Saw The Psychiatrist

[Guest i is Sam :-)]

I am now actually worse off than had I not gone.

Not really ready to talk about it right now.

Screw them I can do everything myself up until I need a letter for surgery. I guess after I've done spending every penny I have on laser, and then If I can afford it speech therapy, and the £25 or so a month it costs for hormones, I can start saving to eventually see a private gender therapist, before then saving for SRS.

[Guest Donna Jean]

Sam......

I won't ask you about it...you can talk about it when you feel ready....

But..How about another Therapist? There are many great ones out there and I'm sure that you can hook up with a good one...

I'm truly sorry that it turned out like this for you....

HUGGS!

Donna Jean

[Guest i is Sam :-)]

NOT THERAPIST!

Sorry to yell, but several americans don't seem to understand.

This guy has no interest in making me feel better, helping me sort out my issues or asking me how I feel.

He has absolutely no training in gender disorders.

He is the same man you would see if you were bipolar of schizophrenic. This is how the NHS works, it'd be a joke except that it really isn't funny.

I'm not allowed to see a therapist or any kind of gender specialist until he has diagnosed and referred me. Which he won't do.

And now his notes will forever poison my medical record biasing anyone I see in the future.

[Guest Soph]

Keep in mind that psychiatrists are not therapists.

They should not do talk therapy whatsoever. They're essentially just med managers.

And if you get a psychiatrist that tries to actually talk to you, chances are he is going to be incredibly ignorant.

Trust me, I know. My psychiatrist tries to guilt me into getting over my anorexia. He has the idea that the only reason I'm anorexic is because I want to control my transition (have no clue where he got this idea >_>), and I can tell (I'm blessed with objectivity) that he is trying to get an emotional response, because he always brings up that if I'm not a healthy weight for surgery I can't have the SRS, being completely oblivious to the fact that it would be a year at least before I'd be even eligible for the surgery (I'd probably be able to gain 15 pounds in a year, right? >_>) and not aware that my genitals do not upset me nearly as much as my voice or shoulders. I'm sure some of his dislike toward my anorexia is from him being overweight. Since he's heavy and unwilling to work to get skinny he maintains that I should be the same, as that is the healthy attitude as far as he is concerned. He is, of course, deluding himself.

But this is your topic, don't let me derail it

[Sally]

Sam,

Is there no way to see a private therapist if you could afford it?

I have to admit that I do not understand the National Public Health in Great Briton but here where medicine is managed by the insurance companies in an ever expanding web of exclusions, you can see whoever you are willing to pay for.

I am so sorry.

Love ya,

Sally

[Guest Donna Jean]

NOT THERAPIST!

Sorry to yell, but several americans don't seem to understand.

This guy has no interest in making me feel better, helping me sort out my issues or asking me how I feel.

He has absolutely no training in gender disorders.

No, no reason for yelling.....

I'm sorry that I used the word "Therapist" instead of "psychiatrists"...I'm American and I DO know the difference!

I just don't understand your health system over there!

My bad!

Sorry!

Donna Jean

[Guest Elizabeth K]

Not a Brit or Canadian...

Here in the USA - AVOID psychiatists. They only do two things (1) give you tons of medication! (2) try to 'cure you'.

Dender dysphoria is not something 'curable' - we are born this way. You cannot 'cure' a club foot - you can only address how to make it more usable for you - and at the same time, more acceptable to society (ain't that something!).

Meds? I don't want to be medicated into oblivion!

I always suggest a psychologist. The pupose of a psychologist is to evaluate what conditions you may have and suggest avenues toward being happy in your life!

Both my daughters are psychologists.

And my therapist is (drum roll) a psychologist - a PhD - one accustomed to dealing with gender dysphoria. She is a wonder! She has 'pulled my bacon out of the fire' [an Americanism for saved my a**) MANY TIMES!

National Health Service? You are the POSTER GIRL for a campaign against it here!

DANG!

DANG!

DANG!

Sorry that all happened! Stay with it - you WILL make it!

Lizzy

[Guest i is Sam :-)]

I'm quite happy for this to be a "talk about how fracking usless all psychiatrists are" thread.

Private gender therapists are available to those who can afford it, but almost no one can, we don't have insurance, it exists, but you don't get it provided by work or anything like that because people think it isn't needed, we have the NHS.

I'm on benefits right now, struggling to pay for the laser, and if I went and got a minimum wage job tomorrow i'd actually be about £300 a month worse off. I can't work yet anyway my anxiety is still too bad.

Yes I certainly would have spoken to the psychiatrist if I'd had any other choice, I hate them so much.

