Starting Therapy

[Lilblondecutie1407]

I haven't been to see a mental health doctor since I was a child when my parents divorced. Does anyone have any advice on what i should do to prepare and what I can expect on a first visit?

Also what would be your "typical" transition pattern or steps that would happen, I have been looking online as to what steps i need to change name and gender markers in Alberta.

I have come out to most if not all my friends and the only part of my life that needs to be illuminated is my family and work.

[Heidi Stevens]

Hey Lil, first and foremost is to be complete and totally honest with the therapist. You are trying to figure out your next move and you will only hurt yourself by withholding info or not answering a question honestly.

Next thing I would do if you think you're on the path to transition is to get your facial hair removed. The sooner the better. Laser only gets dark hairs and electrolysis is slow and tedious. As far as name changes or surgery, I'd wait until the therapist agrees you're transgender.

Keep your ears open and give straight answers and you'll do ok. Good luck

[Marcelle]

Hi there,

One word of advice . . . not all therapists are created equal. If you have not already done so, ask if the therapist you are seeing is knowledgeable in the area of gender identity issues. If not, I would highly recommend a referral to someone who is as they will better understand what you are going through. As Heidi indicated, be honest and open and now is not the time to hide things. Your therapist should guide you along the pathway and help bring order to chaos and help you discover where you fit in the grander scheme of being TG. If you are looking for the "silver bullet" answer from your therapist ( you are/are not) TS/TG/CD whatever, it is not something that comes out right away and if a therapist is telling you so on the first visit . . . to be honest I would be a bit skeptical. This is a process and your therapist should work with you over several visits to help you get an idea of who you are.

Cheers

Marcelle

[Lilblondecutie1407]

Thanks to both of you for some insightful replies. The first psychologist is one that is contracted through work and though he deals mostly with other specialties is willing to meet with me and see what options he can provide. the second is a lady I found online that specializes in gender issues as a MSW and she has been very accommodating with not only my schedule but also with getting documents to my insurance company.

When I first thought of seeing a professional I goal was for them to say yes you are who you think you are but as I talked to more people and did more reading and like Marcelle said there is no silver bullet.

what I hope to get out of therapy is a better understanding of myself and how to best inform my family and work of what I am planning. I also hope they can help me navigate and come up with a transition plan that works for me. I maybe getting ahead of myself but also hoping they can guide me to the path of getting on HRT.

When I first started to explore who I really was and not who I personified I used to think I was as some say just a CD but I soon realized it was much more and much deeper than that. Here is a post I made on an other forum that I think helps show where I was, where I came from and where I am now:

I have been looking around and researching all over the internet and have landed here, hoping to learnand grow on this finally discovered path I had always been on.


I recently started to understand and grasp not only my feelings but who I am truly. I’m 30 years oldnow and been living my life as a male though I remember times as a kid that i used to play dress-upwith my sister and always as a girl and also used to make skirts out of towels after a shower. I reallystarted to want to wear female clothing when puberty started and kicked into full swing when I startedseriously dating at 18.


What started as a fantasy that an ex-girlfriend tried out with me lead to me doing it secret when nobodyhas been around and finally became almost a stable occurrence with last last girlfriend (who Ironicallyfigured it out before me). However ever since we broke up these feelings have gotten stronger andstronger each year and they keep getting stronger, until I finally met a girl that has helped me get out ofmy shell and the house and see who I truly am. I’m so scared of people not believing me as I'm not thatyoung anymore, though I have told most of my friends and those that have known me the longest I’mvery feminine(most thought I was in the closet about being attracted to men) and I have never reallybeen that comfortable doing the typical boy stuff, though to help keep up appearances I have done it foryears and spent a lot of money on a lie. But I know I have to deal with these issues sooner or later. Ihave been thinking about transitioning but I don't know, is it the right thing to do? I have anappointment to see a psychologist and gender therapist about this.


I go by two names at the moment and my friends have been super understanding and have made great efforts to use femalepronouns but having to switch back and forth around work and family makes it hard for me and forthem too.

