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Thread: gatekeeper vs candystore

  1. #26
    Call me Pam pamela7's Avatar
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    While the error rate is apparently low (few reversed transitions), there is a genuine concern here that we're in long queues to transition because maybe others are clogging it up unnecessarily.

    It's not a lifestyle choice.
    https://www.youtube.com/watch?v=dJFyz73MRcg
    I used to believe this, now I'm in the company of many tiggers. A tigger does not wonder why she is a tigger, she just is a tigger.

    thanks to krististeph: tigger = TG'er .. T-I-GG-er

  2. #27
    Isn't Life Grand? AllieSF's Avatar
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    Kaitlyn, I like your description of those most at risk and basically agree with you. You do mention those that "cannot ,,, access a qualified person". Many of those need urgent help and then it becomes do nothing and suffer more, maybe to the point of suicide thoughts or attempts. I have no problem with them going into a Planned Parenthood or other qualified clinic that are there to help those who can't afford other professionals. They may or may not be making a mistake, but they also may be saving their lives for the time being until they can get back on track to where they can afford better and longer time therapy and medical services.

    Pamela, Are there any studies confirming that belief by some? I would be worried that some of those in those long lines and wait times for treatments may also be those that need it the most and the quickest. Is there a triage type initial interviews or sessions where some may be allowed to move ahead of others quicker in order to avoid maybe more serious consequences due to lack of needed quicker help?

  3. #28
    Silver Member Devi SM's Avatar
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    I think that physical illnesses many times can be diagnosed just with the doctor's judgment or experience, sometimes, to be sure of what they suspect, they need blood tests or others exams before to prescribe a treatment or medicines. Mental illnesses are more complex because are sometimes tricky and hard to diagnose, so psiquiatrists need several sessions with the patient to arrive to a diagnose and sometimes they need someone else opinion. I wouldn't call them gatekeepers but responsible professionals.
    In the case of us that in a sense is something very abstract, mental, no called today mental illness, related with behavior, they need to developed a kind of relationship with the customer, us, before prescribe a treatment or medicines, as well that your primary doctor concurr in agreement with the treatment.
    Lastly, remember that endocrinologists don't do therapy, neither have the medical history or records accessing as well the primary doctor. There's no test to determine the gender orientation and even for us that had lived with this for all our life is confuse, I think that is correct they be sure before to prescribe something as hormones that have a huge influence in the body.
    In my case, after a year on GT, the therapist mention the HRT, then I did my own research here and with others, then I mention it to my primary physician so finally the endocrinologist request the GT letter and after that he interviewed me for around one hour.
    I wouldn't call them gatekeeper but responsible system.
    Last edited by Devi SM; 11-06-2018 at 05:37 PM.
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  4. #29
    Call me Pam pamela7's Avatar
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    Quote Originally Posted by AllieSF View Post
    Pamela, Are there any studies confirming that belief by some?
    I'm not aware of studies. My doctor seems well informed. He says there are on average 5 cases per year of reversals in the NHS, and he is handling one at the moment.
    Last edited by Rianna Humble; 11-06-2018 at 06:29 PM. Reason: Excessive quoting
    https://www.youtube.com/watch?v=dJFyz73MRcg
    I used to believe this, now I'm in the company of many tiggers. A tigger does not wonder why she is a tigger, she just is a tigger.

    thanks to krististeph: tigger = TG'er .. T-I-GG-er

  5. #30
    Gold Member Kaitlyn Michele's Avatar
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    Allie I hear you.

    I dont disagree with anything you said. My own concern selfishly may be to make sure that people are successful...it sure makes me look bad when detransitioners are highlighted by the media...its not helpful and it satisfies a prurient interest in our plight...

    but its not fair of me to draw only that line... and without a doubt those desperate people have every right to try to improve their quality of life... and as a human being (not a trans person) I think all I can do is make a best effort to be supportive and helpful....and for me personally that happens right here.... trying to be honest and focused on making sure folks keep their heads about this... others success is good in itself and it helps all of us...even if that success means avoiding transition or HRT


    Pam, that is such a small number ...I hope its right!!!! Its certainly worth helping folks and trying to reduce that number but it means that the vast majority of transitions stay that way...

    as an aside, it may surprise folks that I still have dreams (nightmares??!) about my old self...going back to work.... sometimes as a man in a dress...trying to explain what I did...apologizing....ugh...
    it can be very very hard to do this.... and I have had alot of success and sometimes I still struggle...so I feel for folks that cant access help but I also know as a practical matter how tough its gonna be for them...

    jeez its so complicated!!!!
    I am real

  6. #31
    Isn't Life Grand? AllieSF's Avatar
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    Thanks Pamela. That answers part of an earlier question, but my last one to you above is about the long queues to get service and about whether the NHS does process some urgent cases through the system quicker, not with easier analysis, but rather putting them ahead of others in the queues with less severe issues.

    Thanks Kaitlyn.

