Therapist thinks I'm cisgendered male with Asperger's

[JenniferMint]

I went to a session with my therapist today. He's been getting to know me better over the past few months. Today he said something surprising to me: He thinks that my gender dysphoria is possibly fake, induced by Asperger's syndrome.

In other words, he thinks I'm a guy who thinks he's a girl, but really isn't.

Upon hearing about my scheduled FFS, he strongly advised against it. I told him I wanted to do this though, and that even if he was right about me being a guy (I don't think he is), I'd just come out looking as a prettier guy.

*shrugs*

I did finally get him to prescribe estrogen though. He's only doing it because (1) he's done the blood tests and knows my self-administered estrogen is not hurting my liver etc., and (2) I'm castrated so it would be a bad idea to go without any sex hormone, and I'm not about to take testosterone. He only prescribed me 2mg/d though (I'm currently taking 4mg/d), so I'm planning on taking double dosage of his pills until I get my next internet shipment.

I'll be seeing him again after my FFS. I don't agree with his diagnosis, but I see no harm in talking to him and exploring his hypotheses, and he's giving me estrogen.

[CaptLex]

Wow, I never heard that diagnosis before, Jennifer. :eek: I'm just wondering why he would come to that conclusion. You're probably just happy to be getting the prescription from him, and would listen to what he says, but if I disagreed with him (after really thinking it over), I would probably try a new therapist to see what he/she might say.

[Teresa Amina]

OK, I just looked at the definition of Aspergers' at Aspergers.com. What the heck does that have to do with being or not being trans? Sounds like more sick-ology junk. To thine own self be true; you've already taken major steps in transition and seem like you know what you want. Go for it.

[JenniferMint]

My doctor claimed that he's seen quite a few cases of Asperger's causing GID. I didn't manage to find much on the web though, besides this:


http://www.transeventsusa.org/ifge/tg06_FridayWorkshops.shtml

Avoiding Misdiagnoosis of the Gender Dysphoric
The transgender person faces certain challenges in getting a correct diagnosis and appropriate therapeutic support. Likewise, the mental health professional faces certain challenges in establishing correct diagnostic impressions. Common consequences of Gender Identity Disorder are depression and anxiety, or specific traits that can be misinterpreted as some other diagnosis, such as Asperger's Syndrome or Body Dysmorphic Disorder. Misdiagnosis can lead to incorrect medication and the failure to deal with the individual's needs. The importance of finding a clinician who is skilled and knowledgeable in working with transgender individuals is therefore imperative. Participants in this workshop will learn: The symptoms of Asperger's Syndrome ; The symptoms of Body Dysmorphic Disorder; The symptoms of Gender Dysphoria; Psychological diagnostic impressions of Gender Dysphoric individuals and how their symptoms often overlap with Asperger's Syndrome and Body Dysmorphic Disorder; Social experiences of the Gender Dysphoric individuals that contribute to the adoption of unusual behaviors; The fad status of Asperger's Syndrome.

[JenniferMint]

One of the reasons my therapist thinks I'm not transgendered is because for me, transitioning seems to be a choice, i.e. I wouldn't be uncomfortable being a guy (though I'd like being a girl better). He claims this rarely happens in genetic males (although can happen in FTMs).

[marie rose]

Apparently Asperger syndrome is related to a form of autism and how that in turn could be related to TSism is beyond me.

[Katelyn]

Well, Like with any Doctor Diagnosis, I'd get a second opinion! Good luck with everything.

[Diane CDN]

As in any bad relationship...maybe its time to move on and seek another doctor.

Diane
:)

[KewTnCurvy GG]

Human beings are very, VERY complicated and yes this could very well be quite accurate. There is the possibility of disorders exacerbating symptoms of another, mimicing symptoms or complicating ones diagnosis. Don't run, just because you don't like what he says. Ask him for supporting information.
Hang in there!
Kew

[AmberTG]

I think a lot of these therapists are stuck with the "all or nothing" way of thinking. They don't look at the possibility that a lot of TG people are actually closer to the middle between genders instead of leaning heavily toward one side or the other. They're not trained to think "outside the box" about other possibilitys then the standard descriptions, they can be a bit rigid. My therapist doesn't seem to be that way at all, she hasn't tried to put me in any catagory, other then that I've been dealing with gender disphoria for many years when I thought it was something else.