Some of you might remember I wrote a very long letter to my GP (that's what we call a family doc) explaining my situation. Well she forwarded that to the psychiatric department, along with her own cover letter when she made the referral.

Well this guy I saw, wasn't even the Locum I was supposed to see, he'd left, this was a different locum who is only here for a wekk, so already I'm thinking I'm going to have to explain myself again to yet another doctor on my next appointment.

It took me correcting him 3 times for him to get my surname right, despite the fact that it's phonetic, so how clearly can he possibly have looked at my notes?

Anyway, he hadn't read the letter, and didn't have the letter, they'd lost it! Now my anxiety is going like crazy cos I'm supposed to talk about my childhood feelings and feelings of inferiority and sexuality andd experimentation, and i know I only have an hour so I can't get into the kind of depth that would be needed even if I weren't obviously hugely embarrased / ashamed to have to admit to many of these things.

I tried to get my sister to email a copy of the letter to them, but they said it was policy not to give out and email address, could I log onto my own webmail to retreive it? of course not!!!

Did I have a fax???? Why the frick would I have a fax machine? this isn't the 18th centuary.

He repeatedly calls me "Mr" and never once asked if I wanted to be called by a different name.

uggghhh!!!!! I'll post more in a few minutes

but principly he didn't believe me, and as far as he can tell that was based on two things that he asked and didn't get the responses he was after.

Which was that I didn't feel like a woman trapped inside a man's body - (that is I didn't, tho I still would never phrase it this way now, I don't feel seperate from my body in anyway so I don't feel trapped inside it, I just know it's wrong)

And that I didn't hate my penis.

I could have told him about times that I had self mutilated myself down there, but I really didn't feel comfortable about it and the truth is i don't know where to draw the line there between what was self loathing and what was BDSM.

[Guest i is Sam :-)]

There's nothing wrong with the idea of a public health service, it's just that certain aspects of ours are worse than having nothing at all. It's still the best thing in the world if you're having a heart attack, and don't mind having massive, ugly keloid scars where they perform the bypass. i swear our surgeons cut you with legos.

I do get to see a psychologist in a few months, but she's not a specialist either, and this was supposed to be something else, structured therapy called CAT to help with my borderline. The idiot quack wants me to wait until after this is concluded, to see if it resolves any of my other issues before he is willing to then decide If I should get a referral.

Except of course it won't be him. and CAT will hopefully start in April at the earliest, and will run on for 6 months (12 sessions, once a fortnight) and then if someone does agree to give me a referral, i'm on what will be at least a 10 month waitinglist. So we're taking 19 months until I get to see my first specialist, and this is just to talk to someone, not for hormones or for surgery.

Principally what he said is that he wants me to cure my borderline first.

Unfortuantely there are no proven treatments for borderline personality disorder, anti depressants don't work, some therapies are only very slightly successful, 25% of borderlines kill themselves if untreated, the only comforting statistic is that after 7 years 50% having just naturally gotten better enough to no longer warrent the diagnosis. Oh yeah it affect 400% more women than men, and about 90% of the men who have it are gay.

[Guest Elizabeth K]

So he thinks you are a gay woman?

[LIZZY - STOP IT!]

Seriously - thats a hoop! We jump through a lot of them. I could't transition (then) until I could prove I had no hangups causing my 'gender dysphoria"

So if i say ' woman trapped in a man's body' its okay - but 'I never liked my body because it was wrong' this is NOT acceptable? Happened to me that way. I fussed about that! I said, "I DON"T think I have the correct body for what I am!" I felt I was something else - maybe really a girl! I mean I wanted to be female with all my heart - but it was a 'born female' I wanted to be. I wasn't asking to change.

I should have said 'I feel like I shoulda been born in a female body.'

That was the truth. At the time of starting theraphy I didn't know I was already 100% a woman! It confused the therapist. "UNIFY" she said, "And we will see what you are?" So I worked on that for a while. I was very dual - but - STRANGE - both my sides were really female! What a revelation! I thought one was male, one was female? NO

I was a female trying to express myself, and I WAS A FEMALE AFRAID TO COME OUT!

HOOPS

I jumped through that hoop, obviously!

I wish there were instructions for all that! GRIN!

