Choosing and working with a therapist
Dec. 10th, 2009 04:11 pm![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
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transFrom time to time there are questions about therapy and therapists from folks who want to go to therapy but are not quite sure how to go about it or what to expect. Here are some guidelines that pertain to individual therapy (not couples or family therapy).
Deciding to enter therapy
I've just come out to myself and I don't know what to do. Should I get some therapy?
Not necessarily. Do some research first and learn more about what you think you're interested in: transition, non-transition, specific aspects of transition, the support system available to you, trans friendly doctors in your area/health plan, whether they operate on informed consent, and how you feel about the whole thing. You may find that knowledge is power and you're clear on what you want and feel okay about getting it. If you are in this situation and your provider does not require a therapist's letter, there is no immediate need for therapy. You could decide to go later if your feelings or situation changes. If your provider does require a letter, then that is a reason to go to therapy.
However, you may have problems with your family, significant others, or employer. You may feel scared, have mental or physical illness that you are concerned might be affected by transitioning, or be experiencing confusion, anxiety, depression, or the self-loathing of internalized transphobia. You may not have anyone in your life to whom you can speak freely about being trans. You may know yourself and recognize that you will need support along whatever path you've decided to take, even if you don't need support right now. All of these are good reasons to go to therapy.
I have issues besides being trans but they're all mixed up and I don't know where to start fixing my life. Should I go to therapy?
That would be a good idea. A good therapist can help you sort things out and re-organize your life so you feel able to do what you want to do. A good therapist can also help you figure out what you want to do, which is generally a prerequisite for doing anything.
I have problems that have nothing to do with being trans and I'm worried a therapist will make it all about my being trans. Should I try therapy anyway?
It wouldn't be a bad idea. If you decide to enter therapy, you have some options. You can not disclose to the therapist. You can screen trans aware therapists closely for red flags. You can go to a therapist who specializes in the issues you want to work on, disclose, and explain that you're there to work on issues X,Y, and Z only.
Why should I go to therapy? I can handle things fine on my own.
That's great. Be open to the idea that it might someday be helpful. And don't, I beg you, soldier on being "fine" when therapy could get you where you're going years sooner than going it alone. You have one life, and blah, blah, blah. Some time in therapy has the potential to let you enjoy more of it.
Finding and choosing a therapist
Who are the therapists in my area?
Phone books are the first place to look. Paper phone books may become obsolete soon, but for now, the Yellow Pages are a good place to start. Googling "therapists [your location]" is another quick and dirty search, and "find a therapist" brings up regional and national databases where you can search for therapists in your area. Often, if there is an LGBT clinic close to you, they will offer therapist services, so check there as well. Googling the names of the therapists you're considering will often bring up information on their specialities that can help you decide which ones to contact. You may also be able to find a therapist near you with T-Vox.
How do I set up an appointment? What questions will the receptionist ask?
Therapists (or clinics) that have a website generally have an email. If you are more comfortable with email than the phone, use email. If you have to use the phone and are nervous about it, writing a short script, notecards, or list of cues can help you keep your nerve. If you can't manage to make the call the first time (or the second, or the third, etc.), that's okay. Take a break and try again later.
When you make your call (or send your email), you will want to introduce yourself simply and say you are seeking therapy for [your issue(s)]. You don't have to explain anything in detail. The receptionist might ask you a few questions, such as the days and times you are usually available, and if you have a preference for a male or female therapist. You will set up an appointment just like scheduling to see the dentist and that will generally be it. If you're particularly nervous, it can help to have something for yourself after you finish the call--a treat, a hot shower, a jog, whatever will relax you a bit.
Additional info:
If you are unsure if the therapist you are contacting is trans friendly, or has experience dealing in what you need to address, it is a good idea to ask, "Does [therapist] have experience working with [your issue(s)] clients?" right after you introduce yourself.
If you are going to therapy strictly to get a letter for hormones or surgery, make that clear right away and ask how many sessions and what time span the therapist requires. You don't want to find out after you commit that this is a therapist that is going to string you along for money or make it harder than absolutely necessary.
What if I don't like the therapist I picked? Do I have to pay up front and risk wasting my money?
No. If you aren't sure about therapy, or if you'd like to check out several therapists, instead of calling to make an appointment, you can call to set up a screening interview. Therapists want good matches as much as their clients do, so almost all of them will give you a short amount of time (5-15 minutes) for free to interview them one-on-one and decide if you want to go to them. During that time you can ask any questions you wish. To arrange this meeting, you can say, "I'd like to meet [therapist] in person before I schedule an intake appointment. Are they available for a few minutes so I can ask them some questions? When can I come by?"
