Why is HRT a goal?

[Guest carolynn2fem]

Reading here I see a lot of talk of hormones. and staying with in theTOC I do not want to get into the ileagal stuff or doses. I could be wrong here but I get the impression that we here self diagnos what we need and hunt down a Dr. that will proscribe them.

I'm confused about the process. how does one come to the conclusion that hormones are needed? does a GT give a referal ? is there a test that would be benifical to determin higher E or lower T? is it reserved for those that are full on TS or is there benifits for those of us that are more in the middle?

[Guest Maria_B]

It's a personal goal for each person, or not a personal goal. No where along the scale can you be put by anyone but yourself. A GT is there to help you discover where you fit, and what treatment best suits you. If you don't need hormones and they aren't a goal of yours, no one is going to force you to take them. If you feel you need hormones, then yes, generally your GT will give you a letter or a referral to someone to monitor and prescribe your hormones.

The conclusion is found by you in short.

[Guest Melissa~]

I can't personally believe that a therapist leads to a diagnosis of a gender disorder too often. It would appear that it's always the patient driving the diagnosis and decisions.

When the APA could do no wrong and knew everything 40 years ago, it lead to lots of horrible problems that are beyond the scope of this thread.

So It's somewhat like this a person thinks they have gender confusion (because of X whatever symptom here.) Real psychologists/psychiatrists are trained in the importance of gender issues anymore, they know the issue is complex, they know the problems are dead serious. If there is no immediate stabilization of the patient required, the responsible therapist hopefully can make the referral to the specialist, hopefully a gender therapist if applicable, and not a sex addiction therapist, etc(assuming the therapist is fairly sure it is a gender issue and not sex addiction etc.)

The gender therapist isn't typically a psychiatrist that's going to prescribe a hormone regimen themselves (I've never actually heard of a psychiatrist prescribing hormones-ever). Most are psychologists, most are going to have some endocrinologists they will refer you to to handle the hormones.

So we have the patient usually has an idea before they get to a gender therapist. The mtf type transsexual is more common, and might even know they want to be a lady instead of just being dysphoric. Even peripheral research by the patient reveals some of the treatment options. Those are: Therapy, hormones, and surgery. Those treatments are progressive and individually they may be all a patient needs to be happy.

Myself I envision needing all three. I've been a miserable cranky cus for a long time with self destructive tendencies, oh and I want to be a Lady. The therapist can definitely help with guiding on the transition process, but I'm really interested in getting away from being a miserable cranky cus. The next step, hormones. They can help alleviate some bodily dysphoria particularly if they have a measurable effect, as well as improve a persons adjustment, if they are so disposed to it. The changes from mtf HT would be crushingly devastating to a person the really wants to be a body builder, or prowling around and getting frisky four times every day. Hormones rapidly weed out such people.

I expect a some therapists would be more than happy to recommend HT to "someone more in the middle," as long as their conditions are met. Mind you plenty of therapist really enjoy the gatekeeper role, and will not allow anyone not fitting their exact standard to get their recommendation.

[Guest KimberlyF]

There are no special classes or requirements to call oneself a GT. Good therapist trumps bad therapist. One plus of going to a self-described GT is they'll be familiar with the issue. That doesn't promise they're any good at their job or that they're not pushing an agenda. Most younger therapists will have had some class time on the subject.

Many think changing the outsides without dealing with anything on the insides is perfectly acceptable. I hear all the time from people who say they have their HRT from their therapist, and other than that they deal with their other issues OK by themselves. They have nothing really to talk about in therapy. It happened again last night in the group chat. Someone said that after talking about all of these fears she had. Why not discuss these fears with your therapist???

And yes, HRT is acceptable for people in the middle of the road. It's says that in so many words in the SOC.

[Drea]

A very good question. It seems to me that getting on hormones as a "goal" is misguided. The same as making SRS a goal or social role change a goal.

There should be a purpose or value to a goal. If not it becomes like the old response a mountain climber might give for climbing a mountain "because it was there". Behind that would be the personal challenge, the sense of adventure, or recognition for such achievement. Would such be a reasonable reason for taking hormones, going thru a social role change, or having SRS, etc? Becuase of the challenge, adventure and recognitiion for doing such? I feel most would agree that it is not.

