Taking Good Care of You!

General Transgender Support

Taking Good Care of You!

Postby Mom2TranAdult » Sat Oct 07, 2017 8:51 pm

Hello all! In my unquenchable thirst for knowledge about all things TG I was very pleased to find the following resource, which I thought may be of interest. It seems relatively up to date, and very comprehensive.

Here is the link for the Standards of Care from The World Professional Association for Transgender Health

https://s3.amazonaws.com/amo_hub_conten ... 281%29.pdf

I think it’s always best to have knowledge so you can advocate for your needs to the medical and mental health professionals you encounter. Just another way to take care of yourself.
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Re: Taking Good Care of You!

Postby MikiSJ » Sat Oct 07, 2017 10:44 pm

Hi mom.

WPATH is an older grouping of thoughts of what an individual seeking to be designated would need to adhere to in order to be deemed transgender. The strictures of WPATH are quite rigid and it would be difficult for most individuals to meet all of the required qualifications.

While some doctors and organizations still adhere to WPATH, most doctors and other gender related professionals use the 'Informed Consent' paradigm for judging a person to be transgender.

You may want to take a look at the following information. It is a bit dated, but goes beyond the WPATH in how to treat transgender: http://transhealth.ucsf.edu/trans?page=lib-00-02
When writing the next chapter in your life, start with a pencil and eraser - my first page as Miki is full of eraser marks. Doodling is allowed. I have started a new chapter but will still use a pencil.
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Re: Taking Good Care of You!

Postby Mom2TranAdult » Sun Oct 08, 2017 9:48 am

Hi Miki.

Thanks for bringing forward this other information/link. It was hard to tell the date of the revison of the WPATH guidelines. (It did seem odd that it says it’s the “7th version”, then gives dates for all the previous versions up to 2001, but not the current one.) Given that your Deutsch Guidelines on the link you provided are from 2016, they seem to be as up to date as you will find!

Thanks again. I find it helpful to be able to refer to something to ensure my adult child is getting the most informed care possible. Us moms worry about stuff like that :wink:-or at the very least, this mom.

If anyone else knows of guidelines such as these I’d love to know about them! Particularly guidelines from other parts of the world too.
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Re: Taking Good Care of You!

Postby Kaylalovescupcakes » Tue Oct 10, 2017 9:28 pm

Well that sucks. A requirement for HRT is "persistent, well documented gender dysphoria"

Guess I was right to not have gone to a doctor. Wouldn't have done me any good. I didn't know I was supposed to be writing this stuff down. :(
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Re: Taking Good Care of You!

Postby Ashley@Heart » Tue Oct 10, 2017 11:18 pm

Kaylalovescupcakes wrote:Well that sucks. A requirement for HRT is "persistent, well documented gender dysphoria"Guess I was right to not have gone to a doctor. Wouldn't have done me any good. I didn't know I was supposed to be writing this stuff down.


From my own experience every properly trained therapist and "approved" endo I have seen has been willing to help. Mind you help was not always at the level I really wanted and especially endos seem to get huffy if you push. But I got there and if I can anyone can.

There seems to be much heavier gatekeeping on the surgery side of things but I have only just started poking around with that. Not that it should surprise anyone.

I can't tell you how much I wish this sort of site and support existed when I was 18/19. But to have transitioned back then in 1988.. I can't remember being able to open up and tell any of the therapists I was sent to back in 1985, I think I at least had the presence of mind to not trust them and to be honest they just wanted to know why this "young man" who tests so well is failing in school. After weeks of tests, He is hyperactive, don't give him sugar.. and give "him" some tutoring. hahahahahah... I tell you what does work.. estrogen and purging this damn testosterone out of me. My therapist was like you have changed.. yea for first the first damn time I don't feel broken, I don't hate the mirror, and when I smile it is genuine. (And those are just the things I am willing to talk about...)
-Carolyn

“To be nobody but yourself in a world which is doing its best day and night to make you everybody else, means to fight the hardest battle which any human being can fight, and never stop fighting.”
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Re: Taking Good Care of You!

Postby Mom2TranAdult » Thu Oct 12, 2017 9:58 pm

Incidentally- both of these “Standards” documents go well beyond diagnosing gender dysphoria.

I just wanted to share that I am personally more interested in the health topics- like breast cancer screening guidelines for m2f individuals, or the health considerations in tucking etc.. lots of good starting points for educating less informed GPs or family doctors who have TG individuals as patients. I thought others might find them useful too. I’m sure there is even more information available that is credible and valid... just feels like lots of misinformation could be out there as well.

This research I did all led me to talk with my adult child about whether they had informed their Endoc about our family history of breast cancer.

I’m still reading both the guidelines (off and on) to become well informed myself. At some point I’ll share the actual documents with my adult child. Doesn’t feel like the right time now. But they May want to have information like this going forward.