What sorts of questions will help me decide if a therapist will be a good match?
That depends on why you're going to therapy and what is important to you in a working relationship. Questions like, "What is your style of therapy?", "What is your interaction style?","What is your philosophy regarding the WPATH standards?", and "It's hard for me to talk about [an issue]--are you comfortable working with me on that?" are all good questions to ask. "Tell me a little about yourself" is also fair game. If you have a preferred style of communication, make that known. Whatever you need to know about the therapist in order to decide if you feel comfortable working with them, that is what you should ask.
I don't think I can afford therapy.
First, check your health insurance, if you have it. Most plans have at least a little coverage for mental health visits. If you have coverage, get the details on it and select a therapist who works with your insurance. Be aware of limits on visits, co-pays, and other potential expenses, including gas and tolls if you have to travel to see your therapist.
If you live in a large metroplitan area, consider therapists are who in outlying areas. Private practicioners charge what the market will bear, and generally the suburbs or exurbs will be cheaper than therapists right in the city. On the other hand, cities are more likely to have clinics where therapy is more affordable, so don't forget to check there too.
If you have no insurance coverage, ask if the office uses a sliding scale fee schedule. Sliding scales are a variable rate structure that charges less to people who make less. Some offices will require proof of income, while some will ask you to pay what you think you can afford. Even if the therapist does not advertise using a sliding scale, be sure to ask. Many will work with you on an individual basis to help you afford it.
Generally, people who are determined to get therapy manage to afford it. If you are having trouble or think you will, explore all your funding options and explain your situation so that you get any available help.
What to expect of therapy
How will it begin?
The first session (sometimes two) are what's known as an intake appointment. You will come to the office, fill out a long questionaire that will ask you why you're there, to explain your situation in a little bit of detail, and give you a couple screening exercises, like the sheets with lists like, "Most of the time, I am happy with how I look" and ask you to pick T/F or 1-5 based on if the statement describes you well or not at all.
After that, you'll meet the therapist and go to their office, where you'll spend a lot of time talking about why you're there. At the session after the intake session(s), the therapist will suggest some things to start working on, and, if you want, explain the bigger picture of your treatment. For example, they may say, "I think you have internalized transphobia that is making your depression worse, so my goal for you is to treat the transphobia and see what that does to the depression." They may also explain what they think is going on in psych terms. If you're familiar enough to engage the therapist on this level, I'd encourage you to do so, if for no other reason than that the jargon allows access to a wider range of description for what you feel is going on with you.
I don't know where to start.
If your reasons for being in therapy are hard to talk about, you can write a list for yourself, or even write a letter for the therapist and ask them to read it instead of you having to explain. The therapist will ask questions to prompt you or for clarification. They will also, at some point, ask what your goals for therapy are, so you'll want to think about that beforehand. Goals can be complicated and multiple. It is perfectly okay to say, "I want to get a letter for hormones" and "I want to work on my relationship even though my SO says they'll leave if I start hormones" and "I have social anxiety". Totally fine. Goals can also stretch across time. If you know you can't handle going back to school now, but want to in the future, setting a goal to start school in two years (or whenever you want to be emotionally ready) is great.
This is also, if you didn't do a screening interview, when you tell the therapist how you like to work. If you need them to ask you questions to get you to open up, if certain topics are triggering and should be dealt with delicately, if you need some direction or if you come in with a list and march right through your topics for the day.
If you mean to do all this and find you can't when you're actually face-to-face with the therapist, it is totally okay to just say, "I need help". That'll get the conversation started.
What if I already know what I want to talk about?
Come in prepared to say it. You can be as organized as you want to be. You can come into each session with an agenda planned down the minute, you can do research and work on your own, and you can email your therapist to keep them updated. You can ask for homework assignments. A good therapist won't fight with you for control of the conversation or the direction of your therapy. You determine where it's going and they just keep it on the rails.
If you are in therapy strictly to get a letter, re-iterate that right off the bat and ask the therapist to explain what they need from you in order for you to get one. Generally speaking, the only thing a therapist really should be doing in this case is ensuring that you are mentally healthy enough to handle transition. They might ask you questions about your self-esteem, or about your expectations for transition, and give you what-if scenarios where your transition outcome is not what you planned, to see if you have been thoughtful in your considerations. If they ask any questions that you feel are invasive or inappropriate, say so. "I 'm not comfortable with that question and I want to know why you asked it,"* is perfectly okay to say. You don't have to accept their answer, either, nor do you ultimately have to answer the question, or even finish the session. Try to give the therapist the benefit of the doubt, but if they do something wildly inappropriate, feel free to walk right out. You don't have to explain yourself.
