Hi all !

Today I asked my therapist about getting the "proper diagnosis". I did not mention 'GID' in so many words, as I thought it could be unwise not to leave some room for his judgment... but I used the whole session trying to establish the right picture (and mood), sort of a foundation for my next steps with him after easter. I dare not set my hopes too high, though, as this means so much to me. But when I came home I swear I could feel the butterflies in my belly.

Linda

Hi Linda

Is your therapist a psychiatrist who has the right to give the diagnosis F64.0 transsexual? Is it that easy in Norway? In the most countries only specialized shrink groups have the authority to give that diagnosis, and after many months of evaluation.

Laura

.. If the HBSoC are followed!

I asked my psych about this, and his answer was that the SoC are minimum requirement guidelines, and that while the SoC are the basis for a system of treatment, that system could easily be hold a longer period to be nessecary.

I guess it all depends on the psychiatrist concerned.

My sincere apologies - I obviously missed the minimum word.

One thing I do have ta suggest though, is that, especally for a m2f, a longer period of psychotherapy is equally disturbing.

It's the point at which hormones START decreasing in efficiency, and for many, the point at which hairloss starts. Personally, I've receded in the temple area quite a bit, and thinned out a little on top. I also know that if this continues at the rate is happening, I'll have no choice but to wear a wig come two or three years time if hormones don't start now, whereas at the moment I could probably just about get away with it. All in all, such a thing wouldn't be neccesary if it weren' for psychotherapy. The psychtherapy isn't a tool to help me anyway. It's a tool for doctors to cover their own backsides in case I change my mind at a later date. All they really need as far as I'm concerned is to certify me as sound of mind and give me a disclaimer form to fill in.

I just think that any prolonged psychothreapy for many people isn't just a waste of valuable time where their lives are held up, but is a stress that such people can do without.

I'm not sure what I will have to go through to get the F64.0 diagnosis, Laura. And I don't know if my psychiatrist must have an approved subspeciality to give me this. But then he should have told me when I brought up the issue, shouldn't he ? Then, again, I did tell him that it would be very difficult for me being "evaluated" by some "tribunal" of men after all I have been through - and coming from a family of MDs - my mother even working as a nurse in the state hospital and an uncle of mine being leader of the urologists association. I compared this to what women were forced to experience before the free abortion law - men evaluating their innermost feelings. I try to be as honest as I can.
The way things normally work here, with medical problems, you have to see a GP first, then being referred to a specialist - in my case a psychiatrist. And if necessary you will be referred to a subspecialist, in which case it could be months waiting. (How this works with a transsexual evaluation group I do not know. I suspect that such a thing exist, but I have been hoping that this only applies to the SRS.)
I have been in therapy for nearly 4 years with my psychiatrist and, in a way, I "outed" my "problem" on the first day. But I was extremely shy at the time. I had been going to a psychologist for more than a year. And I had stopped seeing this one after he, contemptously, told me that I could risk ending up with "an inwardturnedp..." And I had not even told him that I had been dressing secretly in womens clothes since my childhood. (Now I find his reaction quite revealing, not just about me, but about him too... I got his male mind moving.)
That is how I tried thinking of (and containing) my "problem" when I started out with the psychiatrist I am seeing now, too - a "clothes problem". So, I was very much in denial of my feelings. And very shameful.
Still, I did feel like kicking him in the butt, too, Sandra, when I saw him a week ago. Couldn't he have "discovered" my true feelings a year or two ago ? In fact, I was really hateful the session after my "breakthrough". I suspect that it could have been dangerous if these feelings had come out in a chaotic way, too fast and too early: Hell hath no fury like a woman scorned...
But wednesday I started thinking that this could be a last attempt on my part at "pulling the breaks". And I told him so this yesterday and then finally reached the point were I could bring up the question of the diagnosis.
For years I have understood that my "problem" in some way had made it impossible for me to finish my education, my architects thesis, falling out of work, never finding many friends, almost loosing the few I had, and withdrawing as much as I could from my family. This way I could find at least some measure of freedom from the male role. But only after putting architecture behind me (finishing my degree with a purely theoretical subject) did I reach somewhere near my true feelings. This was two years ago. But I still have made some small attempts at "escaping": For a year I put some energy into writing several articles on politics, many of them typically feminist issues... (I am trying to find some other way of making a living and in my denial I have been thinking that I must make it totally on my own somehow. I am still thinking along those lines: If I do not get the diagnosis I simply must find some way of solving this myself.)
So, this has been a very slow process were I have been "pulling the brakes" all the way while still going in the same direction. But my breakthrough the last few weeks makes me hope that the process will speed up now. The stages I have gone through surely must count for something ?

Linda

Your thoughts on youngsters, Lucy, i agree totally. This should be taken seriously at a very early age. Looking back now I can see that the signs were there. I used this angle to make my therapist understand, telling him that I could have been a happy normal person if I had been allowed to be the girl I was at age eleven. Instead my father bullied and forced me into acting like a small "male". And I did not get much support from my mother. So to a large extent he succeeded, not making me into male, but in isolating me from other children and suppressing my desires. I think this have complicated things a lot. And I have been thinking of what he did to me as being put into a straightjacket and sealed off in a coffin. Being a TS is not the problem, but the straightjacket and the coffin is and could require extensive therapy to open up.
I do feel that too many years have passed. It hurts terribly. But still: It feels wonderful taking the first steps outside.