[KewTnCurvy GG]

http://cat.inist.fr/?aModele=afficheN&cpsidt=16896863

The case of a 35-year-old biological woman with Asperger syndrome (AS) and gender identity disorder (GID) fulfilling DSM-IV criteria is reported. Against the background of recently emerging theories of cognitive male pattern underlying autism we present additional psychological assessments in order to discuss any possible interaction or discrimination between AS and GID. Whilst we explain GID as a secondary feature of AS, we examine the assumption of the necessity of treating GID in AS as a primary GID in accordance with international standards. We consider the treatment of GID as compelling, particularly because curative therapy for AS is lacking and with GID treatment in this vein, the patient gains psychosocial improvement

[GG Vanya]

Jennifer,

If I were you, I'd set up an appointment with one of the Doctors listed as specialists in Aspergers' on the site that Teresa mentioned.

Going straight to one who specifically treats this disorder is the best way to either confirm or discount the diagnosis of your therapist.

[Jennifer Devine]

Gender Dysphoria isn't brought on by Aspergers Syndrome!
It's something you are born with. I have Aspergers Syndrome and I know that what the therapist said was a load of rubbish.
I think he needs to do a bit more research.

Jen xxx

[Clare]

I have lots of experience with Asperger's Syndrome as my (former) Stepson was diagnosed with it when he was a teenager. Believe me, Asperger's Syndrome covers a wide range of 'presentation' and it is complicated to correctly diagnose and understand!

Although I don't discount the possibility of being GID and AS concurrently, it would be wise to seek the assessment of a specialist in AS. They can confirm if/the extent, of any Asperger's you may have.

Once you know whether you have one of both GID or AS, you can then plan your future treatement based on that knowledge. I think it important you fully investigate all potential aspects that may affect your transition, whether you like it or not.

[Ms. Donna]

Hi Jennifer,

Everyone here has given excellent advise: a second opinion - on both counts - is probably a good idea. That said, I offer the following opinions on this in general.

You need to be comfortable as yourself, with your body and with your gender role in society. Whether you have GID is irrelevant. Whether you have AS is also largely irrelevant. Regardless of the diagnosis, you still need to live in the world and to do that in the best way possible. You need to move away from a place of gender 'discomfort' to a place of gender 'comfort'. Your pdoc should be working towards that goal, not evaluating how serious your desire for transition is.

Transition need not be an overwhelming drive. Transition also need not necessitate SRS. One can transition to their preferred gender presentation without surgery and it is as valid as any other path to comfort. That your pdoc takes issue with your 'decision' about transition makes me very nervous. It sounds as though he's looking to take a very 'narrow' approach to all of this - looking more to 'treat the condition' rather than 'treat the patient.'

Being TG does not mean you need to do anything. Nor do you need to do it in a specific way. If you have a pdoc who does not seem to be working with you in a collaborative way to come to a solution for your personal situation, then you need to find a new pdoc.

More often than not, we know who and what we are better than any doctor out there. The pdocs are supposed to be helping us as people - and that goes beyond any and all 'diagnostic criteria' they may wish to apply to us.

Get your second opinions and diagnosises - and temper it all with the question "Are they looking to treat Jennifer the person, or simply the 'condition' it appears I have?"

Love & Stuff,
Donna

[Stephenie S]

The link between Asperger's Syndrome and Gender Dysphoria is tenuous at best. Also, Asperger's and Autism do not apear to be linked at all except to contrast the two.

For those of you who may be wondering, here is a short definition from Taber's Cyclopedic Medical Dictionary:

ASPERGER'S DISORDER -

A severe and sustained impairment of social interaction and functioning.

In contrast to autism [which is also a severe and sustained impairment of social interaction and functioning (ss)], there are no clinically sigificant delays in language, cognitive, or developmental age-appropriate skills.

It would apear to me that you need a LOT more assessment before you can diagnose Asperger's here. Why not see a specialist?

Or why bother at all? Of what value to you would such a diagnosis be? Do you really feel you have a "severe and sustained impairment of social interaction and functioning"?

