Jump to content
  • Welcome to the TransPulse Forums!

    We offer a safe, inclusive community for transgender and gender non-conforming folks, as well as their loved ones, to find support and information.  Join today!

Therapist cancelled, devastated

Deanna Celia M

Recommended Posts

Was so excited about starting with a great therapist tomorrow. Cost would be $0 out of pocket since it was telemedicine so my spouse was pleased (didn't actually know what it was for though...)

They called this morning. Apparently since I live in PA and they are in NJ, the client confidentiality is not secure or something? The admin. person at the clinic said it's a law. I don't understand, I didn't think the internet was affected by state lines... So they can't see me. 

I live literally 2 miles from the NJ state line. My employer is in NJ and I have a NJ based insurance plan. 

I have been sobbing the last few hours.

Looking for a therapist in my state who does trans issues and telemedicine but there's nothing. Not even any in person in my area (which would mean a fairly hefty copay) taking new patients.

The therapist I had book was fairly far away but it was going to be online so...

My insurance website could be wrong, maybe there's more in my state who work online, but do I call them all to check?

Depressed and want to crawl into a hole... Feel like I was smacked down for having a stupid idea, maybe it is selfish to want to transition... 

There are online options like Folx but my family may not see that as legit and may see the cost as selfish when there are things they want for themselves and I am doing something "crazy." 

Other online counseling services cost even MORE than that and none take insurance of course.

Sorry just... Felt like my journey was started and now I'm on the side of the desolate road with a a smoking engine and no cell phone reception to call for a tow truck :(

Link to comment

I dont see what living in another state has to do with privacy. they still have to follow hippa which is federal. i would suggest callong

your ins and the Nj state ins dept

Link to comment

@Deanna Celia M I am sorry - that is a very discouraging experience. It can feel like a personal betrayal because so much was at stake for you, emotionally. Take some time to comfort yourself. Allow yourself to express feeling so upset and deflated. But, make a goal to pick up and carry on because these feelings will pass. Once you've collected yourself, call your insurance company, and speak with someone in behavioral health. Be prepared for a potentially long phone call, especially because insurance companies can leave you on hold for long periods of time sometimes, and they may transfer you to a few different people. Stay on the phone with them until you get answers to your questions. Write the questions down before you call, and keep a pad and pencil nearby when you speak with them. Try not to interpret this setback as any kind of "sign" that you don't deserve help, health and happiness because you definitely do. It's just a bureaucratic obstacle you've encountered, and that is unfortunately not atypical when it comes to dealing with healthcare and insurance. Try to see the effort of seeking out answers to these questions about your insurance as an act of self-care - you are doing it to take care of you and you deserve it. You may feel more frustration in the process of finding the answers, but you will feel accomplished once you do, and even more confident once you have a clearer path to finding a therapist. Just take your time, and wait a little while until you're ready to take on that challenge. Good luck and stay strong!

Link to comment
  • Forum Moderator

@Deanna Celia M I don't know if this would work BUT - I wonder if it's possible for you to open a post office box in NJ and use that address to get around privacy issue. I seems to me that for ever rule made - there is some way to get around it.

Link to comment

I've heard of similar situations but if I remember correctly it wasn't about privacy, it was about a patient needing to live in a state the professional is licensed in.  I wonder if that was what they were trying to get across.  I may also be misremembering it. :P

Link to comment
  • Forum Moderator
1 hour ago, Kelly2509 said:

I've heard of similar situations but if I remember correctly it wasn't about privacy, it was about a patient needing to live in a state the professional is licensed in.

I think this may be what it was actually about, interstate commerce and crossing borders.  Last year as Covid set in many medical organizations moved to telemedicine and insurance companies paid claims. I got messages early in 2021 that if you lived out of state they would not be able to offer this.  I live in NH, but minutes from MA where all my doctors are.  So I understand your confusion and dismay.  

Link to comment

That would make sense, my speech therapist only offers telehealth to people who live in the state.

Link to comment

Oh, that sounds awful. It's happened to me, too.

My Fenway therapist was willing to see me after my first prescription for 12 visits, possibly for a longer term, but she just told me since she's moving out of state, she can't because of some law. That's awful--she turned out to be a great therapist.

