Expected length of therapy

[2.B.Dana]

I am receiving care through the VA system at a local therapy clinic. Fortunately I get to meet with the lead therapist and owner who is quite experienced in trans issues.
My initial authorization was for two visits which went quite well and helped me clarify a lot about myself. I was comfortable with the GD diagnosis and have subsequently come out to my spouse and a couple of others and am working through the relationship issues.  The therapist put together a treatment plan and submitted it for further authorization so we can progress towards HRT, etc. The VA approved 8 more visits over the next 90 days and I have my first visit of this round in a couple days.
I have read many horror stories of lengthy therapy arriving at nothing in the end and have read of others who go once or twice to get their HRT letter and are done. I feel a good connection with the therapist and am quite trusting at this point of her judgement. She has said I am in the drivers seat and this goes on as long as I want it and in the direction I chose as far as transition etc.
I have read the trigger/red flags etc and the only I have experienced with her is a momentary reference to some people needing to work through religious conflicts through the process but thats it. I would appreciate input from those who have made it past a few sessions as to what topics were covered or directions the therapy went in your sessions.
Any advice or comments would be appreciated as I prepare for this next set of sessions.
Thanks, Dana

[JeanetteLW]

Hi Dana,

   I am Jeanette and I too am getting care through the VA here in Oregon. I had no problem with getting HRT after coming out to my primary care physician. Through him, I met with a psychiatrist for my initial mental health intake assessment and am currently awaiting word about meeting with a gender therapist.
   As I understand it, with the VA if you identify as trans then you are trans and eligible for the various support services they offer including HRT. They do not at this time do surgical procedures though they will provide necessary pre and post surgical care.  For me so far it has been smooth sailing.

    I hope all is as smooth for you.

   Hugs,
    Jeanette

[2.B.Dana]

I had my third meeting today and it went very well. I spoke to the therapist about this and she said the length is case by case but for a reason I hadn't considered. The whole system is based on the therapist approving or recommending and if anything goes wrong it all comes back on them. So each therapist has boxes to check off in their mind before they will recommend HRT or other things.

[Jessie007]

I have had 62 therapy sessions with 4 seperate psychologists since mid 2015 (yes, I am counting). 3 of the psychologists have extensive experience with trans issues, 2 of them ONLY deal with trans. Everybody is different. I am probably not a good example. I have no idea who or what I am. People tell me that if I think I am trans, then I must be trans. That logic is difficult for me to process. I am very envious of people who are confident in themselves and who they are and are able to make progress within a few therapy session.

Dana, I wish you well in your journey and hope the process is a smooth as possible for you.

Jessie

[Amy Chislett]

Too bad some therapeutic approvals are drawn out so that only those who can afford it get it.

Jessie007, what types of questions or angled concerns are they directing at you?  Or, are they letting you ramble?

[AlyssaJ]

I don't have experience with the VA and obviously can only speak from what I've been through.  I had 10 sessions before my Therapist (or I for that matter) was ready for the HRT letter.  I had a lot of discovery to do and a lot of work tearing down denial and fear before I was at that point. 

My plan is to continue seeing her throughout my transition.  I figure the more support I have through the process the better.  There will be a lot of challenges to face and having someone who's helped others through it before will be very beneficial for me.  She actually included a statement about me planning to continue therapy in my HRT letter.

[alejandratx]

I'm going this route as well. although the one comment makes me wonder if i could just see my primary care and avoid the therapist altogether. my situation is one of impatience. over the last 2-1/2 years or so I've seen 3 different therapists for ptsd. and during each of them i mentioned my gender issues several times. one therapist referred me to another. one ended up leaving. another just wanted to focus on other issues. SO in a sense i can see myself becoming rather annoyed at any prolonged sessions. you want me to come back and back prove this isn't just a phase basically when I've been saying the same thing for 2 years and nobody has been listening. It just boggles my mind so to speak. I made one statement that at the time was a eye opener even to me . not that anyone wants to think about  or death. but i said i had a trans friend who was killed last year and just an example of how serious it is for me. i would trade places with them to have lived the life they lived even to know it would be a short one. but that didn't do anything but get them to take me more serious but not actual do anything for me. one therapist said everything in our conversations he sent to the VA. so maybe ill get lucky and they can find those. doubt it but maybe. anyway I'm rambling here.

[JeanetteLW]

I'm going this route as well. although the one comment makes me wonder if i could just see my primary care and avoid the therapist altogether. my situation is one of impatience. over the last 2-1/2 years or so I've seen 3 different therapists for ptsd. and during each of them i mentioned my gender issues several times. one therapist referred me to another. one ended up leaving. another just wanted to focus on other issues. SO in a sense i can see myself becoming rather annoyed at any prolonged sessions. you want me to come back and back prove this isn't just a phase basically when I've been saying the same thing for 2 years and nobody has been listening. It just boggles my mind so to speak. I made one statement that at the time was a eye opener even to me . not that anyone wants to think about  or death. but i said i had a trans friend who was killed last year and just an example of how serious it is for me. i would trade places with them to have lived the life they lived even to know it would be a short one. but that didn't do anything but get them to take me more serious but not actual do anything for me. one therapist said everything in our conversations he sent to the VA. so maybe ill get lucky and they can find those. doubt it but maybe. anyway I'm rambling here.