*I actually said this to a therapist.
What sort of relationship should I expect with my therapist?
It is tempting to think of a therapist as a friend you pay to listen to you, but that understanding is misleading. Try to think of the therapist as an expert you are hiring for their services. You want a cordial, working relationship with clear boundaries. No inviting the therapist out to lunch. No giving them birthday presents. You are a client; they are a consultant. In the same vein, if after a while you feel you are outgrowing your therapist, that they are not providing you with insights you couldn't get on your own, then it is time to find a new therapist with the expertise you need. Having too "friend-like" a relationship with your therapist can delay this transition because you want to avoid hurting their feelings by leaving. Not that you want to go out of your way to insult your therapist either, but establishing a more distant relationship will help you get more out of therapy.
The therapist may take notes while you're talking or record your sessions with a voice recorder. If they are to be recorded, you will need to sign a consent form. They may say only "mm-hmmm", and "How do you feel about your mother?", or they may really like to engage in dialogue. They may share a bit of their personal lives or they may not.
Whatever your in-session interactions look like, you will get the most out of therapy if you commit to working outside of session. Reading, journaling, doing thought or physical exercises as assigned by the therapist--all these will help you get where you're going faster. Put simply, the more you put into therapy, the more you'll get out of it. This is one area of life where hard work is amply rewarded. Maintaining a good rapport with your therapist and putting in effort outside of session will get you where you want to go much more quickly than only thinking about therapy for an hour a week while in session.
What if I don't think it's working?
Say so. Therapists are observant, but they can't read minds. If something about your interactions with the therapist is bothering you, say so. "I wish you wouldn't smile at me so much; it makes me uncomfortable,"* is a perfectly valid thing to say. Likewise, so is, "We've been trying [a technique] for a month and I don't feel I've improved. What else can we do?" If you are frustrated or uncomfortable, speak up.
*Something else I actually said to a therapist. They smiled all the time. It was too much.
How long should I stay in therapy?
As long as you feel you need to. By the same token, you can go as frequently as you like and change that depending on your circumstances. If you need to go twice a week for a while, okay. If you need to check-in once a month, okay. You will eventually start to get a feeling that maybe you don't need therapy anymore, or at least not regularly. This may be a sign to try stopping for a while. If you like the way you're functioning, you're probably done except for maybe going back occasionally to deal with new issues. If you're not doing so hot, you may want to go back. It could be you just needed a break, or to find a new therapist. You decide when you're done with therapy. It could be three months or fifteen years. You may get sick of it and take breaks and then start again. The point is, you control the process, so go as long as you feel it's helping.
How do I stop therapy? What will the therapist say?
Therapists deal with clients coming and going all the time. If any therapist gives you a guilt trip for leaving, they've crossed some boundaries with you and you can say so. On the bright side, your therapist may actually recommend you stop therapy and see how you feel without it. If you've maintained proper boundaries, the two of you will probably be on the same page regarding your progress and you may have been feeling ready yourself. When you make the decision to stop therapy, you will probably spend your last session recapping the work you've done and summarizing where you are now. You may be asked to take an exit survey. That's it. If you are grateful towards your therapist, a thank you letter is absolutely an appropriate gesture.
Things to watch out for
Conclusion
There are, of course, bad therapists and good therapists, and it is an unfortunate fact that many therapists have no experience working with trans clients, are prejudiced, or both. Nevertheless, good therapy is an immensely powerful tool that can help reshape your life. This post was written to hopefully provide the information needed for a person to successfully find a good therapist and make the most of their therapeutic work.
This post is public so that it can be a resource for those who aren't members of![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-community.gif)
transgender.
Deciding to enter therapy
I've just come out to myself and I don't know what to do. Should I get some therapy?
Not necessarily. Do some research first and learn more about what you think you're interested in: transition, non-transition, specific aspects of transition, the support system available to you, trans friendly doctors in your area/health plan, whether they operate on informed consent, and how you feel about the whole thing. You may find that knowledge is power and you're clear on what you want and feel okay about getting it. If you are in this situation and your provider does not require a therapist's letter, there is no immediate need for therapy. You could decide to go later if your feelings or situation changes. If your provider does require a letter, then that is a reason to go to therapy.
