Monday, December 22, 2014

A $1,000+ Transition Permission Slip

So on an unintentionally related note, today is my hormone anniversary.  I've been on testosterone now for three years.  It has been one of the best decisions I ever made for myself, but not without a lot of hoop-jumping and stress that I never should have needed to go through.

I'm going to write about something I've wanted to write about for a really long time, and then consistently decided against it in order to preserve the feelings of somebody I really shouldn't feel obligated to preserve the feelings of.  I'm not going to name names.  But I know if she reads this she'll recognize herself and probably go on a moping fit with her current transgender clients, a tactic she pulled with me early on.

I'm talking about my gender therapist.

This is basically a rant.  I am not talking about solutions (although there are some attempts in progress, like the informed consent model).  I needed to write this because it's something that's frustrated me ever since I had to go through it, and I never put the full story into words.

For some quick context:  I came out as transgender in 2003 and persistently identified with it for years before I finally went to a gender therapist.  I shouldn't have actually needed a therapist, having already lived for years in my current gender, but I couldn't find any other option that wasn't prohibitively far away or not taking new patients.  Over the phone she said that I would only need nine of the usual twelve sessions, because I'd already gone through the business of changing my legal name, coming out, and pretty much everything up until hormones.

This would turn out to be a lie.  When I say "lie," I don't mean "we went through the nine sessions and learned I needed more time to think about it."  I mean "after I'd already signed up and started going through all this shit she acted like she'd never even told me I'd need fewer sessions when I brought it up."  She also eradicated her student rate somewhere around session 10, meaning my rate nearly doubled.  To top it all off, she didn't tell me until after I got my hormone letter that if I didn't continue going to her sessions for two months after I started hormones she would contact the doctor and cut the whole thing off.

In the sessions themselves, we rarely talked about my gender identity at all.  This made perfect sense, because I was already pretty well situated in it.  Instead we talked about things like relationships and sexual orientation, which she--surprise surprise--handled very poorly.  I told her that I didn't really like identifying as "pansexual."  Rather than say "cool, your identity is your identity," she spent at least fifteen minutes trying to convince me that I should start calling myself that, including an entirely ludicrous story about how even though she was a married heterosexual woman she was "spiritually pansexual."

She was vaguely Pagan-oriented, which would have been fantastic were it not so often used as a stopping block for me.  One day she declared she was going to speak to my spirit guides, and her "messages" from them were word-for-word the exact things we'd talked about in a prior session.  If she wanted me to stop talking about something, she'd tell me I was "shapeshifting."  Even as a Pagan and spiritualist myself, these incidents eventually grated on me so much that I pretty much ignored them whenever they happened.

Every session was peddled with these weird instances of undermining my identity, undermining other peoples' identities, and pushing me to get more invasive and unnecessary psychotherapy.  In fact, when she'd told me I only needed nine sessions to begin with, she exclaimed that so many of her other clients "come in looking genderqueer," as if this alone would be perfectly acceptable grounds to keep them coming back for her $60+ and later $110+ sessions.  Throughout the entire process of tacking on more therapy, she insisted that she hated being "a gatekeeper," believing that hormones should be accessible without therapy by people seeking them.

And this all wasn't even the worst part.  The worst part was when I dipped a bit below the financial ability to pay for some sessions and I asked her if I could delay a few.  She said that this was fine, and we could just pick up where we left off when I had the money--great!--and then went on to tell me that not having enough money is a spiritual sign that maybe I'm not ready.

I didn't say anything at the time, but what the fuck?  Poverty is some sign from the Gods that I'm spiritually not ready for hormones?  And this woman is one of the most revered gender therapists in my area.  She speaks at schools and hospitals about transgender children, she has a lot of local power.  How many people believe things like this from her?

And how many therapists are exactly like her?

I have had bad luck with therapists, psychiatrists and all.  I went to one for depression several years ago who turned out to have so little experience with transgender issues that I basically had to teach her every step of the way.   My gender therapist herself was useful in getting my gender marker changed on my driver's license and giving me a letter... after going through a gauntlet of gaslighting hippie hell.  A therapist I worked with to help build a new GSA took months to recognize that it's OK for people to identify as "queer" if they want to, and it's clear from talking to trans people who have sought out her services that she doesn't understand what transition really requires.  And these are just the ones who don't work in the prison system, which leads to its own brands of fuckery and gatekeeping, brands that are much more intense due to the systematic dehumanization and punishment-over-rehabilitation attitudes we have toward prisoners.  That's a subject for a different time, though.

Why?  Largely because doctors want to cover their asses.  Because people have it in their heads that transition is something people do on a whim and will totally regret later.  Because people are convinced that transgenderism is so awful that they have to weed people out to make sure there are fewer of us.

I am sure there are people who have benefited from this therapist's services, as well as the services of many other gender specialists currently practicing.  There genuinely are people who feel they need therapy to help get them through the process, to help them discover if it's what they really want, to help them with coming out to family and at work, and so forth.

But therapy as a hard and fast requirement by doctors to gain hormones or surgery, by family members to "prove" we are legitimate, to change IDs, to gain access to necessary services, this is something I really can't support anymore, if I ever really did.