I’ve been referred to a Non-gender therapist. Could this be an issue?

[Guest Amber90]

So I went to my local doctors this afternoon for an appointment. I told them that I was extremely depressed and anxious as a result of my gender identity. At the end of the appointment we came to the conclusion that I suffer from numerous psychological problems which my doctor believes all stem directly from my crossdressing (anxiety, self-hatred, confusion, insomnia, suicidal thoughts, chronic shyness, constantly distracted ect). She also said that I need to be helped as soon as possible.

I completely agreed with her conclusion and she was extremely supportive; however the only problem with this was that my doctor admitting to having very little knowledge on trans issues and didn’t know what to do with me. She then decided that the best thing she could think of was to put me onto anti-depressants for 30 days and to refer me to a therapist immediately.

She said that because I’ve always identified as a transvestite – as opposed to a transsexual – there will absolutely be no need for me to see a gender therapist, and that regular therapy would be just fine for me. This I’m a little worried about, as I’ve heard many horror stories about some standard therapists expressing trans-ignorance and therefor not understanding such issues.

Do you think my doctor is right in her conclusion? Is the fact that I identify as a crossdresser (despite not being completely sure) mean that gender therapy is not needed. I’m going to take the path that she has set for me, but I’m still a little worried as to whether this could end up being more problematic than helpful.

I did tell her that I hate my male body and that I sometimes fantasise about living full time as the opposite sex, but she said that the whole thing still sounds like transvestism to her. I trust her in her knowledge as a doctor (plus she's a lovely person), but I’m still a little worried.

Obviously I'm not expecting anyone to come up with a real right answer. I just want to know what others think about my doctor's oppinions, and whether they sound reasonable or not.

Also, just to add, I’m receiving this help on the NHS, so I can’t just ignore her and go to a gender therapist instead. If I want to receive help on the British National Health Service then I will need to follow my doctor’s referrals.

Amber

xx

[KathrynJulia]

Amber

Maybe you ought to go to the therapist your doctor has referred you to with an open mind and discuss all your issues with this thereapists. You can always ask this therapist if they have any experience with transgendered patients and what that experience is and what their comfort level is working with Transgendered patients is. The therapist you are being referred to may turn out to be outstanding and very helpful to all the way to the other side of the spectrum where they are a nightmare. If you don't work well together, you might respectfully ask them if their is somebody thay could recommend you to who does have considerable experience and training in Gender Therapy. I would not walk in with a closed mind, instead I would try and get as much out of the therapy as I could. Good luck Kathryn

[Guest]

Hi Amber,

I saw a regular therapist for over a year before going to a GT. It was my own choice, wanting to make certain that I wasn't making gender assumptions as a result of other mental issues. My therapist knew little about gender identity, but helped me immensely in other ways. After I "graduated" from her care, I went on to a GT. It made a big difference for me - by the time I saw the GT, I had little uncertainty about my direction; the rest is history...

I know that the NHS gives you little choice in the matter, and what recourse you might have. But, I'd encourage you to keep an open mind. Therapy can help in many ways, even if unexpected. And, if your experience isn't positve, then you'll be able to talk again to your GP about a gender therapist instead.

Take care - let us know how it goes, okay?

Love, Megan

[Guest Mia J]

I would take your doctors advice and see the general therapist to begin with. Once that therapist determines that some or all of your issues are gender related then they may be able to get you with a therapist that specializes in gender issues.

Mia

[Guest Krisina]

Sounds like your doctor is trying to help you the best she can, with numerous issues to deal with. I would bring up the gender issues with the person your doctor recommended when you see them too. Maybe with many other issues, this specialist might be more beneficial in the meantime. I hear your concern too when hearing about people who didn't go to a gender specialist and didn't get the help needed. Bring up those concerns when you have time seeing too what knowledge they might have in that area. All the best to you.