They are doing great, by the way and much more open to chatting ... feels like it will just keep getting better. I was glad to know my private health care plan will fully cover their HRT and I am sure they were too- now that they aren’t keeping their transition private I was able to do that for them and save them some money.

They are still not wanting me to change their name or pronouns - by the way- even privately. They haven’t changed how they dress in public that I have seen, and they seem to be working most on hair removal and changing some personal hygiene products. I have finally gotten used to the idea that they may never change anything else ...or they may... and this will just take more time.
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Re: Taking Good Care of You!

Postby Ashley@Heart » Thu Oct 12, 2017 10:58 pm

Mom2TranAdult wrote:They are doing great, by the way and much more open to chatting ... feels like it will just keep getting better. I was glad to know my private health care plan will fully cover their HRT and I am sure they were too- now that they aren’t keeping their transition private I was able to do that for them and save them some money.

They are still not wanting me to change their name or pronouns - by the way- even privately. They haven’t changed how they dress in public that I have seen, and they seem to be working most on hair removal and changing some personal hygiene products. I have finally gotten used to the idea that they may never change anything else ...or they may... and this will just take more time.


That is awesome. We all have our own paths. Part of me never expects to be gendered correctly like I dream of. As such I don't care at this point but I will when I am finally comfortable full time I will change my name and every record I can and likely become far more sensitive about the whole thing. I also rejected obviously feminine clothing and make-up for a long time because it could trigger dysphoria if it didn't fit/look right. Some of us first discover the truth of ourselves doing what we think at the time is "crossdressing" and then realize there is more to it. Others know who they were from early on.

Breast screening... not on my top ten things I am looking forward to but if I move quick enough maybe I can at least skip the need for regular screening of my unwanted bits. (So tempted to make a joke about having my boyfriend regularly giving me a breast exam... oops too late. :lol: )

That reminds me I promised as a part of taking better care of myself to find a transgender friendly GP. Bleh more appointments and paperwork. Now off to read my voice homework, I don't want to get in trouble early...
-Carolyn

“To be nobody but yourself in a world which is doing its best day and night to make you everybody else, means to fight the hardest battle which any human being can fight, and never stop fighting.”
― e.e. commings
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Re: Taking Good Care of You!

Postby BK199 » Sat Oct 14, 2017 6:41 am

i think the issue with WPATH isn't so much the revision date, is the "old mindset"....

popular approach to TG in western medical has been dysfunctional, and is improving...

yeah there are medical considerations/ i hear HRT can effect liver etc.

TG in other traditional cultures is better understood and accepted.


we went through a dark age with LGBT in western civ, and forced muc of the planet to comply..


there is less darkness on the issue in other cultures.

that being said we are a little different in that we have kind of introduced HRT and surgery, a new concept in the history of TG

its a strange thing really to learn all about this, esp in our culturs.

i dont speak anything but english but there is some good stuff going on in some european counties like germany etc . re: trans

do you have any specific questions or information desires?

interested in psychological aspects, or just physical?

t/c
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Re: Taking Good Care of You!

Postby Mom2TranAdult » Sat Oct 14, 2017 12:43 pm

Hi Bk199... thanks for your comments — you are absolutely right that everything is culture - bound, including gender. And it’s true that anything that isn’t normative ( is different) tends to be scrutinized, marginalized, and medicalized. Then at times , even just being female gets medicalized ... pregnancy and menopause get treated as things that require medical intervention ( estrogen therapy, inducing labour, providing epidurals etc. Women have PMS rather than just being accepted for having a full range of emotions that rise and fall. Or they are seen to be Frigid rather than reacting normally to an abusive relationship which is the cause of the lack of desire. Don’t get me started or this pose should be in the political section...lol

Having said that, I don’t think that changes the fact that there are things which are unique health issues for TG people ( like Tucking and the associated risks and precautions) which doctors and TG need to be aware of so they stay healthy.

I have a tendency to try not ta throw the baby out with the bath water - I take what’s useful from these types of Standards, and leave the rest.

As for your question I am interested in both Psych and Physical aspects as I am trying my best to understand all of this.
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Re: Taking Good Care of You!

Postby jentay1367 » Sat Oct 14, 2017 3:08 pm

The WPATH kind of looks sadistic to me. Always has. I'm an adult of the age of consent, I can die in their wars but have no control of what I do with my body? Just a little draconian. The amazing thing is how many still adhere to it. There are workarounds but I learned about most of them after the fact. Every person has a right.
I will paraphrase Arthur Schopenhauer:
it is obvious that there is nothing in this world to which every woman has a more unassailable title than to her own life and person.”


Who are these people to decide and deem what's fit or unfit for us. If you've substantiated previously that you're mentally unbalance by your previous acts, this may be a caveat, otherwise..LEAVE ME ALONE. Of course I've funded my own transition, if you rely on others to help you such as an Insurance Carrier, you will need to meet their guidelines. But in the case of a self funding adult? .........LEAVE ME ALONE.
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Re: Taking Good Care of You!