[Eringirl]

Hi there:

Welcome to this side of the forum! There have been some really good comments by Heidi and Marcelle. A few things I would add....no one, I mean no one transitions because they want to. We all did it/are doing it because we have to. This is something that a good therapist can help with. There are no short cuts through this (at least none that are safe), so being patient was a big thing for me. But well worth it. Everyone's journey is different, though we do follow a similar path. But one thing that we do have in common is that we did it by being smart and safe. Doing it under medical supervision, both physically and emotionally, I think, is key. As Heidi mentioned, start laser and electro ASAP. I started before I started HRT and went pretty hard to get as much done as I could. Because...if you think it is uncomfortable before you start HRT, wait until hormones start to kick in. Then it really starts to sting!!! Your skin gets softer, thinner and more sensitive, so that's why starting sooner rather than later is a good thing!

There will be good days and bad days....there just are. For some, their entire life blows up, for others, not so much. For me, I lost my marriage, but everything else is stable. Job is great, friends are awesome, I still have a great relationship with my kids, so it is all good. But I did have to pay that price. But that was my choice...to survive. And FYI....at 30 you are still really young!! Ha ha. I am 56, started by journey a year ago, but was first diagnosed 17 years ago. Decided to ride the roller coaster as long as I could before I pulled the pin on the Tranny grenade (TM), and that was out of necessity, not want.

The other thing I would do, is to try to find a local support group if you can. That has been a big resource for me. Bottom line? Surround yourself with good support, think it through, be honest with yourself and others, and ask lots of questions. Lots of questions.

Hang out here, this is a great resource. I have made some really great friends on this site that I speak with almost on a daily basis. And I know of few in Alberta that are here (I think Calgary??)

Anywho, that is my two cents worth......

[LeaP]

I echo most of the prior responses. I really do think that knowledge of, and experience with gender therapy is critical. This is a highly specialized area. Why are you planning on going to both a psychologist as well as gender therapist?

My usual advice is not to worry too much about preparation. Initial sessions are intake sessions to see if the two of you are comfortable working together. You may find that the therapist will drive initially. That's just fine.

[Kaitlyn Michele]

Right dont worry about preparation!!! just let if fly as best you can.... if you prepare too much it becomes a chore in my opinion...jotting down a couple notes makes sense or writing down some topics that are important as well ..but then just do it.

to me the very biggest issue is that you have to be WILLING and ABLE to look at your own internal dialog and ANALYZE it with no judgement of yourself..

this can be very difficult and it requires hard work.... you have be willing to do it,,,, and then its up to your therapist to point you in the right direction...that's the able part... you may have to learn some new skills ...thats a really good thing imo

it took me a long time to see how my actual thoughts were influenced by the way i thought...and the way i thought was totally influenced by my transsexuality and the internal coping skills i developed....
i was not thinking constructively.... i was not being realistic about my quality of life.... that was a HUGE empowering realization...i started to learn how to have my thoughts be more consistent with what was going on... see what i'm saying??

if you don't like the therapist after a couple sessions, you must move on to the next one....some are great, some are not...and you may not connect ....

Good luck and keep talking about it.

[LeaP]

it took me a long time to see how my actual thoughts were influenced by the way i thought...and the way i thought was totally influenced by my transsexuality and the internal coping skills i developed....
i was not thinking constructively.... i was not being realistic about my quality of life.... that was a HUGE empowering realization...i started to learn how to have my thoughts be more consistent with what was going on... see what i'm saying??



Yes, and I'm still amazed (and appalled) by the depth and breadth of this. Its discovery may be empowering, but it can also be disturbing. Unwinding it is difficult ... and easy. The former is the typical view from where you (the OP) are now. The latter is in hindsight once you reach the consistency of thinking and decision-making that Kaitlyn mentions.

[Kaitlyn Michele]

power is disturbing in almost all its forms

it is impossible to have power without vulnerability and risk, and the responsibility of the consequences ...

IN my opinion.....its a natural part of transition to learn to feel something naturally and then grow to beleive that its actually true.... the first part is the "Easy part"..it really just happens if you proceed with transition steps and make progress...it will feel natural..... but the 2nd part can be tricky...can you trust your feelings??.... that's tough....we don't grow up in a world consistent with our feelings!!!!!!!!!!!! Zero validation.....so we all end up going back and forth...maybe even distrusting the natural feelings.......so you have to learn to trust your feelings, and to do that you learn how you think..