Krisina

[Drea]

She said that because I’ve always identified as a transvestite – as opposed to a transsexual – there will absolutely be no need for me to see a gender therapist, and that regular therapy would be just fine for me. This I’m a little worried about, as I’ve heard many horror stories about some standard therapists expressing trans-ignorance and therefor not understanding such issues.

Well seems your doc expressed something akin to what many trans seem to express. That seeing a gender therapist is only about being transsexual and transitioning. As a specialization, experience of a "gender therapist" would be relevent.

On the other hand, it probably isn't a big deal. Yes there are times when a therapist might not understand, but many do have some experience and many do quite well with a therapist that doesn't specifically specialize in gender issues. Furthermore this therapist should know more than your doc and refer you to a gender theapist if needed.

[JJ]

You actually find therapists across the spectrum and some are knowledgeable while most are not. Your Dr appears to have the old concept that crossdressing is a fetish while being a transsexual is a gender issue in mind, That was once a common view unfortunately and just because they are a Dr does not mean they are up on gender issues, Especially since it is a field that has changed radically in just the last 3 years or so. Being a crossdresser is also a transgender condition according to most definitions and therefore would qualify for seeing a gender therapist.

Not to mention that you have doubts and there may be deeper issues. It is very common for people to crossdress for years and identify as crossdressers before they realize that they are in reality transsexual instead. That may or may not be the case for you but a person trained to recognize and deal with all the effects of gender issues is the best person to help you decide.

Gender problems are physical in origin-in the brain. Many therapists are unaware of that and try to treat you for a mental condition. Others are not aware that many of the symptoms arising from GID mimic symptoms of mental illnesses you don't actually have and therefore label, diagnose and treat incorrectly. Or you can get lucky and find the rare therapist who is up to date or willing to spend the precious time to get up to date on gender issues. It is a gamble at best and I have heard both ways but actually more times that a therapist was a waste of time and money ultimately when they tried to treat gender issues without experience. I think when you are uncertain that gamble is even greater. But that part is just my opinion

It might be a good idea to go ahead with the referral and find out what gender experience this therapist has and what their attitude is. If they see it as a mental illness or crossdressing as a sexual fetish or aberrant behavior then I'd say turn elsewhere. If they start using labels not associated with gender I'd say the same.

Sadly this field is really complex as well as rapidly evolving and we are so few in number that the specialists -or even those with any real up to date knowledge-are few and far between

I wish you all the best!

Johnny

[Guest KimberlyF]

There are good and bad therapists and good and bad GTs.

My therapist told me the topic is covered in the general work load and she took a few electives.

According to her bio, Dr. Mildred Brown saw a single person at a seminar she was giving, she became interested in the person who took her to a group meeting.. She took 3 T patients with no special training, and turned it into her life's passion. She cowrote True Selves. She didn't take any special classes. She cared for her patients and one day she said she's a GT. then years later she worked with others on the SOC.

Does anyone know of any accredited GT programs in the US?

[JJ]

Actually unlike using the term psychologist there is also no national standard for calling yourself a therapist either. Because I have a degree in social sciences, another degree in child development and have been certified to train alcohol and drug abuse counselors along with having done years of social work and received at least 8 hours training a month for over 20 years in family and behavior related fields I can legally call myself a therapist in many if not most states so it is not surprising there is no certification program for GTs, Especially given how small our numbers were always considered. By the way let me say flatly I do not work as a therapist here or anywhere else or represent myself as one. But legally I could if I chose.

Right now someone calling themselves a gender therapist is simply sayimg that the therapist has an interest in and experience with gender issues. It does not guarantee that that they actually are experienced or up to date or informed. Just far more likely to be. It's an indication that the deck is more likely to be stacked in your favor than against you

But the therapist still needs to be competent no matter how well informed and perhaps as important needs to be a good fit for you and your personality to get real work done on issues and not just as a rubber stamp for HRT,

Johnny.

[Guest Sarinah]

Amber, based on what you have said in your post I would say that you probably should try to see a gender therapist. A general therapist may be able to help you with some issues but if those issues stem from gender related distress than a general therapist will be ill equiped to give you adequate care. A good general therapist should be able to recognize that they are ill equiped and refer you to someone else.