However, you may have problems with your family, significant others, or employer. You may feel scared, have mental or physical illness that you are concerned might be affected by transitioning, or be experiencing confusion, anxiety, depression, or the self-loathing of internalized transphobia. You may not have anyone in your life to whom you can speak freely about being trans. You may know yourself and recognize that you will need support along whatever path you've decided to take, even if you don't need support right now. All of these are good reasons to go to therapy.
I have issues besides being trans but they're all mixed up and I don't know where to start fixing my life. Should I go to therapy?
That would be a good idea. A good therapist can help you sort things out and re-organize your life so you feel able to do what you want to do. A good therapist can also help you figure out what you want to do, which is generally a prerequisite for doing anything.
I have problems that have nothing to do with being trans and I'm worried a therapist will make it all about my being trans. Should I try therapy anyway?
It wouldn't be a bad idea. If you decide to enter therapy, you have some options. You can not disclose to the therapist. You can screen trans aware therapists closely for red flags. You can go to a therapist who specializes in the issues you want to work on, disclose, and explain that you're there to work on issues X,Y, and Z only.
Why should I go to therapy? I can handle things fine on my own.
That's great. Be open to the idea that it might someday be helpful. And don't, I beg you, soldier on being "fine" when therapy could get you where you're going years sooner than going it alone. You have one life, and blah, blah, blah. Some time in therapy has the potential to let you enjoy more of it.
Finding and choosing a therapist
Who are the therapists in my area?
Phone books are the first place to look. Paper phone books may become obsolete soon, but for now, the Yellow Pages are a good place to start. Googling "therapists [your location]" is another quick and dirty search, and "find a therapist" brings up regional and national databases where you can search for therapists in your area. Often, if there is an LGBT clinic close to you, they will offer therapist services, so check there as well. Googling the names of the therapists you're considering will often bring up information on their specialities that can help you decide which ones to contact. You may also be able to find a therapist near you with T-Vox.
How do I set up an appointment? What questions will the receptionist ask?
Therapists (or clinics) that have a website generally have an email. If you are more comfortable with email than the phone, use email. If you have to use the phone and are nervous about it, writing a short script, notecards, or list of cues can help you keep your nerve. If you can't manage to make the call the first time (or the second, or the third, etc.), that's okay. Take a break and try again later.
When you make your call (or send your email), you will want to introduce yourself simply and say you are seeking therapy for [your issue(s)]. You don't have to explain anything in detail. The receptionist might ask you a few questions, such as the days and times you are usually available, and if you have a preference for a male or female therapist. You will set up an appointment just like scheduling to see the dentist and that will generally be it. If you're particularly nervous, it can help to have something for yourself after you finish the call--a treat, a hot shower, a jog, whatever will relax you a bit.
Additional info:
If you are unsure if the therapist you are contacting is trans friendly, or has experience dealing in what you need to address, it is a good idea to ask, "Does [therapist] have experience working with [your issue(s)] clients?" right after you introduce yourself.
If you are going to therapy strictly to get a letter for hormones or surgery, make that clear right away and ask how many sessions and what time span the therapist requires. You don't want to find out after you commit that this is a therapist that is going to string you along for money or make it harder than absolutely necessary.
What if I don't like the therapist I picked? Do I have to pay up front and risk wasting my money?
No. If you aren't sure about therapy, or if you'd like to check out several therapists, instead of calling to make an appointment, you can call to set up a screening interview. Therapists want good matches as much as their clients do, so almost all of them will give you a short amount of time (5-15 minutes) for free to interview them one-on-one and decide if you want to go to them. During that time you can ask any questions you wish. To arrange this meeting, you can say, "I'd like to meet [therapist] in person before I schedule an intake appointment. Are they available for a few minutes so I can ask them some questions? When can I come by?"
What sorts of questions will help me decide if a therapist will be a good match?
That depends on why you're going to therapy and what is important to you in a working relationship. Questions like, "What is your style of therapy?", "What is your interaction style?","What is your philosophy regarding the WPATH standards?", and "It's hard for me to talk about [an issue]--are you comfortable working with me on that?" are all good questions to ask. "Tell me a little about yourself" is also fair game. If you have a preferred style of communication, make that known. Whatever you need to know about the therapist in order to decide if you feel comfortable working with them, that is what you should ask.
I don't think I can afford therapy.
