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Hi all, 

    I am not sure how to approach my next adventure and need some ideas to think over before I finally start gender therapy. I found a therapist near me and I have a virtual meeting coming up in November. I am not sure how to start the conversation, unsure how I should be dressed, etc. I do have some specific things I want to address but I have no idea how this person will approach my situation. I'm just curious if anyone could share some thoughts on how they handled their fear. I do not know if it is my goal to convince this person to prescribe hormones but, the dysphoria diagnosis (controversial as it may currently be) seems like a very important part of getting the best overall care from all providers and insurers alike. I know I could just go to an endocrinologist and skip this part of the process but, that seems like a really bad idea to me. I know who I am and always have. It's just taken a long time to understand how to express this without feeling bad about myself. So many people have helped me with self acceptance over this last couple years. I'm just unsure how to voice this to a stranger in an hour. It feels like I have to prove myself feminine in order to feel acceptable yet, I also feel like I shouldn't have to prove myself to anyone to be who I say I am either. I want help with making a healthy plan for my life moving forward but I think the real outcome will help everyone else in my life more than it will help me. I wonder if anyone else sees that from their experiences?



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For my first visit to a gender therapist, I dressed nice, but nothing over the top. It was summer so I went with my black pants, a dressy tank top, my... ahem... butt-enhancers and I stuffed my top. I went in knowing that my goal was to get a gender dysphoria diagnosis so I could start on HRT. I'd talked about it advance when I made my appointment, stressing that I already had a therapist that was working on my everything else, she just didn't have the credentials to give me the dysphoria diagnosis.


I let her lead the conversation. She asked questions and I answered them to the best of my ability. There were tangents when I talked about the incidents and accidents that make up my childhood and what led me to realize that I needed to transition. It was pleasant and she offered to take me on as a regular client. I'd like to, but my car is very old and her office is a good twenty minutes from my house in good traffic. Honestly, I adore her, we would have been a good fit.


I may have cried a couple of times during the interview. All I was is myself. That was all I needed to be. I kept focusing on her shoes and her feet. I wish mine looked as nice as hers (I'm sensitive about my giant sasquatch feet). Crying aside, it was a very pleasant experience. It was a good cry. The kind that makes you feel lighter when it's done. When it was over, she said her office would have the papers signed and in the endocrinologist's hands by the end of the next day (State requirement before starting HRT, we don't have informed consent here).


I was definitely nervous going in. It turns out that she didn't think the state guidelines were fair to begin with as I was an adult and perfectly capable of making my own decisions. That was kind of funny, I was more supportive of the process than the gatekeeper. I still maintain that it's the duty of the profession to help people find the solution they need rather than the one they think they want. I realize that that's a big responsibility. Especially considering that transitioning likely saved my life. Making the wrong decision would be nerve-wracking.


Anyway, yeah, don't stress about it @Abi. All my visits with a gender therapist have been super positive and validating. They know what they're doing. Just work with them and answer honestly.



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@Jackie C.,

    Thank you for sharing this with me. I ended up having to choose a male gender therapist, which I am a bit apprehensive about. I have heard they are good and they are on a list of providers listed by one of my local lgbtq support sites. I want to give them the chance to help me but, I am always more comfortable talking to women about being a woman. It's just a greater sense of comfort for me. My visit will be virtual so I feel better about this right away honestly. I do not like leaving my house. When I go out all of my clothing is ladies but, not heavily feminine usually. I do not pass anyway I go. I kinda just do me and try to avoid the world between me and my destination. Headphones in and few words spoken as I dash to the finish line. I feel good about me being dressed the way I like but, I feel like less flare is best for the moment. 

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1 hour ago, Abi said:

I ended up having to choose a male gender therapist, which I am a bit apprehensive about. I have heard they are good and they are on a list of providers listed by one of my local lgbtq support sites. I want to give them the chance to help me but, I am always more comfortable talking to women about being a woman.


I feel the same way about my gynecologist. Still, he's good, in network and comfortable with trans patients. I still prefer female doctors, but what are you going to do? @ShawnaLeigh and @Patti Anne go to a trans-man and they're very happy with him, so there's that. At least you know he's solid if the local community supports him. Like I said, relax, be yourself and answer honestly. It'll be fine.