Postby Mom2TranAdult » Sat Oct 14, 2017 6:07 pm

Jentay- can you help me understand in what way the standards are sadistic? I can’t say that I have read them cover to cover, but they seem from my (maybe uninformed ) perspective to be reasonable starting points for good health, and they seem to allow for professional discretion/ variation to come into play (see the intro for example).

I am not, by the way, advocating for WPATH or any specific standards, but rather like the idea of having a set of guidelines to help doctors in treating their TG patients most effectively. Perhaps the Centre for Excellence Guidelines are better and more up to date than WPATH for that as Miki said.

If not these guidelines then— I guess I just wonder what you would recommend that a young person (such as my audit child) consult in order to get reliable and effective information about health concerns for TG people. The informed consent for treatment, or refusing treatment, needs to be based in something doesn’t it?

Sorry if it seems I’m belabouring the point... not trying to be right but just trying to understand.
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Re: Taking Good Care of You!

Postby jentay1367 » Sat Oct 14, 2017 6:44 pm

Hi Mom,
I'm going to be frank with you and say I probably have spoken off the cuff and may not be up to date. The new guidelines have recently come out and may have changed. At the time they pertained to me, I was forced to find a therapist to validate what I already knew to the tune of 175.00 dollars per hour. The decision as to when to issue a letter to allow script for hormones to be issued is wholly up to them. So an unscrupulous Therapist may decide you need to put thousands of dollars in their account before you're ready. I watched a number of young people taken advantage of in the office of the "therapist" I used as she was one of the few gender therapists in my area. I literally saw screaming matches in her office while I waited for my appointment. At any rate, she's only an example of those that are predatory regarding our situations. It is not all puppies and unicorns out there. Another peccadillo is that you used to have to present as the gender you identified as for a year before surgery was allowed. At one point and in some places still, they make you do this before they'll even give you hormones. The "man in the dress" forced to undergo this in awaiting hormone therapy for her crippling dysphoria may not only be ridiculed or humiliated, they could possibly be hurt or killed as well. Their is a gang mentality in the medical profession that wishes to extract a ton of cash and a pound of flesh with their carrot and stick routine that is designed to humiliate and break bank accounts. How bad do you want it ? syndrome. All in the purported effort to keep the patient from "making the mistake". There are precious few of us who are sorry after we've completed our journey.
I can appreciate you're looking for guidelines. You know your child, you raised her. You want the best for her. But I assure you, the mere process of doing this, regardless of people standing in your way is more than an excellent gatekeeper. This is not a walk in the park, it's not easy on any level. And if it's not right for you, you won't need any pompous medical team standing there to tell you so while they have their hand out for the precious dollars you need to transition. Aside from all of this you also have a drug protocol that is well aaccepted and most definitely for a good number of our population wholly inadequate. And initiating change is nearly impossible. I have been forced to educate my endocrinologist in an effort to drag her out of her apathy towards our plight by dropping a number of NIH studies that were wholly contradictory to her agenda. She has finally acquiesced and even apologized to me, but not until thousands of dollars for needless testing was extracted from my wallet. We are cash cows for a select part of the medical profession. One that is not completely altruistic. So as you can see, it's a bit of a pet peeve for me. But I do understand your need for some guidance. This is one of those things that it's difficult to see the forest for the trees till you're actually in the forest and then, unfortunately, it's too late. I wish you luck with your young one. Watch her and talk to her. Plug into her world and you and her will know and understand innately what will be the right course of action to effect. Good luck to you! Jess
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Re: Taking Good Care of You!

Postby BK199 » Sat Oct 14, 2017 6:59 pm

jentay perhaps you can i can celebrate someday the 100th anniversary of US suffrage.......

Mom - how young is your young adult?

there is a lot of good trans stuff going on in portland oregon re: care. maybe tap into that ?

things have been draconian. there have been requirements to get surgery to be legally recognized or change your gender marker, or HRT, or stay on HRT (despite funding problems), eetc. ect. ect. etc. actually a lot of TG killed themselves because they process to get help was so hard to get through fast enough

things are chagning thank goodness.

you can PM for some resources if you like.

maybe Australia has some good info. t/c
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Re: Taking Good Care of You!