I'd like to add to the OP
i didnt go into therapy looking for answers
.... i was just miserable and i wanted it to stop... so dont worry if you have no clue about what you want...i got the opposite of what i wanted!!! and it was the best thing for me!!!!

[Georgette_USA]

I have never been big on the idea of a Therapist, unless you have problems that you can't work / figure out on your own or just talking with others. My own bias as I never got much from talking with Psychiatrists when young. Was always MADE to go. One even asked about that and I explained that I talk with all my close friends / relatives.

I see many now that do that, especially with the idea of GD. If that works for them I do not discourage them, if they feel that it helps them go for it.

When I was in Navy and in charge, I learned to make snap decisions and go ahead. After the Navy I met with others with GD questions, some were Post and some were Pre, and some were CDs. There were NO support groups, NO Internet, Not many in medical field that knew anything about GD and treatments. May have been impulsive, but after going over the pluses and minuses, determined to just jump in. Did all the preliminary and somewhat reversible stuff first. Had to visit with a Pysch, but that was a requirement for the letters to surgeons.

[Lilblondecutie1407]

Well here's the details from my visit with the general physiologist, he was very nice though I think we was taken back by the fact that I wore some pink runners, flared jeans and a white and charcoal TNA hoodie. I also had a nice hand bag for my ID and such. We talked about the confidentiality and what my goals were going in. Which were to get some resources and information and possibly some clarity on me understanding me. We started with some background which touched on how I moved out from home, my experience with other doctors in the field and how I got to be here today.


Then we started talking about how I was feeling with regards to my goals on expanding my wishes to work and family and we sorts got stuck on when I said that I miss having my forms on when I'm out without them, like something is missing. All in all it was a good meeting to have and see what a not for me doctor was like, I think as much as he was trying to be professional and helpful it was out of his comfort zone and "scope" so to speak.


Though I did learn that I have a feeling of missing out growing up as girls got to do things that I didn't and that the way I dealt with that as a kid / teen was to have a place in my head that I could be what I felt I couldn't in reality.


I'm defiantly glad I went and that I really know I on my correct path just would like a professional to more help with the check and balances of transition, I am overall a happy person but know that I order to really be the happiest I can I need to be true to myself.

as much as memories are frames by our now current perspective there is some truth to what they make us feel now and weather they validate or invalidate out views of ourselves is totally up to us.

I'll post again tomorrow with the outcome of the therapist that lists gender issues as her area of focus.

[PennyNZ]

There are some really good suggestions above (or below)
Good luck
Penny

[kelseygal]

That really is key. When you find the right therapist, it clicks. Good luck with the new therapist tomorrow! Oh and one more thing, I discovered that many of the therapists I found online that listed "trans" anything did not really have experience in the field. If you find this is the case up where you are, I would reach out to a local LGBT center or group for a referral.

J

[LeaP]

I agree completely, Kaitlyn, but we're talking about different things. I meant disturbing in the sense of losing your sense of self, of having it undermined. With the easy/hard thing, the difference is that I was speaking of what it feels like to consider taking action in the beginning (hard) vs. it becoming natural, or easy, later on.

Your point on feelings is excellent. Lots of us are TRAINED to ignore feelings.

Georgette, I agree in theory that not every trans person needs a therapist. I also believe that it is abundantly obvious, however, that many - perhaps most - do. That's evidenced in suicide attempt rates and psychological issues in the population. I would suggest anyone even remotely considering transition see a therapist, especially since gender issues commonly manifest in non-trans situations.

[Kaitlyn Michele]

ahhh..i totally get what you are saying Lea...

its so bizarre... that sense of self you are talking about, the one that you lose, is a fraud!!! so you freak out as your self knowledge melts...its very powerful stuff... but BECAUSE it was a fraud....it gets easier as you go as you realize that the current sense of self is more authentic than before....

but of course, that's not easy either because you have to work at it, you have to face many obstacles...
++++++++++++++++++++++++++++++++++++

i found that too kelsey//my 3rd therapist was the charm.... my 2nd therapist was so uninformed that my 3rd therapist demanded she drop "TG issues" from her profile...

that 2nd therapist once brought in her daughters bridesmaid dress and had me stroke it and hold it while we talked...it was so strange and humiliating

+++++++++++++++++++++++++

georgette i think its an obvious thing that some people don't "need" therapy....was that your point? that you are one of those people???
since you didnt do therapy what exactly do you know about it? and how it can help people??

do you have any constructive thoughts on a person today in 2016 transitioning and doing it without the help and guidance of a good therapist?