Lizzy

[Guest Sarah]

not to break the chain of hating psychiatrists, but I have one and she is great, she also is specialized in transgender issues (and is the most well known psy in genderproblematics in belgium) But i mean even when I was having doubts and scared feelings and stuff, she felt apparantly that it would be right for me, because she asked if I wanted to start hormones before I brought it up(I have talked about the fact that I would like them, but never suggested it) and she said then, that if i really wanted it, then i should bringt the topic up myself a couple of times. she also doesn't push me into having SRS, she says that i don't have to get it, but she did insist to talk to the local specialiezed surgeon unless i was certain i wouldn't have SRS in at least 10 years. I could go into a lot of details, but wha I'm trying to say is, don't just go overgeneralise things. you wouldn't want people to think all transgendered people are the same, would you? so don't do it yourself, there are great psychiatrists out there.

the only pity with mine is i only see her now every 4 months (in the beginning every month, then every two months). so i have a psychologist a little closer to home, whom i see about every two weeks.

Anyway: NOT all psychiatrists are bad!!!

grtz and hugs,

Sarah xxx

[Guest Elizabeth K]

I don't intentionally bash psychiatrists - sorry. I have only had bad experiences. That's just me!

Lizzy

[Guest i is Sam :-)]

ditto

also only ever had bad experiences, and I think I've seen 4.

And everyone I've ever known has only had bad experiences.

But... I'm quite happy to apologise to your psychiatrist Sarah, I'm sure there are few enough good ones that I could apologise to them each individually.

[Guest Chris_421]

I say do your best to search out another psych, preferrebly one with some experience with trans patients. I have had my psych visits covered by either the provincial health care or my treaty status. So I got referred to them by my gp and didn't have a choice in it, which we actually have one well known (locally at least) psych who has seen many trans patients. Anyway, what I'm trying to say is even if the psych doesn't have experience in trans issues doesn't mean they can't be of help. Mine did some research during the time she was seeing me for my T letter, it took a while but I got it. She has brought in collegues twice for a second opinion on paper and I've had no issues. The last psychiatrist she brought in was a little taken back by my sexuality but he wasn't rude and I did my best to explain it to him which he thanked me for.

So yeah, do research of trans-friendly psychs and see what you can do, they're not all in it to make others miserable.

[Guest Anna_Banana]

Did I have a fax???? Why the frick would I have a fax machine? this isn't the 18th centuary.

Please excuse my lightheartedness, but I simply can't resist:

Would you please fax me all of your future responses? I'd very much like to read them! *straightens bowler hat; rubs monocle*

Oh! Just a sec, my carrier pigeon has arrived!

.Anna

[Guest julia_d]

Again assumptions from the world of private medicine..... in the UK you are not given a choice who you see.. as all of this falls under mental health they use that as an excuse to strip all your rights of choice away and force you to see whatever quack has open appointments maybe 9 or 18 months down the line.

Yes you can pay.. but over here they expect you to pay up front for maybe 12 monthly sessions at £250-500 a shot.. or nothing.. which means transitioning in the UK is still a rich persons sport

As transwomen in the UK are generally horribly discriminated against for employment and about every other aspect of life we don't generally have the earning potential to afford to jump through the hoops.. I transitioned 11 years ago.. and I haven't had one single legal job from that day to this.. Nobody will employ somebody with a "mental illness" .. so we play the disabled card to keep our heads above water and a roof over our heads praying for the day we get a little piece of paper which says "legally female" .. and then we can change things. Right now I know where Sam is.. the non-person place.. the place where names haven't been changed.. I'm in the other limbo.. a different name to the one on my birth certificate.. I can't prove who I am to satisfy the immigration law to get a job without outing myself, and then it's game over...

I suggest Sam you go pay up your £5 and get your name and title changed .. deed poll or stat dec.. high street solicitors.. Stephensons will swear oaths and they do a flat £5 .. shop around.. I can provide the full text for a stat dec if you require one, though a solicitors should be able to get that fixed for you but it may cost a few bob more *winks* Then you off to the dole and the tax office and the PCT homebase (they have offices y'know) and your docs and anywhere else you can think of.. get it all changed over .. nobody will bat an eyelid.. honest.. Then let some shrink locum refuse to call you by your legal name and title.. hahahahahahaha.

BTW .. The system has changed since my day.. I was diagnosed by a psycho-sexologist .. a consultant no less.. who as a shrink could also give me a clean bill of health for ant co-morbidity symptoms or any other mental illness which could be causing me to present the way I do..

my appointment has been changed to 15th BTW ..I think you need a bit of moral support.. why not look in your docs for an organisation called "pals" (leaflet or poster on the wall.. or up the hospital.. somewhere like that).. stands for "patients advice liason service" .. they tend to know all the voluntary sector support groups, and I think there will probably be a small gender awareness/support/guidance group local nearby.

[Guest i is Sam :-)]

Right to try and continue with the story

First thing he asked me was why do I think I have GID.

