Transitioning 101 - Therapy

In my last "Transitioning 101" post, I touched on HRT; and one of the routes to obtain HRT involves following the WPATH Standards Of Care (SOC) which involves obtaining a letter from a qualified mental health professional - which is generally a licensed therapist.

As I touched on in that prior post, this is the route I chose to take.  I chose that route mainly because I did (and still do) want to have SRS at some point and to my knowledge no surgeon - at least no reputable one - will perform SRS without following the WPATH SOC.  Now this alone did not preclude me from going one of the other two routes for HRT and then later dealing with obtaining the requisite letters for SRS, I felt if I was going to have to do so at some point anyway, well I might as well follow the SOC from the beginning.

Now my personal thoughts on therapy are no secret to anyone who's read much of this blog; but for those that haven't let me briefly touch on them.  I was never a believer in therapy for much of anything.  Maybe it's just me, maybe it's the way I was brought up, but whatever the reason(s) were for that I was a firm believer in handling your own issues and as such I felt that therapy was not only a waste of time/money, but also something that only "weak" people did.  So while I did make the decision, in conjunction with my wife J, to pursue therapy for the purpose of obtaining an recommendation letter for HRT, I wasn't overly enthusiastic about what that would entail.

That all being said, if you asked me today how I feel about therapy, the answer I'd give you would be 180 degrees from what it would've been before my transition.  I firmly believe that choosing to go that route was the right decision for me, and I no longer feel that therapy is a waste of time/money or that it's only for "weak" people.  I'm not saying it's for everybody, but I do think that for many who transition, the right therapist can be incredibly helpful.

Now, initially I was going to discuss my specific experiences with therapy and with my therapist, but I actually wrote a post about that a bit over a year ago.  For those that are interested in some "specifics" - like I was way back when - that post is HERE.  For those that don't really care about my specific experiences, which is probably most of you, I'm going to touch on a few points that I think are important and then wrap this up.  So in no particular order, here are some things that I feel are important when it comes to selecting a therapist, and therapy itself.  As always, these are simply my feelings and you may feel differently.

• Finding the right therapist is crucial in my opinion.  This is something that I struggled with as I couldn't find any that were reasonably close that seemed to be experienced with gender issues.  Eventually I expanded my search area and ran across several.  Now, me being me, I've always had a preference for dealing with women in general.  It doesn't matter what the context is, I'm just more comfortable around women and always have been so I immediately narrowed things down to female therapists.  I'm not saying that anyone else should or shouldn't do that specifically, but what I am saying is that it's important to be comfortable with your therapist and in my case I felt I'd be more comfortable dealing with a woman.  

• If per chance you don't mesh with your therapist, don't hesitate to move on.  I'm not saying you should ditch a therapist just because they might ask difficult questions or something; but if the therapist isn't right for you for whatever reason, talk to them about it and if things can't be worked out - well there are plenty of other therapists out there.

• Be open and honest with your therapist.  A good therapist isn't there to judge, they are there to listen and help you work through the things YOU want to work through.  I believe a good therapist will ask questions, maybe to fill in "blanks", maybe to flesh out things you've said, or maybe even to move things forward.  But regardless of the "why", a good therapist will have good reason(s) for those questions and by being open and honest you can only help yourself.  Now, I'm not saying that perhaps you might have thing(s) that you consider "off limits" for one reason or another and that's okay.  You shouldn't be afraid to do that; though I do believe that the more open you are and the more you are able to share, the more successful therapy can be.  

• Therapy isn't a "cookie cutter" solution.  If I had a dollar for every time I've seen a question on Reddit or elsewhere about "how long did it take to get a letter", I'd probably be retired by now.  Personally, I've ran across some people who got a letter after one visit, others who have been in therapy for a significant amount of time and are still working towards a letter, and plenty who fall in between.  I do think that if a letter is one of your goals from therapy that you should discuss that with your therapist early on.  In my case, I mentioned it when I was looking for a therapist as I wanted to be sure the one I chose was versed in writing them, and we discussed it at my first session as well.  

• Assuming that they are willing, and your therapist is as well, don't be afraid to involve those key people in your life in your with your therapy.  I've had my wife J along a few times and my "sister" M and my daughter P along once as well.  The first time each of them went with me, my therapist spoke to me alone first to see if there was anything that I considered "off limits" (there wasn't) and then spent some time alone with each of them, then we spent the last few minutes in there together.  Not everyone may want to do this, and I'm not saying it's crucial by any means; but I do feel it was helpful.  

• Just because a therapist doesn't offer to write a letter for HRT within the first five minutes of the initial session; or they ask questions that may require thought on your part; or a lot of other things - well that does not make them a "Gatekeeper".  All too often I see people tossing that phrase out indiscriminately and that's wrong.  Hey, I'm not saying that any given therapist or other professional isn't a "Gatekeeper" (though I really do dislike that word in general); but just because things aren't happening exactly how you envision them doesn't make them guilty of gatekeeping.  If you're only there for a letter and nothing else, then make the effort to find a therapist to "pencil whip" you a letter.  Don't head to a legitimate gender therapist and then badmouth them just because they actually expect you to make an effort.

Compared to the other posts in this series, this one is really more subjective than those.  As I said above, I'm sure that therapy isn't for everyone, though it's been great for me.  With that, it's getting late so I'm going to wrap this up.  Have a great weekend everybody and for those that celebrate it, a great Memorial Day as well.

- M