Bit of a shock

[PennyNZ]

I have read this forum for several months and had a reasonable idea what to expect re HRT

Had my first talk with a theropist on Monday night after being referred by my doctor a few weeks ago.
I felt that all was going well, was open and honest and we were mirroring our siting positions so felt comfortable.
She is really nice.

I was telling her of my plans and proposed schedule, but she interrupted me saying, "do you know what the proceedures here in this area (of NZ) are?"
"No, not reallly I said"

"Well, before you can start HRT, the Endocrinologist requires you to live for one year as a woman"

Oh, how naive I have been. I had read that happens in some places, but did not think it was required in NZ.
I can understand the commitment requirements of the Endocrinologist

And here's me thinking that I could gently start my transition, coming out in about a year or so.

Well I guess it is different schedule for me now. I am going to do this !!!


Penny

[Kaitlyn Michele]

Good luck to you Penny

Remember in all things medical you are your own best advocate. Get to know those rules.. as you go forward you are not going to want surprises to derail your progress!!

For example, who is going to "decide" on what living as a woman means? Do you dress frequently? Make sure you get very specific feedback from the specific person that is going to sign off and if you work with them and you are serious you never know if that timetable can get moved for you or accomodations can be made for you specific circumstances

[I Am Paula]

My only thought. REALLY? That seems so archaic, to force you to live, right off the bat, as a woman. It's outdated ideas like that, that cause people to self med, and other dangerous practices. Sorry, I'm speechless.

[DebbieL]

You should find out if this includes work. Many states in the United States require that you live as a woman for a year, but therapists will often let you do "120 mode", essentially, everything EXCEPT work and commute time.
Once you start hormones, you don't have much time before you will have no choice but to live 100% female.
Your therapist will also want to know that you have a plan for a stable work situation, for example, an employer who has a strong diversity program that supports and includes LGBT people. Even then, your employer may decide to reassign you to a different location or department, so that you can have the experience of people who DON'T already know you accepting you as female from the start.

Your therapist will also be looking for other signs of commitment, like have you done laser or electrolysis, are you managing your weight, are you beginning to move and gesture like a girl, and other subtle things that are hard to fake.

If you are living 120 hours / week as female, it will become obvious to coworkers and management that you are transgender, you will just have to tell them when you plan to transition.

[Dianne S]

Penny,

Find another therapist. According to the NZ Ministry of Health at http://www.health.govt.nz/our-work/h...gnment-surgery the prerequisites for HRT are:

Demonstrating knowledge of what hormones can and cannot do, as well as their risks and benefits.

Documented real-life experience of more than 3 months and/or counselling for at least 3 months.

See also the publication http://www.health.govt.nz/system/fil...nz-v3oct14.pdf which on page 18 says: "The WPATH Standards of Care recommends that a person has either lived in their appropriate gender (real-life experience) or undergone psychotherapy for a minimum of three months prior to starting cross-hormones. Either can help a trans personexplore the implications of transitioning. However, due to safety or other issues, there may be good reasons why a trans person may wish to commence hormone treatment before changing their gender role,and this is regarded as the typical treatment pathway in the HBSOC. It is useful for the health professional to check whether a trans person feels safe to present in their appropriate gender identity and what, if any, further support they require.

So yeah... educate your therapist or find another one.

[PennyNZ]

Thank you Kaitlyn, Paula, Debbie and Dianne for your replies.

Dianne I will follow up those resources you quoted with the therapist, thanks
Good advice to define " live like woman" Kaitlyn
Debbie, thanks - I am a part time contractor with a small progressive thinking business, whose owners are quite liberal, but one never knows I suppose. Not the end of the world if they strong negative reactions.
My other work is for my own clients, and I can expect some negative reactions from some I guess.

Thanks again
Penny

[Heidi Stevens]

By all means Mary, find out if the RLE is required in NZ. Arkansas allows the three month therapy rule and I was allowed to begin HRT last month. My personal plan is to not present as a woman full time for the time being, but the HRT therapy has helped me mentally tremendously. It does seem strange that after a few years of the current WPATH standards some places still demand RLE.

[Dianne S]

My other work is for my own clients, and I can expect some negative reactions from some I guess.

You may be surprised. I have had only positive responses from clients since coming out. If you're good at your job and you provide good value to your clients, they won't care what gender you are.

[stefan37]

You should find out if this includes work. Many states in the United States require that you live as a woman for a year, but therapists will often let you do "120 mode", essentially, everything EXCEPT work and commute time.

What are you talking about. I haven't heard that states require you to live a year as a woman before being prescribed hormones. You can easily hide hrt changes for well over a year before needing to go full time.

[Barbara Ella]

I know of no requirements of RLE for HRT acceptance, just surgeries, and even that is being relaxed. Educate your therapist as to the mental calming HRT provides by lessening your dysphoria. It makes planning and taking actions much more realistic since you are not rushing to get things done in an attempt to "find" yourself. You are right there, and the HRT helps you find yourself and see precisely what you need to do next.

Never had to see a therapist for my Dr. to put me on HRT. No need, it is a medical condition, and only a first step in any transition.

Barbara

[PennyNZ]

You may be surprised. I have had only positive responses from clients since coming out. If you're good at your job and you provide good value to your clients, they won't care what gender you are.

That is great news for you. I hope it is the same for me. Some of them go back to the mid 1990's

So yeah... educate your therapist or find another one.