I know I should've just said "because i'm a girl" but I was so thrown off about not having the letter so he had no back story, and he'd called me Mr like half a dozen times by that point.

I just kinda fumbled into back story, told him that I remember crying myself to sleep, praying to be made a girl.

When I tried to explain how the depression that started at puberty made me hate myself so much that I didn't think I deserved to be what I wanted (it was the only explanation I could think of why) and so developed fairly twisted fantasies about wanted to be treated like a girl but not being allowed to become one. Well he didn't understand that at all, really didn't get the self hate thing, didn't understand how I might direct it at myself in general rather than just at a specific body part.

He twisted it into "didn't want to become a girl" which I didn't really pick up on at the time, I'd said "wasn't allowed" or "couldn't".

He goes into "because the reason I'm asking Matthew, is if you felt like a female trapped inside a man's body then you wouldn't... I'm just wondering why you felt inferior"

I tried to explain that not everyone feels like that, that it's a fairly small percetage of us who feel that dysphoric that quickly. I tried to explain that I was on the androgynous side of female on the gender spectrum, And as such wouldn't have suh strong feelings of being wrong. I really don't think he understood this whatsoever.

He goes on to say "In terms of, sometimes when people have similar difficulties they might have things like not liking their penis, you know, not liking bits about their bodies, I'm just wondering if you ever had any of that"

I told him that I'd always hated my facial hair which is true, I've been talking about getting laser for like a decade. I told him that I didn't like my body in general, that I hadn't looked after it, didn't stay healthy, let myself gain weight, didn't take my medication, I've self harmed. That when I became diabetic that I just didn't care about keeping my blood sugar low, I didn't care that I was going to be blind and in a wheelchair because I honestly didn't expect to live more than a few years.

Again it's just not what he wanted to hear.

At that point he tried to reassure me that he wasn't just going through "some tick box thing" which is funny since I recognised most of his qustions from one of the horribly outmoded and inaccurate and frankly sexist gender tests.

Oh yeah of course, cos his next question, classicly straight from the test

"When you were younger, were you playing with dolls that sort of thing or involved in activites that would be considered to be feminine"

I told him that I never played sports, that I liked to play imagination games, that I wasn't really interested in trucks of things like that, that my favourite toy was probably lego. That when I was much younger I remember playing house or mummies and daddies with the girls on the play ground, but that my friends had been mostly boys because girls weren't interested in me. I told him I took up cooking, my mother taught me how to sew, that I did things like weaving and glass painting, but that I generally struggled with creative things, because my mother would always try it and be like 1000 times better than I was so I'd get disheartened. That generally I felt intimidated by girls and so wouldn't approach them but that really I just barely had any friends at all (the sad fact was, tho I really didn't mention this, my friends were the people that were left over, gender wasn't important we were just the unpopular kids, nobody liked us so we stuck together) I told him that I generally didn't like boys and thought they were mean and rough and I didn't want to play football with them, or go smoke and look at porn.

He picked up again on girls not really being interested in me. It seemed like the idea that people wouldn't befriend me just because I'd've liked to be their friend.

He continues into "I'm going to have to ask you some personal questions now, because obviously we need to take a kind of sexual history" "Umm how old were you when you hit puberty?" I started when I was 11 going on 12 I remember my voice broke very abruptly when I was 12 because I was in the choir and then couldn't sing anymore.

I told him it never broke low enough for me to ever be able to sing in another range, and that I really hated my voice.

"When did you have your first wet dream?" - I honestly don't remember exactly what age, 10 - 12 somewhere there, I was wearing my sister's leotard.

"How were you when you had your first girlfriend or boyfriend?" - I had my first girlfriend when I was about 13, pretty much just because of peer pressure, I really wasn't interested in dating at all, I like being able to take her our and treat her well, but I wasn't at all interested in like ripping her clothes off or whatever.

"How long did that relationship last?" - A few weeks.

"First kiss?" - Probably with her, but I don't know maybe I'd kissed someone when I was younger, I really don't remember.

"What of you first sexual activity?" - When I was 16

"And with who" - Do you want a name or just gender? "Gender" - that was a girl, although we actually did some threesome stuff with another guy.

"Was I romatically involved with her?" - Yes, "How long" - About three months maybe.

"When was you first sexual activity with a male?" (so he'd nicely skipped over my marriage and like 4 years of my life there but oh well) - Umm that wasn't all that long ago, I've only had one boyfriend and that was my last relationship, that was about 2 years ago.

"This was your partner you met on the internet" (somewhat disapproving tone) - Well yes well I spent almost all of my time on the internet so I met most people there.

"How long were you seeing each other for" - About a year.

