Are There Alternatives?

[Guest Strawberry]

Curious. When discussing gender issues with a doctor or therapist unfamiliar with gender issues are there any alternatives to the The Harry Benjamin Standards of Care? I have found mention of the "The Tom Waddell Standards" only very briefly online, but very little information on them.

Thank you

[Guest Donna Jean]

.

That's interesting....

I've been on these boards every day for over two years and I've never heard of "The Tom Waddell Standards".

So, obviously, I had to do some reasearch.

It looks to me to just be a fast track around the accepted SOC to quickly get on HRT...

It requires little to none of a therapist's help...bassically a 1-3 visit to check sanity...

They say that to go this route, you are already POSITIVE that you are Transsexual without a doubt and need to quickly get on HRT.

It does reccomend a doctor's monitoring...

But, again, you'd have able to find a doctor willing to perscribe to you without an acceptablle therapists letter.

They are few and far between. People have ways of getting HRT...

I guess you could just go to a doctor and ask for blood monitoring, but, would they really know what they are looking for?

To me it just seems to fall short of self medicating.

Which, of course, we simply do not support....

Donna Jean

[Guest Strawberry]

I understand, I am simply seeing what is out there.

[Guest Donna Jean]

I understand, I am simply seeing what is out there.

Cool....

Donna Jean

[Milly]

Maybe on topic maybe not. The therapist I went to yestrday said there are glbt clinics where you pay 100 dollars for bloodwork and the docs prescribe you the meds you need. Im a bit miffed I just heard about this now...

[Guest ChloëC]

Hi Stawberry,

Ok, you've got me curious. Is Tom Waddell (or any associates) still around and involved in this? What is his success rate? Where is he now?

I suppose anyone could post a SOC document on the internet, give all sorts of outlandish claims and instructions (and possibly ones that are deceiptful), post letters of positive results, and sit back. I personally find that distasteful at best and extremely deceptive and possibly dangerous at worst. I wouldn't recommend that for anyone.

We're talking serious steps in someone's life if they decide they want to seriously explore transitioning. To do so without professional guidance and assistance when there are so many doubts and possible problems and known risks is asking for trouble. And anyone encouraging people to do so should be ready to step up and take some responsibility for what they are suggesting. I know Laura has made that commitment here for everything she is trying to do. Is Tom Waddell making that commitment? Are those espousing his methods? I have to wonder.

Chloë

[Guest KimberlyF]

I've posted this before, and this is all I'm gonna say on the matter. Gay was once a mental condition too. It's the future. Not every post-op has gone to a therapist. Most need them but not because we're insane.

http://womenborntranssexual.com/2010/06/24/us-thinc-trans-hormones-%E2%80%94-informed-consent-program-puts-transgender-process-on-an-easier-path%E2%80%A6/

Kim

[Guest KimberlyF]

Maybe on topic maybe not. The therapist I went to yestrday said there are glbt clinics where you pay 100 dollars for bloodwork and the docs prescribe you the meds you need. Im a bit miffed I just heard about this now...

OK...I said that other post was the last I was gonna post but yes...it's informed consent and people are demanding it. As for it by name

[Guest Strawberry]

AshleyJ01: The closest clinic to me that is a gender clinic that I know of is 5 hours away. If that truly is the case then I will be calling them.

Chloë : I dont know, thats why I was asking =/

[Guest Strawberry]

KimberlyF: Thank you very much for the info.

[Carolyn Marie]

Kimberly, thank you for the link. I had not seen the article previously. It is certainly the largest and most organzied alternative treatment plan that I've heard of. In smaller ways other G.T.'s or therapy groups have been whittling away at the SoC as well.

For example, the group my G.T. practices in gave up being, what they called "gatekeepers" for something akin to the "informed consent" model, and they no longer issue HRT letters. The trick is to find endocrinologists or other doctors willing to go along with that approach. Not every therapist or therapist group wants to go to the trouble, and certainly

not every M.D. wants to risk moving away from the SoC.