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@Abi If your therapist is good they will more than likely put you at ease very quickly especially if they pick up any cues that you’re nervous or apprehensive. They will draw you into a conversation just to get you started. A good therapist knows very well how to quickly read their clients. I’ve only had two for any length of time and they are good. Mine are both woman which is what I prefer but that should not be a huge factor once you get into doing some of the real work. By then you’ll likely know whether they are the right therapist for you.


Susan R🌷

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I didn't see an official therapist. (no insurance)  I did have conversations with people I trusted, and journaled a lot.  (NC is an informed consent state)  When I went to the first clinic I had someone with me for support - which I needed.  Not because I had doubts, but was flat out scared.

They asked me a lot of questions, and were satisfied with what I told them.


Later I got accepted into the VA system.  I was already on HRT although not what I needed (It was an age thing at the first clinic)  I told the primary care team the first day.  I wasn't trying to hide anything anyway.  They referred me to the psychologist.  As far as dressing, I was pretty neutral although I had nail polish and was carrying my bag.  She was nice and easy to talk to.  Just asked a few questions and let me talk.  And I sure did.  I told her stuff that I hadn't told anyone else.  Some things I had never heard anyone else ever talk about, but apparently are quite common with people like me.

Anyway, she had no problem giving me a referral to the endocrinologist.

1 hour ago, Abi said:

When I go out all of my clothing is ladies but, not heavily feminine usually. I do not pass anyway I go. I kinda just do me

This is kinda me too

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14 hours ago, Abi said:

I am not sure how to start the conversation


Hi Abi!  I had ALL the same questions and concerns going into my first therapy session about 3 months ago.

Here's how it went.  We met, sat down, she explained just some basic administrative things about our meetings, and then she said .. "OK, where would you like to start?"  that was a good question, where to start?

So, I just started from the very beginning, my childhood, early adulthood, 2 marriages, career, kids, and all the underlying experiences and feelings about ... EVERYTHING!  I did not hold back and it took almost 2 fulls sessions to get through my Life story.  She would occasionally ask a question, but she really just wanted me to TALK and not hold back or worry about it.

She REALLY appreciated that I was so open, because that allows her (the therapist) to do what they do, i.e., they are not there to make judgements, its not your job to "convince" them about your gender dysphoria, and they are definitely not there to tell you what to do, or try to "Fix" you.  They are there to help you through the process of self-discovery and self-acceptance.

I am very happy for you to be starting this journey.  I hope your experience with therapy is as Positive and Life Changing as mine.
Just be YOURSELF ... just tell YOUR STORY❣️

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I’d start with what your goal is and fill in the details based on what you’re asked. If not sure about the specific goals at least what you’re considering as options. 

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Hello, I have the same fears around meeting and discussing my MTF issues with male Doc’s. but so far, every Doc that I have come in contact with has been great. My Med Doc was the 1st male Doc’s that I told my story too. Although I was very nervous starting out, once I started talking it all came out. He was awesome. I have come to realize that if I am not completely honest with my medical team, how am I going to be authentic in my life. I have to remind myself that the Doc’s are there to help me be the healthiest me. It has gotten easier for me to talk to Doc’s as I belong to a teaching family medical center and see different Doc’s all the time. I hope it goes well. Take care.


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7 hours ago, KayC said:

I am very happy for you to be starting this journey.  I hope your experience with therapy is as Positive and Life Changing as mine.

This will be my first opportunity to talk to a gender therapist but I have been getting therapy from a domestic abuse center for about a year and a half. It was their kindness and the sense of safety, that I felt there, that convinced me to come out to them. They have been helping me get to this point for some time. The mission that the center has is not for this kind of thing but, they have still shown me the greatest of respect. They were encouraging me to take this step months ago. If this therapist is anything like that, I am certain to have a positive experience. 


Thanks Kay,


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5 hours ago, RhondaS said:

I’d start with what your goal is and fill in the details based on what you’re asked. If not sure about the specific goals at least what you’re considering as options. 

My goal is to have someone that can help guide me while I make as many physical changes as my body can allow. Other than that I really just want this person to be able to talk to me about transgender issues. My other therapist is not allowed to diagnose anything they are only allowed to be supportive and a place of safety. They have done a wonderful job helping me with so many fears and so here I am. Thanks

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2 hours ago, Jocelyn said:

Although I was very nervous starting out, once I started talking it all came out.