I don't think it is the Therapist Dianne - sounds more like the Endocrinologist, but will find out more next meeting in 10 days or so

Thanks again
Penny

[PretzelGirl]

What are you talking about. I haven't heard that states require you to live a year as a woman before being prescribed hormones. You can easily hide hrt changes for well over a year before needing to go full time.

I was thinking the same. Now I understand the WPATH standards used to require that. But we used to start cars with a crank on the front too. Long gone and glad for it!

[HelenR2]

Also bear in mind they might want PROOF of RLE.

[Kimberley]

It is safe to assume the doctor does not ascribe to the WPATH Standards of Care? The standard in the latest Version 7 is informed consent. That is what is being used here in my part of the world. RLE can come before during or after and is not a prerequisite to any healthcare under the standards. This sounds more than archaic; a step backward 20 years.

Very strange in this day and age in a modern country. For me personally it stirs horrible memories.

I am so sorry you have to go through that.

[Dianne S]

sounds more like the Endocrinologist

OK. I find it a bit odd that an endocrinologist would be willing to prescribe cross-hormones, but doesn't know the latest transgender standards of care. There's a bit of a disconnect there.

Perhaps your therapist could have a word with the endocrinologist? Or find another one?

[JohnH]

I don't understand why a genetic male would have to live as a woman for a year before HRT either. I have been on M2F HRT for over three years and I still live as a man for the most part, except for my long hair, and lipstick and eye makeup for church and business. I have D cup breasts but I have retained my masculine name and gender designation. I have made no effort to raise my deep bass speaking voice nor do I intend to do so.

If someone sees me it is readily apparent the effects of the M2F HRT. I make no effort at all to hide the effects.

I did not have to see a therapist to get the medication from an endocrinologist. But the effects of calming me and making myself feel better about my body are priceless.

John

[karenpayneoregon]

Hear in Oregon I was permitted to start HRT by consulting with a doctor which I did then months later started my 12 month live as a female. Seems every state has their own twist on HRT.

[PennyNZ]

Wow Karen - that is great and is how I wish to progress my transition.

[Eryn]

It's amazing how standards vary by location and how many are apparently made up on the spot by the professionals involved.

For HRT, I needed a letter to the endo from a therapist stating that I had received counseling. That's it. My personal criteria was much greater than that.

[Michelle789]

In California, you don't even need a letter from your therapist to start hormones. Unless you're getting covered by insurance, then the insurance company may require a letter to cover you.

My own personal criteria is that I was certain enough that I am trans and going to transition before starting hormones. I was living "165" for almost two months before starting hormones. I was laid off from my job and lived as a woman entirely except for my once every other week AA meeting. I ended up starting hormones, getting rehired as a woman, and came out at AA and went full-time by last August.

I guess many places still require the archaic living full-time as a woman to get hormones. I don't like that because it forces you to come out, risk losing your job, friends, family, and everything, just to get hormones. Sometimes we require the confirmation of our gender identity from hormones before we have the confidence to come out to people and take those risks. My own personal belief is you should only come out to people when you know you are definitely going to transition. This move is irreversible, and is the only other irreversible move aside from surgeries.

[JohnH]

Michelle,

I agree with you. It would be mighty hard to pass as a woman having the body hairiness and scent of a male in addition to being flat chested.

Suppose an individual comes out as a woman and lives as such for a period of time as a condition to starting HRT. He starts HRT, and hates the effects of HRT and realizes transition is not for him. Now this poor individual is placed in a very awkward position of explaining to his relatives and acquaintances he is not going to transition and the reason.

Now in my case it would be quite easy to pass as a genetic woman - all I would have to do is to learn to speak with a treble voice. But I have decided that "it's not going to happen" (to use a phrase from Rick Harrison of Pawn Stars ) as I am content the way I am.

John

[Kris Avery]

Johanna,
I will 2nd that statement. The voice "ain't gonna happen", of course, neither will the face or hairline.
Does it count if I am female looking from the chin down?

[Eryn]

In California, you don't even need a letter from your therapist to start hormones. Unless you're getting covered by insurance, then the insurance company may require a letter to cover you...

In my case it was an insurance requirement. The therapist is also covered, except for co-pays, so the requirement isn't onerous.

[JohnH]

Johanna,
I will 2nd that statement. The voice "ain't gonna happen", of course, neither will the face or hairline.
Does it count if I am female looking from the chin down?

"

I don't have a brow ridge nor do I have any beard shadow. I frequently get ma'amed and when I reply in my deep bass voice, the person says,"Oh sorry, Sir". What really irks me is how society regards being masculine as being superior to being feminine. It's OK for a woman to dress as a man but it is regarded as perverted for a man to dress as a woman. What a damnable double standard!

On a side note one time I got ma'amed over the phone. That was a mystery to me since the pitch of my speaking voice is toward the bottom of the male range (typically 90 Hz but sometimes as low as 65 Hz where a typical man is at 120 Hz). I guess there were other clues since I speak with a wide range of pitch and speak expressively.

John

[Michelle789]

Suppose an individual comes out as a woman and lives as such for a period of time as a condition to starting HRT. He starts HRT, and hates the effects of HRT and realizes transition is not for him. Now this poor individual is placed in a very awkward position of explaining to his relatives and acquaintances he is not going to transition and the reason.

This is exactly why the live full-time as a woman for a year requirement to get HRT is ridiculous. If you take hormones for a few weeks and don't like it, you can stop. You won't get any irreversible changes.

Once you come out, there's no going back.