I'm not sure of the details in the laws or why they exist at all. Seems it would benefit large health organizations in some way (they hold all the power), but I don't know for sure.

Is there anyone here on TP, who's a lawyer who could check this out?

This could be a far-reaching change for anyone needing help.

Hope this gets fixed.


-- Davie


Link to comment

to me it sounds like bs. when I lived in nj both me and my wife saw doctors in NYC with no problem. the same for people that go out of state for specialized heart or cancer care

Link to comment

I don't think it's BS, but it's a new rule. My therapist wouldn't do that. She was upset about it, too. Like to know the real story behind it. I'll look for an answer.


-- Davie

Link to comment

@Deanna Celia M Chin up girl! I'm sorry you hit a road block. If this journey was easy they'd let anybody do it. It took four months to see my therapist, I didn't know it at the time, but she was dealing with COVID. I'm so glad I waited, she's amazing & has been wonderful for me. She & my doctor blessed HRT two months ago, but the insurance said I needed 90 days seeing a therapist to start, that date was a month ago. I don't know why these delays happened, but they did. I quell the gender dysphoria to tolerable by doing what I can: dressing feminine or androgynous, working on my voice & make-up, a support group & this amazing forum. I'm working through a workbook I really like, titled You & Your Gender Identity by Dara Hoffman Fox.


Once when I was trying to get help for a child I had to politely ask for the specific cause of rejection, then persistently, not always patiently, appeal three times. They finally granted the treatment.


Not sure if it's your issue, but there are some interstate telehealth issues, and some states have entered a Compact to allow easier licensing; it appears neither NJ or PA have passed bills for it yet though. If the issue is on the PA side there was a note about an exception for areas close by in adjacent states.  





Link to comment

Thanks @Delcina B  . Yes, this complicated because medical licenses are issued  by states and the legal issues of inter-state practices have yet to be fully addressed. It's a legal mess, but it's not just BS. Some states have agreements and some don't. Your doctor or clinic will have more info.

Be persistent, Good luck.


-- Davie

Link to comment

So this I copied from my health provider about televisits:


"Due to the re-instatement of state and federal restrictions, as of August 31, 2021, Fenway Health will no longer be able to schedule telehealth visits for patients located outside of Massachusetts."


No explanation given.

Thank your own insurance companies and state politicians for this complication.



Link to comment
  • Forum Moderator
1 hour ago, Davie said:

"Due to the re-instatement of state and federal restrictions, as of August 31, 2021, Fenway Health will no longer be able to schedule telehealth visits for patients located outside of Massachusetts."


From talking to my own therapist, it's probably a licensing issue. A lot of that got suspended during the worst of our COVID epidemic because telehealth was so important. Now that things are getting back to a semblance of normal, people are starting to look at what states they're licensed to work in.


If Fenway is only licensed to operate in Massachusetts their hands are kind of tied. I don't see the point either, but licensing requirements vary from state to state.


I hope you can find someone local to you who fits your needs!



Link to comment

Yes, thank you, Jackie. That all makes sense (not all of it good sense, but mostly some sense "I don't see the point either," LOL). I'm doing fine with what I can get which fills my needs if not my fears and dreams. With my regular Primary Care center I asked for a Gender Therapist and actually got one. So cool. Not sure they've had one before, so maybe this will do other trans folks some good. Asking is good, though we have to follow the rules to get coverage. Grateful for what I have including loving care here on TP.

-- Davie

Link to comment

Hi all I am sorry to go silent. Thank you for all of your responses. Been really down and stressed with the therapist thing and other issues. Spent a lot of time on my insurance website and on trans resource websites and sending out emails trying to find a new therapist.


After some googling, I believe the therapist cancelled me because the state of PA, which I live in, needs the credentials of providers doing telehealth for PA residents. They have allowed out of state providers to do telemedicine during the pandemic but they must submit credentials to some entity in PA. I doubt this therapist's office wanted to do this for me, I don't blame them.


The good news is I think I have a new therapist, they still have to confirm insurance (fingers crossed). Ironically, they are just down the road from me, even though it is going to be virtual sessions. If everything checks out I should have first session Friday evening. 


