Monday, May 01, 2017

"How does that make you feel?"

When it comes to mental health care for us it will be getting harder as the Republicans tries to overturn the ACA that guaranties healthcare for us and it will depend more and more on state laws.
Transgender health
Las Cruces Sun-News
By Alexia Severson
April 30, 2017

At first, Johnson thought he might be gender fluid, so he experimented going between male and female identities. After about two years of experimentation, Johnson found he felt most comfortable identifying as male, and came out to his parents as transgender when he was in eighth grade.

“If I identify myself as a female, it just feels like I’m lying to everybody and that’s just not something I was about, because you only have a certain amount of time living here,” Johnson said. “You don’t know when you’re going to die. So, I was going to try to live my life to where I was happy and not try to please others so much.”
But now he is running into problems in getting mental health care,
Some of the most common mental health issues transgender people face are depression and anxiety, said Andrea Dresser, a licensed marriage and family therapist who works with several transgender clients at Counseling Las Cruces, 133 Wyatt Drive.

These issues can often stem from a lack of support from family and friends, feelings of isolation or mistreatment, and violence experienced by transgender individuals, Dresser said.
Anxiety in transgender people can often be caused by the trepidation of coming out to family members, deciding which bathroom to use, workplace situations that may arise and how to deal with being misgendered, Dresser said.

“It creates a lot of discomfort and anxiety for the person,” she said. “Should I correct my boss? Should I not correct my boss? It’s an educational process for everybody.”

Dresser said while seeing a therapist can help transgender people individuals cope with depression, anxiety or other issues, it’s critical that they also connect with others who may be going through similar life changes — such as through a support group.
Finding a therapist who can treat clients with gender dysphoria is hard especially in states that does not have protection for us and also in most states it is not against the law to practice conversion therapy.

Psychology Today has an article about how to choose a therapist.
How to Find the Best Therapist for You
Seven tips on finding the best fit for you.
By Tracey Cleantis, LMFT
Posted Feb 16, 2011

I thought, as a public service of sorts, and because I am a therapist and I write about being in therapy, it might be a good thing if I shared some thoughts about picking a therapist—should you ever find yourself in need of one—as they can be harder to find than a good mechanic.

1. Ask friends and family
Ask friends who are in therapy if they like their therapist. If they do, find out what it is they like about them and ask your friends to ask their therapists for referral lists. I have never gotten a good referral that way, but I have given out some good referrals because friends have asked me if my therapist knew anyone for them. But no matter where you go for help it has to be a good fit and remember the purpose of a therapist or a support group is to guide you and not lead you. No one should tell you what to do but they should present all the options and let you chose your path.

3. A picture tells a story
Take a look at therapists' pictures on Psychology Today's Therapist Finder. Red lights for me: Therapists who use glamour shots or whose portraits seem in any way seductive. I would also steer clear of therapists who use a photo of themselves partaking in a favorite hobby or recreational activity. If you have any doubt about a therapist based on photos, I would listen to your intuition. See if you can find someone who you could easily sit across from. I am not saying your therapist needs to look like a supermodel; you just want to look at the therapist without feeling any concern or apprehension. I would heed any intuition.

4. Gender
When choosing a therapist, almost all people have an instinctive idea on gender they would prefer to work with. For me, my default therapist choice is always male which, in fact, comes out of my relationship with my parents. I don't think there is a right or wrong when it comes to choosing which gender you prefer to work with. However, I think it can be clinically valuable to notice which gender you absolutely wouldn't want to work with. I would make note of that and let my therapist know about my strong feelings of "no way" when considering a certain gender for a therapist.
And probably the most important consideration is…
5. Theoretical orientation
This one is really tricky. There are many theoretical orientations and I certainly cannot explain them all in one single post. Here is what I can say in a huge and gross oversimplification:

If you believe there is an unconscious motivation for your behavior, you might want to go to a psychodynamic therapist.
  • If you want to change your thoughts and you think doing that will change your life, and you don't believe in an unconscious, then you might want a cognitive therapist.
  • If you don't ever want to talk about mom and dad and you only want the here and now then maybe narrative, behavioral, or solution-oriented therapies are something to consider.
  • If you want to work on your family and not just on you, then try a family-oriented systems therapist. Let me say again that was an enormous oversimplification. If you want to know a little more read this.
If you still have no idea at all about what orientation you might want, I would then call the referrals you found and ask about orientation. If the therapist says, "I am an existentialist" and leaves it at that, then have her explain what that means and how you would experience that orientation. Keep calling until you find someone whose style resonates with you.
Support groups can be found in just about all states some are professionally moderated and other support groups that are peer moderated. Both have positive outcomes and preference is based on the trans person, some like the professionally moderated because the discussion trends to state on track while sometimes in peer support groups the topic might drift off target (in one support group the topic drift was toward trains). Many trans do like the peer group better because they feel that we know the pitfalls better than a non-trans person.

But no matter where you go for help it has to be a good fit and remember the purpose of a therapist or a support group is to guide you and not lead you. No one should tell you what to do but they should present all the options and let you chose your path.

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