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How do I start transition?


Mitgefühl

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I can't take this anymore, I can't take just laying around and doing nothing while living as male anymore. I just turned 18, I'm in complete control of everything now. How do I transition? How do I even start? I am getting everything in West Virginia since that's where I get both of my parent's insurance coverage. When I told my doctor I was trans a year ago he sort of just ignored it and focused on the fact I had depression, gave me medication, and told me to go to a psychiatrist. The medication I was on was giving me severe headaches so I quit cold turkey after 4 weeks and the headaches disappeared. Less than a year ago I went to a psychiatrist and I told her how I have depression, anxiety, and gender dysphoria and that I think gender dysphoria is the biggest problem of all. She seemed to focus mostly on the fact I have depression and anxiety. She offered me to go to a therapist and or take medication. At first I declined to take the medication but three weeks back I went met with my psychiatrist again asked to begin taking it. Now I'm on depression/anxiety medication, this one isn't giving me any problems so far. I've been going to a therapist for a while now and I've told her how I feel that deep below all my depression and anxiety my biggest problem is my gender dysphoria and nothing really seems to be becoming of this and no one has given me any real direction on where to go with this. So how do I transition now?

Thank you.

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  • Forum Moderator

If you are going to a therapist is it a gender therapist? If not i'd change and start to deal with your gender issues. pity that you've been open to others and they haven't helped.

I would also find an LGBT center near you and go to some meetings.

Reading and posting here are also good steps.

Most of all try to remember that this is a process. Try to enjoy each day as it comes. I know there were many when i was desperate for change but over time i grew to understand that as slow as it seemed each day i was changing. Looking back i am amazed.

Hugs,

Charlize

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If you are going to a therapist is it a gender therapist? If not i'd change and start to deal with your gender issues. pity that you've been open to others and they haven't helped.

I would also find an LGBT center near you and go to some meetings.

Reading and posting here are also good steps.

Most of all try to remember that this is a process. Try to enjoy each day as it comes. I know there were many when i was desperate for change but over time i grew to understand that as slow as it seemed each day i was changing. Looking back i am amazed.

Hugs,

Charlize

I do not think they're a gender therapist. The psychiatrist said they were the most qualified to deal with gender dysphoria in the region. Also, I don't know of any LGBT centres around here. I'm currently residing in Charleston, West Virginia for the next few months and I don't think there are any within an hour drive and I do not currently have my own vehicle nor a license and my parents aren't going to drive me that long of a distance.

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Guest Clair Dufour

Not a great place and when they just offer drugs for depression, you have to wonder. However, there are people right there in town who do. Often doctors who understand TG issues in such places are underground even to other doctors. That is true even here in Colorado. As this website points out, your not alone there. Contact them. http://fairnesswv.org/advancing-transgender-rights/

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Also, there are many gender therapists across the country that can meet with you via Skype. The lady that I am seeing is about as far away in this country as you can get, but she specializes in gender identity issues. She has been a huge relief for me, and I've only had 1 session with her so far.

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Guest Alicia Rose

I can't take this anymore, I can't take just laying around and doing nothing while living as male anymore. I just turned 18, I'm in complete control of everything now. How do I transition? How do I even start? I am getting everything in West Virginia since that's where I get both of my parent's insurance coverage. When I told my doctor I was trans a year ago he sort of just ignored it and focused on the fact I had depression, gave me medication, and told me to go to a psychiatrist. The medication I was on was giving me severe headaches so I quit cold turkey after 4 weeks and the headaches disappeared. Less than a year ago I went to a psychiatrist and I told her how I have depression, anxiety, and gender dysphoria and that I think gender dysphoria is the biggest problem of all. She seemed to focus mostly on the fact I have depression and anxiety. She offered me to go to a therapist and or take medication. At first I declined to take the medication but three weeks back I went met with my psychiatrist again asked to begin taking it. Now I'm on depression/anxiety medication, this one isn't giving me any problems so far. I've been going to a therapist for a while now and I've told her how I feel that deep below all my depression and anxiety my biggest problem is my gender dysphoria and nothing really seems to be becoming of this and no one has given me any real direction on where to go with this. So how do I transition now?

