nor are you obligated to) but you have to remember that we are required to be first diagnosed with GID before you can be treated/start receiving treatment.  It really doesn't matter what you think, it's about what she thinks, how she feels as a result of counselling.  If she is a licensed gender therapist then she is obligated to follow ICD-10 to determine the correct diagnosis.  Ya it sucks, hang in there, just don't fall into the trap of shopping for a diagnosis.

Therapy progressed with me being really nervous and uncomfortable for the first two or three visits.  Divulging things I'd kept primarily to myself for my entire life to a stranger (in person) was difficult to get used to.  Topics pretty much centered around this being an issue for me from a young age, how it has affected me over the years, why transitioning frightens me, worries about how it would impact my relationship with my SO, friends, and relatives, anxiety, depression, past suicidal thoughts, past and current substance use, chronic sleep problems, and some journals to help work around the initial nervousness.  After each visit she usually gives "homework," which has been helpful.

Her desire to push me towards RLE for a lengthy period of time prior to HRT is what really worried me.  This seemed more like a significant difference in opinion on how a transition should be handled, and it's something I felt unable to do.  This upset me,

Either way, it turned out not to be an issue, and she actually had my letter ready for me at our last session.

Quote from: Steph on September 13, 2011, 07:36:14 AMyou have to remember that we are required to be first diagnosed with GID before you can be treated/start receiving treatment. 

Is this uniformly true in your neck of the woods (your profile says you are in Canada)? Because I was never diagnosed with GID by my therapist. In fact, he manifestly declined to label me in this fashion. But I am in the U.S.

Most trans friendly docs will start you on spiro without HRT letter. "It's to control blood pressure" is easy enough reason to prescribe this legally.

Getting the T under control will clarify your feelings IMHO. If you freak out when your male sex drive starts to drop, that's a good sign HRT probably isn't going to improve your quality of life.  And that is a much better indicator than any information a therapist can discover about if you are really trans or not. I honestly think they should start every trans person on AA for a month and see how they react. The patient would quickly know if they wanted to continue on HRT after they saw what this does to them. It doesn't take a professional therapist to diagnose the results of this litmus test and would get them out of the loop. Someone who is a fetish CD etc will NOT like that AA's do to them. And one month of AA isn't going to cause any permanent damage. People who have other issues can seek out a therapist. IMHO whether someone's life would be improved from HRT should not be a choice given to a mental health professional when there is a simple way to start someone on HRT that will reveal this.

I totally agree Stephe, in that every potential trans person should be put on AA's to weed out any that do not like the effects they bring, let alone what HRT would do. My ex - therapist did not agree with this, which was unsurprising from his attitude. My Doctor was willing to prescribe them, that was until he rang the therapist to see if it would interfere with his treatment plan.

Here ( in Australia ) it seems that you need first to be diagnosed with GID by a psychiatrist  before any hormonal treatment can begin. That is because ( as it was explained to me ) due to legal connotations where the patient after a period of treatment has found some of the changes irreversible and been unhappy with the clinician involved and tried to sue them.

At least a good thing is that I have a new psychiatrist , I just have to wait two months to see her as she is on holidays

Quote from: Beni76 on September 18, 2011, 06:44:44 AM
I totally agree Stephe, in that every potential trans person should be put on AA's to weed out any that do not like the effects they bring, let alone what HRT would do. My ex - therapist did not agree with this, which was unsurprising from his attitude. My Doctor was willing to prescribe them, that was until he rang the therapist to see if it would interfere with his treatment plan.

Here ( in Australia ) it seems that you need first to be diagnosed with GID by a psychiatrist  before any hormonal treatment can begin. That is because ( as it was explained to me ) due to legal connotations where the patient after a period of treatment has found some of the changes irreversible and been unhappy with the clinician involved and tried to sue them.

At least a good thing is that I have a new psychiatrist , I just have to wait two months to see her as she is on holidays

I actually think some therapy is a good idea - just to weed out the co-morbid diagnosis's..  But AA's early on would certainly also be a good idea..

I'm an Aussie, started HRT about 4.5 months ago and I have no diagnosis.. My referral for hormones simply stated that I was 'a suitable candidate for hormonal reassignment'..

Quote from: Stephe on September 17, 2011, 09:52:58 PM
Most trans friendly docs will start you on spiro without HRT letter. "It's to control blood pressure" is easy enough reason to prescribe this legally.

Getting the T under control will clarify your feelings IMHO. If you freak out when your male sex drive starts to drop, that's a good sign HRT probably isn't going to improve your quality of life.  And that is a much better indicator than any information a therapist can discover about if you are really trans or not. I honestly think they should start every trans person on AA for a month and see how they react. The patient would quickly know if they wanted to continue on HRT after they saw what this does to them. It doesn't take a professional therapist to diagnose the results of this litmus test and would get them out of the loop. Someone who is a fetish CD etc will NOT like that AA's do to them. And one month of AA isn't going to cause any permanent damage. People who have other issues can seek out a therapist. IMHO whether someone's life would be improved from HRT should not be a choice given to a mental health professional when there is a simple way to start someone on HRT that will reveal this.