"So how would you describe your sexual orientation?" - Bi sexual, well actually pansexual but most people don't know what that means.

"What does it mean?" - It just means you don't limit yourself to only men or women, so androgen, MTFs FTMs it doesn't matter.

"Ooookay?"

"Now in terms of cross dressing, you mentioned you wore your sister's leotard, is cross dressing is it a sexual thing?" (Me again stupidly trying to be honest) - Umm no not really, I mean I wouldn't put clothes on with the intention of gratifying myself, I sometimes might end up doing, but only because I would get dressed and then I would feel happy and then maybe I would have the ability to be turned on.

I said that now that i'm in womens clothes all the time it certainly doesn't have any sexual component, tho obviously the spiro has also seriously deminished my sex drive, which doesn't bother me at all anyway

"And in terms of, so you in terms of, why do you dress like a woman? What's your reason?" (again my answer should've been that it's how I feel comfortable, but I was still trying to think back to when I was a child "what's your reason through me off, because I just thought, I don't really need a reason to put clothes on) - I don't know it just made me feel good, I never really thought about it beyond that

I then explained that when I was younger as a way of coping with how I felt, I developed very liberal views on gender and sexuality, and just figured people could be whoever they wanted and labels didn't matter.

And that although I want to be a woman I didn't particularly mind doing things as a guy

"So what you are saying is that there is a flexibility in terms of..." - I think I fell more fixed now, but it was certainly a method to cope by trying to be more flexible.

"Hmmm, mmmm, mmmm"

"In between, when you were 12, when you started to wear women's clothing" - Well I started way before then, ore puberty, I started before I'd had any kind of sexual experience (perhaps I should've been more specific, I started before I had ever had a wet dream or even knew what self gratification was)

"was it a regular thing?" - Maybe once a week on average I suppose, more often at times and then I'd go through times when I'd feel disgusted with myself and stop, or after I'd been caught.

"And would you obviously dress, would you wear external stuff or would it be more underwear, female underwear that kind of thing?" - Underwear to begin with, and then I was living by myself at 16 so then like nightware that kind of thing. As soon as I was safe to do so.

(I didn't get the chance to explain that I was regularly beaten and bullied by other kids, so how could I possibly wear outer clothes and my mother would have never allowed it. And I couldn't afford it, And even when I was older, I'd been beaten up by teens, been mugged, really wasn't very brave)

"I'm just wondering, If, one one of the things that struck me is that you said there is a flexibility, you understand, and if somebody said that there was the possibility that you still weren't really sure about what was going on that you were still being flexible in terms of the boundries, what would you say to that"

(This is where I realise it's all gonna go horribly wrong)

They're wrong, err, I wasn't sure for a very long time, umm but i've never been sure of my identity, I mean I'd never, ever had any idea of a fixed identity and I didn't know that that was unusual, I didn't realise that people just knew exactly what there were, and now I do.

"Hmm, hmm, hmm, Now in terms of, looking at your previous notes, looking at your previous notes, your mood has been pretty unstable, how is that going at the moment?" - I started taking spiro about 6 weeks ago, the last 5 weeks I haven't been depressed at all.

(Actually you know I had about 3 days of feeling awful that was when i'd cut my dose right back to try and make it last, but I didn't want to overcomplicate things)

"Hmm, hmm, hmm" - I went on a diet, I was 14st 6 on the 6th of december, i'm 13st 5 today, umm I'd been in diabetic ketosis for about 6 months because I hadn't been taking my insulin, now i'm testing around 4 or 5 all the time (72 - 90mg/dL for you americans)

"Well the spironolactone, what is that about, why do you take it?" - Well because it get's rid of the testosterone, I'm not ready to start oestrogen at this point I hope to by march, I thought that I probably wouldn't cope very well with having 2 different sexual hormones racing around my system ... And also to start with I was 100% sure, and really didn't want to have to come out to a bunch of people (and go through this type of nuts) with being sure so I thought I'd start low and see how I felt, and after a week I was sure.

"Well now in terms of self harm when last did you self harm?" - Umm it depends what you consider to be self harm, I haven't cut for at least a year, but if you mean starving myself and binging, not looking after myself, not taking my medication, then yeah 6 weeks ago, I mean certainly the fact that I don't take the insulin was self harm.

Now I'm doing everything I can to get myself as healthy as possible because the future looks like something I'd actually like to take part in and I'd like to not die for a while.