It does seem hard to find therapists who deal with trans issues. I was getting desperate, feeling like searching for a needle in a haystack...


I really want to thank everyone for their advice and support, sorry to be such an emotional wreck.  

Link to comment

@Deanna Celia M -- your perseverance paid off!  That's good news.  If your journey is anything like that of many of us, there will be other detours along the way.  But determination has a way of finding a way forward through the maze 🙂




Best wishes,



Link to comment

OK update--the new therapist appointment is confirmed for tomorrow evening, he looks like a good therapist, very excited.

I think the therapist may be a trans man based on the picture on their website (I know, kind of impolite to try and clock your therapist, but I'd feel very comfortable with a trans person).

Fingers crossed everything goes well, I am still nervous.

Link to comment
  • Forum Moderator

@Deanna Celia M THAT IS FANTASTIC NEWS - I'm excited for you!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!


Link to comment
  • Forum Moderator
1 hour ago, Deanna Celia M said:

I think the therapist may be a trans man based on the picture on their website (I know, kind of impolite to try and clock your therapist, but I'd feel very comfortable with a trans person).


I hope you're right. That can be a very rewarding experience when your therapist knows EXACTLY what you're going through.



Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Who's Online   5 Members, 0 Anonymous, 50 Guests (See full list)

    • Jamie73
    • AgnesBardsie
    • Robin.C
    • Ryan
    • Becoming Diana
  • Recently Browsing   0 members

    • No registered users viewing this page.
  • Forum Statistics

    • Total Topics
    • Total Posts
  • Member Statistics

    • Total Members
    • Most Online

    Freyja Clark Turner
    Newest Member
    Freyja Clark Turner
  • Today's Birthdays