I'm going to see a therapist soon and try to get on HRT asap, but paying for the it and the therapy and college/car/internet/insuranceis a huge deal so the thing about blood pressure interests me a tad...
as for the starting on small dose of HRT to weed people out I can see that being the fastest and less time consuming route, but there would be so many things that could occur as a repercussion, though I hate to say it a mild length of time to weed them out with therapy is the safest method. I really don't like saying that because I hate what I look like and what I'm labeled as, I cringe inwardly when someone calls me handsome 
So yeah though the time span may be a huge blow to those who are rearing to go (myself for example) it's a needed evil those who dissolution themselves. I just wish there was a fast and safe(emotionally/mentally/psychically) route.

Quote from: Sam(my)I am on September 20, 2011, 05:58:33 PM
I'm going to see a therapist soon and try to get on HRT asap, but paying for the it and the therapy and college/car/internet/insuranceis a huge deal so the thing about blood pressure interests me a tad...
as for the starting on small dose of HRT to weed people out I can see that being the fastest and less time consuming route, but there would be so many things that could occur as a repercussion, though I hate to say it a mild length of time to weed them out with therapy is the safest method. I really don't like saying that because I hate what I look like and what I'm labeled as, I cringe inwardly when someone calls me handsome 
So yeah though the time span may be a huge blow to those who are rearing to go (myself for example) it's a needed evil those who dissolution themselves. I just wish there was a fast and safe(emotionally/mentally/psychically) route.

One month of spiro before they add E is not going to "slow down the process" enough to notice. I'd be shocked if in a double blind test one year later if you could see the difference in a 1 month spiro before adding E patient and a patient that started on both..

Quote from: Stephe on September 20, 2011, 10:06:38 PM
One month of spiro before they add E is not going to "slow down the process" enough to notice. I'd be shocked if in a double blind test one year later if you could see the difference in a 1 month spiro before adding E patient and a patient that started on both..

Unless you're in early/mid puberty a year later you wouldn't see the difference between 1 month nothing 11 months full HRT, 1 month spiro 11 months full HRT, and 12 months full HRT.  Natural variance in effectiveness between people would vastly outweigh that month. The issue wouldn't be results 1 year down the road, the issue would be psychological during that month when your itching to get started and being held up by doctors "protecting you from yourself".

Quote from: Renee_ on September 20, 2011, 10:16:22 PM
Unless you're in early/mid puberty a year later you wouldn't see the difference between 1 month nothing 11 months full HRT, 1 month spiro 11 months full HRT, and 12 months full HRT.  Natural variance in effectiveness between people would vastly outweigh that month. The issue wouldn't be results 1 year down the road, the issue would be psychological during that month when your itching to get started and being held up by doctors "protecting you from yourself".

OK then how about the other option of no HRT at all and 3-9 months of psycho therapy to get a letter to even start with an AA instead, like we have now...

I'd much rather get on AA immediately, see how I feel in one month (rule out fetish reasons for HRT) and if I like what this is doing to me, let them add E to the mix. Avoid the therapist letter and waiting months to even start on anything altogether.

Quote from: Stephe on September 20, 2011, 10:32:30 PM
OK then how about the other option of no HRT at all and 3-9 months of psycho therapy to get a letter to even start with an AA instead, like we have now...

I'd much rather get on AA immediately, see how I feel in one month (rule out fetish reasons for HRT) and if I like what this is doing to me, let them add E to the mix. Avoid the therapist letter and waiting months to even start on anything altogether.

Why the false choice? There are an increasing number of sources for informed consent HRT. There is no reason at all adults can't make their own medical decisions without gatekeepers telling them when they can start what. Let the individual decide whether and if so for how long they need therapy in advance of starting HRT.

Quote from: Stephe on September 17, 2011, 09:52:58 PM
Most trans friendly docs will start you on spiro without HRT letter. "It's to control blood pressure" is easy enough reason to prescribe this legally.

Getting the T under control will clarify your feelings IMHO. If you freak out when your male sex drive starts to drop, that's a good sign HRT probably isn't going to improve your quality of life.  And that is a much better indicator than any information a therapist can discover about if you are really trans or not. I honestly think they should start every trans person on AA for a month and see how they react. The patient would quickly know if they wanted to continue on HRT after they saw what this does to them. It doesn't take a professional therapist to diagnose the results of this litmus test and would get them out of the loop. Someone who is a fetish CD etc will NOT like that AA's do to them. And one month of AA isn't going to cause any permanent damage. People who have other issues can seek out a therapist. IMHO whether someone's life would be improved from HRT should not be a choice given to a mental health professional when there is a simple way to start someone on HRT that will reveal this.

I'm wondering if there are any countries or therapy/endocrinology practices where this is standard practice near the beginning of treatment? It sounds good in principle.  However, rapid changes in hormones have other effects on the body including driving depression, moods, fatigue, and physical problems. And is it possible that this approach generates more false positives and false negatives relative to more comprehensive gender therapy?  Also it might take more than a month to get to a real equilibrium and have enough time in therapy to interpret what it means to the client so I might be the best approach but still take a few months.

I'm not excluding this approach just curious how it might play out in actual cases and what the history of it is if and if there is any known history. That being said, I would be tempted to try this approach if I got to a point of wanting to try something other than therapy.