(Then I told him I'd had my death pills destroyed)

[We try to find the letter, get a copy of the letter, can't be done against proceedure etc. I'd taken my coat off and was presenting very obviously female at this point (breast forms etc), he was happy to parade me infront of the secratary while very loudly calling me Mr X, and then made me sit in the waiting room for like 5 minutes while they sorted it out. Whole thing took about 10 minutes]

"So Matthew in terms of what we've discussed so far, I'll tell you what I think, really" I mumbled something along the lines of this'll be good.

"The thing is" - The thing is i'm sure you're not a specialist and have absolutely no training in gender identity at all.

"Ok that's fair enough" - Do you have any experience? "Yes I have met people, you understand matthew"

"But the thing is, what I know in terms of, there's some things that need to be clarified, you will know your diagnosis of borderline personality disorder. "Umm can you have borderline personality disorder AND gender identity... yes" I jumped in with Well of course you can, especially since it's 400% more common in women. But of course he meant that he found it incredibly unlikely that I would have both.

"Well Mat-uh... what I would suggest is this, the thing is, if, if let's say, am i guessing it correct that what you want is a referral to charring cross, because from what I know is that the proceedure is that.."

I rattlled out the full proceedure including the average waiting times, from GP to eventually getting my letter, so that he would understand i'd done my research and it wasn't a whim.

I then went on to explain what my timetable was for this year, that I was intending to be full time by september, and what I'd done so far.

"Well Matthew, the thing is, the way I understand it is, if you get the diagnosis the next thing is suitability for referral to get the ball rolling, what concerns me is obviously you've had a turbulant few years, with the borderline personality"

- Well I've had borderline longer than that I've just only been fairly recently diagnosed

"I know, I know, I know, Matthew you, you were recently diagnosed will you hear me out Matthew?" - Ok

"Ok, now , you're due to have CAT therapy, cognative analytical therapy, aren't you? Do you know when that is going to take place because what I would suggest is that you have that first" - Well in november I was told it would be about a six month wait

"Because what I suggest is that you have the therapy first" - I'm very happy to have the therapy I wanted to find out if I could be referred to just any kind of talking therapy in the mean time, but it would be very nice if you could write a (english swear word) referral because I'm going to have to be waiting to then get on a waiting list for a year.

"Well the thing is i'm not going to write a referral because I think you need to have the therapy first and I'll tell you why. With borderline personality disorder what sometimes an happen is that people tend to split objects up, do you understand?" - No I don't

(angry)"Well I'm telling you Matthew what my own impression is" - No I literally don't understand what split objects up means.

"Well basically what that means is that you could have a situation where you see things in absolutes, so you can see see something or someone as absolutely good or absolutely bad" - I'm aware of that response but I don't tend to have it, usually i'm very rational and analytical.

"Ok so my view Matthew is that, if you have this therapy, the thing is, is that the difficulties you desribe, if they persist after therapy, you understand, and your coping stratergies are improved (This is basically what's called not engaging with the patient, it's a stratergy used with borderline patients to not reward their negative behaviour with attention, so the more you hurt yourself or try to kill yourself the less they are willing to do until you stop it) because the thing is going through this whole transgender process, you will, what you would need to demonstrate is that you can cope well with stress, you understand, and I think it will go well in your favour if you've had the therapy, you understand. I think you should have the therapy first before considereration is made to refer you, because you've got to deal with those difficulties first, because to do it at the same time, I don't think, I don't feel able to do that in my profession capacity"

- Well I had a similar thought about 10 years ago, I thought there is no way I can possibly make this decision while I'm depressed an I thought I had to deal with that first, 10 years later I've had 7 different anti depressants, anti psychotics I've been through 3 or 4 different psychiatrist, I've had CBT, DBT, been referred to the haven, I've had ECT (that's electroshock) and I have killed myself, I actually died, and now, I haven't gotten better until 5 weeks ago!

"It's still early days, Matthew look at things from my position, you understand, you have all these difficulties, it's still early days, you understand, Have the therapy first"

I'm going to have the therapy first, I'd just like to be on a waiting list.

"I don't feel able to do that Matthew and I know you're going to feel unhappy about it"

Well obviously I'm going to be unhapy, because it's going to be april before the therapy then that's 6 months, then after that if I get the referraly after another month or two to see a psych again, then it's at least a 10 month wait so it's going to be next may before I get to go to charring cross, and then one person I spoke to their second appointment was scheduled for 6 months after that

"But you need to remember Matthew" - What you need to understand is that I'm not stopping the spiro (I was seriously peed off by this point) I'm going to be taking the estrogen and by the time I get to the GIC I'm going to be sterile.

"Well Matthew, you own you body, you understand, you're free to do what you want to with your body" - But I don't own my mind?