Thank you.

Perhaps finding a good gender therapist could help give you some relief and ease your depression. It has for me, and I've been dealing with my depression for many years for various reasons. Discovering my Gender Dysphoria issues, made me really understand the cause of my depression for myself, personally. I've never taken medications for that before and probably won't have to, my therapist is hoping.

So my advice, and it's exactly what I've done, is try looking for a Gender Therapist. Even if there are not any close enough for you to visit, there are some available via eTherapy - which is all done online using something like Skype webcams. I've been seeing an awesome therapist online since April, and she follows the WPATH guidelines and knows what she's talking about. You want to ensure that the therapist you find goes by the WPATH standards and can write Letters for HRT, not all of them do and if your plan is to transition with HRT, that's a must. Also, let them know where you live (certain therapist can only help in few places) and ask if your insurance is covered. They can find out for you.

That's likely the best Step A option. If you need help, you can also PM me here if you're interested in which Therapist I see personally. I know it can be tricky finding one.

If you can do that, the next steps will come in time, and your therapist will help you figure those out. For me, it was to find Trans Allies aka Coming Out to friends I felt would be accepting. Which I did. Another big step was to come out to my family, again I did with help from my therapist. She wrote me a letter for HRT, so things are falling in place for me.

Hopefully that helps ease some of your worries.

I'd like to also share this: Although my best friend and family knows that I'm Transgender, I'm not living full time. Although I'll be starting HRT in September, I know that to fully transition still depends on me. I could begin today, tomorrow, whenever. The main thing to keep in mind is your safety. If you're wanting to live an authentic life right now, that's up to you. You may not be ready.. Do you have a good job? Do you have supportive friends? Once you can safely transition without the fear of getting hurt or rejected and losing everything, it's best to plan ahead and take your time. Waiting.. the one thing I hate.

You're on a good path of transitioning already. Keep going. :)

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Guest Alicia Rose

Another tip: You could always look into Uber or some other taxi service that could be available in your area. They don't cost too much from what I've seen and can quickly get you around. If you have a smart phone, I'd suggest looking into that as another option aside from online therapy. In Sept. I plan on using the Uber service to visit the hospital for my HRT stuff. I don't drive either.

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Okay, yesterday I contacted Fairness as Clair suggested and was greeted by a man named Andrew who told me he would be contacting a nurse practitioner in Bluefield who would be able to give me more information. He told me to e-mail him my contact information, which I did. I've been waiting for a response for a day now, hopefully everything is going to plan and I can find a gender therapist in either the Huntington or Charleston areas.

Both of my insurance plans cover HRT and after 12 months of "Documented Real Life Experience in the opposite gender role" I will be able to get SRS if I wish. However voice therapy and FFS are NOT covered which strikes me as bizarre since those two are much more important to the safety of trans women than SRS will ever be. Hopefully these policies will be improved upon at a later date.

If worst comes to worst I might consider finding an online therapist. I'm not sure if I'll actually be able to begin transition until I'm 19, but I would like to at least have some sort of actually helpful therapy from a person qualified to handle me. I won't be graduated until 2017 when I'm nearly 19 and school would get in the way of working a job and I don't have a license yet anyway. I doubt my parents are going to pay for me to "Look like a woman." They aren't exactly the most supportive.

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  • Forum Moderator

It sounds like your off to a good start. I remember that once i made a decision it was difficult to think of much else. The whole process seemed to move so slowly and i wanted it over and done with. Perhaps that was a gift. The slow pace allowed me to develop as well as find a peace within myself. Transition isn't easy as your already finding. We simply have to learn to be patient and slowly make our progress step by step. Just getting to a therapist will be a great step forward towards making dreams a reality.

Let us know how it goes. Your not alone in this frustrating but beautiful journey towards finding your true self.

Hugs,

Charlize

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  • 4 weeks later...

