Question about therapy

[AliceInMirror]

Hello it's Alice. After some diggings in topic of therapy I have question, maybe pretty stupid, but... I want to prepare myself,so.
 How often your doctors tried to convince your that it's not gender dysphoria but any other problem. Especially helpful will be experience with psychiatrists, because on this day here your need few years under them to even diagnose dysphoria (and it's very,very,very frightful).
 Oh,and I really understand necessity of it all,and really need to work it all with  therapist,but this question scares me.

[Stottie Girl]

Hi Alice, it is a difficult question to answer as every country will have different guidelines regarding diagnosis. Here in the UK if you were to go to a private gender specialist psychologist you can get a diagnosis in a single hour long assessment. If you need to go though the NHS (our public health system) it takes 6.5 years just to be able to speak to someone! The diagnosis will enable you to get HRT and other gender afirming treatment but if you wish to get gender reassignment surgery you will need two further referrals from two clinial psychologists.

A psychologist may be appearing to talk you out of it to test your resolve and whether you have full grasp of what life changes you can expect. It may not be quite what it appears. It is a very personal and embarrassing thing to have to discuss with a stranger but the right professional will have been through this many times before. If your doctor is simply a GP or family doctor then it is unlikely they will be able to deal with your issue from a point of experience. You really do need to speak to a gender specialist if your doctor is not already one.

I hope that helps a bit. I'm sure others will be along shortly to discuss their experiances.

Sarah xx

[Lori Dee ✅]

I have been in therapy for many years, under the care of therapists and PhD-level psychologists, and I am a retired certified hypnotherapist.

If your therapist/psychologist/psychiatrist tries to convince you of anything, they are doing it wrong. The purpose of therapy is to listen. Full Stop.

They can tell you what they think they are hearing from what you tell them. They can tell you that you are showing signs of x, y, or z. You are fully entitled to challenge their opinion if you disagree with it.

I was diagnosed as transgender, and I rejected it outright. I went to a different doctor. Same diagnosis. Then I questioned why they thought what they thought. I spent two years in therapy trying to understand what Gender Dysphoria and being transgender actually mean.

The main purpose of the sessions is to make sure that you do not have some other delusional disorder, that you are thinking correctly, and can make sound decisions about how you want to live your life. They rely on the DSM (Diagnostic and Statistical Manual of Mental Disorders), a guidebook that outlines symptoms and behaviors associated with various disorders.

If they try to persuade you that your gender dysphoria is something else, ask them about why they think that is true. What guidelines are they using? Pay attention to their answers, because they may see something that you don't. Think about whether it fits with what you know about yourself, especially things you did not tell them.

Be prepared to accept what they say if they explain it thoroughly. One of the most difficult things we can do as humans is to take a long, hard look at ourselves, especially deep down inside.

Do not arrive at your session with the goal of walking out with a diagnosis of GD. Go in with the idea that you are having some issues you would like to discuss. It is okay to ask if those indicate GD, but let them use their methods to make that determination. You are going to learn something about yourself. If they are pushing one way or another, walk away. Find someone who will listen.

[AliceInMirror]

Thanks for great answer Lori Dee. It's very helpful and reassuring. For clarity, I had very unhelpful sessions several times, which made all even worse. Advice to walk away when they pushing would be very helpful in that times.

[Lori Dee ✅]

Advice to walk away when they pushing would be very helpful in that times.

That is what I did at first. But keep an open mind. There is a reason for it. Later, when I got the same diagnosis for the second time, I stopped and really spent time thinking about it, asking questions, and looking at my past behavior. It turns out they were right. I just didn't see it.

So keep an open mind. Ask questions. You do not need to accept their answers, but at least give them some thought. Maybe they are right after all. Maybe not.

A good therapist will never push in any direction. They let you decide by helping you find the answers you seek.

[Athena]

First which Country do you live in ? I imagine that the country you live in will make quite a large difference. I live in Canada and I had absolutely zero issues, now there are some clinics that are probably less helpful but any of the people I talked to have been nothing but lovely.

The big thing to do to prepare is to be willing to be truthful. The 2 things I had issues with in my transition was A) my doctor is not qualified for informed consent which meant I had to wait for appointments at a time I was really suffering. B) I had to drop weight for my surgery but I managed to do it.

