I'm not cheerleading for the gatekeeping process. I followed it because it was my understanding that it could be the best way to achieve my goals. I certainly didn't need a therapist to tell me that I'm trans. But getting the letter from her certainly helped.

And if that therapist had been clueless or anti-trans, I would have chosen another. I chose this particular therapist as she was listed in the BlueShield database as one who works the LGBT clients.

Quote from: Connie Anne on April 11, 2012, 06:04:06 PM
I'm not cheerleading for the gatekeeping process. I followed it because it was my understanding that it could be the best way to achieve my goals. I certainly didn't need a therapist to tell me that I'm trans. But getting the letter from her certainly helped.

And if that therapist had been clueless or anti-trans, I would have chosen another. I chose this particular therapist as she was listed in the BlueShield database as one who works the LGBT clients.

Some people assume that if you do not mind the gateway process then you're a tool and you cannot effectively manage how a therapist treats you. In my opinion, that's just an unproductive stereotype that does utterly nothing but divide people. When people call those who enjoyed their therapy experience as cheerleaders, you can only shake your head and feel sorry for them for being so narrow minded.

 Some people are so aggressive...

I didn't find my gatekeeping experience very positive or helpful, but if my therapists/doctors were competent, I may have found it helpful. I will still say, though, that gatekeeping should be reduced overall, mostly just for hormone access, as while gate-keepers can be helpful, they often waste valuable time that an individual spends becoming more masculine, depressed, and etcetera. I spend a lot of time with the younger crowd, where the effects are most devastating, and that's my basis.

And the best thing about being where I live... you don't have any choice in who keeps your gates.

Quote from: Annah on April 11, 2012, 06:08:15 PM
Some people assume that if you do not mind the gateway process then you're a tool and you cannot effectively manage how a therapist treats you. In my opinion, that's just an unproductive stereotype that does utterly nothing but divide people. When people call those who enjoyed their therapy experience as cheerleaders, you can only shake your head and feel sorry for them for being so narrow minded.

That's not how I would have worded it, but I can see how some might come to that conclusion.

I find it fascinating that the entire point of my OP is being missed by folks who insist on defining and viewing "Gatekeeping" as any process that involves therapy or a Doctor and lump any adherence to Standards of Care into a single category.

There are a lot of gray areas here, and my point was that by avoiding blanket labels and not stating personal experience and opinions as facts that universally apply to everyone, folks reading can more easily distinguish the difference between helpful, objective statements and angst-ridden, agenda-driven bull->-bleeped-<- pulled out of someone's ass.

People who insist on playing the 6 Degrees of Self-Serving Rationalization Game™ are beating wardrums and intentionally painting with the broadest brush possible in order to be right at the expense of being accurate, objective or helpful.

You can play that game with anything, and it always, without fail, looks stupid at the end:

"I once ate a red jelly bean, then I got sick."

"OMG, red jelly beans make you sick!"

"Jelly beans are dangerous!"

"We all know that oval shaped candies are dangerous!"

"Obviously, all those candy supporters want you to be sick!"

"Brachs is involved in a world-wide conspiracy, everyone knows that!"




Ridiculous yammering is ridiculous.

-Miki

So, why stop with what they have? Why are we in such need of "protecting"?

How about before you can by fast-food they will run health tests on you to make sure you aren't obese and doing further damage to your body?

How about they make you see a therapist before buying alcohol (many people use alcohol as crutches to deal with serious issues in their lives, this is for their own good... sure, not everyone has this problem, but better safe than sorry right?).

How about others force their way into EVERY aspect of your life to double check your choices and make sure you are doing it for the right reasons and understand the consequences?

The rest of the world gets to make their own choices for their body... but transgendered people are OBVIOUSLY nuts, so it is ok if we just make sure? Cool beans.

Perhaps because buying and eating a Big Mac and being disappointed in how the special sauce tastes after the fact hasn't ever led to someone killing themselves.  Drinking a beer hasn't, to my knowledge, removed genitals as a result.

In a perfect world, where there are no such things as liability, tort law, malpractice and ambulance chasing lawyers, you should have the right to determine your own path unhindered and unquestioned.  That would be amazing.  Even then, making medical decisions in a vacuum would be dangerous.  Are you qualified to check for liver issues?  Monitor the effects of HRT on your system?  Going to perform your own surgery?  Ah, right, you require others to facilitate your transition. 

What if you signed a waiver, would that be ethical then?  "If I die, it's my own damn fault because how dare anyone tell me ->-bleeped-<-."   I'd buy into that.  That's just natural selection in motion at that point. 