You are trying to explore your TG tendancies with this therapist. Getting sidetracked into Asperger's seems a bit of a waste of time to me. Bear in mind here, however, that I am NOT a clinical diagnostician. By the way, if your therapist is actually proscibing hormones, he must be a psychiatrist, ie, an MD, not a psychologist. Does he specialize in Gender Dysphoria? Finding a therapist who spcializes in GD is crucial, IMHO. There are so many people out there who want to "cure" you that it can get really dangerous, not to mention a complete waste of time.

Stephenie

[great gg]

All excellent points. the consensus seems to be that you should at least get another opinion from an expert in tg issues. good luck and on your surgery as well.

[staceyTN]

Jennifer,

Be very careful, because it's highly possible that he is right. I should know. I have been diagnosed as Transgender, and my son is a 15 year old Asperger's. My heart goes out to you, though. Having Asperger's can be so difficult, because of the social awkwardnesses. Please trust your therapist, and allow time to pass, before pushing too hard toward your transition. Very possible, transitioning into your perceived gender may not erase all the other things that you are dealing with.

[Calliope]

In other words, he thinks I'm a guy who thinks he's a girl, but really isn't.
[...] I did finally get him to prescribe estrogen though. [...] I'm planning on taking double dosage of his pills until I get my next internet shipment.



If I were you, I'd take my happy Rx and start looking for another professional. The relationship isn't healthy with both of you working against each other's 'vision.' My humble opinion.

[Kimberley]

Find a new counsellor. Sounds like this one is buzzword influenced and has absolutely no idea of what s/he is talking about.

:hugs:
Kimberley

[Lauren B]

What I don't like about the SoC is that your gender and your true nature are "self-diagnosed" (I don't like using the word diagnose as it implies sickness, which we are not). No one, even the most gifted therapist in the world, can sit back and definitively say that someone is or isn't fit to transition, and for someone to try to do that leads me to believe that he really doesn't know what he's talking about. Keep shopping:2c:

[Kimberley]

What I don't like about the SoC is that your gender and your true nature are "self-diagnosed" (I don't like using the word diagnose as it implies sickness, which we are not). No one, even the most gifted therapist in the world, can sit back and definitively say that someone is or isn't fit to transition, and for someone to try to do that leads me to believe that he really doesn't know what he's talking about. Keep shopping:2c:

I dont think the SOC tell the doctor to make that decision. I believe they tell the doctor to ensure you are ready to make that decision. That is why the second and third opinions (yes the surgeon has to be convinced too.).

:hugs:
Kimberley

[Lauren B]

I dont think the SOC tell the doctor to make that decision. I believe they tell the doctor to ensure you are ready to make that decision. That is why the second and third opinions (yes the surgeon has to be convinced too.).

:hugs:
Kimberley

I meant to say that the SoC is how many therapists justify doing this sort of thing- they can act as authorities and as gatekeepers and say that they're following protocol. I mean, if in a therapist's professional expertise, an obvious red flag jumps out at them, fine, do something about it, but I think a lot of gatekeeper types do exactly the sort of thing that Jennifer is telling us about.

[staceyTN]

Find a new counsellor. Sounds like this one is buzzword influenced and has absolutely no idea of what s/he is talking about.

:hugs:
Kimberley

At the risk of being incredibly insensitive to many of you, the counselor may be very right. I am more of an expert in Asperger patients than I have ever wished to be. It is entirely possible and often common for Asperger patients to assume the roles of other personas, simply because they often fulfill all their relationships within their own mind and self. One of the marks of Asperger is social dysfunction, and they often are very isolated and live within themselves. They have a very difficult time with human relationship (which absolutely breaks my heart) and it's not a stretch for some of them wanting female relationships to become that which they wish for. I am absolutely not being insenstive, but just accurate is Asperger possibilities. This is NOT to say that you aren't transgendered (which I know much since I am one), but that your therapist is offering wise advice that must be explored, since you say that you are Asoerger (which I know about, since my son is one). Be patience and stick with your therapist, who is at least leaving the possibilitiy of you being transgndered open.

[MJ]

well i looked up Asperger's syndrome on the Internet. and well i think you better get another therapist. a second opinion wont hurt . better safe than sorry ..hugs mj