I think being nervous about this is normal. I prefer to talk to females about my feelings but, I know there are men that will do their best to understand what I am going through. I am certain that they will help me if they are able. It may take a while to explain my feelings to them. I just have not been sure where to start. From the sound of it, they will know how to nudge me if I am stuck. I have been searching for someone that the local community had acknowledged as LGBTQ friendly. I need a therapist that has experience with our community. I am not interested in educating my healthcare team. I am happy to explain certain personal things but, there is a point where they are learning everything as they go. I need more than that. I tried calling one office a while back that had been recommended by my insurance. The receptionist made me uncomfortable about their office when they kept calling me "Sir". I knew that they would not be a place of safety for me so, I kept looking. I often share more than is really needed. If it were not for having to here my awful voice I would be happy to talk a lot more. I can only imagine how liking my voice would feel. 


Thank you for sharing your experience with me,


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When I first went to a gender therapist, I didn't know what I really wanted.  I just knew I need something....just to know way I was the way I was maybe.  I didn't know if I wanted to transition or what.  I just needed to talk to some one about what was going on.  I saw her for a couple of months before I was able to accept the fact I was Trans, and then another month or so before I decided I wanted to go on HRT and transition.  She was a good gender therapist, and the primary focus of her practice was working with LGBTQ+ people, and that was what we focused on.  We never really focused any time on the other issues in my life, such as the fact I was going through a divorce, my major depression, substance abuse (I had been white knuckling sobriety for years at that point and ended up relapsing a few years later), and my self-harm and suicidal ideation.  As a result, at one point I severely cut my arm in a session, and sliced my wrist in her waiting room on another occasion.  I don't blame her for any of that.  I was not fully open about everything I was going through.  I did wind up transitioning with her help, but my other issues led to a series of hospitalizations, and I wound up in the VA system.


My doctor at the VA had no experience with Trans care, and in 2001 or so, the VA did not have much of a Trans care system.  I wound up de-transitioning and stopping all therapy and medications.


In 2016, I sought therapy again in the VA system.  This time I told my primary care doctor about my depression and that it had been a lot worse since being unemployed and I was ready to give up.  She got me into the mental health clinic, and this time I was fully honest about everything.  I didn't go there seeking HRT.  It was over a year before I mentioned that I was thinking about transitioning again.  A year later I began HRT, and a year and a half after that, I began living full time as the real me.


I guess what I am trying to say in a round about way is that your therapist (and your entire health care team) needs to know everything that is going on with you in order to help you make the decision that is right for you.  I didn't do that the first time around and it almost killed me.  For some people, it may be fine to go to a therapist and say "I want a diagnosis of Gender Dysphoria so I can get HRT", but I feel that the best approach is just go in to it being fully honest about everything.  If I had done that in the first place, I think my life would have been different.  The doctors are there to guide you in making the best decision, and they can only do that if they have all the information.

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Hello @MiraM,

    I have to admit reading this made me so sad. There are so many wonderful people that have done themselves harm over their feelings of loneliness and confusion. I feel all of that but, I can't exactly relate. I have never had a thought that I would harm myself. I think I had enough other people trying to take care of that for me over the years. I've had my fair share of violent people throughout my life. I just found out very young that many people are unable to accept other's for who they are. I told a couple people over the years that I felt kind of wrong in my skin but, they didn't get it or care. I just want to feel comfort in my body and I don't. I avoid the mirror like it's the plague. I try to limit speech to only the most important people in my life. I get upset that I can't wear what I want without feeling like someone will do something to hurt me. When I do get dressed and try going out, I inevitably end up looking in the mirror and even though I love the clothes, I just feel like so much is missing underneath. I stay away from people as much as possible. I like online friendships more than anything.

    I won't hold back on my feelings unless they start talking negatively to me but, I am not expecting that to be the case. I have heard this person is a good therapist. I just don't know how to approach them with some of my feelings. I'm really hoping they just help me find a good way to express myself and that I can finally be happy when I look in the mirror or have something to say out loud.