Hi Alejandra,

  I'm Jeanette and as you can see I posted above. I am getting care through the VA and my primary care physician was the first person I told I thought I was trans. I also had confessed to him that I had been taking HRT meds obtained illicitly. One of the questions he ask was if I intended to get my HRT from the VA and another was if I wanted to talk to a therapist. Initially I told him no to the meds and yes to the therapist. After a couple days I reconsidered on the meds and let him know I did. He order the meds that day. He had also started the ball rolling on the therapy.
   With the VA a qualified primary care physician has the ability to prescribe HRT as mine did.
   The first question I have for you is ... Have you told your therapist you thought you were trans and asked for HRT?  Sometime you just have to spell things out for people. Even therapists. They could even have been waiting for you to do so before going there with you.
   My second thought is to do so with your primary care doctor. No hinting, just actually verbalizing what you want from them.
   In my case I was not initially out to get my HRT from them but I felt I had to tell my doctor what I was doing in order for him to properly provide my care. I was open to the therapy due to all I had read here and elsewhere saying therapy was recommended. Now I am getting both through the VA.

  Wishing you luck and the gumption to state your case to obtain the care you desire.

Hugs,
    Jeanette

PS I see you are new so why now hop on over to introductions and create a post there so everyone can properly welcome you?

[2.B.Dana]

Alejandra,

My therapy has progressed well in most ways but has had frustrating delays built in as well. My therapist told me that unresolved gender dysphasia is a form of PTSD.

To follow up on Jeanette, I would tell whoever you are seeing that you need to need to speak with a therapist who routinely handles gender issues. I was glad that my psychiatrist referred me out and didn't try to handle it internally. She said she asked within the dept and no one had enough experience to deal with this.

Make enough noise and something should happen.

[Colleen_definitely]

The VA loves turning everything into PTSD.  I had one tell me my back pain from an injury in Iraq was tied to PTSD.

I don't go to the VA for anything any more and have an extremely dim view of them. 

[JeanetteLW]

The VA loves turning everything into PTSD.  I had one tell me my back pain from an injury in Iraq was tied to PTSD.

I don't go to the VA for anything any more and have an extremely dim view of them.

I've have nothing but good things to say about the VA here in Portland, Or. They've been taking good care of me for anything that I've needed. My cancer, my eyes, me regular meds for heart, cholesterol, diabetes, and not HRT and therapy. I surely cannot complain.

  Hugs,
   Jeanette

[Rachel_Christina]

I went once got referred for endo, got HRT and never looked back haha

[Colleen_definitely]

I've have nothing but good things to say about the VA here in Portland, Or. They've been taking good care of me for anything that I've needed. My cancer, my eyes, me regular meds for heart, cholesterol, diabetes, and not HRT and therapy. I surely cannot complain.

  Hugs,
   Jeanette

That's great news and I hope they continue.  They were pretty bad in the 2004-2005 timeframe at the Tucson VA hospital for me.  Of course they may have been itching for a fresh back from Iraq guinea pig to play with in my case.

[alejandratx]

How often does a gender therapist see you is it the same as like my regular therapist sees me every week. S even if it was you know 8 sessions well that would still be like 2 months or something. but if we are talking only once a month then well thats quite some time

[JeanetteLW]

How often does a gender therapist see you is it the same as like my regular therapist sees me every week. S even if it was you know 8 sessions well that would still be like 2 months or something. but if we are talking only once a month then well thats quite some time

  The gender therapist I am seeing has suggested a weekly visit at on point and this last visit he left it open to me completely. I could have chosen any interval from weekly to only calling for an appointment if I felt the need. I an not having any big issues right now but I did want to have a scheduled appointment instead of leaving it open as I am not one to seek help for my problems. I set the appointment for the next month and as usual my therapist is available before then if needed.
   Apparently he agrees with me that I do not have any pressing issues.

  Hugs,
   Jeanette

[staciM]

My thought is that it shouldn't be up to a therapist to determine how often and how many sessions are "required".  Therapy is for you.  If you feel you need someone to talk to, (outside your head) to resolve things, go and see your therapist.  Personally, I didn't need a therapist to tell me what I was thinking or feeling. I figured that out for myself and through heart to heart discussions with my wife.  The only reason I went to a therapist was a technical need for referrals for HRT and future government funded services and procedures.  That part was frustrating for me....getting past the "built-in" gate keeping process.

[donnanewgurl]

I have been in therapy since February of 2016, and received my letter in March of 2016, I have been on HRT for just over 8 months now. I'm still seeing my therapist and I intend to continuing to see her as long I can. I know some girls stop going to therapy after they get their letter, I feel that they are missing out!