Postby BK199 » Sat Oct 14, 2017 7:06 pm

jentay1367 wrote: So an unscrupulous Therapist may decide you need to put thousands of dollars in their account before you're ready. I watched a number of young people taken advantage of in the office of the "therapist" I used as she was one of the few gender therapists in my area. I literally saw screaming matches in her office while I waited for my appointment. At any rate, she's only an example of those that are predatory regarding our situations. It is not all puppies and unicorns out there. Another peccadillo is that you used to have to present as the gender you identified as for a year before surgery was allowed. At one point and in some places still, they make you do this before they'll even give you hormones. The "man in the dress" forced to undergo this in awaiting hormone therapy for her crippling dysphoria may not only be ridiculed or humiliated, they could possibly be hurt or killed as well. Their is a gang mentality in the medical profession that wishes to extract a ton of cash and a pound of flesh with their carrot and stick routine that is designed to humiliate and break bank accounts. How bad do you want it ? syndrome. All in the purported effort to keep the patient from "making the mistake". There are precious few of us who are sorry after we've completed our journey.
I can appreciate you're looking for guidelines. You know your child, you raised her. You want the best for her. But I assure you, the mere process of doing this, regardless of people standing in your way is more than an excellent gatekeeper. This is not a walk in the park, it's not easy on any level. And if it's not right for you, you won't need any pompous medical team standing there to tell you so while they have their hand out for the precious dollars you need to transition. Aside from all of this you also have a drug protocol that is well aaccepted and most definitely for a good number of our population wholly inadequate. And initiating change is nearly impossible. I have been forced to educate my endocrinologist in an effort to drag her out of her apathy towards our plight by dropping a number of NIH studies that were wholly contradictory to her agenda. She has finally acquiesced and even apologized to me, but not until thousands of dollars for needless testing was extracted from my wallet. We are cash cows for a select part of the medical profession. One that is not completely altruistic. So as you can see, it's a bit of a pet peeve for me.



oh god. why wont people believe me when i tell the m just going to "any therpist" isn't trustworthy or safe, and any doctor is the same. the dont believe me. and its for my disabliities - PTSD and immune system, and colon . try dealing with tehm on THAT and watch them torture you. mercy

most doctors are narcissits. most narcissists saidistic. your money racket doesn't begin to desrcibe, the sticks and carrots dont begin to descirbe, the truth that patent medcicine is just one big out of control S&M unethicle victimization machine
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Re: Taking Good Care of You!

Postby Mom2TranAdult » Sun Oct 15, 2017 10:16 am

Jentay thanks for taking the time to explain. Now I understand. The harrowing experience you and other TG people have had is saddening- I’m truly sorry that has been your experience. This is also precisely why I feel the need to “plug in”(as you say) to them and to help them open to me. It isn’t an easy process on any level and they need an ally with some wisdom and who loves them.

I will say that the waiting game to access very limited, qualified, professionals where we live seems to be the biggest obstacle for my adult child (in their early 20s BK). There are still those professionals that believe the sudden increase in people coming forward as TG is proof that this is actually a sort of “fad”— I personally am shocked by intelligent people who honestly believe this. So I understand your perspective.

Even here, where there is universal access to health care, and a growing community of gender and sexual diversity advocates, the government does not pay for HRT nor certain aspects of SRS almost arbitrarily (they cover breast removal for FTM but not breast augmentation for MtF). And while there is less money involved, it is money none the less. It always bothers me that we readily- with no questions asked- routinely pay millions of dollars to treat COPd and lung cancers, which are almost entirely preventable diseases that are a result of LIFESTYLE CHOICE.

Anyway, I get it now and see where my reference to the Standards May have triggered your response. I guess the good news is that it does seem in these latest revisions that things are changing... thanks as always to pioneers like you who fought their way to make it impossible to ignore your needs. We thank you for that.
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Re: Taking Good Care of You!

Postby jentay1367 » Sun Oct 15, 2017 12:56 pm

I do wish you and your daughter all the best in her and your respective journeys. It will be very elucidating and not what you might suppose. I suggest you research all you can and look at anything that's told to you by "Professionals", with a bit of a jaundiced eye. You seem quite introspective so I will share with you that you will be alarmed at the cottage industry the Transitioning machine is. Do not be put off by it. It must be travailed and pragmatically approaching all the different situations is always your best tact to get the most of it. Use us and use the internet to educate yourselves as you already have. Eventually, this will all be behind you and you can experience what we all hope to attain, which I dare say is some sense of normalcy in our world. You may have your daughter create an account here or at Susans Transgender Resources if she hasn't already. She will learn some things. Some good and some bad, but I think the shared sense of community and universal plight is a good thing for all. All the best to you, Jessica
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Re: Taking Good Care of You!

Postby Mom2TranAdult » Mon Oct 16, 2017 8:32 pm

Thanks Jessica. So far I am letting her know about resources and letting her choose what she wants to follow up with. She tells me she is already online.. not sure where- doesn’t seem to be interested in much more. I”ll stick around here though. I’m still learning about local resources so am really relying on being here, at least for now.

Meanwhile I personally have a happy busy life with lots of other things going on.... I’m sure I won’t be able to keep up this obsession for long.. but I’m feeling so much more able to support my older daughter now. It’s been worth it.
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