The SoC, as we have often pointed out in these forums, are guidelines after all, not laws or FDA regulations. Many members have reported getting their letter on the 1st, 2nd or 3rd visit. Some have waited months. Some members spend just a few hundred dollars on the initial battery of blood tests, while some unlucky few have spent thousands. It really does vary.

If you live in or near a big city, you should definitely check around. If not, you may have few, or no, choices.

Carolyn Marie

[Milly]

Tbh im glad I went to the therapist. She was super nice and helped me immensely. Next thursday I will be getting bloodwork done. I wouldn't be without her. Its a moot point for me since I wouldn't have known about that program wihtout her. I still plan on going back to her in december.

[Guest KimberlyF]

Kimberly, thank you for the link. I had not seen the article previously. It is certainly the largest and most organzied alternative treatment plan that I've heard of.

Well I've mentioned it a few times since I'm in it

The people at Howard Brown are very much involved in Trans health issues. They talked about their informed consent hormone program at the Philly Trans-Health Conference. I think they're pretty involved in that every year.

Kim

[Guest Donna Jean]

.

I certainly hope that I didn't step on anyone's toes with my post here...

If informed consent was available to me, that's the route that I probably would of taken...

But, this site supports the SOC and that is why I talk about that...

Donna Jean

[Guest KimberlyF]

.

I certainly hope that I didn't step on anyone's toes with my post here...

Huggs Donna Jean.

If anyone thinks you have a mean bone in your body and would purposefully try to hurt someone, as long as I'm around they'd have to get thru me to get to you. But seriously if that ever happens start booking it the other way cause I'm not gonna hold them off too long jumping in front of them and rolling into a ball.

The SOC are a constantly changing 'guideline'. Nobody should rush into any perm changes to their bodies without some serious 3rd party intervention.

It's a double edged sword. On one hand it chafes me that transsexualism is a condition with a treatment plan in a book much like bipolar or OCD. And yet take that away and how can any insurance not deem any procedures voluntary and the whole thing a choice? I guess this is why I really like what Howard Brown does (doubt they were the first) and think it should be embraced by the T community as a whole. It is not a mental condition. It's a medical one. They bill it is an endocrin disorder. Hormones and surgeries and the treatment, not time on the couch.

20 years ago w/the SOC the way they were you really had to be middle class or more to have a good shot at transsitioning. The time and money involved just in getting on hormones was crushing to some people. But just like poor people finding it difficult to resist dealing when the draw is so strong and there aren't too many other options, the draw to self-medicate back then when you KNEW but couldn't do a Gosh darned thing about it. Where is the compassion in the SOC care for those people? That's just one more reason why programs like the one I linked at Howard Brown are popping up. You may not get SRS, but you sure as heck can get on hormones and find some comfort to your pain. Even if you have no job or insurance. And the doctors and therapists there will make sure you are ready and put the informed in the informed consent program.

Kim

[JJ]

While this site supports SOC and no one is advocating self-medicating or abandoning them, I believe it is valid to discuss flaws in that system and ways to get those flaws addressed. The research and awareness in this field are progressing much more rapidly now and it makes SOC confusing and unevenly administered. The loophole about "as deemed" is being used more and more.

I'd like to see the whole thing rewritten. So it could be administered in a remotely cohesive way from one Dr or therapist to another. This uncertainty about what we are facing as far as expenses and treatments is a huge stressor in an already stressful situation. How many people have sunk into despair and opted out of existence because they ran into obstacles that couldn't be surmounted with the resources available to them?

There is also a vast difference in the level of need for therapy. The potential for subsequent regret is, I think, much higher among those just beginning to explore their identity and place in the world. But the whole tying HRT to therapy is such a difficult thing. Especially when gender therapists are too few to go around and vary greatly in experience and approach. Some people don't even have access to online therapists because of the quality or type of their internet connection. Another problem is that our access to a second opinion or a different therapist or DR. may be nil because of the lack of therapists and Dr.s willing to become involved.