Thank you for sharing your experience, 


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Hi Abi, The very first counsellor I chose conducted online meetings, she was reasonably priced but was attached to a private trans clinic so I knew she would not judge what I said. I gave my male name, and "turned up" dressed male, even though they knew what the appointment was for. They did offer to use whatever name or pronouns I chose and obviously mentioned that everything would remain confidential unless I admitted anything that suggested was a danger to myself or others. It took several meetings but I asked her to call me Dee so I could see how the name felt out loud, and soon after I realised that really what she was doing was helping me to recognise that Dee was more than simply a form of every day escape and that I was looking for permission to explore further. My last session with her was also the first session I dressed as Dee, but I connected with the GIC as a direct result o those sessions, so far I have attended all those sessions as male me too, but I am scared and cautious by nature, and I think I am looking forward to being able to meet my current counsellor in person. For me the reason is my age - I am trying to understand how I got to 40 without having a crisis sooner, and because it came as my marriage ended I wanted to make sure I wasn't just distracting myself.  They will not tell you who you are, but will help you to answer your own questions. 💛

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Hi Abi, My first, current and only GT is awesome. It did take me a bit of time to work up the courage to book the appointment. Then came the pre-appointment anxiety where I was playing through all kinds of worst case scenarios in my head, it's what my brain does. When I went to the first appointment, I was still very much hiding in my male costume. I was nervous, for the first few minutes, until I actually said I was trans out loud. After that it got a lot easier. It was still difficult to talk and open for the first couple of sessions, but as we built a rapport and increased the level of trust, I was able to open up more and more. Now the hour flies by I talk so much. We deal with more than just my gender related issues, build all kinds of useful coping skills and allow me a confidential and impartial place to vent.


One thing to remember is that your privacy is paramount, the therapists can lose their ability to practice if they breach confidentiality, except in very specific circumstances (ex. imminent harm to yourself or others and by order of the courts), at least where I and my therapist reside. So everything you tell them will remain between the two of you, unless you authorize the sharing of any of your info. This was one of the things that got me over my initial fear of booking that first appointment.


I also went in treating that first appointment as a job interview, where she was applying to be my therapist. I asked her a bunch of questions about her, her practice and methods. Tried to feel out if there was any sort of connection. Thankfully we hit it off pretty well and I didn't need to continue the search. Remember, if you don't have that connection, you are not necessarily stuck with that person as your therapist. Shop around if necessary.


Good luck, I hope you find therapy as wonderful I have. Hugs!

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Hey Abi

.I really only  had a one great TG, but she move on to teach in different sate. The rest of my TG( aka assistant TG) come for the LA Transgender Center and they have not being very helpful, but that's all I can offered.

My dysphoria and still not in good shape, 

I had 6 TG with the LATG because the just leave, but the have help a little on being Lexi Full time.

Just be open with yr Tg and if she or he is any good you will feel it not right  away, but little by little.

Much Kindness

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7 hours ago, DeeDee said:

I am trying to understand how I got to 40 without having a crisis sooner, and because it came as my marriage ended I wanted to make sure I wasn't just distracting myself.  They will not tell you who you are, but will help you to answer your own questions. 

I had a similar experience, but I was in my 60's.  I think no longer having to live up to a certain role freed me enough to let me explore who I was outside of that relationship.  Then things began to fall in place.

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    I had about the same kind of experience. My ex was abusive and dealing with that took a lot out of me. I have been getting counseling for the abuse for about a year and a half. I already knew long before I met her that I was transgender. I just wasn't ready to acknowledge it or embrace it. I knew I would never be able to share that with her either. I don't know why I stayed in that relationship before we found out we were having our daughter but, I knew I wanted to be with my child once I did. I have said many times that I married the devil and my prayers for happiness were answered with two angels. I tried to be good to her but she never cared about my feelings. After so many years of giving my all and getting nothing back, I decided it was never going to get better. I always showed everyone my heart and expressed it as my true self. My ex was the type of person that would get angry at me for expressing my hurt feelings. Asking her to stop calling me names just made things worse. I hit rock bottom by the very end of the divorce. There really was no other way to go but up. I started really looking into transition as a real possibility rather than as an aggravating daydream. 