There are no local gender therapists in my region to my knowledge and Fairness never contacted me back. Tomorrow morning I'm going to ask my psychiatrist to refer me to a local one that lives in Kentucky state. Hopefully if she refers me then my insurance will cover it, otherwise it costs $40 per session which i suppose is a better price than some people have been lucky enough to get though.

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  • 1 month later...

I went to the Kentucky therapist today at a center for change. Without insurance my appointments will cost $125. She wants me to go once a week for 5 years, after the first 4 months she wants me to begin dressing as a woman, after doing that for 2 months at month 6 she will allow me to begin HRT, at 18 months I can get bottom surgery, and then I must continue to go to her until my 5 years is up. I had friends up north and out west who were able to begin HRT without this entire mess, I told her this and she told me I "better find another therapist then" but there are no other gender therapists within a 2 hour drive that I am aware of. I wish she would at least let me begin HRT before dressing as a woman, I was hoping to not start dressing and identifying in public until I had some time in HRT to have some fat redistribution to make myself more believable. I don't exactly feel that I live in the safest area to be easily identified as trans. But, well. That's assuming I even get the money problem figured out, first I still have to wait for my insurance to get it figured out. I'm unsure what she wants me to do if I move away before the 5 years is up.

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  • Admin

Six months before getting an HRT referral is on the longish side, for sure, but not completely unreasonable, IMO.  Therapists do have their individual philosophies.  But the Standards of Care Version 7 does not contain a specific requirement, or even a specific recommendation, for the length of therapy prior to recommending HRT.  It may be worthwhile to ask (not demand) for an explanation of her reasons for such a long therapy regimen.

She cannot demand or force you to commit to five years of therapy.  If that is her condition for approving HRT or surgery, then there is something very strange about that.  I've never heard of such a requirement.  Does she want you to sign a frigging contract? 

It is possible to find endocrinologists who work with trans patients who will start HRT on an "informed consent" basis, but I have no idea how common that is in your area.  I wish you luck.

Carolyn Marie

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1 minute ago, Carolyn Marie said:

Six months before getting an HRT referral is on the longish side, for sure, but not completely unreasonable, IMO.  Therapists do have their individual philosophies.  But the Standards of Care Version 7 does not contain a specific requirement, or even a specific recommendation, for the length of therapy prior to recommending HRT.  It may be worthwhile to ask (not demand) for an explanation of her reasons for such a long therapy regimen.

She cannot demand or force you to commit to five years of therapy.  If that is her condition for approving HRT or surgery, then there is something very strange about that.  I've never heard of such a requirement.  Does she want you to sign a frigging contract? 

It is possible to find endocrinologists who work with trans patients who will start HRT on an "informed consent" basis, but I have no idea how common that is in your area.  I wish you luck.

Carolyn Marie

I'm not sure if I can afford 6 months of weekly therapy. She told me that the shortest she's ever waited before letting someone begin HRT was 16 weeks because they truly convinced her that they were ready. She also said that she's one of the most acclaimed Gender Therapists in The United States.|

No contracts have been spoken of thus far.

I have no idea where you would find one of them.


This whole thing has me feeling really depressed, I was feeling pretty okay until this all happened. I had always been told that gender therapists were supposed to let you guide the wheel, make decisions, help you make the best decisions for yourself, and better understand yourself. She said "I'm not here to judge whether you're a woman or not, I'm just here to check out the boxes to make sure you're ready."

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  • Admin

You say you live in Ohio, but are going to Kentucky for therapy??  There are therapists in Ohio who are members of WPATH ( I have met them at conferences) and follow those guidelines. The Cleveland area has several since my friends go to them.  I am not sure what this person can do if you get bottom surgery at say even two years which is what some surgeons are running right now, and then no longer pay her a weekly visit at the $125 rate.  Smells fishy to me and smells like she said GO SOMEWHERE ELSE.  I hope she gave you a written piece of paper on this so you can ask other therapists what their differences are.   You do not give the name, but I have my reasons to doubt she has the good reputation she claims.  Hopefully the two or three members here that live in Kentucky and the ones from Ohio chime in here too. 

