Upcoming Therapy Anxiety

[Alice K]

I've been seeing a regular therapist for... about 2 years now, and I have an appointment to see him in 10 days. I like him, I think we have a good relationship and all. But I've never mentioned anything, even the slightest inkling, of any sort of trans thoughts or "weird fantasies" that may have flitted though my head. But for various reasons, I haven't seen him in about 5 months now (not by choice, just circumstance) and these past 5 months my feelings about being trans have really come to the fore and hit me hard and won't stop. So I feel like I need to talk to him about it.

 

At the same time, well, I'm not out. Certainly not to him, of course, but not really to anybody. One person, actually, and she's mostly an online confidant. So obviously, I'm terrified of that. There's also that he's not a gender therapist. I don't know really anything about his experience with trans issues, or training, or anything. I assume that he will at some point refer me to someone else, but there's definite worry. And then there's just the repercussions from actually saying anything. He's part of my HMO system, and they all use the same EMR system, so anything in his notes will be readable by anyone else in psychiatry--I know for a fact my regular psychiatrist reads his notes, and if I need to switch therapists then -they'll- have access to that bit of notes. And I know that's only a useful concern if I want to pack my trans self away into a tiny box labelled Do Not Open Ever, but part of me is absolutely terrified right now and really wants exactly that. But that trans part of me is already out of that box and she's not going back in without a fight. So then there's the least of my worries, which is that the relationship will be ruined and I'll have to find a new therapist. It would be hard to drop 2 years of trust building, but I will.

 

And part of me is hopeful that he'll be of course supportive, and even if he doens't know gender specific therapy he knows me well enough to offer good guidance. I need some good guidance. I'm waiting until after I get someone to help sort me out a bit to come out to my mom, which is it's own whole big bundle of impending anxiety. But I can't move forward until I do that, and I can't do that until I see a therapist.

 

So the next 10 days is going to be excruciating, from an anxiety perspective.

 

~Alice

[Jackie C.]

5 hours ago, Aliskirin said:

I've been seeing a regular therapist for... about 2 years now, and I have an appointment to see him in 10 days. I like him, I think we have a good relationship and all. But I've never mentioned anything, even the slightest inkling, of any sort of trans thoughts or "weird fantasies" that may have flitted though my head. But for various reasons, I haven't seen him in about 5 months now (not by choice, just circumstance) and these past 5 months my feelings about being trans have really come to the fore and hit me hard and won't stop. So I feel like I need to talk to him about it.

 

Not weird. Being trans is perfectly natural and it's normal to fantasize about fixing things so you feel right in your own skin. No judging here. Not even if there's tentacles with clown faces on them.

 

5 hours ago, Aliskirin said:

At the same time, well, I'm not out. Certainly not to him, of course, but not really to anybody. One person, actually, and she's mostly an online confidant. So obviously, I'm terrified of that. There's also that he's not a gender therapist. I don't know really anything about his experience with trans issues, or training, or anything. I assume that he will at some point refer me to someone else, but there's definite worry. And then there's just the repercussions from actually saying anything. He's part of my HMO system, and they all use the same EMR system, so anything in his notes will be readable by anyone else in psychiatry--I know for a fact my regular psychiatrist reads his notes, and if I need to switch therapists then -they'll- have access to that bit of notes. And I know that's only a useful concern if I want to pack my trans self away into a tiny box labelled Do Not Open Ever, but part of me is absolutely terrified right now and really wants exactly that. But that trans part of me is already out of that box and she's not going back in without a fight. So then there's the least of my worries, which is that the relationship will be ruined and I'll have to find a new therapist. It would be hard to drop 2 years of trust building, but I will.

 

Maybe he will, maybe he won't. My therapist isn't specifically a gender therapist either, but she's an ally. I've seen gender therapists outside her practice though. They're good people. That's pretty much my experience with therapists (and psychiatrists) in general: They're good people. They're trained to accept you for who you are, identify your issues and help you live your best life. Your odds are pretty good that your therapist isn't transphobic and he'll be happy to set you up with a gender therapist if he thinks you need more specialized care.

While your mental health professionals can share notes in system, they're still bound not to talk to anyone outside the system about your issues. That's part of the process. You can tell your therapist absolutely anything and it won't leave the room.