Additionally although I believe more therapy may be beneficial for the younger trans community I also know that they are the most at risk as the delay daily alters a body they can no longer accept or live in comfortably. The delay causes additional damage psychologically and additional expense in transitioning not to mention changes that can't be undone. This is also the population least able to afford it when they run into a therapist and Dr. situation that will be tremendously expensive.

Our older members are also often in crisis mode by the time they identify and are in need of therapy. But diriven to obtain hormones and begin a journey so long delayed. Their need for therapy is of a different kind than that of a younger community. More advise and guidance than gender identity resolution.

So we desperately need the SOC revised-and perhaps regulation of certain aspects so that delays and abuses are less prevalent-but until that revision happens it is our best safety net.

I hope wholeheartedly that with increasing awareness of the truths of out conditions and advancing scientific evidence concerning the underlying medical causes the SOC will be rewritten in the not too distant future. Till then our best bet is to share information here about how to best work within the system. and to continue to work for changes so necessary to spare the torment too many of us have endured with a system so diversely and unevenly administered.

Love

John

[Carolyn Marie]

John, that is truly a brilliant assessment of the situation.

I can add nothing to your views, and just say thank you. You've really hit the nail on the head.

Carolyn Marie

[Guest kelise]

DJ's description at the top reminds me a lot of the way I went through transition. I believe in a SOC being in existence, I know it's important. Though as we all know the SOC has changed quite a bit since Good ol' grandpa Harry first wrote them. I went fast, but only as fast as I was able. When I went to my first counseling session, I basically said, "I'm a transsexual. I've known I was since the first time I heard about it...." and on with a summary of my life and my trans experiences, and I walked out with a hormone letter. Now I'm cringing a little writing this because I don't want to give somebody a script to go into their therapists office with, so I will say this, use what I say only if you truly believe it. If you don't it will come back to bite you, and it WILL hurt. Please, this is why there are SOCs. If you question your transsexuality at all spend the extra time and disscuss your concerns with the therapist, until you are confident and believe in yourself. I was, and am, and that's why my transition was so succesful. I for one have NEVER questioned myself. I learned about GID at about age 13 and that was that, it's what I had. I should've been a girl. All the pieces fit, and to this day I know what I am. So for those like me, I'm glad the SOC is lienient enough to allow me a fast lane. However, if the SOC gets too lienient, I can see a great danger happening there too. For example another thing DJ said (your a wealth of references, sweety!) about how in Iran we have gay men getting sex changes just so they can marry men without fear of being hung, which is the law in Iran, only to find out they're not women at all, and being a woman is not easy when you're a man. Basically in their case their surgeon GIVES them gender dysphoria rather than takes it away. That's a pretty extreme example, but it shows what can happen if you rush into a transition with out being sure.

[Guest KimberlyF]

Kelise,

I've mentioned this here before I've ran from a GT trying to push hormones on me in my mid 20's cause I was open with them and never really had doubts. Yeah I know I'm TS but I'm not transisitoning you quack. Should I bow cause you offered me the hormone cookie?

I even posted here when it happened that my last one, in passing mentioned off hand to me about hormones right before I stopped with her because My insurance doesn't cover her and it would just be too much week after week. She kinda said oh by the way for people interested, this is how I deal with hormones...

I give off this medicate me vib I guess

I could have started Estro 3 months ago the day I started the t blockers. I agreed w/my doctor to let the t-blockers deal w some other issues and I could work on my relationship w my wife too. It was my idea. I just admitted that here this week. I wanted to be on Estro so bad and once again, just like the last 41 years, I put other people in front of me. I had to give my doctor a reason to not give me Estro 3 months ago while everyone else on the board fights to get it. The t blockers would take care of the erections which were causing so much stress but if I started Estro then my wife would leave me or hate me or something.. 3 months later I couldn't wait any more so I had to start the Estro this week. I'm hardly the poster child for rushing into things. You know I have a point here somewhere but honestly since I started the t blockers I'm all over the place Oh yeah...anyway so I'm not saying this as someone who's been shafted by the current system or anything like that. But I do read a lot of posts by people every week who are so nervous going to see their therapist for the first time and their biggest concern is being denied hormones. If you're worried about that you prob also have a pretty good idea about who and what you are. That's where the issues with almost asking therapists for permission is a rub. And I'm not giving away my answers either cause I always seem to have the right ones too...but I've always jut told people be honest and open. It does you no good to lie.