[pamela7]

I have been my own therapist so far with my TG, though i have to see a psychiatrist to get formal approvals. So I've not needed a therapist for the process. I have been to two pairs of therapists in the past, for supervision, but I found myself having to deal with their issues both times within a few sessions, and gave up finding anyone able to cleanly deal with me after enquiries with some top UK psychotherapists came to nothing. I've used peer support ever since, which works fine.

I'm not a believer in the specific domain knowledge of an expert; a good therapist remains independent of the issues; the more they know about something more likely they are to end up interfering with the natural process of self-revelation. A lot of what I've read here about the hormone effects sound the same as my own path 10-15 years ago of opening up to deep emotional sensitivities; different paths, same outcomes - i can only feedback after enough time on hormones though, to be sure.

I'd say though that I'm the exception that proves the rule, because i've done some much self-processing beforehand I live with inner peace by default; other people don't. So make sure you have a very very good therapist.

[Georgette_USA]

Kaitlyn

As for the sense of self, I really had NO solid sense of that previous self. To me it was all a game I played to survive.

I think Pamela made some points about the usage of peer support therapy, if all your concerns are on the GD thing, and the knowledge you need to prepare oneself.

I am active in 3 local TG support groups now. Most are or have been to therapists. This is true with both the FtM and MtF people. Not all their problems are with the GD. They have problems with family problems, how to disclose and when. They have concerns with and when to start HRT. They have other medical / psychological concerns also. I have NO idea if it helps them or not. In fact by some of their talk, it might be for the best, as they seem to be waiting for the therapist to give them all the answers. I warn all too really think what it is they want. They can lose family jobs friends. Their presentation may not be the most ideal.

I never advise people to do it my way, and understand that some people do have other concerns that need to be worked out before they add all the problems transition will bring. How or why has a therapist helped with your own concerns.

I may be an outlier in my background. Single, NO wife/GF/children to contend with. As I was doing my early transition came out to my mother, which meant the WHOLE extended family would know. I had a small peer support group of 6-12 that had or were going thru the same. My family is a small part of support, as new join and their families, I can answer any questions and show that we are not weird but just like any other people.

The reason I have joined all these groups is when my partner died in 2014, had no one else other than family to really talk with. And I wanted to find out just what is going on in the TG/TS area now. I have learned a lot and still do, can give the old days of 40 years ago view, and lend moral support where I can.

[LeaP]

As mediated by an excellent therapist who focused on the right things, in the right way, in the right sequence, I'm VERY clear on where my transsexuality plays in my issues. Which ones it triggered. Which it exacerbated. Which affected my personality. Which my social interactions. Which my coping skills. Which are congenital. Etc. Crystal clear.

She is, by the way, a gender therapist primarily, with gender clients for approximately 30 years.

I'm happy, amazed really, for those who really and truly don't need the help of a therapist. I think them the exception, though. Many of the issues with which I have dealt are typical.

[Lilblondecutie1407]

The outpouring of support and information has been so amazing, reading people's stories has opened my eyes even more. I went for the second appointment and wow. Here are my reflections about that visit. I was also so happy I went completely as me not so much for the therapist but for me.

Wow what a day, she was so nice and very open. Much more comfortable able talking to her and she is a lot closer to my age which makes things so much more relatable. We started off with just getting to know each other and then talked about how I got to being at her office. Of course I got side tracked a few times and but it helped to paint a clear picture for her I can tell. Was great to hear her call me by "my" name and see her reactions to my stories and anecdotes about life as a girl, like she didn't already know.


She reminds me of an old HS friend that I could say anything to and no there was no judgement. We talked about my goals for therapy and what I hope to get out of it and what she brings to the table. Then we talked about some options and how we can proceed from today.


It was a much better experience than yesterday's and you would think I would have tones to write about but really it was all the same stuff covered in yesterday's meeting but with someone that really seemed to care and want to invest in helping me get to where I need to be.


already booked my next session for middle of the month so we'll see what happens then.

[Kaitlyn Michele]

really glad to hear!!