I have often posed the question "What is the goal of treatment?" which has yielded typical responses from MTF of "to be myself" or "to become the woman I am". This sort of thing makes the action sound like a lifestyle choice. Perhaps that is the case for some?

If this condition is truely a medical condition and not a lifestyle choice, a condition that makes it hard to live and requires medical intervention, shouldn't the goal of treatment be something relevent to those reasons, those stressors? For example to address the body dysphoria. Or to address the social dysphoria or the depression or whatever difficulties this cause in our lives?

Too often however, treatment options get made the goal rather than the stressors that originally motivate one to seek those options. This doesn't mean they aren't the right options, but this is a subtle distinction I have observed that often is missed. By making the treatment option the goal instead of what that treatment option is suppoed to address, one is at risk of not considering all options to address the underlying stressors or may miss important other aspects that need to be address. Then when one reaches the "goal", reaches their pre-decided treatment option(s), and find it hasn't solved the issues they expected it to, they end up feeling worse. Sometimes this leads to re-examination of the underlying motivation. Sometimes it results in fixation of a different treatment option as a "goal"

I seen plenty examples of this sort of goal chasing. One particular individual, her "goal" was to get on hormones and start living full time. She got to that quickly but then found problems remained and there were new life problems such as getting a job. So next the legal name and gender marker chang was the focus after which she would be "legally a woman" and this problem would be solved. Well all problems continued and next goal became SRS because then her body would be totally a woman. Well again that didn't work out as she had planned. So what now? FFS become the next goal? In her case she didn't go on to FFS. She got back into therapy and finally dealt with the self esteem and other personality issues that were the root of many of her problems. Issues that were there before, but because of this fixation on treatment options as a "goal" or solution that would fix her problems, she spent a great deal of time missed those items.

I'm confused about the process. how does one come to the conclusion that hormones are needed? does a GT give a referal ? is there a test that would be benifical to determin higher E or lower T? is it reserved for those that are full on TS or is there benifits for those of us that are more in the middle?

A good question about how one determine if hormones are needed. In the past that would be a treatment option discussed with one's therapist and therapist would give referral. Now the standards of care no longer require seeing a therapist for such a desire and with no shortage of clinics or doctors who use an informed consent model, such becomes a decision one comes to on their own. Thru their own research or from advice given by others in support enviorments.

As to benefits for those "in the middle". Well what is "in the middle"? There are lots of levels of dysphoria and treatment options are not "transition" or "not transition". There are plenty of folks for whom hormones are just right for them with no need of other treatment options. Determining if you fit that, a therapy is the best way to explore that in my view. Having said that, there are plenty of folks out there "experimenting" with hormones who wouldn't traditionally fall into the definiton of "transsexual". As for that being good or bad and how it works for them, I can not say.

[Guest LizMarie]

I agree with Drea. Hormones are a treatment not a goal. Your goals need to be centered on discovering how you can live with yourself, be happy, and be content. For some this means nothing more than acknowledging their feminine or masculine side. But for many others, they feel like they need more to achieve that goal of living happily and congruently with themselves.

At its core, gender dysphoria revolves around a sense of self that is one gender and a physical body that is the other gender. That's the source of the dysphoria. And thus the goal is resolving the dysphoria so you're not questioning why you're even alive or if you want to continue (something I did at one point). Finding the right treatments for you is what therapy is about. If you feel happy just cross dressing then that's all you need. But if you're like many of us, you want your body to be more in sync with what your mind expects. I can state quite honestly that getting out of the shower and seeing a flat chest and a penis makes me unhappy. Thus, in working through this with my therapist, I know I want HRT to make my body more feminine, and very probably SRS to change what's between my legs.

But that's me, not you. What you need can only be found by you and that's why you want a professional therapist - someone who can lead you along that path to discover what your needs are and how to fill those needs in order to resolve your dysphoria. I met one man (who presents and lives male) and he addresses his dysphoria by writing female fiction, making as many female friends as he can, and rarely cross dressing. That's all he has ever wanted and it works for him. So HRT is treatment, not a goal. It's one kind of treatment for the dysphoria we experience. Whether you need HRT or not is entirely for you to discover with the help of your therapist.

[Guest MissSiul]

For now,hormones(specially T blockers) are my goal,because I'm very very far from it,and I can't stand my body,specially the fact it is still growing(I'm 16),and that I'll probably get more masculine by the time I start HRT.

