Gender dysphoria is a condition where one’s biological genital organs given at birth (one’s sex) does not match the mental and emotional way one sees oneself (gender). Gender nonconformity is an identity, role or expression that is different from the cultural norm. In itself, gender dysphoria is a natural and normal condition for some people. The struggle associated with it relates to self-acceptance and acceptance by others. Gender dysphoria presents in young children, adolescence and adults.
Many people with gender dysphoria come to therapy to:
1) Explore their gender identity or expression
2) Facilitate a “coming out” process
3) Get an assessment and referral for feminization or masculinizing medical interventions such as taking hormones or having surgery
4) Receive psychological support for family members
Hormones, Sexual Reassignment
I follow the World Professional Association for Transgender Health (WPATH) Standards of Care when treating those with Gender Dysphoria. The major purpose of the Standards of Care (SOC) is to state the organizations professional consensus about the psychiatric, psychological, medical and surgical management of gender identity disorders. Professionals use the standards to understand the suggested guidelines within which to offer assistance and services. I recommend that anyone who desires making any changes regarding their gender dysphoria read the standards that apply to them. The standards set the suggested / required recommendations for surgery, hormones, etc.
You can obtain a free copy of the SOC through: SOC FREE DOWNLOAD
Requirements for Letters for Hormones / Surgery
The following are requirements for (F to M) or (M to F) SRS letters according to the Standards of Care:
- Assessment and Diagnosis of gender dysphoria and identification and treatment of any other known diagnosis that may also be active (by therapist)
- Review of gender history (outline will be provided)
- Review of family history (outline will be provided)
- Discussion in counseling or during the assessment about risks and benefits of treatment options
- Reviewing the psychological and practical criteria set by the SOC to determine eligibility and readiness for surgery
- A completed “Request for Letter” which requests necessary information such as doctors name, address, fax, when you would like the letter, etc.)
According to the Standards, therapy is not a requirement for surgery, and the above can be done through individual assessments. Yet, many people choose some therapy to discuss and work through their individual and unique situations.
Real Life Test Issues for M to F transitions
It is required that those going from M to F transitions be living full-time for one year prior to SRS. The following are topics covered during the assessment or in therapy, to process the 12 month Real Life Test. Not all of the following are applicable to everyone transitioning.
1. Self acceptance
2. Religious / spiritual issues
3. Dealing with spouse and children
4. Telling family and friends
5. Experiencing discrimination from others
6. Establishing a new network of friends
7. Starting hormone therapy
8. Transitioning on or changing jobs
9. Undergoing electrolysis for hair removal
10. Developing a wardrobe
11. Learning to “pass”
12. Voice coaching
13. Cosmetic surgical procedures
How I can help with Gender Dysphoria
Therapy is a safe place where gender dysphoria, and gender variant conditions , are seen as a matter of diversity and not pathology. We will explore your gender history, gender expression and the history and development of your gender dysphoric feelings. Also, the impact of any stigma you have experienced and how these feelings have affected your mental health and ability to function in everyday life. We will discuss the range of treatment options and their implications. We will ascertain your eligibility and readiness for hormone and surgical therapy as well as the risks and benefits of each, if you are interested in these options. Each person makes informed choices about what works best for them. I am able to give letters and formal recommendations to medical and surgical colleagues when appropriate. You also have the opportunity to bring family members / partners / employers / others to therapy for educational purposes and to enhance understanding and strengthen relationships. I can also work with them on an individual basis, when appropriate.
My goal is to provide a safe space where those with gender dysphoria can discuss their issues and concerns and make educated and informed decisions regarding what would work best for them to alleviate their symptoms. In addition, my goal is to help those with gender dysphoria achieve lasting personal comfort with themselves.
Gender Dysphoria Resources:
For a list of the current Transgender Support Groups in Houston, Texas go to:
http://www.meetup.com (search for “Houston Transgender Meetup”)