It's like no one even believes me..

My therapist won't advance in writing any letters or anything because she says I'm not "stable"..    how am I supposed to be when I'm in this body?   but I don't see how I'm not stable besides that. 

I just want to be normal..   I want T..

I can't take this ->-bleeped-<- anymore. 

Please, how do I get over this?   Is anyone else having as difficult of a time as I am? 

It's a weird mix, therapists. Many therapists want to help out other psychological issues you might be having then let you transition as opposed to the other way around. What other problems are you having? Is it possible that maybe you could write down a list of things you want fixed in order of importance to you (to show your therapist how you prioritize things)?

She says I have depression when I don't.  I feel awful because I am in the wrong body.  I don't understand why she twists it around like that. 

Could you go to a different therapist? Perhaps someone who's more comfortable with trans* issues?

I say this because I also had to clear up mental health history before transition. The main difference being that I believed I was crazy and I needed help accepting that I wasn't before I could even begin to explore my sex. My therapists just knew I was leery of counselors and didn't trust them.

Being trans & dysphoric could easily lead to depression, but if a professional insists on separating them you might have more luck seeing someone else than proving them wrong.

Well, it's worth talking with her to see how you can either show her you're not depressed (which in young adults includes being irritable, easily frustrated, temper tantrums, for example)...or to learn some skills for dealing with the inevitable frustrations that are going to come along whether or not you start T soon.

Also, "feeling awful because you are in the wrong body" might also be what she's referring to when she says depression. Obviously, seeing some hope for medical transition can help that, but so can taking actions in other ways. (For instance, doing what you are now - connecting with other people for support online.) If she thinks that you starting T is just going to add energy to fuel all that frustration (as it can), then you can ask her about how to manage things. My guess is that even asking could demonstrate some insight, which can only help things.

Get a doctor that listens. I have had therapists tell me how I felt when I felt differently. I could go on for days about how frustrating they were.  If you are paying them they should give you the proper services. If said doctor does not understand trans issues then find one that does.

It sounds like you are pretty upset and frustrated. I understand that because I have gotten that way too. Most therapists may want you to take it slow before they give you a T letter. Yeah it sucks but they are just trying to cover their ass. If their client abuses medication they prescribed they will get the blame and can lose their career for it.

It's not very cut and dry dealing with therapists. And they're all different. When you see one, you want to believe that they have your best interests in mind, but when you want something and you're not getting it, that can negate that belief pretty easily.

When I was seeing therapists I didn't even know hormone therapy was an option. For me, personally, therapists never did anything for me but make me worse. They created problems where I had none and ignored problems where I did have them.

I'll echo what some others have said and say to find another therapist. But also bear in mind that you can't just waltz into a new one, demand a note for T and think that will work out. Each therapist has to do their own evaluation on you. But a good therapist should also be offering other suggestions to get you through rough times. Be wary of therapists that immediately get out their prescription pad for antidepressants as well as that's just another way to mask symptoms but not get to the root of the problem.

Changing ones outward sex is a huge, life-altering step. As Mr. Rainey points out, therapists can also put their career on the line when dealing with cases such as this because it could come back on them - that they did not do a proper evaluation, etc.

As much as it may suck - you're always going to be "stuck" in your body. You can change the outward appearance of it, hack bits of it off, but you're still going to have the same body until you die. It never hurts to explore other coping mechanisms. Don't view one single treatment/medication as the cure-all for all your problems. There are many paths you can walk to get to your destination and it's usually a combination of things that end up actually making you feel comfortable in your own skin.

my question is, is it a therapist that deals with trans issues?  If not, that may be the first step.  Even a therapist can have their own "agenda".... which is unfortunate.  But if they are not well versed on trans issues, who knows what they are thinking when they are trying to work out a course of treatment.

I've been looking at therapists and I would never go to one who isn't a specialist in gender identity issues.

Also, I didn't think you needed a letter for T anymore... Heard that somewhere, could be wrong.

According to WPATH "initiation of hormone therapy may be undertaken after a psychosocial assessment has been conducted and informed consent has been obtained by a qualified mental health professional...A referral is required from the mental health professional who performed the assessment, unless the assessment was done by a hormone provider who is also qualified in this area."

http://www.wpath.org/documents/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf (see page 34)

Quote from: ameline on April 26, 2012, 04:04:26 PM
According to WPATH "initiation of hormone therapy may be undertaken after a psychosocial assessment has been conducted and informed consent has been obtained by a qualified mental health professional...A referral is required from the mental health professional who performed the assessment, unless the assessment was done by a hormone provider who is also qualified in this area."

http://www.wpath.org/documents/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf (see page 34)

Psychotherapy is not required.  It's a suggestion.  The SOC is just a guideline, not a rule.  Long story short, it's up to the prescribing doctor as to what they require.

The therapist I went to should have understood trans issues, she was a post-op MTF. Instead of talking about my trans issue (wanting a HRT letter and why I wanted to be on HRT) she explained how my mother made me have issues with authority and my feelings of needing permission to go on HRT. Given she was the one stopping me from getting on HRT and I did need her permission to start HRT, I'm not real sure how my dead mother I never discussed with her was my problem.