Hugs,
Linda

That's it, Sandra. My earliest memories have been from my tenth year - when I made my timid attempts at being accepted as a girl. But I have not been able to remember the innocence of it all. My hair, my clothes, wanting to be kissed like a girl - it was all there. I wish someone would have seen it and accepted me. I am glad though that I, in a certain sense, have been able to reenter this phase. It certainly could have turned out worse. (All those teenagers taking their lives)

Linda

Oh Linda

You will become an architect? Gee, I´m an architect, too!
Welcome to the ts-architects club.

Laura

Lucky me, Laura !

Love joining that club !
I finished my thesis two years ago, but still have not worked as an architect. (only doing CAD work and some menial tasks in an architects office some years ago) And I have great doubts that I ever will. My wish to be an architect was quite a conscious attempt at finding some tolerable way of living as a "male". I had my subconscious reasons too - dimly understood at the time. (related to memories from my tenth year...)
But I have no regrets about my choice. Somehow I managed following my deepest desire there... while still playing the "male rationalist". My "expressionism" was a problem though and prevented me from doing my thesis back in 1996. I felt hopelessly restricted. For obvious reasons... So for the next three years I studied art - being sort of an apprentice with a relative of mine. And making another attempt at escaping... still following my desire.
I felt really lucky when I saw you here. Almost makes me cry...

Linda

escape artist

Thanks Wendy !

I do need that reminder. But I guess it could be easier seeing it that way in the States were the money goes directly out of your own pocket. There are many positive things to say for the scandinavian welfare state, but we're easily led into thinking that we're somehow "lucky to get this for free" - which it isn't.
As for analysis: Yes, if I had to choose I probably would have preferred him up mine to my foot up his.
A touch with the knee - I liked that one.
And then we'll see...

Linda

Yes, Wendy, we sure do pay high taxes. Problem is that the services offered doesn't necessarily reflect this. There is far too few therapists, especially certified MDs and psychiatrists. I think that an important reason for this is that theres no functioning supply side in this market. (the state educational system, that is) There is a limited market for therapists where one can choose freely and get more intensive care. But after having paid the high taxes (and there being a very high price level on most things here) I would have problems financing this in my current situation.
An example of how this "socialist" system can work: Last year I had my left sinus operated and some enlarged adenoids removed. My urologist uncle referred me to a friend of his at the State Hospital (where normally only foreigners and very special cases are treated) and one of our very best surgeons did this not so very important job. Well, important to me, of course. But without my uncle knowing this surgeon I would have had to wait for at least six more months and would have no influence on the quality of the surgeon. (This one actually straightened out my nose somewhat, too, for free.) The only alternative would be a purely private clinic where I would have to pay for everything myself.
Still, I agree on "making a row". Now that I know what I want I am prepared to leave my current therapist quickly if he will not comply with my wishes. I would simply have to. Actually, I am very frustrated that he has left for England (being british, yes) till over easter.

Linda

quite right sandra; how can it possibly take any shrink 3 years to come up with an accurate diagnosis? perhaps that is a euphemism for 3 years of lucrative income! the kick in the ass was well deserved, though i presume you mean metaphorically. perhaps a real kick up the ass would have done him more good.
the harry benjamin standards of care state that there should be a minimum of 3 months psychotherapy before hormones are prescribed, i know that's not exactly what we're talking about here but it does suggest that 3 years is somewhat extreme in order to reach a proper diagnosis. disgraceful, if you ask me.

yes rhia, i did say the magic word "minimum", and of course they are only guidelines. but i just think 3 years is taking the p***.
perhaps if a patient is only 18 then a longer period of psychotherapy would be reasonable; at my age it would simply not be acceptable.
xx

i couldn't agree more rhia. i think that for someone to even approach the medical profession with gender issues means that those gender issues are probably quite serious and distressing for the individual. it infuriates me that some psycho's (a suitable abbreviation?) seem to think it is reasonable to prolong this distress. it is our lives that are at stake and we need help now, not in 3 years time.
despite my last post mentioning assessment of younger people, i do actually think it would be a good thing if youngsters could start receieving treatment even before puberty, it certainly would have saved me a huge amount of misery had i been able to stop the testo before it did its damage, though of course this is difficult ground. the point that i didn't make very well was that once you get past 40 female hormones have much more limited effects; were i in my twenties say, a 3 year wait would be nowhere near as detrimental as it would be now, not that i would agree it was neccessary you understand, but now, having to wait 3 years just for a diagnosis would simply be too late.
like you say, a disclaimer should be enough to cover their backs; 3 years of analysis suggests to me that they are simply raking it in.
at the end of the day, the medical profession is supposed to consider the patient, not the psychotherapist.
xx

At the risk of putting a shot across the bow-wow of my professional "collegues" who run with a different "pack of dogs" than I do....you can't have "Anal-ysis" without "Anal".

There is a slowly growing shift towards early "HRT" since the teen years are the ones in which hormones are most effective, and I believe the Harry Benjamin SOC do address this issue.

Linda, never forget the therapist who you pay to see is YOUR employee. Tell them if there is a problem with their work. If you can't work it out, fire them. This doesn't mean they must agree with you but they should be addressing the issues that are important to you. I had a fine therapist that occassionally needed a touch with the knees to redirect our sessions where I wanted to go. They are not psychics, and a good therapist will respond appropriately. I have seen some real dumbass therapists with M.D. and Ph.D's. I have seen some very good ones make mistakes.

Linda,
You pay very high taxes out of your pocket. Those taxes pay the therapist's salary. He works for the Govt and the Govt works for/is paid by you. He is still your employee, like the police and fire department and the mayor. It is your right, at least here in the US, to demand a change of doctor. In any event, if you make a row I'm sure you can change doctors...enough rows can get even a govt doctor in hot water.