  7. #32
    Call me Pam pamela7's Avatar
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    Yeah, but I do not know if they do that in the gender clinics. I do know they do that in most other cases.
    https://www.youtube.com/watch?v=dJFyz73MRcg
    I used to believe this, now I'm in the company of many tiggers. A tigger does not wonder why she is a tigger, she just is a tigger.

    thanks to krististeph: tigger = TG'er .. T-I-GG-er

  8. #33
    Country Gal.... Megan G's Avatar
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    Quote Originally Posted by Ashley in Virginia View Post
    I don't see why y'all are so worried over it?
    Hypothetical.....

    So Steph has been struggling with exhaustion, weight loss, decreased appetite and a few other symptoms for quite some time. One day she goes and decides to look up her symptoms on “Dr Google” and the top results are Non-Hodgkin’s Lymphoma. The more she reads about it the more certain this is her problem, she can relate to so many of the signs and symptoms, her glands in her neck are even swollen after finding them...

    So a friend points her to a surgeon a couple towns over that will fast track the surgery and promises if she acts quickly that she can beat this. Why spend the time and money waiting on PET scans and biopsies to only confirm a diagnosis that she already knows...

    She has the surgery and after waking up the surgeon tells her that he opened her up and quickly found out that she did not have lymphoma..... so she goes back to the doctor that she skipped initially to seek answers and after sending away a blood test they quickly find out that she is anemic on iron, something that shares many of the symptoms of lymphoma. The doctor prescribes iron supplements and recommends adjusting her diet and within 4 weeks she is feeling much better.....

    So what i wrote above may seem crazy and out to lunch but if medical decisions are left completely unchecked without proper assessments and diagnosis by trained professionals this kind of story would happen more than you realize.......

    Quote Originally Posted by Ashley in Virginia View Post
    I didn't want to deal with the hassle and cost of paying a therapist and a Dr for something he was positive about.
    How positive? Enough to risk dealing with the fallout if he decides he is wrong down the road and suddenly realizes that irreversible stuff has been done?

    I’m not advocating for the old gatekeeper method where you have to jump thru a million hoops and a years long ordeal.... but there needs to be some checks and balances kept in place by trained medical professionals.

    It should not be a free for all as it would be a great way to destroy a lot of lives...

  9. #34
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    I technically needed up to a year for her to consider it, which was with two therapists (one quit her job) in order to get started on HRT. It's ironic, but I know now that of what I went through a year ago was with merit and that they wouldn't have put me on hormones if I knew about their location much sooner.

  10. #35
    Gold Member Kaitlyn Michele's Avatar
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    the overall thing is...

    This is REALLY HARD.

    If you find it easy, or your kids find it easy, then count your blessings and enjoy.

    Making money, physical pain, being disbelieved and marginalized, being scrutinized and often discriminated against, comorbid mental health issues, making the money and then SPENDING the money...it can be so expensive... there is alot to learn and lots of support is very helpful if not essential.

    I can get very comfortable with gatekeepers. If you want to avoid them, thats up to you. But that doesnt mean it applies to anybody else, and oh yeah, good luck with that.
    in my opinion all you are doing avoiding paying therapists now is paying more for them (or for other things) later....

    it is incredibly short sighted and irresponsible to have your kid go down this path and skimp on mental health ..
    I am real

  11. #36
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    Oh Kaitlyn,

    Thank you so much. My oldest is, and not taking counsel from me or my wife. Plunging headlong into transition but has never dressed or presented as female in public as far as I know. Spends all if their time on the internet, has employment issues, won't shower or shave unless harrassed. They have all the technical data, but no life experience. And I am disgusted that their past 20 years of mental health history was probably not reviewed.

    Asked about that they told me that the doc in the box suggested a psych we started to look at, but the kid said the psych would never schedule anything. Of course they have a history of lying about things like that, and since they are over 20, I can't get info back from the docs, even though it is my insurance.

    I fear this kid is headed down the wrong path, and is so headstrong, it will be tragically too late, or end badly.

    I am beside myself and don't know what to do. My poor wife. The thought of sacrificing Meghan keeps haunting me. I blame myself for the kids struggle and the wife's depression.
    Last edited by Meghan4now; 11-12-2018 at 03:04 PM.

  12. #37
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    Whatever happens to kids growing up, real or imagined, becomes moot when they become adults. All of have personal and family issues, some of which are pretty daunting. It doesn’t change the fact that adults are responsible for the choices they make. You’re off the hook - even if you were were a proximate cause.
    Lea

  13. #38
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    Perhaps, but there are extenuating circumstances. They are on the autistic spectrum, and while intelligent, emotionally less mature than most their age. Which is part of the problem, the lack of emotional sophistication makes decision making at this level challenging. But the stubbornness combined with the immaturity has me specifically worried. They are not demonstrating a level of competence that would suggest they could be self sufficient. Age does not make an adult, legal definition aside.

  14. #39
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    Blaming yourself makes even less sense, then.
    Lea

  15. #40
    Gold Member Kaitlyn Michele's Avatar
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    I am all for being there for kids as best you can even into adulthood.

    However, you are going to struggle if you continue to look at transition or your gender identity as something you've done "wrong"..

    I struggle with this idea and I just power through it... you should do the same
    I am real

  16. #41
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    I tend to write replies advocating for transitioning or at least exploring one's gender identity. While I certainly do not think all people with gender issues should transition I do come from the mindset that fear and making excuses prevents or postpones many people from transitioning that would ultimately be happier. Again, not everyone should transition, far from it.

