Meeting Psychiatrist: Good Questions?

[Autumn]

Hi everyone,

I've been given an outpatient appointment with a psychiatrist, 3 months from now. I'm feeling nervous about it. I wish I knew what to expect. I've never had to see a psychiatrist before. I have been assured that he has a lot of experience dealing with gender identity issues. My questions to everyone here:

What are your own experiences of dealing with psychiatrists, in particular that first appointment, what was it like?

And are there any good questions which I should be taking with me to ask the doctor on the day?

[Carolyn Marie]

Autumn, your questions are very good ones, and very often asked. I did this post a while back, and I think there is still some good information and guidance there.

http://www.lauras-playground.com/forums/index.php?showtopic=13018

If your therapist/psychologist is any good at all, the first session should be a get-to-know-each other chat. It will give you a chance to feel each other out. Your G.T. will probably guide things, but don't be afraid to ask your questions. In later sessions, it might be a more narrowly focused discussion. Every therapist has their own technique, their own style, and if you connect, then its all good. Please just try to relax and above all, be honest. Without honesty, the whole thing becomes pointless. They aren't there to block you from your goals, but they need to understand what those goals are.

Best of luck.

Carolyn Marie

[Guest erinanita]

Autumn, I agree with Carolyn Marie. I believe your therapist/psychiatrist will try to put your mind at ease so that you'll find it easy to talk about yourself. You can help by showing acceptance of your situation and your feelings. There are no wrong questions. Good luck.

Thtufus (Erin)

[Charlize]

Perhaps the most important thin to remember is to be open and as honest as you can be. If you are uncertain about something express that uncertainty. The therapist is there more for guidance and as a facilitator than as an expert witness. I have trouble remembering if i had any questions but i'm sure there were procedural ones that needed to be answered once we got to know each other. The one i do remember asking was if i "passed". When i look back on that i'm a bit embarrassed because it almost seems irrelevant but like many it seemed very important at that time.

Hugs,

Charlize

[Timber Wolf]

Hi Autumn,

As mentioned, your first session should be for getting to know eachother. Don't be nervous about it. Your psychologist will guide the conversation until it gets going by itself. It always feels uncomfortable when you first go, but he knows this and will help get you past your discomfort. You'll probably be surprised how quickly you become comfortable talking with him. (I say "him" because you said it was "he"). The next thing you know, you'll be looking forward to your sessions!

Lots of love,

Timber Wolf?

[Guest KerryUK]

Hi Autumn,

The advice given by my friends here already is good but it is biased towards those who live in the US. I see you are living in the UK and therefore on the NHS - a bit different to the US.

It's been a few years since I went through the process so I stand to be corrected. When I went through the process, you were referred by the GP for an initial assessment by the local Mental Health Service (a psychiatrist/psychologist) who assessed you for any underlying issues which could explain your 'feelings'. If he/she felt that you showed Gender Dysphoric 'symptoms', then they referred you back to your GP who was then requested to refer you to the Gender Identity Clinic. As I understand it, the GP now refers directly on to the GIC and that there is no longer the requirement for the local Mental Health involvement.

In my case, the local Mental Health psychiatric assessment was really very informal and he basically asked me questions about what I was feeling, how long I'd basically felt like I did and all sorts of other questions - all you can do is to be as truthful as you can (if you try to deceive anybody, the only person you will deceive is yourself). I was as nervous as hell but I tried to answer everything as best as I could.

If that part of the process has changed where you don't do that anymore and you go from the GP directly to the GIC, well, you will have already been having assessments with a Lead Professional. He or she is a specialist nurse in Gender issues and so you will have already got to know them over quite a time already. When they feel that the time is right, they then put you forward for an assessment by the Gender Clinic psychiatrist - this follows pretty much the same format. They ask you questions around how long you have felt the way you do and lots of other questions about your life and how you live it. They also ask you what you know about the surgery and what you expect from it - just be honest.

Then, once that is out of the way - if you wish to go for surgery, you will be referred to another psychiatrist who will assess you again (like a second opinion - to make sure the original assessments are correct).