    I have been taking baby steps to see how things made me feel ever since. Each step has made me feel better by affirming my feelings. I have been socially transitioning for about a year. Now I wear all women's clothing except for a couple of t-shirts that are pretty gender neutral. I have come out to a few people in real life but, that hasn't been going the greatest so I have been reluctant to tell more people. It's all about taking steps when you're comfortable in my opinion.

    I am glad you are working through your feelings. It isn't easy to do alone. I know that very well. I'm here to talk to, if you ever just want to vent.


Thank you for sharing so much.


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Hello @SaraAW,

    I think my only anxiety over meeting this therapist is that I do not want to be told I am wrong for my feelings. I fear people will try to convince me this is because of something else that happened over the years. I do not want to have to validate myself to them. I want to know this person has some experience with helping transgender people become happier and healthier by learning to live as their true selves. There is a lot to navigate through, especially since I have children to worry for. They will always come first.

    Since I have been seeing a therapist for abuse for over a year, I have learned to just be up front and I know they will not betray the trust I have placed in them. I like the idea of treating the first few moments as a sort of interview. I will make sure I have some of my questions answered before we go too far. I am very patient and thankful for the time anyone gives me. I have not had a lot of that until recently. 


Thank you so much,


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Hey @Lexi C,

    I am sad that your treatment has been with so many different people. It must be difficult to have to keep repeating the same things to each new one. You might be able to make the case that this is causing you more harm than good. Dysphoria is not easy. Mirrors bother me a lot. I don't see enough of who I wish to see even dressed up. It gets better I hope. I know it takes time to do all of this and that having a stable source of support is important. At least we all have each other here and can try to be happier together. Helping each other feel good when things get tough. You can talk to me any time you need. 


Keep working at it and you'll get there, 


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Hi @Susan R

    When you were beginning therapy, and they drew you into the conversation starter, did you feel like they had a real plan for how to help you moving forward? Did they know what things you needed to focus on first? I have a lot of concern about my safety and seeing my children. I am terrified they will be taken away from me. Nothing could give me comfort if that were to happen. I spoke to my divorce attorney and there have been a lot of positive answers but the fear is ever present. I am also alone and concern for safety has been very worrying. My ex and her family are the types of people that will trash talk people publicly and may even go beyond that. Fear is very real for me even if they do not end up attacking me. It's paralyzing at times and what kept me in an abusive marriage for so long as it is.


Thanks for any advice you may have,


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On 10/3/2020 at 1:21 PM, Jandi said:

 Some things I had never heard anyone else ever talk about, but apparently are quite common with people like me.

I do not mean to pry if you are not comfortable with it but, can I ask what kinds of things you mean by this? I really appreciate any insight on this even if it may not be exactly like my experiences.


Thank you for any thoughts you can offer me,


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3 hours ago, Abi said:

I ask what kinds of things you mean by this?

Well, for example, fantasizing about being penetrated as a woman.   And then the idea that my genitals were "inside out".  And there was an experience I had with a guy that's kinda complicated, but - kinda long story.

I would have been embarrassed to tell anyone this stuff.  But I trusted her.  And it seemed to help explain how I felt about things.  I was surprised when she told me she had heard this stuff before.  She was very understanding.

She referred me to the endocrinologist.

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    I don't know if that is extremely common but, I can relate very well to that. I stopped willingly giving as a male about 6 years ago. I consider myself to be celibate and refuse offers to date because of this very issue. My intention is to never date again. I have my freedom and aim to keep it. Thank you for sharing something so personal.

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      Thank you!
    • Jackie C.
      While I'm not an expert (Hey, I went the other way), I can say that it takes a LOT of weight training to build big muscles on E. You'd want to focus on your upper body (Arms, chest, shoulders) and core work (Waist, obliques). Fun fact: If you do your obliques (those are the muscles on either side of your waist) with a weight, the muscle swells and you'll have a more boyish appearance. The thing is, that if your body is only producing female levels of T, it's going to take a pretty major lifestyle change. I spend two hours in the gym every morning and I pass pretty easily as female. If you want to build muscle mass, it's gonna be work.   Otherwise, you seem pretty on-point. Binder. Short hair, etc... I'm sure some of our other FtMs can chime in with better advice, but Welcome to Transpulse! We're glad you're here!   Hugs!
    • Jandi
      @Red_Lauren.Sounds like things are going well for you.
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