There is a huge difference between feeling like you have to justify yourself in order to receive the care you need, and participating in a process that allows you to receive that care in a safe, structured fashion.  How many people misinterpret other issues as GID?  How many of those people would have rushed ahead on impulse and made irreversible medical decisions if there was absolutely no check and balance mechanism in place?

Having an SoC structure in place saves lives.  Railing against it as some greater manifestation of being controlled in your life is broad-brushing in the extreme in my opinion. 

If after that beer or that Big Mac, I decide for myself I don't like either, I can choose not to partake with zero consequences. 

The same cannot in any way, shape or form be said of transitioning from one gender to another.

-Miki

Quote from: Miki on April 11, 2012, 08:01:10 PM
Are you qualified to check for liver issues?

Nope but you don't have to have a psychotherapists approval to have it checked either.

The again I forget many people here believe being TG is "a mental disorder". Maybe that's why you feel it's OK to have all these special rules for us?

Quote from: Connie Anne on April 11, 2012, 06:04:06 PM
And if that therapist had been clueless or anti-trans, I would have chosen another. I chose this particular therapist as she was listed in the BlueShield database as one who works the LGBT clients.

My therapist was a post-op MTF TS. Hard to say why she was so clueless but I doubt she was anti-trans. Maybe she just enjoyed the role of being the gatekeeper?

Or maybe it was just the fact I didn't need any therapy and was forced to have it, so others who don't want to take responsibility for their own actions are "safe"?

Quote from: Miki on April 11, 2012, 08:01:10 PM
Perhaps because buying and eating a Big Mac and being disappointed in how the special sauce tastes after the fact hasn't ever led to someone killing themselves.  Drinking a beer hasn't, to my knowledge, removed genitals as a result.

You are right... they both simply kill you.

Sometimes slow. Sometimes fast (sometimes you take other people with you! like with drunk driving).

I want to be free to make my own choices. But, of course, society thinks I'm crazy because I'm trans... they think something is wrong with my brain... so obviously, I shouldn't be trusted to make my own choices. That is the ONLY reason these gatekeepers are in place...

This is a fascinating thread.

The only thing I really have to add, regarding the issue of choice, is this. Using fast food as a good example... a lot of people like having the choice right up until something happens that they don't like as a direct result of that choice. Then they look for someone to blame for it.

"I ate and ate and ate until it caused problems to my health but do I take ownership of that and deal with it? No, I sue the makers of the fast food for making it so damned tasty and not telling me how bad it could be for me if I ate and ate and ate."

Being transgendered may or may not be a mental disorder, that point has been argued and re-argued many times over, but whether it is or it isn't, there are some psychological issues that people may have which may also illicit symptoms such as body dysphoria and/or a desire to be the opposite gender that, when discussed with a mental health professional, come to light and are discovered to have nothing to do with being transgendered whatsoever. Perhaps deep-seated traumatic events in a person's past that, when worked through with said professional, lead to the person in question realising that they, in fact, don't want the procedures that they once thought they did.

And in light of surgical procedures that are irriversible, and which impact so greatly on so many aspects of a person's life, it's better to be safe than sorry, in my opinion.

Eliminate this process and who knows, it may reach a point where surgeons refuse to perform such procedures on the grounds that they don't want to get their asses sued by people who thought it was what they wanted and decided down the road that it wasn't, and since there's nothing they can do to put things back to how they were, they have to find someone to blame instead for not helping them figure out what the real issues were sooner.

I wouldn't call it gatekeeping, I'd call it a safeguard for the benefit of the individual.

^agreed!

Quote from: Stephe on April 11, 2012, 05:18:10 PM
I wonder if  the cheerleaders for  gate keeping would feel the way they do if their therapist had been clueless, had bad advice and they felt forced to continue sessions anyway just so they could get a letter to get on HRT, after living full time for several years already and knowing what they wanted.

Wow. I'm sure you'd like to know I had a horrible therapist experience. My first therapist, was gross, horribly stereotypical, and obviously did not know what he was doing. I went home crying, more confused then ever. So before you assume all the ''cheerleaders'' for gates keeping had it all good, think about it a little. And you know what I did with my old therapist? I fired him and never went back. Duh.

But it would be ignorant and selfish of me to be all against gates keeping just because I personally had a bad experience. I keep in mind all the people that need it, whom gates keeping has saved them from making a major mistake. I keep in mind that some people don't understand what they are doing, that they obsess over things and don't realize what is going on. Gates keeping is a way to assure everyone knows how serious the matter is. Not everyone is responsible enough to understand how serious transition is. They need someone to just stop them at some point and force them to think a bit.