    1. ShipwreckedGirl
  • Posts

    • next_level_mom
      Thanks Jackie C. I'll do a little research and check in with her about whether she can handle it.
    • Becoming Diana
      I came out last week at a thrift shop where I'm the assistant manager.  Saturdays are our busiest day.  This is what I wore today.  It felt so good to just be myself at work!
    • Becoming Diana
      Thank you @Vidanjali  You've just added fuel to the fire lol.  I will get there one day.
    • Vidanjali
      Hesitating to be out & proud as nonbinary because it almost always requires so much explanation. Tempering dysphoria induced by being gendered binary requires energy expenditure, and having to explain myself does too. Individually being a conduit to challenge others to change the paradigm of their thinking about gender (let alone pronouns) seems an uncomfortable role for myself; I imagine myself a burden to others in that case. While I'm an ally and activist for the disenfranchised in general, I'm not comfortable being so for myself, personally. 
    • Vidanjali
      I enjoyed reading this poem, @Becoming Diana..   I was very lucky to be able to visit Paris in 2018. I was there for 2 1/2 days en route to Central Europe. Paris is all that. Believe the hype. The first day I was there, I thought I'd hyperventilate because everywhere I cast my gaze made me gasp. I had to deliberately slow my breathing because I felt so exhilarated to be there - I could easily see myself staying there indefinitely, and I am not usually a city person. It just felt so lovely and natural to be there. Now, I dream of returning some day. I hope your dream to visit Paris will come true for you. 
    • Jamie68
      Like Dr Seuss said, those who care don't matter and those who matter don't care 
    • Vidanjali
      Loving all the autumn looks, friends! 😍☺️ Here in South Florida, autumn means it's in the mid to high 80s occasionally, lol. I love the heat, though. 
    • Vidanjali
      Hi @Xrystiana ! Nice to meet you 🤗 
    • Vidanjali
      Hi @MaybeImSkylar . As Jackie said, let what makes you comfortable guide you. While having a clearly defined label for your identity can be validating and comforting, don't beat yourself up if it's not currently clear to you. There are endless varieties of gender and sexual identity, and very often it's more nuanced than homo vs hetero, or male vs female. I, for one, salute you - whoever you are - you are valid, beautiful, and loveable.    The confusion you speak of is relatable, and you're not alone. I identify as asexual, panromantic, and trans nonbinary. It took many painful years to come to the clarity I have at present (and no one ever reaches a point where personal self-discovery is complete). To give you an idea, I neither identify as female nor male. My birth certificate says female. I feel my personality is some combination of the two plus something other than either, but it's a homogeneous mix. So, it's not like I can separate the two and say in this instance I'm more female and in another, I'm more male. I'm just me all the time, and whereas I used to feel frightened and disgusted with myself, I have become much more accepting. Before I became more accepting, I used to wear men's clothes and preferred them, but hated myself for it. Then, I began to present very femme, but it felt exhausting, like I was always being judged. I've never had sexual attraction for anyone in what most people would consider a natural manner. I've experienced romantic feelings for people of a variety of genders. I am married to a cis man, and although I don't desire him sexually, the attraction I feel for him seems to me more like how gay men enjoy men rather than how hetero women enjoy men. But, I'm not a man, nor am I sexual, so I could not say for sure - it's just an instinctual notion I have.    So, as you can see, you're not alone in not having a clearly defined experience of your gender and sexuality. Try your best to learn to love yourself in every instance. Be comfortable. Celebrate you. Overcome perceived expectations. Have fun. And keep writing to us here - there are great friends to be had. I wish you the best. 
    • Jackie C.
      I'm pretty sure that covers a lot of us on some level. We'd just like to get on with our lives, be recognized as our actual gender and have rights. I mean that's the whole "agenda."   As for the rest of it, in my opinion anyway, if you wait for the perfect moment you'll wait for the rest of your life. Bite the bullet. Tell who you need to tell and get on with it. They'll accept you or they won't. That is utterly out of your control. If they don't accept you, that's on them, not you.   Hugs!
    • Jackie C.
      There's nothing wrong with being a women who presents in a more masculine manner. My aunt did it and we all loved her. By the same token, there are some lovely non-binary people here and out in the world who don't especially feel like either binary gender. I would advise you to dress how you feel comfortable.   Now, I have no earthly idea what the environment in Cyprus is like for the LGBTQ+ community, (Though my quick internet search says the EU enforces a certain level of rights) but it seems like you should be OK presenting in a manner that doesn't fit the gender binary, which is fantastic. So... experiment. Find out what makes you feel the most like you. Maybe not your whole wardrobe at once, but pick out things and looks that make you feel the most like yourself. Like I said, masculine lesbians exist. Non-binary people exist. You exist. Try to become the very best you that you can be. You absolutely deserve to be comfortable in your own skin.   So, on to the sex talk: Toys exist. If you find you want to add something "extra" to please a woman, that's completely a thing you can buy at your local shop. Personally, I don't find it that appealing but I have friends who do. What makes you happy in the bedroom is a special part of you. Mechanically... my metaphorical hat is off to your heterosexual lovers if you consistently achieved simultaneous climax. My spouse and I generally take turns. You may find that in a more typical lesbian lovemaking session the foreplay goes on for longer than you might be used to with a male partner. Of course I don't know your male partners, but the average for lesbians is clocked at between one and two hours which lines up pretty neatly with my personal experience. Again, take your time with your partners and figure out what you're into. Communication is key. Presumably you know what you like so share that with your partner and have a blast getting to know each other's bodies.   Hugs! 
