Depression and Mental Health

Finding a therapist, psychiatrist, or faith-based counselor can be challenging for many folks. As one person at the meeting noted, finding a therapist is nearly like finding a life-partner: You need to be able to build a trusting, deep, relationship with them.

For trans+/SOFFA individuals, we often add a layer of complexity to the “usual” quest for a therapist. Many therapists say they are “gender experts”, but when we walk into their offices, we quickly realize that we are far more educated about trans+/SOFFA issues than they are!

Providers also sometimes have difficulty separating out what issues belong in which camp. For example, some therapists may assume everything has to do with gender issues, while others may not see the interconnectedness of gender with other issues.

One excellent article, published in the mental health issue of FORGE’s own Connectivity is Reid Venderburgh’s article: “What to Look for in a Therapist: A Trans Perspective”
http://www.forge-forward.org/newsletters/v07i02/therapist_lookfor.html

Reid also offers many other articulate, balanced articles on his own website: http://www.transtherapist.com/

Therapist Katherine (Kit) Rachlin has also written extensively on trans+ (specifically FTM) issues and experiences with psychotherapy and mental health concerns. One of her articles (“Transgender Individuals' Experiences of Psychotherapy”) can be found in the International Journal of Transgenderism at http://www.symposion.com/ijt/ijtvo06no01_03.htm

FORGE also provides a limited resource guide for therapists and other providers in Wisconsin/Illinois who have been recommended (and have been confirmed as “good” therapists/providers) by more than one person. While these providers have worked for many individuals, everyone’s needs and expectations are different. If you’ve worked with providers not on this list and wish to recommend them (or have further feedback for those already on the list), please email info@forge-forward.org. The resource list of Wisconsin/Illinois providers can be found online at: http://www.forge-forward.org/handouts/Milwaukee_Resources.pdf

 

A common question asked about testosterone is if and how it may affect mood and/or personality. While everyone’s experience is different, the majority of people report experiencing a CALMING, stabilizing, less moody effect when starting on testosterone rather than the hyped-up reports of increased aggression, anger and rage.

The belief that testosterone causes aggression or anger is often highly over-reported. Many FTM+s and SOFFAs find that the introduction of testosterone results in moods stabilizing, the person becoming easier to be around, more able to socially relate to others, and many other positive characteristics.

Again, the Mental Health issue of Connectivity contains an in-depth look at mental health issues and how they intersect with transness (from a trans person’s or SOFFA’s perspective). We collected data from 96 individuals who participated in an open survey. The analysis of this survey is lengthy, but contains highly relevant information on the types of mental health services people used, reasons people sought therapy, common diagnoses, SOFFA therapy about trans+ issues, psychotropic drug use, the practical impact of mental illness, how or if mental illness is attributed to being trans+/SOFFA, letter requests denied due to mental illness, experiences with mental health professionals, involuntary treatment, suicide attempts, mental health and hormones, mental health techniques, insurance coverage, and more. You can read the mental health survey results in Connectivity online at: http://www.forge-forward.org/newsletters/v07i02/MHsurveyresults.html

Many individuals believe that starting transition/transitioning will resolve pre-existing issues in a person’s life. Some people assume that all difficulties are related to being trans. While this MIGHT be true for a rare few, most of us live complex lives that are laden with various challenges and experiences to work through.

Also, many individuals seek therapy ONLY to gain access to transition services (i.e. receive a letter from their therapist so that they can acquire hormones and surgery). While this gatekeeping part of the system is perhaps unnecessary for some people, therapy can OFTEN benefit many people with a wide variety of issues and concerns. Some trans+/SOFFA individuals do take the time prior to transition to work on issues that they feel need to be resolved - and possibly need some closure PRIOR to their gender journeys moving into the hormone, surgery or legal realm(s).

Some people feel that taking these steps to resolution on some issues is essential before taking transition-oriented steps. (Others feel that the issues have been there a long time - perhaps - and transition is something that is necessary, regardless of whether or not they address particular issues ahead of time, and realize that the same issues will be there for them to look at after they take transitional steps.)

Some issues that people often feel need to be “resolved” or worked on prior to transitioning can include:
• making peace with parents or other relatives
• working through issues of sexual assault or domestic violence
• addressing misogyny, misanthropy, or other gender-based oppression and beliefs
• getting clear on differences between body issues and gender issues
• solidifying or working on any existing partner issues
• working on better financial management
• etc

The Harry Benjamin Standards of Care (HBSOC) are what many trans+ people and therapists/physicians/surgeons use as a guide for assessing who, when and how people can access medical-oriented services typically associated with transition (e.g. hormones, surgery).

The HBSOC are highly controversial and have created a division among and between providers/professionals and trans+/SOFFAs/consumers/clients. The HBSOC are controversial, in part, due to their pathologizing of transgenderism, when some people believe that it is not a medical issue, but rather a social, political, or personal choice issue.

Regardless of your personal opinion on the HBSOC, if you or your loved one are interested in pursuing hormones and/or surgery, you will likely run across providers who insist on a “letter” or other documents (suggested by the HBSOC) in order for you to proceed to accessing hormones and/or surgery.

