Should I come out to my therapist?

[grubsky]

Hi, this is my first post, so hopefully I didn’t screw up somehow. I’m bisexual, AMAB, and right now I am struggling with gender questioning and feeling nonbinary (specifically genderqueer or bi-gender.) I already have a therapist who is a grad student, who I really like and enjoy talking to, but I have presented to him as a cis male from the beginning of our correspondence. I am currently working with him to battle my anxiety and depression symptoms and working with his office to get a formal diagnosis. I don’t know if he has experience in gender therapy, but I feel a need to get help from someone who can help me address my gender identity. The obstacle is that I’m really scared and I don’t know what to say, especially since he already knows me as male, and my gender identity is a bit more complex than just transfeminine (not to undercut the struggles of all of you trans femmes out there, love you!) Anyway, do you think I need to look for a separate gender therapist who can help me? Should I focus on getting my anxiety and depression sorted before I tackle my gender? (Keep in mind I may want to pursue gender affirming medical transition.) Should I just bite the bullet and tell him in an email if I’m too scared to do it in person? I feel terrified, and any response would be appreciated. Thanks.

[Carolyn Marie]

Hello, Grubsky, and welcome to Trans Pulse.  My apologies for taking so long to approve your post.  I guess we're a bit short handed tonight in staff.

 

There is no one right answer to your questions, hon.  IMHO, a gender specialist is often preferable to a general therapist, if only because they would prob have connections to other resources in the community that trans folk need to follow their path, such as trans friendly doctors, hair removal techs, local clinics and such.  But as long as a regular therapist seeks out the appropriate information or knows how to find resources, they can do fine.  That's especially true if you are already comfortable with them.  It's pretty much up to you.  Starting over can be time consuming and intimidating.

 

I would be guided by your therapist as to what issues to tackle first.  None of us know you and none of us are therapists, so I'm not qualified to say what is more important, only that they are all important in one way or another.  Boy, what a wishy washy answer that was.   

 

As far as whether and how to tell your current therapist, please don't worry about it.  The honest truth is always your best bet, and the sooner the better.  They would probably prefer an e-mail to not telling them anything, but if you can muster the courage, I think you'd be better off telling them in person.  Having a dialogue works much better that way.

 

You're welcome to provide an intro in the Intro Forum.  Short or long it doesn't matter.  Take care and good luck.

 

HUGS

 

Carolyn Marie

[Susan R]

6 hours ago, grubsky said:

Anyway, do you think I need to look for a separate gender therapist who can help me?

Welcome @grubsky, it’s a pleasure to meet you. As @Carolyn Mariestated...it’s always better to have someone with the specialty that fits with your needs. It’s possible that your current therapist has some of the qualifications you require. Unfortunately, you won’t find out unless you ask them. Everything you discuss with them is confidential and based on the fact that you like working with this therapist, I very much doubt they would ever pass judgment on you for issues you’re looking to resolve. Even if they themselves don’t feel qualified to assist you, they very likely can refer you to someone that can. If it was me, I’d be up front and tell them what you’re really thinking and feeling. Without full disclosure about information that may or may not be causing your “anxiety and depression symptoms”, they are working with you blind. I find the more truthful I am in therapy, the more I gain from the experience, time and effort.

 

7 hours ago, grubsky said:

Should I focus on getting my anxiety and depression sorted before I tackle my gender? (Keep in mind I may want to pursue gender affirming medical transition.)

IMHO, they are more than likely correlated. From my own dealings with anxiety and depression these last few years, I can say with some degree of certainty that it has at least some effect and could be a major cause of these symptoms. If your therapist knew about your transgender issues, they just might agree.

 

7 hours ago, grubsky said:

Should I just bite the bullet and tell him in an email if I’m too scared to do it in person?

There is nothing wrong with doing it any way you feel comfortable. The priority is to let them know the full truth and scope of your life story so they can better help you help yourself. The way you tell them is likely much less important than what you tell them. So dig deep and be a honest as possible...you will thank yourself later.

 

7 hours ago, grubsky said:

I feel terrified, and any response would be appreciated.

I understand your feelings of terror. I was there once myself. Your therapist is not going to think less of you. By the time they get to where they are, they’ve already heard it all for the most part. Very little you say or write to them is going to ‘blow them away’. They themselves have secrets or things they choose not to disclose as everyone does. It’s commonplace to think they’ll think less of you after full disclosure...the opposite is more likely the case. You will feel a freedom is sharing this with someone who cares.

 

Thanks for reaching out today!

Warmest Regards,

Susan R?

 

[MiraM]

I agree with Carolyn and Susan.  Your therapist can't be of the most help unless they know what you are struggling with.  They may or may not have direct experience in dealing with gender identity topics, but they should be able to direct you to someone with the experience if they are not able to help you.  I was seeing a psychiatrist at the VA hospital for depression, and a host of other issues.  I had been seen by a doctor there years ago for gender issues, so this doctor already knew about them.  When I told her I was thinking about transitioning again (long story), she said she had no experience with trans issues, but still helped me explore my feelings around it, and said she would not be comfortable giving me a referral to endocrinology for HRT since this was not her area of expertise.  She had me talk with my primary care doctor for a referral, and also got me schedule for an appointment with the psychologist at the hospital who is the lead for the trans care team.  I still see the psychiatrist for managing my anti-depressants, and everything else is handled by the psychologist.  My point is, once I was told her about everything I was struggling with, she had the information needed to get me the care I needed, even if it was from another doctor.  You current therapist needs all the information in order to get you the care you need and deserve.  How you tell them is up to you, as long as you DO tell them.

[KathyLauren]

Hi, Grubsky.

 

I agree with the advice above.  It is best to tell your therapist as soon as possible.  Gender struggles are often a cause of depression, so it would be useful for your therapist to know about yours, in case there is a connection there.  And he may have connections and could recommend a therapist who specializes in gender issues.

 

Regards,

Kathy

[grubsky]

Thank you all for the advice. I think I'm going to commit to working up the courage to tell him.

[Jani]

You note your therapist only knows you as male.  I would suggest he sees you as a person in need of help.  As Susan notes your anxiety and depression are probably linked to your gender issues.  I know it was for me.  He will only be able to treat what he knows so open up and you will able to address the complete you when you meet.

 

Jani