Seeing a therapist
It’s been nearly six years since I came out to my wife (then girlfriend). But before I came out to her, I think one of the most important and helpful things I did for myself was to find a therapist to talk to. There’s such a stigma attached to mental health, and I was acutely aware of it. When I contacted my therapist the first time to make an appointment I created a separate email account using a false name, and emailed in and asked a few basic questions. I was scared to death that somehow the person I was emailing might know someone I know and that my secret might get out. Of course, now I realize I had nothing to worry about. At the time, I was searching for therapists in “Cognitive Based Therapy” in the hopes that I could be “cured” of my transgender thoughts. Getting “cured” was more important to me than finding someone that had dealt with gender identity issues before, but luckily I did end up getting someone who had worked with the transgender community before.
It doesn’t take long before you realize that therapy is both a lot more simple than you might imagine it to be, and that it’s a lot more helpful than you think it might be as well. In my case, having someone to talk to about my gender identity allowed me to grapple openly with thoughts and feelings I’d been burying for years. My first session was petrifying – even though it was all internal. Holding this king of thing in for 20+ years isn’t healthy. I cried through the session as I explained some of the things I wanted to talk about.
I continued seeing this therapist over a period of about 6 months as I came to terms with my gender identity, and told my wife about it. Having someone I could meet with and discuss things as they came up was so helpful, but eventually I felt I could continue forward without the need for regular appointments, and so the therapist and I parted ways.
Over the last 5 years or so my wife and I have spent time educating ourselves about transgender culture, and I’ve spent time experimenting with her help. Whereas 10 years ago I felt so much fear and shame in the idea of wearing a dress, I semi-regularly will wear a dress around the house the days. I’ve gotten better at putting on makeup, and finding clothes that fit my shape better. I’ve also I think become more appreciative of what my wife does to get ready in the morning, and I think also have become more helpful in pointing out things that look good on her too. While my gender identity I think has altered the standard expectation each of us had going into the relationship, I think in many ways my gender identity has made us a closer and stronger couple.
Recently though I’ve been feeling the need to see a therapist again. As I’m getting into my early 30’s I’ve been noticing some of my more masculine features are “setting in”, and I’ve been noticing what seems to be an increase in my testosterone levels and libido – which for me is undesirable. I had originally thought that I might start feeling better if I incorporated more femininity into my life and sought to understand more about my transgender feelings, but as time goes on it feels like my gender identity problems are not really getting better. These feelings have got me thinking about whether or not I should consider seeking medical treatment to lower my testosterone, and consider the benefits and risks of doing so. It seems like a reasonable next step to me in working through my gender dysphoria. Some of the things I wonder are:
Is it possible to lower my testosterone in a way that doesn’t present other health risks?
What are the effects of lowering testosterone without adding estrogen?
If estrogen is added, is it possible to continue presenting as a man for professional reasons?
How long can someone undergo HRT (of any kind) before it may start to create health problems or side effects?
Will lowering testosterone and/or estrogens improve how I feel, and lower my libido to a comfortable level?
What other different methods of treatment are available to me to address my continued GID?
In order to answer these questions I spent some time researching out various therapists that specialize in transgender and transsexual issues. After going through the list of transgender therapists at Laura’s Playground (which I highly recommend as a starting point) I settled on Katherine Rachlin, who is well known within the transgender community. She isn’t in network for my health insurance, but I do receive some out-of-network mental health benefits through Aetna and just submit the paperwork manually (and pay my deductible, and coinsurance). [Side note: If you can’t find a therapist in your area, please contact some of the therapists on the Laura’s Playground list and ask for referrals in your area. Or post to a transgender forum at crossdressers.com, susans.org, or laurasplayground.com)
I’ve been seeing Dr. Rachlin for several weeks now and have been really happy working with her. Not only is she helping me find answers to my questions, but she has also been a great resource for me in finding new questions and issues to consider as I think about possible treatment. I’ll say it again, having a good therapist who is available and knowledgeable can be so helpful in working through these issues. Dr. Rachlin doesn’t push me, neither does she hold me back – she just helps me work through the questions I have, and provides resources for me when needed to help me figure out what I really want for myself.
In future posts I’ll talk more about the process, and what treatments I’ve discovered and have considered.
Image Credit: stevelyon