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50 minutes ago, VickySGV said:

You say you live in Ohio, but are going to Kentucky for therapy??  There are therapists in Ohio who are members of WPATH ( I have met them at conferences) and follow those guidelines. The Cleveland area has several since my friends go to them.  I am not sure what this person can do if you get bottom surgery at say even two years which is what some surgeons are running right now, and then no longer pay her a weekly visit at the $125 rate.  Smells fishy to me and smells like she said GO SOMEWHERE ELSE.  I hope she gave you a written piece of paper on this so you can ask other therapists what their differences are.   You do not give the name, but I have my reasons to doubt she has the good reputation she claims.  Hopefully the two or three members here that live in Kentucky and the ones from Ohio chime in here too. 

I live in the most Southern Point of Ohio, just across from Huntington West Virginia and a 10 minute drive from Ashland Kentucky. I don't know of any other Gender Therapist's around here, and is the WPATH outdated? The nearest therapist my my Psychiatrist in Huntington knew of lived on the far other side of the state about 2 hours away. I wish my psychiatrist could be my therapist, I trust her and feel completely comfortable when I talk to her but she probably gets paid more as a Psychiatrist and she's not trained to handle trans people. Anyway, the therapist's name is name is Tonya Bond-Judd of A Center 4 Change in Ashland, Kentucky. If you can find any other gender therapist's around the South Point, Ohio or Charleston, West Virginia areas then please do tell me!

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  • Admin

WPATH Standards Of Care Version 7 is still the gold standard for Gender Dysphoria care.  I was at the WPATH convention where it was ratified by the membership at the convention. A new version is in the works, but it may be a couple more years before it is ready. Professional Members of WPATH do receive regular updates to V 7 in the form of  ongoing research paper references.

I do not personally know any therapists in the specific areas you mention, since I am firmly in Southern California.  This link is to our Therapist Listing page and there are folks mentioned in Ohio, West Virginia and Kentucky, including Judd, so possibly she has helped other people.

  http://www.lauras-playground.com/gender-therapists

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20 hours ago, VickySGV said:

WPATH Standards Of Care Version 7 is still the gold standard for Gender Dysphoria care.  I was at the WPATH convention where it was ratified by the membership at the convention. A new version is in the works, but it may be a couple more years before it is ready. Professional Members of WPATH do receive regular updates to V 7 in the form of  ongoing research paper references.

I do not personally know any therapists in the specific areas you mention, since I am firmly in Southern California.  This link is to our Therapist Listing page and there are folks mentioned in Ohio, West Virginia and Kentucky, including Judd, so possibly she has helped other people.

  http://www.lauras-playground.com/gender-therapists

The nearest one in Ohio is all the way on the other side of the state in Cincinnati bordering Illinois, the one in West Virginia is way up north on the border of Pennsylvania in Morgantown, and then finally the nearest one in Kentucky that isn't Bond-Judd is in Lexington! Those are all absurd distances. And I heard that WPATH usually leads to gatekeeper behavior and thus many therapist's in more progressive regions abandoned it.

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  • Admin
1 hour ago, Mitgefühl said:

The nearest one in Ohio is all the way on the other side of the state in Cincinnati bordering Illinois, the one in West Virginia is way up north on the border of Pennsylvania in Morgantown, and then finally the nearest one in Kentucky that isn't Bond-Judd is in Lexington! Those are all absurd distances. And I heard that WPATH usually leads to gatekeeper behavior and thus many therapist's in more progressive regions abandoned it.

It does indeed seem like you are in a very bad place to live if you need to transition, and I am sorry the site's resources are inadequate for you, but life does not always hand us easy living. 

I do not know what you mean by "progressive regions abandoning the WPATH SOC7" since I know that the major Trans* health care providers here in the U.S. are members and supporters. The major U.S and Canadian and even Thai GCS surgeons are members in good standing. Their most recent convention a year ago was in Thailand.  I am a non professional member of it BTW.  I do believe you have been getting some bad information that may severely limit your ability to move forward with transition if you are intent on doing so. I wish you well on your journey however.

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  • 1 month later...

I tried going to a regular therapist who has LGBT training. They want $190 per visit with weekly visits. I can't afford any of this.

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