Does anyone know of any accredited GT programs in the US?

I am a psychology student in a masters program and I am focusing my path on becoming a Gender Therapist. I have done extensive searching and have not found any accredidation programs anywhere much less the US. There are also no programs which offer a specialization in gender therapy in the US. The school of psychology in chicago offers a specialization for sexual orientation and gender identity. This is a combined specialization but at least it covers some things.

-Evalyn

[Guest KimberlyF]

A general therapist may be able to help you with some issues but if those issues stem from gender related distress than a general therapist will be ill equiped to give you adequate care. A good general therapist should be able to recognize that they are ill equiped and refer you to someone else.

There are also no programs which offer a specialization in gender therapy in the US.

These are two very interesting statements. How does the General therapist who is ill equipped to deal with this issue suddenly have the needed tools when they hang the GT sign on their door?

[JJ]

As I said above-they don't EXCEPT that by adding that GT they indicate an interest in the subject and you as a client have a better chance that they have more knowledge and experience You also know that they are more likely to be trans friendly. Not all therapists are.

Because we are so few and tend to be economically more distressed with Medicare, Medicade and private insurance all denying us coverage a therapist won't add that GT designation from any financial motivation. It is only because they care about the subject. Which leads to more experience in the field etc, You even have a possibility of finding a therapist who is also trans among the GTs,

We advise people to check the list of therapists on site here for a reason. All have been verified. A person can also check with local support groups and organizations for people with gender therapy experience.

The problem is that the medical community-like most professions-tends to move slowly and meet needs as it becomes necessary. Much of the scientific verification about the physical nature of this condition is new. And society's attitudes which are allowing more and more people to seek treatment and at a younger age have really changed in a short time. We will see standards eventually I believe when the medical and therapeutic community has a chance to catch up.

It's the same with hormone treatment. Why does a Dr or an endo suddenly know how to treat us? It is all so new as far as numbers and being open that there are no set standards there either, Especially for FTMs by the way, One Dr prescribes one way or one dose and the next Dr may prescribe as much as four times as much or a totally different routine because knowledge and treatment haven't caught up yet. They are doing best guess based on their perceptions. But going to a Dr who has experience with trans clients if possible gives you a better shot at a good result with fewer complications. Just the realities of being a very small minority in a rapidly changing field.

Bottom line is that we have to make judgments and decisions. When we go to a GT we at least have a much better chance that we will receive appropriate treatment because the therapist cares about trans issues or they would not bother with the GT label with so many more lucrative ones they can add instead.

Johnny

[Guest Sarinah]

These are two very interesting statements. How does the General therapist who is ill equipped to deal with this issue suddenly have the needed tools when they hang the GT sign on their door?

Johnny has given good responses to your question. I would just emphasize that a general therapist who transitions into a GT does so very slowly.

Part of the ethical code of being a psychologist is the principle of "do no harm" (non-maleficence). For this reason good therapists are hesitant to treat transgender individuals. This is because they recognize that counseling a transgender person has special considerations and requires special knowledge. So lets say a transgender person comes in to see them. They are unfamiliar with us so they decide to either "do their best" or refer you to someone else. Either way they decide they better educate themselves on transgender individuals. They start to seek knowledge. Eventually they feel comfortable enough to see more clients who are struggling with gender. Once they have seen a few and word gets out they do therapy related to gender identity, whether they identify themselves that way or not, they are now a gender therapist.

My therapist was not a gender therapist. We took that journey of discovery together. She just happened to be willing, and I was comfortable enough with myself that I didnt need a specialist. We educated ourselves and eachother along the way. She has now seen several trans clients and is well on her way to becoming a gender therapist. I am on my way to becoming a gender therapist because I have the gender knowledge and now am learning the therapist knowledge.

Hope this gives you an idea of the process from the other side of the therapeutic relationship.

-Evalyn