First, check your health insurance, if you have it. Most plans have at least a little coverage for mental health visits. If you have coverage, get the details on it and select a therapist who works with your insurance. Be aware of limits on visits, co-pays, and other potential expenses, including gas and tolls if you have to travel to see your therapist.
If you live in a large metroplitan area, consider therapists are who in outlying areas. Private practicioners charge what the market will bear, and generally the suburbs or exurbs will be cheaper than therapists right in the city. On the other hand, cities are more likely to have clinics where therapy is more affordable, so don't forget to check there too.
If you have no insurance coverage, ask if the office uses a sliding scale fee schedule. Sliding scales are a variable rate structure that charges less to people who make less. Some offices will require proof of income, while some will ask you to pay what you think you can afford. Even if the therapist does not advertise using a sliding scale, be sure to ask. Many will work with you on an individual basis to help you afford it.
Generally, people who are determined to get therapy manage to afford it. If you are having trouble or think you will, explore all your funding options and explain your situation so that you get any available help.
What to expect of therapy
How will it begin?
The first session (sometimes two) are what's known as an intake appointment. You will come to the office, fill out a long questionaire that will ask you why you're there, to explain your situation in a little bit of detail, and give you a couple screening exercises, like the sheets with lists like, "Most of the time, I am happy with how I look" and ask you to pick T/F or 1-5 based on if the statement describes you well or not at all.
After that, you'll meet the therapist and go to their office, where you'll spend a lot of time talking about why you're there. At the session after the intake session(s), the therapist will suggest some things to start working on, and, if you want, explain the bigger picture of your treatment. For example, they may say, "I think you have internalized transphobia that is making your depression worse, so my goal for you is to treat the transphobia and see what that does to the depression." They may also explain what they think is going on in psych terms. If you're familiar enough to engage the therapist on this level, I'd encourage you to do so, if for no other reason than that the jargon allows access to a wider range of description for what you feel is going on with you.
I don't know where to start.
If your reasons for being in therapy are hard to talk about, you can write a list for yourself, or even write a letter for the therapist and ask them to read it instead of you having to explain. The therapist will ask questions to prompt you or for clarification. They will also, at some point, ask what your goals for therapy are, so you'll want to think about that beforehand. Goals can be complicated and multiple. It is perfectly okay to say, "I want to get a letter for hormones" and "I want to work on my relationship even though my SO says they'll leave if I start hormones" and "I have social anxiety". Totally fine. Goals can also stretch across time. If you know you can't handle going back to school now, but want to in the future, setting a goal to start school in two years (or whenever you want to be emotionally ready) is great.
This is also, if you didn't do a screening interview, when you tell the therapist how you like to work. If you need them to ask you questions to get you to open up, if certain topics are triggering and should be dealt with delicately, if you need some direction or if you come in with a list and march right through your topics for the day.
If you mean to do all this and find you can't when you're actually face-to-face with the therapist, it is totally okay to just say, "I need help". That'll get the conversation started.
What if I already know what I want to talk about?
Come in prepared to say it. You can be as organized as you want to be. You can come into each session with an agenda planned down the minute, you can do research and work on your own, and you can email your therapist to keep them updated. You can ask for homework assignments. A good therapist won't fight with you for control of the conversation or the direction of your therapy. You determine where it's going and they just keep it on the rails.
If you are in therapy strictly to get a letter, re-iterate that right off the bat and ask the therapist to explain what they need from you in order for you to get one. Generally speaking, the only thing a therapist really should be doing in this case is ensuring that you are mentally healthy enough to handle transition. They might ask you questions about your self-esteem, or about your expectations for transition, and give you what-if scenarios where your transition outcome is not what you planned, to see if you have been thoughtful in your considerations. If they ask any questions that you feel are invasive or inappropriate, say so. "I 'm not comfortable with that question and I want to know why you asked it,"* is perfectly okay to say. You don't have to accept their answer, either, nor do you ultimately have to answer the question, or even finish the session. Try to give the therapist the benefit of the doubt, but if they do something wildly inappropriate, feel free to walk right out. You don't have to explain yourself.
*I actually said this to a therapist.
What sort of relationship should I expect with my therapist?
It is tempting to think of a therapist as a friend you pay to listen to you, but that understanding is misleading. Try to think of the therapist as an expert you are hiring for their services. You want a cordial, working relationship with clear boundaries. No inviting the therapist out to lunch. No giving them birthday presents. You are a client; they are a consultant. In the same vein, if after a while you feel you are outgrowing your therapist, that they are not providing you with insights you couldn't get on your own, then it is time to find a new therapist with the expertise you need. Having too "friend-like" a relationship with your therapist can delay this transition because you want to avoid hurting their feelings by leaving. Not that you want to go out of your way to insult your therapist either, but establishing a more distant relationship will help you get more out of therapy.