    That long disclaimer said, I do think it is more challenging when children are involved. I have 3 children ages 26, 24 and 23. The youngest two have severe Autism, require 24/7 care and have very limited communication skills. My oldest is very mildly affected but leads a normal life.

    Regardless of the circumstances with children whether they be healthy and happy or not, that does not erase GD and feelings of GD are not doing anything 'wrong'. No one should punish themselves.

    I also believe we should teach our children courage and to live honestly and openly. They learn from their parents at any age.

    On the other hand would I have transitioned when they were 5 yrs old or 10 yrs old? Nope. That's just me. But I also believe the right thing to do if at that time in your life you have serious gender issues is to...

    A. See a therapist, not for 'cure' rather to learn how to cope and live.
    B. Be honest with the other parent.
    C. Make a plan for transition if that's where you ultimately see your life going and follow through on that plan.

    As someone that stayed in an unhappy (miserable) marriage for 18 years for the kids I speak from experience.
    In retrospect I stayed too long, but I don't regret staying just maybe for the number of years I did.

    But if you come to the conclusion that transition is where your life is heading make real plans and stick to them. Don't let 2 years turn into 5 into 10 into 20 into never.

    I wish someone had told me this years ago but better late than never.

  17. #42
    Silver Member Devi SM's Avatar
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    I usually say that there's a lot of wisdom in this web. We're people that had had to live a different life and in that road learned different things from "normal" people (not saying we're abnormal but for the sake of the idea I use that expression) that give us a wider view of life, deeper senses and bigger love and comprehension for minorities as we're. A good example of this is Kymberly. Thanks for your post, as you say, I would like to had hear that 20 years ago...
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  18. #43
    Aspiring Member Dorit's Avatar
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    Finished my Gatekeeper Experience

    We have public health in Israel that will provide free SRS and BA if you qualify. This is obviously gatekeeping, partly for the protection of the candidates and partly for the protect of the public purse. I just completed five months of evaluations and medical interviews, I had a total of eight different appointments with both psychological and medical staff. Anyone with money can do all the surgeries outside the country and ignore the Israel Ministry of Health Sex Change Committee.

    I wanted to go through the committee for both financial reasons and to know myself better. I have a lot of insecurity about who I am after decades of shame and self hate over wanting to be a girl. I wanted to hear what they had to say.

    When I walked out of my final session with the committee yesterday, I just broke down and cried. Loosely translating they declared that "I was discerned as a transsexual and qualify for sex change surgery from male to female, for I had passed all the medical-professional criteria that had been set by the Ministry of Health." They also declared that because of my age and the long wait in Israel, I should have my SRS in the US paid for by the state. Wow! For me it was a validation that they saw who I had always thought I was!

    Sometimes gatekeepers can really help you on the journey!

  19. #44
    Silver Member Devi SM's Avatar
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    Wow! I'm so happy for you!
    It's amazing and you're right. It's a confirmation for who you really are.
    Well done Dorit. Congratulations! And when it's gonna be?
    HRT 042018; Full time 032019
    Orchiectomy 062020; gender& name legal changed 102020
    Electrolysis face begins 082019, in genitals for GCS 062021
    Breast augmentation surgery 012022
    GCS 072022; BBL 022023; GCS revision 04203;END TRANSITION

  20. #45
    Aspiring Member Dorit's Avatar
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    When I started the Israel process five months ago I learned that if I qualified at the end it would be a two year wait for surgery. So I then began my search for a solution, and in August made the commitment to SRS on December 14 in Philadelphia with Dr. Sherman Leis.

  21. #46
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    I personally believe that gatekeepers perform an important function in the sense that any assumption that holds water can survive objective scrutiny. As a person perhaps endlessly caught in the maelstrom of uncertainty, I can appreciate the importance of that objective assessment.

    will it be perfect? Hardly. I can’t answer a question the same way twice...have mercy on the professional trying to help me clarify my thinking. But, certainly I’m better off with objective appraisal than my own addled thinking.
    Last edited by kimdl93; 11-22-2018 at 04:23 PM.
    Remember always that you not only have the right to be an individual, you have an obligation to be one.

    Eleanor Roosevelt

  22. #47
    Aspiring Member grace7777's Avatar
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    I think that there needs to be some gatekeeping by trained medical people.

    When I decided to pursue transitioning and wanted to begin HRT, I had to see 2 different therapists and also had to attend multiple support group sessions. It took about 2 months until I was able to get a referral to an endocrinologist to begin HRT.

    To have SRS, I had to have 2 therapist letters recommending me for it.

    Grace

  23. #48
    Member Katie Louise's Avatar
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    I Just started HRT yesterday in informed consent. BUT. I had to go through my history in great detail from earliest memories to now and then get blood tests. Started a minimal dose of Androcur because my T was insanely low at 10mmol/L and then E with reviews monthly after bloods done at the third week
    Last edited by Nigella; 11-25-2018 at 11:04 AM. Reason: We do not permit the posting of dosages on the forum

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