You can learn more about the HBSOC at http://www.hbigda.org/socv6.html

There have been several “alternatives” to the HBSOC. You can review a couple of them by going to the links below:

ICTLEP's Health Law Standards of Care for Transsexualism
http://my.execpc.com/~dmmunson/ictlepSOC.htm

From Dimensions at the Castro-Mission Health Center in San Francisco
http://tghealth-critiques.tripod.com/consen1.htm

From the Fenway Community Health Center in Boston
http://tghealth-critiques.tripod.com/fenway1.html

Parents are often some of the people that are the most puzzling for trans+/SOFFA individuals to come out to, or to help get support for. Many resources are geared around the trans+ person and/or the spouse of a trans person. Few resources directly focus on parents.

In Wisconsin, there are a few PFLAG chapters - some of which address Trans+ issues, some of which don’t have any direct experience. Here is a list of the chapters we could locate in Wisconsin. (If you know of other chapters, please contact us at info@forge-forward.org)

PFLAG Madison
Box 258168
Madison, WI 53725-8168
(608)848-2333
Email: elderj@ssc.wisc.

PFLAG Janesville
2116 Mineral Point Ave.
Janesville, WI 53545-3455
(608)754-0261
Email: ringlett@prodigy.net

PFLAG La Crosse/La Crosse Area
P.O. Box 3655
La Crosse, WI 54602-3655
(608)787-0466

PFLAG Galesville/ Western WI
P.O. Box 399
17150 N. 4th St.
Galesville, WI 54630-0399
(608)582-2114
Email: marinuka@aol.com

Many parents may also benefit from the PFLAG transgender-specific website, which can be found at http://www.youth-guard.org/pflag-tnet/ (PFLAG Transgender Network).

Another useful resource is the Trans Family of Cleveland website, which provides many email lists and services/resources to family members of a trans person. Their primary email lists include ones geared towards general discussion, parents, couples, spouses, youth, and children. http://www.transfamily.org/emailist.htm

This issue has been discussed at length at other FORGE meetings, as well as in many other forums. FORGE’s focus is on the whole - of a person, their network of partner(s), friends, families and allies. This includes looking at this network FROM a spouse-of-a-trans-person perspective, with the “spouse” as the primary person seeking support, understanding and resources.

There are many resources for spouses and how transition can and does impact the spouse of a trans person. Key issues such as core identity (Am I straight now? Am I now going to be seen as a lesbian or gay man?) can cause confusion, frustration, joy, and/or even comfort.

The impact of one person’s transition on a partner can be wide-ranging. For support (of partners of FTMs) on these issues, we recommend subscribing to the FTM SO list at: FTMSOs-subscribe@yahoogroups.com

We will continue addressing partner identity issues in other follow-ups and at our meetings.

Many communities struggle with issues of “only space” and inclusion. While safety is often touted as the reason some groups are exclusive, inclusive, or identity-based, one of the core issues is that SOMEONE always ends up feeling excluded. FORGE’s national newsletter Connectivity will be addressing the issues of “only space” in an upcoming issue. If you would like to share your opinions with our readership on “only space”, please send submissions to editor@forge-forward.org. Below is the call for submission(s). Due to a lag in our production schedule, there is no deadline set for submissions at this time.

ONLY Space Call for submissions

"Only" space can take a variety of forms. Basically, it means space where some people are welcome and others are not.

All of us have used "only" space -- single-sex bathrooms are one ubiquitous example. But there are many other examples, including restricted-membership email lists, workshops at conferences, identity-based organizations, segregated schools, single-orientation social support groups, etc.

What's good about such "only" space? What personal revelations or growth have you experienced in "only" space? In what ways does such space promote community-building? What stories of "magic" happening out of "only" groups can you share?

What's bad about such "only" space? When you've been barred from space because of your identity, how have you felt? In what ways do you think a community loses out when it permits "only" space? What stories of harm that resulted from "only" space can you share?

Who should be able to determine the existence and boundaries of "only" space? Is "only" space created/policed by the government different from "only" space created/policed by a group of individuals? If so, how and why? Should only "non-privileged" or "disempowered" or "stigmatized" people be able to create "only" space? If so, how do you define "non-privileged," "disempowered,"or "stigmatized"? Are there instances in which members of traditionally more powerful groups are actually harmed by less powerful groups through "only" space? If so, why or why not should this be justified?

Have you ever been involved in protesting "only" space? What, why, and how did you choose to protest? Did anything change as a result of the protest?

"Safe" space is often associated with "only" space. How do you think safety is -- or is not -- promoted through "only" space? What does "safety" mean?

"Empowerment" is also sometimes associated with "only" space. How do you think people are "empowered" through "only" space?

What are our alternatives to "only" space? How can we make "only" space work better for more people?

How do we resolve any contradictions we may feel about "only" space we choose for ourselves versus "only" space someone else has decided we can't access?

 

Many trans+ people have chosen to call themselves intersex(ed) because it “sounds” like an appropriate description of who they are. Unfortunately, while people can choose to label themselves in any way they choose, this can also be offensive to people who have a medically intersexed condition.

The Intersex Society of North America defines intersex as:

“a set of medical conditions that features ‘congenital anomaly of the reproductive and sexual system.’ That is, a person with an intersex condition is born with sex chromosomes, external genitalia, or an internal reproductive system that is not considered ‘standard’ for either male or female.”

For more information on Intersex, contact the The Intersex Society of North America at
http://www.isna.org/

“One bonus of being bisexual is that you never have to change your identity label!”

For more information about FORGE (meetings, past meetings, basic information, resources), please contact FORGE, PO Box 1272, Milwaukee, WI 53201. Phone: 414-278-6031. Email: info@forge-forward.org.