The therapist may take notes while you're talking or record your sessions with a voice recorder. If they are to be recorded, you will need to sign a consent form. They may say only "mm-hmmm", and "How do you feel about your mother?", or they may really like to engage in dialogue. They may share a bit of their personal lives or they may not.
Whatever your in-session interactions look like, you will get the most out of therapy if you commit to working outside of session. Reading, journaling, doing thought or physical exercises as assigned by the therapist--all these will help you get where you're going faster. Put simply, the more you put into therapy, the more you'll get out of it. This is one area of life where hard work is amply rewarded. Maintaining a good rapport with your therapist and putting in effort outside of session will get you where you want to go much more quickly than only thinking about therapy for an hour a week while in session.
What if I don't think it's working?
Say so. Therapists are observant, but they can't read minds. If something about your interactions with the therapist is bothering you, say so. "I wish you wouldn't smile at me so much; it makes me uncomfortable,"* is a perfectly valid thing to say. Likewise, so is, "We've been trying [a technique] for a month and I don't feel I've improved. What else can we do?" If you are frustrated or uncomfortable, speak up.
*Something else I actually said to a therapist. They smiled all the time. It was too much.
How long should I stay in therapy?
As long as you feel you need to. By the same token, you can go as frequently as you like and change that depending on your circumstances. If you need to go twice a week for a while, okay. If you need to check-in once a month, okay. You will eventually start to get a feeling that maybe you don't need therapy anymore, or at least not regularly. This may be a sign to try stopping for a while. If you like the way you're functioning, you're probably done except for maybe going back occasionally to deal with new issues. If you're not doing so hot, you may want to go back. It could be you just needed a break, or to find a new therapist. You decide when you're done with therapy. It could be three months or fifteen years. You may get sick of it and take breaks and then start again. The point is, you control the process, so go as long as you feel it's helping.
How do I stop therapy? What will the therapist say?
Therapists deal with clients coming and going all the time. If any therapist gives you a guilt trip for leaving, they've crossed some boundaries with you and you can say so. On the bright side, your therapist may actually recommend you stop therapy and see how you feel without it. If you've maintained proper boundaries, the two of you will probably be on the same page regarding your progress and you may have been feeling ready yourself. When you make the decision to stop therapy, you will probably spend your last session recapping the work you've done and summarizing where you are now. You may be asked to take an exit survey. That's it. If you are grateful towards your therapist, a thank you letter is absolutely an appropriate gesture.
Things to watch out for
- A therapist should never sound like your nosy neighbor. If the questions you are being asked are invasive, inappropriate, or you mistrust the motive behind them, you can say so and refuse to answer them. You can also leave the room.
- A therapist should never touch you without your permission. They should not be sitting on the same piece of furniture as you, either.
- A therapist should never ask to see a part of your body that would require you to disrobe. There is absolutely no valid reason for a therapist to see your torso, genital area, or any other part of your body that is not normally visible when you are fully clothed.
- A therapist should never make sexually charged comments about you or come on to you. If they do, get the hell out of there.
- A therapist should never record your sessions without your signed consent.
- A therapist should not say, "All my trans clients [something something]." The only thing all trans clients have in common is that they are trans. If you are being put through a standard number of sessions even though you have nothing to say in session and sit there paying to twiddle your thumbs, get out of there.
- A therapist should not hedge when asked about a timeline or requirements for a letter. It is understandable that different people take different amounts of time to meet those requirements, but they should not be vague and the goalposts should not move. If you feel you are being strung along, say so.
- A therapist should not treat you like a lab rat. If you are willing to educate a therapist on trans issues, good for you. But don't put up with questions asked out of nosy curiousity, or being told you are so fascinating, or that trans people are so fascinating. Ew.
- A therapist should never laugh at, shame, or belittle you.
Conclusion
There are, of course, bad therapists and good therapists, and it is an unfortunate fact that many therapists have no experience working with trans clients, are prejudiced, or both. Nevertheless, good therapy is an immensely powerful tool that can help reshape your life. This post was written to hopefully provide the information needed for a person to successfully find a good therapist and make the most of their therapeutic work.
This post is public so that it can be a resource for those who aren't members of
transgender.