Counsellor/Therapist Needed?

[Leah Lynn]

Last month the psychiatric bigwigs decided that transgenderism/gender dysphoria is no longer a mental disorder. It is now labeled as a physiological disorder. Okay, I'm sure you're all aware of this. My question is: If this is so, can one begin HRT by merely visiting a medical doctor, and skipping the counselling and therapy? I damned well know what I want and I would consider seeing either a waste of my time and money. Not saying this is the correct approach for everyone, but by now, I know what I want.

[AnitaH]

One of the comments that I read was that this does not change the need for counselling and therapy. One of the concerns was that if they did eliminate that need it would be classified as elective surgery and not covered by the few insurance companies that offer it and nearly guarantee that no one else would offer it. At least that was the impression I got from several sites that commented on the change.

AnitaH

[Eryn]

I very much doubt that the psych community would write themselves out of a job. With medical liability being what it is you're still going to have to jump through all the hoops no matter how sure of yourself you are.

[LeaP]

Last month the psychiatric bigwigs decided that transgenderism/gender dysphoria is no longer a mental disorder. It is now labeled as a physiological disorder. Okay, I'm sure you're all aware of this. My question is: If this is so, can one begin HRT by merely visiting a medical doctor, and skipping the counselling and therapy? I damned well know what I want and I would consider seeing either a waste of my time and money. Not saying this is the correct approach for everyone, but by now, I know what I want.

Even if your opening sentences were true (they're not), at this point NOTHING has changed vis-a-vis the only standard of care that is in common use in the US (WPATH's SOC). The APA, which publishes the DSM, has no practice guidelines (its version of care standards) in this area.

Medicine is practiced in the context of care standards. While any doctor is free to depart from them, as a practical matter very few will except under very unusual circumstances because it opens the doctor to risk. You could start HRT after bypassing current standards-based practice, should you find a doctor to prescribe, then turn around and sue the doctor, with some hope of success. A doctor bypassing standards is leaving behind the backing of his peers and boards, opening himself to regulator's scrutiny, and probably forfeiting his malpractice insurance coverage for the case unless he can document a very sound medical rationale.

Besides, it's well understood among practitioners that patients may present with your expressed desire but that it may be a symptom of other issues. Part of their due diligence is to validate what is real and what is not. (That's the psych practitioner's role and specialty, not typically that of the physician handing the HRT.) Mind you, *I* have no reason to doubt what you are stating about yourself, but I'm not on the hook for the consequences if things go South, either. The therapist/psychologist/psychiatrist/physcian IS.

[Leah Lynn]

Thanks, ladies. At this point it's pretty much a pipe dream, unless I hit the lottery, or Obamacare picks up the tab.

[Kaitlyn Michele]

are you saying you have no insurance?

if you have any insurance, any decent therapist with gender experience can treat you for generalized anxiety at whatever your copay rate is.. you don't need alot of visits, you just need a therapist and you need to demonstrate that HRT will benefit you..

[noeleena]

Hi,

This concerns myself & may not be of benifit for others, yet itll depend on the person concerned,

Im a very strong person & no i did not need to see a Psychiatirst or any one for talks about myself, what i did do was see a Psych for less than an hour & i told him the same as i told our Endo.

I am a woman & will live as one i explained what i had done was doing & what i will do at that time i saw him my first ? to him was did he know anything about people like us, he said yes so once he knew about myself he told me he would not need to see me again & signed me off there & then,

My difference is im intersexed allready being female so why would i need to be told what i am from birth, no need,

our endo was happy with me as well so every thing went as it should you see i did not see things as a Trans person does though some surgerys are similar some hormones do work & others dont, my own hormones did more for myself than the H R T, so there are differences in our bodys to start with,

The ? is when some one who belives they are trans yet ? themselfs then yes to talk over about them selfs will help yet dont ever let any one tell you what they think you are , because that takes the onous off who you are away from you & they may be very wrong,

the way i see it is not if you are a woman, its are you so sure you are a woman there's just no dought at all no if's or but's it has to be i am a woman, end of thats it, & how you live is then up to you, no one else,

I was born intersex so theres no dought about what i am. even before i knew anything about male or female i knew what i was then age 10 so the imprint was stamped on my mind long before birth, now of cause i did not have words to explain that not then.

As a thought here i paid for my surgerys so would i waste my money to do or have surgerys if i did not know what i was doing,

Would i bother playing games for a bit of fun. go through all what i went through to have a regret & posiable lose of family ,

I could have brought a new car , sorry, as i said i knew what i ...NEEDED...not a wont .

& heres the neat thing about all of this every one who helped me all the way through bent over backwards to make sure every detail was right & with out any problems so much was done for me it was just so fantastic ,,,GET IT .....FANTASTIC......

...noeleena...

[Sandra1746]

You may need to do some searching in Iowa but I'm sure there are 'doctors' who can prescribe HRT and get you started after an evaluation. An office visit will likely run about $100 or maybe more but Estradiol is cheap, the local WalMart would sell me a 4-pack of patches for about $45 and if you have insurance it is less. The pills are cheaper yet.

First you need to find an MD, psychriatrist, or PA who will evaluate you and write a prescription. That may take some sleuthing but they are there; just need to look.

Good luck,
Sandra1746

[StephanieC]

are you saying you have no insurance?

if you have any insurance, any decent therapist with gender experience can treat you for generalized anxiety at whatever your copay rate is.. you don't need alot of visits, you just need a therapist and you need to demonstrate that HRT will benefit you..

This was my understanding as well. Doc writes the prescriptions, I pay the copay.

Don't the standards allow for a "implied consent" or something similar? You answer a series of questions, indicate you understand the risks, and promise not to sue anyone (not sure about this one). But there are lots of doctors that still do old method that requires a battery of specialists to get just as far.

-stephani

[morgan51]

If I can find a therapist in this small town and a doc. you can too. I'm in wyoming and its a very small town. Do some footwork!

[Leah Lynn]

My company is upgrading the health insurance package, so I'm waiting to see what it'll include this time around. Previously, it excluded anything tg, little help for therapy. I still need to check with the cardiologist to see if any of this is possible. I have a checkup with him next month.

Not sure how the company will accept me transitioning. Oh, well, I was looking for a job when I found this one.

[StephanieC]

From an insurance company standpoint, I don't think it's identified as a transition treatment. And I don't think the employer knows the treatment (let along any diagnosis) anyway.