My ultimate goal is to live as myself,be female.Be able to undress and like what I see in the mirror,not feel depressed and disgusted.Of course I can work on the fact I'm shy,I've been shy my whole life,but my body getting so masculine made me feel really awkward and bad in social situations.Hormones will not solve everything,but will help me in what I most need.

[Guest DanD]

i follow what youre saying about the goal/treatment thing,,its all a bit too much to get into the word game again,

goals are things you set up for yourself to accomplish.

like, you want an apartment;

so your goals would be:

to save money for a security deposit and rent.

to have some basic furniture and house keeping things

to get a truck and movers to get things to the place

to have the phone line started up

to have the electric account started up

etc etc

ok so yeh the goal, you might argue is, to get the apartment, the other things arent real "goals".

Yeh, but theyre steps, and count as goals.

As you find yourself able to accomplish each othese mini-goals, or, steps, you can achive your goal, which is the higher purpose to it.

I would have been a very normal guy if i only were born male, and had no issues with any of the gender things in my life.

but i wasnt, so, what can i do about it?

i could sit and do nothing and whine and be miserable

i could end it all, in some ways or fashion

i could try to change things so its more tolerable. (what those are might different from person to person in here)

All i really know is I want to just be a regular guy, and I know I cant have that.

and I dont need people to remind me of all the ways that this is simply impossible either!

So you find out options towards that end... what CAN be done?

and those answers rely on alot of factors..and details..

Alot of people think i am "post-op", or fully transtioned.

Even the gender therapist specialists i have spoken to in recent years consider me done at this point.

But i havent had any bottom surgery yet, and my chest is stil messed up, needs fixed it didnt heal right somehow so it looks weird. I dont mean scars, i told her to begin with scars aint so much, they fade in time anyway..

i just wants the basic shape and everything to be all there, and of course, to have the muscles and everything functioning like normal is a part of that. I dont see why parts that got damaged in the process shouldnt be fixed, you know?

As far as the bottom surgery goes, i know al the options.. and i have a good idea of what i want.

what i want is to appear to be as normal male as possible, and to function as such.

I dont need reminded of what is not possible, and what is possible.. but i also have asked the surgeons questions they dont even know the answers to, so then, sometimes, they find it out and let me know. Other times, i get that "Oh thats a good question. i dont know why ive never heard of that idea before" or some such thing.

but anyway..i disagree with it that each step is not a goal to achieve. Its a mental thing.. a one-day-at-a-time kind of approach.

my goal was to find more info.. my goal was to get to a therapist.. my other goals were to do other things i had to get done.. getting yoursel to a therapist is a major step and a small one at the same time, its a goal..

getting hormones might be a goal, and a major step and a small one at the same time.

sometimes you have to readjust your goals in life.. you havs short term goals, and long term goals, goals for the next month or year or the next five years.

the overall goal is the do some kind of change in your life. you could debate whether its a lifestyle choice or not.

If youre starving but you could kill a baby and eat it, is that a choice? well, id starve along with the baby, i know i couldnt do it.

but for me it wouldnt be a choice, because its so deeply set in my sense of humanity. other could argue its a choice and they might be right.

maybe this is sort of like that. How much does it mean to you to be in the body matching your gender?

would you settle for something less? some in-between ground?

there's no right or wrong answer, as it depends on each person. Some of you might call it a choice, and some would say its not.

I know i cant live if i have to live as a girl, its not even a question of well maybe somehow...

but for some the answer might be, well, if i can just dress the way i want and talk the way i want, and do the things i want, then maybe thats all that matters to me. (or something along those lines.)

I cant tell someone else whether its the right thing to do or not, and therapists cant tell. theyre supposed to try to help you fo figure things out, for yourself. Some people act like because they felt this way, and did what they did, means its the same way for others but some people its not.

its hard to encourage someone without seeming pushy sometimes, or to not want to push, and appear indifferent.

If someone wants info i can share info i have, i can share experiences and my own opinions sometimes, but nobody else is exaclty like me, and they might not feel the same, but maybe they do in alot of ways too.

[Guest carolynn2fem]

In short there are some great answers here. some push my limits and go into information overload. in my case it is a good reminder that hormones may or may not be a needed option and as Drea pointed out each new step brings on its own complexities and the isnt or shouldnt be any hurry to push it to the step