I think a two tier approach would work pretty well. It should be fairly easy to get HRT. It's cheap and it cures GID in the vast majority of TSs. The total number of TSs who go on all the way and have SRS is very small. That should be a much harder process to finish. I'm fine w/the current set up. If you're on HRT and live in that gender for a year to game the system, you are one sick puppy and none of the safeties matter anyway. You'd hope one of the pros that have to write a letter would catch it.

[Milly]

My only real complaint about not mentioning a vastly easier and cheaper way to hormones is this. some of us are very very poor and need to plan accordingly. I felt a bit irritated to go into a session where I already knew what I needed only to find out I could have done this months ago. Now if you didn't know that's fine but considering people come to this forum for info, you think that would have been mentioned once or twice. Its not self medication so its not like its against the rules. However I don't believe the not mentioning of this is a act of malice but more one of not knowing about it. So for the people in north texas here's what my therapist gave me and told me. The g.e.a.r. program is a lbgt clinic of some sort where if you know you are transgendered you can get your blood drawn and get prescribed. Like said its only if you know. She gave me a email and website to it as well.. web: www.rcdallas.org email: [email protected] phone is 2145280144 toll free is 18666572347 my therapist says when you call ask if they know about the gear program. If not hang up and get to one who does. Phones are done by volunteers so not all of them know about this program.

personally if you're of age I believe you can determine if you are what you are. Hell I knew what I was :/ go figure..anyway goodluck.

[Guest N. Jane]

As one who went through all this in the 1960's and 70's I see the value of "standards of care" but I also know that I would not have survived if so many road blocks had been thrown in front of me.

By my early teens I was taking hormones whenever I could steal them and living part time en femme. I saw Harry Benjamin in 1966 (age 16) and it took him all of 5 minutes to pronounce me transsexual, not that it did any good in those days. At 17, after an exhaustive search, I found a doctor who was compassionate enough to put me on HRT (though I was a minor and without parental consent) and that helped to carry me through. He also arranged a psych evaluation (just to determine I was sane and rational) since he knew that would improve the chance of finding a surgeon - the "evaluation" took one day! Still, by the time Dr. Biber came on the scene I was highly suicidal - probably as close as SRS ever came to "emergency surgery"!

The assurance that the desire to "change sex" is genuine, strong, and realistic makes some form of assessment mandatory but once that is established the priorities need to be:

#1 - control the hormones to prevent further physical damage and improve moral

#2 - move toward social transition as quickly as possible

#3 - evaluate the effects of transition and determine mental stability

#4 - surgery

The first three steps are reversible (within a limited time frame) and I am pleased to see very young TS being treated this way (usually with Step 4 being completed after age 16 to 18, depending on local legal requirements).

I understand the reluctance of the medical system to follow the same short path with older patients but I can't help wonder how much of the "extended therapy" is financially motivated.....

[Guest KimberlyF]

I think a lot of the SOC are financially motivated, be it the 12 sessions/3 month deal or the multiple letters from different Drs. to get surgery. Spread the wealth and keep the money flowing. There are plenty of GTs who have dealt with transsexuals who put the patient above the paycheck and have no problem writing a letter for HRT after 1 or 2 sessions. Hormones can always be pulled from someone, which is how I think the process would work better. If you're just taking pills and not working on fixing/changing your life you could be in for big troubles ahead.

I never had to wait 12 weeks before a GT started talking about HRT being right for me, but I didn't bring it up so I ran in the other direction. When I was finally ready, I was ready yesterday and I couldn't wait 3 months plus. I did an informed consent program and had blood work, a consult w/a doctor and a therapist and had pills in hand in less than a month.

Kim