I'm afraid that you didn't say whether you are already attending the GIC and so I couldn't be more specific. But, it's the NHS and you have to be patient - it's a bit of a long haul but whilst I realise that I'm on the 'other side', I'm still glad it took so long. There is a lot of adjusting to do and it isn't easy - I'm still coming to terms with how people interact with me and sometimes it can be hard.

I hope this helps Autumn.

Kerry

[Autumn]

Thank you Kerry this is really what I was looking for, someone who ahs experienced it through the NHS. Thank you everyone else too. I appreciate the guidance

This is an initial assessment that I'm going for, referred by my GP. I wasn't referred directly to a GIC. I don't mind that the process itself will take time. I'm going to need to adjust a lot of things in my life so a gradual transition over a few years would probably be good for me anyway. I am impatient about getting things started properly though. How long after the initial assessment could it take for me to see an endocrinologist? providing things go smoothly with the psychiatrist and I get a diagnosis that confirms my Gender Dysphoria?

[Guest KerryUK]

You're very welcome Autumn, I know how scary a time it is.

Well, you do need to be prepared for quite a wait though it does depend on where in the country you are.

Okay, your initial appointment is like I said - an assessment to find out whether you are Gender Dysphoric or whether there may be other causes for the symptoms. For me, it took about 8 months to be referred on to the GIC in Leeds after I'd revisited my GP. By this time, I'd already 'come out' to family. After I was accepted onto the GIC caseload, I agreed with my Lead Professional that I was going to change my name and title by Deed Poll. I made plans to 'come out' at work quite soon after. So, I think I started hormones about 7 months after first going on to the GIC caseload - this was quick. Every case is different Autumn and so this is why I am being quite vague, if you would like more information, please do ask but as is often said here YMMV (your mileage may vary).

Hope this helps

Kerry

[Guest]

It is apparent from my emails that those who do the best are those who saw a mental health professional. Being transgender is no longer considered a mental illness. Even so we always recommend that people see a gender therapist and a psychiatrist. Such a life changing permanent event as hormones and surgery need all the advice and support you can get. The biggest regrets we get are from people who did not see mental health professionals. Besides it will give you the confidence you need to transition if that is recommended. Remember that they are there to listen to you and it is confidential.

Good luck

Laura

[MarcieMarie12]

The one i do remember asking was if i "passed". When i look back on that i'm a bit embarrassed because it almost seems irrelevant but like many it seemed very important at that time.

Hugs,

Charlize

While discussing this with another girl, we're wired to be our own worst critic. I think it is an inherent female trait!!!! That said, I don't think I pass, but apparently to the rest of the world I do, even in the moning, sans make-up.

[Guest KerryUK]

I absolutely agree Marcie,

Even now (over a year post op and over 3 years on HRT) I still often see 'him'. I have to remind myself that I'm not him anymore. However, when I see old photos of myself before - it suddenly dawns on me that actually, I've changed a lot. This is why I believe that the transition period that we have to 'endure' here in the UK is actually good (I never thought I would say that). There is sooooo much adjustment that we (and those who know us) have to go through - it does really take time and is still ongoing for me, though not as difficult as at the beginning.

I've made quite a lot of friends over this past few years (more than I've ever had before) and they all see me as ME. They all treat me as I would want to be treated and that is as one of the girls. I really couldn't ask for anything more.

[Jani]

Kerry, Thank you for the words of wisdom. While I'm no where near as far along as you, I see that all the points you made beginning to make sense in my life. I see that I need this time and more importantly so do the people that are important to me.

Jani

[Guest KerryUK]

Hi Jani,

You're very welcome.

Just to add to what I said in my previous. I met up with my best friend for our monthly catch up. She's known me since before I started transition and been a huge support.

Well, she said to me yesterday that her boyfriend (who is a proper blokey bloke and who gets quite jealous if she associates with any other men) has no idea of my past. He sees me as one of her girlfriends and is never worried when we are meeting up - I'll add that we have met a few times too and had a few lengthy conversations. So, it just goes to show how our own perceptions of ourselves can be quite different from those of others. Even then, her remark surprised me.