"What I'm telling you Matthew is that I would rather you have the therapy first, Matthew and let's see how things are, the thing is if these difficulties still remain, you understand, then there's no reason why that referral can't be made, but for me to do it before you've had that therapy, I don't think would be, in terms of what I perceive and again I do understand your frustration because you think the referral should be made, I would rather you have therapy first and then we will see how things are/ you understand."

- Well WE won't be seeing how things are because you won't be here

"Ok it will be someone else, I'm sorry you feel that way Matthew but that is what I will suggest really"

- Well I've never met a good psychiatrist yet.

"Well you could have your perceptions about me really, but that is what I would suggest really."

Yeah well it's not what you would suggest, it's what you dictate, and you seem to be missing the logical portion of how making the referral now would mean that I wouldn't get the therapy first (remember guys this is CAT we're talking about, NOT gender therapy, and with a women who is very nice, but also has no training or experience with gender issues) it would just mean that I got it 3 or 4 months before the appointment not a year before.

"I think, that it is early days, and the thing is it could all, (I wonder what he corrected himself from there) If you don't have the therapy that you will find it very difficult to cope."

-Do you think that I'm going to get the referral and then refuse to show up for the therapy?

"No it's not about that, Its just 5 weeks it's still early days, I can't see I can't defend sending a referral without.. 5 weeks after you've had all these difficulties, it's still too short a period (and ladies and gents we have a winner here, this is discrimination against me on the grounds of a pre existing mental health condition) I would rather you had the referral first, and see how things are after that, but to refer you without having had the therapy, you know, we know, with borderline personality disorder it's one of those difficulties that, there's good evidence that that psychotherapy, specific psychotherapy does help with it, you understand and if you don't have the therapy you run the risk of finding things difficult along the line." (So here he's admitted he wants my BPD cured before I can transition, and of course ignoring that I can't get better without it, and am going to find it considerably more difficult trying to struggle with my transition - that i can't stop now, without having any kind of help)

- This is why I want the therapy, I'm aware I have borderline, and that although my depression has lifted I still have anxiety issues and that I still have great difficulty with interpersonal relationships, and I know that may help me with some of it, but I also know it isn't a miracle cure, there is no miracle cure. The only thing that happens to borderline patients is that they very gradually get better, but that's not going to happen until I've stopped hating myself however, and that's why I have to do this.

"Well I'm not going to change my mind and I'm sorry that you feel that way, the easiest thing would've been just to refer you but if I did that then I wouldn't be doing what I felt was right."

- Well I'm terribly sorry you have to do a difficult thing then

"Well we're not going to agree on this"

- Well I just want to be able to see someone who has some real training or real knowledge of GD and not just someone who understands and appreciates stereotypes

"Ok well" - I would like a referral to someone anyone at all who is qualified

"Your GP can do that" - Apparently not, she said she had to refer me here, she wasn't able to refer me anywhere else

- I would like any kind of therapy with anyone who has some kind of special interest or any kind of training or at least some knowledge of GD, CAT probably isn't the best thing for me to be spending my time discussing gender issues

"No I do agree with you but you are missing the point Matthew that you've got to see the impact of the therapy first, you need the therapy first, then we've got to consider it because I just think that if we're not careful what we're going to do is basically have a situation where you're going to find it very difficult futher down the line, you've had difficulties up until 5 weeks ago, now that could just be the natural history and difficulties will emerge in a few weeks time, I don't know (Hey at least something he said was right).

Ugh ok there were a few more minutes where I explain the difference between having brief periods of happiness and actually not being depressed, and that this just isn't the same, the best i've ever been was at the start of a relationship during the summer, and even i just had days of feeling awful that i just don't get now. I explained about developing self control etc.

"So I will write a letter to your GP stating why I have come to the conclusion that I have come to. And I'll say that you requested a specialist in transgender issues" (Ok I have to question, did anyone at any time think I wouldn't want to see a specialist, the truth is that whoever makes the referral, their department has to pay for it, so this is why we get tossed back and forth so much)

"You are free to ask for a psychiatrist (why would I do that) but what I would suspect is that he's likely to come to the same conclusion as me"

Ok and then I said something about a specialist would actually understand gender spectrum and that people don't always face their denial until they're in their 60s, and that they might acutally have done their (f word) home work, and read what was sent to them with the referral.

Soo yeah that pretty abruptly ended the meeting then, these jack asses actually believe they're entitled to respect.

Soo the long conclusion of that is that he won't refer me for gender therapy because I need therapy. TADA!!!

[Guest i is Sam :-)]

Sorry that was so long, I feel sorry for the poor mod who had to approve it.

