Transsexual - Article

HORMONES, SEXUAL REASSIGNMENT AND LETTERS

I follow the World Professional Association for Transgender Health Standards of Care when treating those with Gender Identity Disorders. The major purpose of the Standards of Care (SOC) is to articulate the organizations professional consensus about the psychiatric, psychological, medical and surgical management of gender identity disorders. Professionals use the standards to understand the parameters within which to offer assistance. Clients and their families use the SOC to understand the current thinking of professionals.

You can obtain a free copy of the SOC through: www.wpath.org/publications_standards.cfm

The general treatment goal of psychotherapeutic, endocrine, or surgical therapy for persons with gender identity disorders is LASTING PERSONAL COMFORT WITH THE GENDERED SELF IN ORDER TO MAXIMIZE OVERALL PSYCHOLOGICAL WELL-BEING AND SELF-FULLMENT.

Tasks for Mental Health Professionals

According to the SOC, there are 10 tasks for mental health professionals:

  1. To accurately diagnose the individual’s gender disorder
  2. To accurately diagnose any co-morbid psychiatric conditions and see to their appropriate treatment
  3. To counsel the individual about the range of treatment options and their implications
  4. To engage in psychotherapy
  5. To ascertain eligibility and readiness for hormone and surgical therapy
  6. To make formal recommendations to medical and surgical colleagues
  7. To document their patients’ relevant history in a letter of recommendation
  8. To be a colleague on a team of professionals with an interest in the gender identity disorders
  9. To educate family members, employers, and institutions about gender identity disorders
  10. To be available for follow-up of previously seen gender patients.

Differences between Eligibility and Readiness: (According to the Standards of Care)

The SOC provide recommendations for eligibility requirements for hormones and surgery. Hormones and surgery are a consideration when these requirements are met.

An example of an eligibility requirement is that a person must live full time in the preferred gender for twelve months prior to genital surgery. To meet this criterion, the professional needs to document that the real-life experience has occurred for this duration.

Meeting readiness criteria – further consolidation of the evolving gender identity or improving mental health in the new or confirmed gender role – is more complicated, because it rests upon the clinician’s and the patient’s judgment.

Requirements for Letters from this Office.

The following needs to be completed for SRS letters:

  1. Assessment and Diagnosis of GID and to R/O a differential diagnosis
  2. A gender history (outline will be provided)
  3. A family history (outline will be provided)
  4. Counseling about the range of treatment options and their implications
  5. Ability to ascertain eligibility and readiness for surgery
  6. To process the adjustment of the following throughout the Real Life Test
  7. Self acceptance
  8. Religious / spiritual issues
  9. Dealing with spouse and children
  10. Telling family and friends
  11. Experiencing discrimination from others
  12. Establishing a new network of friends
  13. Starting hormone therapy
  14. Transitioning on or changing jobs
  15. Undergoing electrolysis for hair removal (for MTF’s)
  16. Developing a wardrobe
  17. Learning to “pass”
  18. Voice coaching
  19. Cosmetic surgical procedures
  20. Sexuality

Meeting regularly throughout the real life test is required for a letter for SRS.

Letters for Hormones can be given when the client's symptoms meet the criteria for GID, when there is an understanding of the changes hormones may have and when a gender and family history have been completed.

 

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or email: deniseod@aol.com.