I think anything that serious needs gates keeping. Better safe than sorry.

Quote from: Sephirah on April 11, 2012, 08:40:59 PM
I wouldn't call it gatekeeping, I'd call it a safeguard for the benefit of the individual.

Agree with you.

Quote from: Sephirah on April 11, 2012, 08:40:59 PM

"I ate and ate and ate until it caused problems to my health but do I take ownership of that and deal with it? No, I sue the makers of the fast food for making it so damned tasty and not telling me how bad it could be for me if I ate and ate and ate."

Does this happen? Has a fat guy sued and won against fastfood for making them fat?

This isn't a legal issue. If they say "you can do this surgery with the consent of the patient" ... then... well... that is what it is.

If they want to put in some safeguards to help protect. That is fine... a year of hormones needed before surgery? Sure.

But, needing a mental screening before you can make your own choices?

Everyone seems to think this is the only area where people have other issues which are influencing their choices.

How about having a child? People do that for ALLLLLL sorts of wacked out reasons. Because they are lonely, or want attention, or an entire host of other issues. It permanently can change your body, it is a very life-changing issue (not just for yourself, but your partner AND the child... 3 lives)... and yet, you are free to get pregnant if you want to without a therapist making sure you are ready. Or a year of "real life baby" experience where you walk around with a child under your arm.

Basically... are there crazy people in the world who do stuff for the wrong reasons? YUP!!!! LOTS!! Tons, all over, for everything you can imagine... from eating to comfort themselves... to doing drugs or drinking... or even buying an expensive car.

Why aren't we protecting any of the other nuts who commonly do stuff we KNOW nuts are doing? Why it is only trans people are special?

This isn't about legal issues... this isn't about protection... this is simply that society thinks we are crazy (more so than everyone else)... so we need to be handled carefully before they will treat us.

Quote from: Rabbit on April 11, 2012, 08:56:45 PM
Does this happen? Has a fat guy sued and won against fastfood for making them fat?

Actually, yes.

http://www.minyanville.com/businessmarkets/articles/obesity-tort-law-tort-class-action/10/29/2010/id/30852?page=full

And there were the lawsuits against the tobacco companies because smoking gave people cancer.

QuoteBut, needing a mental screening before you can make your own choices?

This is exactly the point. When dealing with an issue stemming from the brain of an individual, you have to be sure that they are your own choices, and not influenced by a state of mind caused by something else, such as depression. And that there is no other cause which can be dealt with without the need for a procedure from which there's no turning back.

QuoteHow about having a child? People do that for ALLLLLL sorts of wacked out reasons. Because they are lonely, or want attention, or an entire host of other issues. It permanently can change your body, it is a very life-changing issue (not just for yourself, but your partner AND the child... 3 lives)... and yet, you are free to get pregnant if you want to without a therapist making sure you are ready. Or a year of "real life baby" experience where you walk around with a child under your arm.

Actually I agree with you there, a similar approach to parenting wouldn't be a bad idea at all.

QuoteThis isn't about legal issues... this isn't about protection... this is simply that society thinks we are crazy (more so than everyone else)... so we need to be handled carefully before they will treat us.

I don't think it's about transgendered people being crazy or not, I think it's more that so many aspects of the human mind are not fully understood. I mean just look at how many debates are had here with regard to what being transgendered is or isn't, and that's from people dealing with it. And athough some professionals are out of their depth in dealing with the issues of transgendered people, that doesn't make the whole process inherently flawed.

 NO LOCKED DOORS!!! Err....and GATES TOO!! 

Quote from: Rabbit on April 11, 2012, 08:56:45 PM...

If they want to put in some safeguards to help protect. That is fine... a year of hormones needed before surgery? Sure.

But, needing a mental screening before you can make your own choices?

...

This makes more sense.  Now you're talking about a very specific facet of a process, not the entire thing as a whole.

I personally resented the feeling of having to "prove" to someone else's satisfaction, professional or not, that I was feeling what I was feeling.  It felt like I had to justify who I was and subject my understanding of myself to someone else's scrutiny and judgement.  I railed against it, initially.

When my therapist actually submitted a diagnosis, recently, she very intentionally communicated to me that GID was the only diagnosis she could determine, and that this was a good thing as it would make forward progress along my transition plan far, far easier.  The immediate sense of relief and involuntary validation that I felt when she told me that was confusing at first, then pretty damn reassuring.  I was not misinterpreting myself, I was not filling in the wrong blanks when identifying how I was feeling, I was not confusing one thing for another.  I was gratified that she was thorough enough to have run down a list of things that my presentation to her could have been, and discounted them all as not applicable to me.  In her words, "Now we can not be distracted and really focus on making your transition as successful as we can."  It is kind of hard for me to resent that.

