Treatment Alternatives In Gender Identity Disorder

        Therapy normally begins by exploring the roots of your discomfort with your birth gender. True Gender Identity Disorder probably occurs less frequently than other kinds of gender dysphoria, so don't assume that a desire to crossdress or live as the opposite gender will lead in the direction of hormones, transition, and surgery.. the numbers fluctuate a lot but something in the area of 1 person in 30,000 is born with an apparent brain gender that conflicts with physical gender. On the other hand, crossdressing is VERY common (somewhere around ten percent of the male population, perhaps more). The most common type of gender identity dysphoria seems to be cyclic gender dysphoria related to medical depressive conditions or Obsessive-Compulsive Disorder -- at least according to one doctor whose opinion I value.

        You must be honest with your therapist! This can be very difficult, I realize. However, if you want real help, you will have to do your part - and your part is, being honest and working with your therapist in a candid and earnest manner. In general, the majority of therapists make an effort to be understanding and compassionate. Your biggest risk is not, as you have feared, rejection or having the therapist think you are nuts (although that is possible if you accidentally get a therapist who is a religious fundamentalist) - your biggest risk is overeager acceptance: that a therapist might push you (perhaps unconsciously) toward hormones, transition, and surgery. Thankfully, you have the ultimate power to stop this before it gets started.

        Once you get the courage together to tell your therapist that you feel you are a woman trapped in a man's body (or whatever your particular issue is), be prepared to defend your position rationally rather than emotionally. A good opening statement is something like, "I've had a problem all my life with gender identity issues. I've always felt wrong and uncomfortable and this has caused problems for me. I've reached the point in my life where I MUST deal with it, and that is why I am here." ...If your therapist is any good, he/she will require you to "convince" him or her that you are transgendered. If, on the other hand, the therapist immediately agrees with you and offers to arrange a hormone prescription just say 'thank-you' and find another therapist. Unfortunately, you found what is known in the community as a 'rubber stamp' therapist: Someone who will agree with anything you say in order to keep you coming back -- or who assumes naively that anyone who says they are transgendered must know what they are talking about. You need someone who will give you real help even if you think that this person is just what you need right now. In the long run, someone like this can do real harm.