Guest Post – Seeking Treatment While Trans: tips, tricks and advice

1)  Do your research.  Find trans-friendly medical professionals that take your insurance.

  • Find a local trans group to ask
  • Google search using such phrases as “trans-friendly”, “gender specialist”, or “LGBT-friendly”; “therapist”, “mental health counselor”, or “psychiatrist” in your local area.
  • Find out what mental health insurance coverage you have, how many visits you can have per year, the co-payment, any restrictions in choosing a mental health professional and yearly coverage limits.
  • If you do not have insurance, some doctors accept a sliding-scale payment plan.  Your other options are community mental health centers, big-city gender clinics, and local hospitals.  Not having insurance makes this process more difficult; it just takes more work, making lots of phone calls and luck.

2)  Prepare Yourself for Your First Appointment

  • What are you looking for: a diagnosis?  A letter to start hormone therapy?  Just someone to talk to?
  • What questions do you have for the person you will be seeing? For example, you can ask how many trans people have they worked with, what to expect for the first sessions, and if they can give you want you want (the precious letter).
  • Be nice to yourself.  Taking steps to deal with your gender problem does not make you weak.  This is a big step and congratulate yourself for making it this far.
  • Don’t over-analyze every detail of your life to make sure it fits some sort of fairy-tale narrative you think they want to hear.
  • Be honest with yourself and the person you will be seeing.  The more information, the better.

3)  General Tips

  • Gender specialists aren’t necessarily better than therapists who have only worked with trans people a few times.
  • Gender specialists usually only do well with gender issues; if you have other things to talk about, you might be better finding a more balanced person.
  • If you live in a rural area and you still haven’t found someone within 50 miles, consider calling a local therapist to tell them your situation.  Point-blank ask them if they feel comfortable with trans patients, particularly the part about approving medical treatment.
  • Sometimes, the least experienced professionals (trans-wise) end up being great, particularly if you have other issues you’d like to address (e.g. depression, anxiety, PTSD, grief).

4)  Advice

  • If you don’t like the person immediately, don’t continue the sessions.  You MUST have a good rapport with them in order for you to trust them.  If this isn’t happening right away, find a new therapist and kindly tell the first one that the fit isn’t right for you. This happens all the time – they will not take it personally.  You may have to see a few people before you find the right one.  Trust me, you’ll thank yourself later.
  • If the therapist starts to trace every issue back to being trans, stop them immediately.   Suggest that your other problems are unrelated but just as significant.
  • If the therapist is having extreme difficulty remembering your chosen name and pronouns, they are not the right therapist for this.  If they don’t understand the basics, they will not understand the complexities of trans identities.
  • If the therapist diagnoses you with a personality disorder, find a second (or third) opinion.  Personality disorders are over-diagnosed and they are usually well aimed at trans women in particular.
  • You can discontinue therapy when you get your letter (about 3 months, sometimes sooner).  There is no rule pertaining to the length of therapy.
  • If your goal is to start hormone therapy right away, find an endocrinologist and book that first appointment (the waiting lists are usually long).
  • If you have trouble making phone calls, as many trans people do, enlist a friend/family member to help.  Do not let your phone-phobia keep you from getting help.  I’m aware that it’s harder than it sounds – I went through the same thing – but remember that getting the medical treatment you absolutely need will help you resolve your phone/voice issues.  Think about your future self and how much they would appreciate you  pushing through the anxiety despite the pain.  The payoff is too big to let this get you down – remember how important this is.

[Disclaimer: I am not a licensed mental health professional.  I do, however, have experience with more than 30 therapists over the last ten years.]

Kian currently lives in NH with his two cats. He would be wicked excited if he didn’t have to move to a ginormous city to the south in order to have a fulfulling sex life (he’ll miss the snow and the ice-skating too much.) He can be reached at kian217 at gmail dot com if you’re interested in conversation, an argument or in sending a nicely worded hate letter.

N.A.’s disclaimer: All opinions expressed in guest posts are the author’s own and do not necessarily reflect the opinions of NotAiden.

5 Replies to “Guest Post – Seeking Treatment While Trans: tips, tricks and advice”

  1. just to add on the issue of phone phobia.Why not just get rid of the phobia problem otherwise it may still hinder your movements especially when there is no one to help you make that call in the future.

    • Sure, yes, life is much easier without phone-phobia and I encourage people to seek treatment for it. The reason I mentioned it is because it sort of creates this catch-22 where you can’t call to get help and you can’t get help because you can’t call someone, so you get stuck. Enlisting the help of a friend is often the first step to seeking treatment.

      Also, phone-phobia seems to be quite common in trans people because our voices don’t align with our genders and this cause peoples to misgender us on the phone. However, in the case of trans men, this becomes less of an issue when the testosterone lowers the voice – sometimes this is the only thing that is needed.

      Phobias are notoriously difficult to treat and become automatic responses to certain stimuli. The only thing that worked for me is Dialectical (cognitive) Behavioral Therapy and that took about a year and a half to work. I highly recommend it for any sort of phobia that hinders your life (not all phobias do, as my crab-phobia is only an issue when I’m around crabs, which is not very often).

  2. Another tip for finding a physician and therapist in your area: If you know other trans people, ask them who they are seeing/saw and try contacting that person. I found my GP that way; he was listed as full and not accepting new patients but when I called and explained that a friend had mentioned him and told me he was good with trans stuff, he took me on right away and has subsequently taken on one of my friends as a patient as well.

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