While the latest SOC doesn't -require- a hormone letter, every doctor I called asked "Do you have a hormone letter yet" so it seems no one has informed the doctors in the major city I live that a letter isn't required. So now I have a official letter and also have a diagnosis as having a mental disorder as part of this process. Joys...

Its possible you have depression but that could easily be cause because you ARE TG, in the wrong body, and need to start transition. I would go to a different therapist and get a second opinion.

That's tough, sorry to hear that. If it's of any help I suppose I was in a similar situation. I knew ultimately that I wanted to begin T so I looked for a therapist, found one and had 3-4 sessions with her. She said I was depressed, which I was but only because of similar to what you're feeling, wanting the change, hating the body you're in, etc. I felt stuck. I was making progress with myself though, as far as understanding and accepting who I am, what change is really coming and letting my immediate family know. Which all was very important. So, slowly I wasn't depressed anymore. But, I got the feeling that that therapist was 'money-hungry' and ultimately wouldn't give me a letter soon. After telling my family and everything was going well, I chose to not see her anymore, instead I found a therapist that was familiar with gender issues. And that went and is going really well. Into the 3rd or 4th session I brought up the idea of writing a letter to begin t and she was more than happy to.....

little did I know after speaking to an internist I didn't even need a letter...lol so hey, I guess we go through these paths for a reason. Mine was, I needed to be stable mentally before beginning t. I, too, did think that I was stable but in hindsight if I had started t immediately during that moment in time, I know it would have been too much for me and family to handle. Maybe you are stable, maybe you're not and maybe you are more than capable of handling such a big step in your life, I know you know yourself better than anyone. But it's up to you to make those changes. Keep your head up brother, things happen for a reason.

Quote from: Stephe on April 27, 2012, 12:50:52 AM
While the latest SOC doesn't -require- a hormone letter, every doctor I called asked "Do you have a hormone letter yet" so it seems no one has informed the doctors in the major city I live that a letter isn't required. So now I have a official letter and also have a diagnosis as having a mental disorder as part of this process. Joys...

You want treatment? Take the letter and the diagnosis.. Or find a therapist that will write a slightly more open letter.. The closest I have to a diagnosis is 'Kelly has significant gender issues and is therefore a good candidate for hormonal reassignment..' Of course, I live somewhere where medicine is still a profession and not entirely a business driven by diagnostic coding for insurance purposes..

Quote from: kelly_aus on April 27, 2012, 05:28:08 AM
Of course, I live somewhere where medicine is still a profession and not entirely a business driven by diagnostic coding for insurance purposes..

Therein lies the problem.. At least in the USA.

Quote from: kelly_aus on April 27, 2012, 05:28:08 AM
..... Of course, I live somewhere where medicine is still a profession and not entirely a business driven by diagnostic coding for insurance purposes.. .

Stephe, I can't read kelly_aus' comment as being directed at the providers of trans medical care in the United States. If it was intended as such, it would simply indicate ignorance of current protocols as practiced in a number of large clinics in cities in the US. In many of these, a referral letter is part of the process...but a referral letter is not the same thing as a GID diagnosis.

In the US, "diagnostic coding for insurance purposes" just isn't connected to the majority of trans care, which is excluded from most insurance coverage. The medical providers and surgeons who work with trans clients most often are choosing a much lower pay scale than they could earn. They treat patients who are less likely to have insurance in the first place, and when we do (usually through a job), it nearly always excludes reimbursement for care coded as trans-related. The majority of competent, qualified providers of transgender medical and mental health care are not in it for the money. They are not only living up to the standards of their profession, but following their vocations.


Back to this thread's discussion. The OP is a minor. He is not able legally to consent all on his own to treatment. He needs to have his parents' support, which he says he has. It's hard to imagine an ethical medical provider giving hormones to an underage patient without a letter of referral from an experienced therapist. An experienced gender therapist is going to directly address issues of depression, and also to present options and information about transition. If he doesn't like the one he has, he might need to take it up with his parents.

Quote from: MrTesto on April 28, 2012, 02:05:22 AM
Back to this thread's discussion. [/b] The OP is a minor. He is not able legally to consent all on his own to treatment. He needs to have his parents' support, which he says he has. It's hard to imagine an ethical medical provider giving hormones to an underage patient without a letter of referral from an experienced therapist. An experienced gender therapist is going to directly address issues of depression, and also to present options and information about transition. If he doesn't like the one he has, he might need to take it up with his parents.

Not all minors have parents. Not all minors are even state wards. When I was his age my parents were not involved. I got medical treatment on my own consent and understanding, and on my own dime. It does happen.

On a different track though, I just want to mention my experience getting hormones. I'm emotionally unstable. I'm 30, and if I were to describe the awful stuff that I have in my head and my history, it would hardly be believable. But I'm as stable as I'm likely to be anytime soon, and it is absolutely in my best interests to be on hormones; my well-being is not helped at all by withholding HRT. My therapist and my physician recognized this, and I was prescribed T. Nobody told me to stop being in talk therapy, and I was encouraged to continue to cut down on smoking and increase exercise etc.

Medical transition can be a good part of your treatment plan no matter what else may be wrong with you. Your health is important and many factors can play into it.