[Allie Jayne]

The practical purpose of therapists is to ensure you have no mental condition which could be confused as Gender Dysphoria, and you are stable enough to make life decisions. The diagnosis for GD is fairly simple as a persistent need to affirm a gender different to you were assigned at birth, and it is basically you saying you fit this descriptor as there are no other clinical tests.

Eliminating all other possibilities is way more difficult, and my psychiatrist gave me a number of those questionnaires with cryptic questions they score. I think there were 11 different tests from memory. He sent me the quizzes after our first session, which I filled in and sent right back, and we had one more session to ensure I had been informed of the risks, was committed to proceed, and prepared to deal with any negative consequences. This, plus a letter from a psychologist, satisfied the WPATH requirements at the time.

At no time did either my psychologist or psychiatrist try to guide me in any direction, and this is how it should be. My psychologist, who was WPATH registered, claimed they diagnosed me with being Transgender, but she had no capacity to do so. At the time we were working with DSM-4, which had a diagnosis of Gender Identity Disorder, but it was already under review, and was dropped in DSM-5. Such a diagnosis opened the way for the disorder to be 'treated', or 'conversion therapy', which has been universally proven not to work, and to create disastrous outcomes.

It is important to note that the diagnosis for Gender Dysphoria is a voluntary statement, and it is not listed as a disorder. There is no psychologic treatment other than support, and the only accepted treatment towards sustained relief is medical. While psyches are often helpful in stressful processes, they often assume they can diagnose and treat transgender and we need to be wary of unnecessary and unhelpful methods. Some governments and institutions gate keep via psychs, and subject trans people to more distress than necessary, but if you are in those countries, you can be stuck.

Hugs,

Allie

[Lori Dee ✅]

The reason for the change is due to the definition of "disorder".

Major global medical and psychological organizations shifted away from classifying gender diversity as a mental disorder to remove societal stigma and recognize that a transgender identity is not a pathology.

The Old Approach: In older editions of the diagnostic manual, the condition was called "Gender Identity Disorder" (GID). This name inherently pathologized the person's identity, implying that wanting to live as a different gender was itself a psychological failure.

The Modern Approach: In the American Psychiatric Association's DSM-5, the term was changed to "Gender Dysphoria". The DSM explicitly states that gender non-conformity is not a mental disorder. The diagnosis now focuses strictly on the dysphoria—the emotional distress or suffering a person experiences due to a mismatch between their gender identity and assigned sex. If a transgender person does not experience distress or impairment, they do not have a medical condition.

[Petunia]

Alice, I'm in Australia and I have been to see a psychologist about a dozen times.

It started as part of PTSD.

I did see a guy first who tried to steer me down a path of his theories. I gave up after 3 visits.

Then my wife selected another psychologist for me.

The one she chose was also proficient in LGBTQ+ issues.

The first visits I just talked about my accident and all I did was talk and talk and cry.

There was no judgement. She just put everything I went through in sequence and showed me I was being too hard on myself.

I realised I would have more compassion if all the things I lost happened to someone else.

At the start, my psychologist told me everything always comes out.

And well I did.

All through it there was no leading, no judgement, just listening and feeding back what I said.

After my last visit she told me she can give me a letter and recommendation for hrt if I want.  At some stage I need to actually make a decision.

The point of all that is you need to find the right councelling for YOU.

If you feel you are being led or judged you need someone else

[KristaFairchild]

Hello it's Alice. After some diggings in topic of therapy I have question, maybe pretty stupid, but... I want to prepare myself,so.
 How often your doctors tried to convince your that it's not gender dysphoria but any other problem. Especially helpful will be experience with psychiatrists, because on this day here your need few years under them to even diagnose dysphoria (and it's very,very,very frightful).
 Oh,and I really understand necessity of it all,and really need to work it all with  therapist,but this question scares me.

I see a therapist because I choose to. My nation may have a ridiculous orange leader, but some wonderful systems remain in place, especially in California. There is no gate keeping. It's called informed consent. I did a virtual meeting with a doctor, said I wanted HRT, and it was sent to my pharmacist. She did discuss options with me and was very helpful, but there was no "diagnosis". I'm not sick. 

Why virtual? Because CA has a stripe of crazy conservative counties running the full length of the state. I live in a dead red county and am grateful for the massive blue areas in the coast that control the state government