The fact that I felt better about it after the fact doesn't mean my initial resentment was misplaced or that I was wrong for feeling that way.  No-one actually enjoys being judged when the result is so important. 

For me, it simply meant that it was something I could deal with, gain perspective on and overcome in order to achieve a more important goal, which is moving forward.

Not for one second did I feel she was Gatekeeping.  I'd prefer my health professionals to be as comprehensive as humanly possible and as thorough as the situation warrants at all times.

YMMV.

I know there are crappy therapists and crappy Docs out there, and my heart goes out to anyone who has ever had the misfortune to be on the receiving end of obstruction, prejudice and ridicule from those who are supposed to be helping and do no harm, but every single experience is just that.  Singular, unique to that person.

That single experience can be shared as a cautionary tale, which is important to those seeking greater understanding and appreciated in that context.

I just feel strongly that presenting those personal, unique experiences as transgospel and pseudo-fact to label all things related in a negative light is dishonest and poorly done.

-Miki

Some instances need gatekeeping, some don't. I personally don't think HRT should require gatekeeping. HRT is not something that is irreversible (other than sterility and gynecomastia, and those come after an extended period of use. I think most people would be able to determine whether they're happier pre HRT than post HRT.

But then again maybe I'm just basing my opinion on how I can operate. My therapist did say I was one of the most grounded people (I assume he meant mentally speaking) he's ever had.

However things like SRS, orchiectomy, and extensive FFS should require some sort of guidelines. By FFS I don't mean things like a brow lift or a nose job, I mean things like jaw / chin reconstruction. These are extensive things that are expensive and alter you dramatically forever.

Whether or not the guidelines are too strict, or too standardized is another issue imo. Everybody is different, you shouldn't need to wait x amount of months or x amount of visits to get the approval, you should just be able to be assessed individually.

Quote from: Sephirah on April 11, 2012, 09:15:14 PM
Actually, yes.

http://www.minyanville.com/businessmarkets/articles/obesity-tort-law-tort-class-action/10/29/2010/id/30852?page=full

And there were the lawsuits against the tobacco companies because smoking gave people cancer.

Well, that case against mcdonalds was in brazil... so... i can't really speak to their laws. If people were winning cases against fast food for making them here in the USA... you can bet there would be a HUGEEEE (pun intended) line of people trying to make some quick money for being lazy.

As for tobacco companies... well...the issue there was they KNOWINGLY sold a product they knew was causing cancers (according to their own studies)... they hid the results... it isn't a case of people knowingly acting and then blaming their choices on someone else (smokers today can not sue the tabacco companies if they get cancer).

QuoteHowever things like SRS, orchiectomy, and extensive FFS should require some sort of guidelines. By FFS I don't mean things like a brow lift or a nose job, I mean things like jaw / chin reconstruction. These are extensive things that are expensive and alter you dramatically forever.

So... "normal" people can get all these surgeries without a therapist (because they have major self esteme issues, or looking for attention, or any other reason...good or not)... but, if we trans people want the surgery, it is because something might be wrong with our brains?

QuoteThis is exactly the point. When dealing with an issue stemming from the brain of an individual, you have to be sure that they are your own choices, and not influenced by a state of mind caused by something else, such as depression.

This is life... making choices are things people have to deal with every day. Making HUGE life or death choices... making choices that affect the rest of how you live.... people deal with these every day. And the thing is, people make choices for VERY bad reasons ALLLLLL the time. Because they have mental issues or baggage that they think they can fix by doing whatever they are doing....

But... why aren't we stopping them? Why don't we hold their hands? The exact arguments for why WE need it can be used for them. It could save so many "normal" people a lot of pain and suffering and making horrible horrible mistakes if they had a therapist there to approve what they were doing....

But... why aren't we?

Why are trans people so special that we need to be approved before we can do what we choose? Are trans people really that messed up that we need to be handled like children? That we can't make our own life-changing choices like the rest of the world?

Thrill seekers...

Thrill seekers die every year. Thousands and thousands of them.

Many go engage in these activities because they are unhappy in their jobs / marriages / life in general... they want to feel "alive".. and doing dangerous things is what they figure will make them happy.

Why are they allowed to do this? We aren't we stopping people from doing activities for kicks? We need to stop everyone going cliff climbing and try to fix them with therapy (to get to the base of their need for thrills)... or , if they feel they really need to experience it... then we should monitor them on indoor cliff-faces with safety equipment and specialists.