So I guess the moral of the story is, don't just be yourself, don't be honest, don't tell the truth, at least not until you're talking to a real therapist. The NHS has to be somehow tricked into helping you.

The real positive thing to take from all this tho is what my sister said

Ana: I know you're really disappointed and angry and frustrated

Ana: But I think you're doing really well

Ana: A few months ago that kind of blow would've left you in a much worse state, and I just wanted to point that out

Ana: And say I was proud

And that's truthfully the case, only a couple of months before if that had happened to me I'd probably have come home and overdosed. But I'm a whole new woman now, and I can cope with this and not let it stop me, not let it plague me, it won't stop me being happy or having a good time, it's just work that has to be done to fix it, and I'll do the things I have to do as and when I can, and the rest of the time, will manage not to freak out about it.

I now have my huge supply of spiro, I'll get new bloods next week I hope, so I'll know where I am, and should be able to get a baseline estrogen too, so I'll be ready to start on that by March, maybe a little sooner if my T is good. I so can't wait.

[Guest i is Sam :-)]

I'm curious about people's opinions on any of this? Was it appropriate for him to ask me about sexuality / sexual experiences at all for instance?

Has anyone else run into opposition because of a previously diagnosed condition?

[Guest Eth]

I don't think it's inappropriate to ask someone with GID about sexual experiences or perceptions, but not in the context that he asked them in or for the reasons that he was asking them. He did seem like he had a hell of a lot of preconceived notions about what it means to have GID and BPD and he sounded like he had a totally one-track mind and wasn't open to anything anyone might say to him.

From what I read in your post, it sounded to me like he heard "GID" and "BPD" and immediately had a diagnosis for you and any details you gave him in between were irrelevant to his "diagnosis". I've had doctors like that in the past and it is completely and totally stupid. It's a "one size fits all" mindset. If you don't have THESE SPECIFIC TRAITS then you aren't "really" this... and if you have this disorder then you AUTOMATICALLY have all of these... etc. etc. They just don't see or understand any variety at all.

I think the especially obvious part concerning this was when you talked about being fluid/liberal with your sexuality and gender expression, he then later said:

"Well basically what that means is that you could have a situation where you see things in absolutes, so you can see see something or someone as absolutely good or absolutely bad."

and you replied:

"I'm aware of that response but I don't tend to have it, usually i'm very rational and analytical."

It was like it totally didn't register with him. Despite the following quotes from you...

I then explained that when I was younger as a way of coping with how I felt, I developed very liberal views on gender and sexuality, and just figured people could be whoever they wanted and labels didn't matter. And that although I want to be a woman I didn't particularly mind doing things as a guy.

"They're wrong, err, I wasn't sure for a very long time, umm but i've never been sure of my identity, I mean I'd never, ever had any idea of a fixed identity and I didn't know that that was unusual, I didn't realise that people just knew exactly what there were, and now I do."

"I'm aware of that response but I don't tend to have it, usually i'm very rational and analytical."

...Where you expressed CLEARLY that you were very flexible/fluid/gradient/saw things as a spectrum/etc... he STILL came to the conclusion that you saw things in "absolutes" and that you automatically thought everything was black and white... JUST because you have BPD.

It felt like every time you spoke, he picked out key words and ignored everything else. Then he judged you based on his preconceived notions concerning those key words. It made about as much sense as a conversation that could have gone like this:

Girl: I'm a girl. I am also a tomboy. I like to roughouse and ride bikes and..

-what he sees: I'm a girl.-

Him: So if you're a girl then you hate the dirt and like dresses and dolls and...

Girl: ...But I said I was a tomboy and...

Him: Hmm.. mm.. I see. -she doesn't fit into his narrow views based on stereotypes- So then I think you're confused.

Girl: ...

His entire "diagnosis" was based on key words and preconceived notions.

[Guest cjnoble71]

Wow, girl, you are having some seriously crummy luck in the mental health help department. I have learned some startling and somewhat depressing news about our friends living in countries with socialized medicine. For the most part it may be better than what we poor slobs in the States have, but they ignore mental health issues an awful lot. I have a Canadian friend that needs help for depression and is having a devil of a time with it. These countries also seem to not take gender identity issues very seriously at all.

I also find it interesting that you are talking to a psychiatrist first Sam. I assume that is the norm in the UK. I just started therapy for depression and I'm not allowed to see a psychiatrist until I've had a few sessions with my therapist. Maybe that's just New York State, or the organization I go to. Anybody else Stateside have any info on that for us?

Christine

[Guest i is Sam :-)]

You first have to see a consultant psychiatrist who then decides what treatment you get and bounces you to the relevant department. That's the case for all mental illness.