    • Jackie C.
      Your doctor's approach is fine. They start low, do blood tests and repeat until your daughter's bloodwork shows estrogen and testosterone levels in the proper range. This is very much a slow and steady sort of thing. Think of it like having puberty again. That wasn't over in a day and your doctor doesn't want to accidentally hurt her with too high of a dose. The basic pattern is two months. Test. Adjust dose. Repeat until she hits her targets. There's no one-size-fits-all dosage so your daughter's doctor has to be careful to feel out what's right for her.   As for electrolysis. If she wants it, I'd say go for it. You need to have hairs of a certain length which might cause her dysphoria while she's letting it grow out, but in the long run it's the only truly permanent solution.   Hugs!
    • next_level_mom
      Hi all, so sorry I haven't replied sooner. Just got busy and forgot to check back. @Kelly2509, she was started on a very low patch dose, though it has been increased. I'm still wondering if we should maybe find a more proactive doctor, though of course the present circumstances make everything more complicated.   I didn't know facial hair wasn't affected by HRT!  I'm not sure she knows either. Would it make sense to take her for electrolysis? (Ironically, I think she got hairiness from me, my husband didn't have any real facial hair til he was in his thirties, lol.)
    • MaybeImSkylar
      Hello,  (Excuse my English, is not my first language ) I am someone who is still in the questioning situation about my sexuality and gender identity. And I sort of need help and quidance. Its a bit of a big story but I will try to keep it brief.    I was born as a female and only twice in my life have question my gender identity and right now is that second time. I happend before,during and after my first girlfriend.  She is a transwoman pre-op and she is my first sexual expirience with the same sex. I have had sex with her as the switch position and the times I was the top I enjoyed it but there was something missing. This is a fear I had before I started exploring with women or at least the homosexual side of me; meaning sleeping with the same sex and I dont get actually stimulated by being the giver or climax at the same time as it is with heterosexual sex. Which I feel is the same case I have rn, I enjoyed it and it was exciting being with a woman but there was something missing. I know there are other ways but what if it doesnt work? On some point I felt like I wanted a man's reprotactive system so i can enjoy sleeping with women.    There is this urge that I want this to work and I am scared what is I am poser after all. BUT here is the thing, I dont only feel like I want to be "masculine" only in sex. I recently found myself being keen on more baggy clothes and androgynous eventho in the past I hated it and made me feel ugly. I felt is a girl trying so hard to look like a man even I behaved,dressed, acted more "feminen" for the opposite sex to be accepted , it felt too much. It was exhausting, like who am I?   I am attaching a file that my friend send me this year about heterosexuality and the steryotypes within it and help understand about being a lesbian.    Right now I feel like I am lost, thinking of trasitioning into a man doesn't seem appealing in the sense of having a male reproductive system, I still want to own what I have but be masculine but I dont feel feminen, this is so confusing.  Also thinking about men naked seem even more unattractive than before, but I feel like a man with nothing down there seem more appealing? I don't know if this makes sense, but I feel like I am mad or I am a Karen at the end of the day which makes me so sad and upset.   I hope you enjoy my ted talk and the attached file    https://www.docdroid.net/N46Ea3o/copy-of-am-i-a-lesbian-masterdoc-pdf#page=2 
    • Ryan
      I haven't logged in in quite a while, but I've been having some nice highs and feeling confident in my transition, to having low lows, and I don't know if this has to do with dysphoria fluctuating. As an update, I moved to the city from my small town and I'm completely stealth in college aside from a couple instructors. When I go out, I'd say I pass nearly 99% of the time, though there are times when I get 'imposter syndrome' and I'm "not really trans", or "not a real man". I do have an appointment with my therapist in a couple weeks and a new appointment with a gender clinic to help me with the legal and medical process which was cancelled and then re-booked.    Regarding my transition process, I'm at the point where I'd like to get my legal documents changed first, but I'm also on a time limit because I'd like to get them changed before I start looking for a job. The thing that makes me stop and hesitate is in regards to my family. I came out to my family October 2020 (aside from my brother and sister-in-law). Last time I went to visit my parents, it seemed like they took a step backwards and wouldn't refer to me as 'Ryan' or he/him for the couple days while I was there (they've been supportive of me since I came out and my mom had even baked pride cupcakes during Trans Day of Visibility last year). When I came out to them I didn't mention too much about past childhood thoughts or desires of wanting to be a boy, which I'm considering sending them a 'timeline' of what I remember from my childhood and when I had each thought, or what I wanted to do at that age. All that being said, I'm not 'out and proud' about my trans identity and I would prefer to live as a cis-passing man telling people about my trans identity on a need-to-know basis (doctors, etc).    I feel that my hesitation comes from family and because I'm not out to my brother and sister-in-law, I should tell them before starting anything and make sure my parents are supportive of my decision to transition. I also don't know how my brother and sister-in-law will react, I don't think my sister-in-law will be too surprised honestly, I'm more so worried about my brother. 
  • Upcoming Events

Contact TransPulse

TransPulse can be contacted in the following ways:

Email: Click Here.

To report an error on this page.


Your use of this site is subject to the following rules and policies, whether you have read them or not.

Terms of Use
Privacy Policy
DMCA Policy
Community Rules


Upstream hosting for TransPulse provided by QnEZ.


Special consideration for TransPulse is kindly provided by The Breast Form Store.
  • Create New...