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HRT requirements

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Sorry, this could fit in several places and I wasn't sure which was best so I just picked here. I"m really confused and looking for advice.

So this is where I am. I see myself as non-binary/trans-masc - essentially, masculine of centre but not fully male (I'm AFAB). In Feb this year, after a very long process of acceptance (years long) I saw a GP at a Trans and Gender Diverse GP Clinic who said I could absolutely access low-dose T, and we could make it flexible - so taper it if/when I started experiencing symptoms I wasn't comfortable with. Great, right? But you can only get T with a psychologist's consent so he referred me to a psychologist who specialises in gender assessments. After three sessions with the psych where gender was discussed for a total maximum of 5 mins, he says I'm not trans (which I never claimed to be) and he's not willing to do a full gender assessment. He said I could go somewhere else and they may approve me for T and it may help, but in his view I'm very dissociative.. which means T may not help. He says to address my dissociation will require therapy for "a long time and maybe a very long time". 

I'm confused because some of what he says makes sense. And I guess I can live with waiting longer for T if necessary - I've made it this long, after all. But I really don't know whether // how much to trust him. He's very expensive. How can I know he's not just stringing it along for his own reasons? (I should say I've googled him and asked all the queer people I know and not heard anything negative about him but.. ?)

Has anyone else been told they're too dissociative for T? 


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I'd get a second opinion and maybe a third.  I'm not saying the guy you talked to doesn't know what he's talking about,  just that he doesn't have to be the end of the line.  Maybe T is right for you, maybe it's not.  It's always a good idea to get another opinion.  You'll know when the therapist you're talking to "gets it" and their council will feel right to you or at least provoke the questions in you that need answers.  Then you'll know you're in the right place.  Keep looking & searching.  Best wishes for your journey.

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You are not the first person here to have run into this problem, and it does apply to both genders.  Dissociation does come in a little more in AFAB to male / masculine situations than in AMAB to female / femme ones and we do have things here on the forums that talk about it.  You say that you spent much more time on things other than actual Gender Dysphoria and it is in those things that you did give the evidence of the psychological phenomena.  Hormones, especially T can be dangerous and could also interfere with dealing with the dissociation issues.  The doctor's first line is to be sure you are not harmed if there could be other roads to the meeting of your real needs. 

I do agree that you may want to find another therapist at least for verification of this doctor's findings and decisions, and this doctor did say others may not share their concerns.  Dissociation does cover a very wide range of things, including issues that I have dealt with long after I was diagnosed with Gender Dysphoria where HRT was appropriate.  Even without the hormones you can still present in the ways you feel most comfortable without the doctor's permission. 

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Thanks for the replies here. I read them at the time but didn't really have anything to say back. The update is that I saw my GP this week and told him what the therapist said and asked what other options I had (thinking maybe another referral even though I didn't know how I would afford it) and he wrote me a script for T :) Pretty damn stoked! I keep grinning for no reason LOL

Now the issue which has driven me back here in an attempt to extract more wisdom, is -what the heck- do I tell my therapist on Tuesday? I could stop seeing him but in spite of all that's happened, I do think he gets some things (MH related, not gender related) and could probably help me with certain things. But is it feasible to keep from him for the next whatever, that I'm on T? He's talking about long term therapy and I feel like T is going to be a pretty big thing in my life for the next little while so I don't know how practical it is to think I can just not tell him. But also on the other hand, I can't just rock up on Tuesday and when he asks how I am, answer (truthfully) that I've had a f-n awesome week because I finally got T after a year of trying. It would feel weird - like I undermined him - and I'm also worried he'll speak to the GP and persuade him to discontinue it. So either way, that's a bad thing. 

I don't know. Any thoughts?

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I'm glad to hear your happy.  This certainly makes for a good week.  

About telling your therapist, I don't know, apparently your doctor feels the T would be of value otherwise they wouldn't have prescribed it.  Not mentioning it to your therapist right away would be an option if it doesn't come up in the conversation.  But eventually you will need to disclose all that's happening in your life as truthfulness is important to get the most of therapy.   As suggested earlier, have you looking into another therapist to get their opinion and to see if you "fit" in better with their counseling philosophy? 


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I would certainly be open and honest with your therapist  The fact that you are so happy is important.  Hopefully he can see how relevant and important gender issues are to you.  At the same time all the other issues we have simply don't disappear post transition so his help may certainly be relevant for other issues.  Being honest about myself with others was one of the biggest gifts of transition.   





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I would echo the advice given above.  It is really important for you to be completely open and honest with your therapist especially regarding the mixed actions/advice of the professionals you saw.  The therapist needs to be made aware of the contradictions.  I hope things work out well for you.

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Thanks all, 

The honesty thing is a good point. I think I'll try to tell him tomorrow. If I can't - because I also don't trust him a whole lot at this point - then I'll drop out and try again with somebody else next year when the funding resets. 

I haven't tried anyone else yet Jani because of the way funding works and how long everything takes. I could see someone else next year but not before then. 

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