 

It can be hard to come out to anyone. Especially the first couple. Your therapist is a good choice. His whole job involves listening to you and taking you seriously without judgement. My therapist was the easy one, I sought her out specifically to help me navigate my trans issues. It's since blossomed into helping me deal with my other issues as well. I'm very nearly a person now. ?

 

After the first couple it gets easier. My wife was the hardest, followed by my parents. My friends were a total non-event. Now there's nothing to it. I'm out to basically everyone I've seen in the last two years. There are two sets of aunts and uncles who may or may not know, but I haven't seen either of them in something like ten years. I don't feel much like hunting them down to tell them that I'm trans.

 

In any case, I know it's scary but coming out is part of the trans experience. The good news is that you can come out at your own pace to the people you want to come out to. After you socially transition, new people just know you as ... well, whatever name you pick for yourself. So yeah, move at a pace you're comfortable with but remember to move. Life isn't just going to hand you a solution. You have to do your part too.

 

Hugs!

[Charlize]

I planed to take my secret to the grave.  I found a need for honesty while getting past my addiction. Over time i realized that my gender issues would not go away.  I have found freedom from honesty.  The fear that had gripped me is not part of my life today and i will go to my grave as myself.  We all have our own journeys but for me honesty and openness has helped me find peace in my life.

If one has an issue that needs to be discussed, hiding it only hurts oneself.  When i finally went to therapy i went with the knowledge that letting go and opening would help me.  I am grateful i took that path.

 

Hugs,

 

Charlize

 

[Carolyn Marie]

Alice, I think Jackie really nailed the response.  I agree with everything she said.  Therapists and psychiatrists are there to help you, not judge you.  An ethical therapist will refer you if they don't feel they are qualified to adequately help.  If the HMO doesn't have a GT, hopefully its rules will allow an outside specialty referral.  In CA more and more HMO's are getting into the trans health game.  Many GTs with private practices, knowing the difficulty faced by many in our community, offer reduced costs if you can show a need.

 

So many of us here feel their sanity, if not their lives, were saved by their therapist.  You have nothing to worry about and much to gain.

 

Carolyn Marie

[TommieAnne]

If it's any consolation, I came out to my general therapist in an off hand remark. He said whoa let's back up, could you clarify. So I did.

That in itself was a huge relief and step forward. From there I was referred on to a gender therapist - still working on things, but I'm trying to get past a lifetime of defense mechanisms and the feeling that I have to have a label for who and what I am. Even things tentacles have a category, but I'm outside the fence on everything.

The therapist is there to help. Coming out, while it may end up on your charts buried in there someplace, my identity has never been mentioned by any of my doctors unless it was relevant to a treatment or condition they were looking at.

I doubt most have the time to drill down that deep into charts.

[Jani]

As others have written, don't worry about your therapist being judgmental.  They are there to listen and offer advise and guidance.  You actually have to take steps to change your life, your direction.  Your medical data is private and isn't shared with insurance companies.  They do see diagnostic codes but nothing beyond that.  My therapist used a code for general anxiety and my endocrinologist uses one for hormone disorder.  Both are fairly common I'm sure.  

 

At your upcoming appointment, since time is limited just say you've been thinking a lot and want to discuss something that it important.  Then just tell him you are transgender and need to work on your dysphoria and how to speak to others.  Other posts of discussion will come along for later talks.  Being in a calmer state of mind will help this quite a bit, although it can be nerve wracking.  Just remember to be honest with your therapist and you'll be all right.  

 

Hugs, Jani 

[Alice K]

Hi everyone!

 

Just wanted to update, I saw my therapist and he was amazing about my coming out and identity concerns. He was supportive, he asked a lot of great (non-judgey) questions, and it was just generally a wonderful experience. He ended by calling a gender therapist he knows who he says is great, and he's going to get me an intake appointment set up. So I am sooo thrilled right now.

 

Hugs,

Alice

[Jackie C.]

Great news Alice! Congratulations and thanks for sharing!

 

Hugs!

[Jani]

Cool!

 

[TommieAnne]

That is such great news!

Congratulations!

TA