Transgender London

Finding a Pdoc

Okay this is not an easy task at the best of times and requires some perseverance. As I said before, most doctors including pdocs get very little, if any, training in transgender. Simply, our population is so small as to be insignificant to the medical community.

Now, there is a difference between a Psychiatrist and a Psychologist. A Psychiatrist is a medical doctor who has specialized in mental health. The Psychologist is a graduate from psychology programs and has a minimum of a Master's degree as well as clinical treatment education and experience. As far as mental health is concerned, their training is very similar. The psychiatrist can prescribe medications and the psychologist cannot. Many private practice psychiatrists will not prescribe but they will work in consort with your GP.

A Psychiatrist is covered by Provincial Health Care (OHIP) and a Psychologist is not. So if you dont have the money or insurance coverage, you will likely see a psychiatrist. If you do have the money, then open the phone book to find a psychologist. Some may even have a sliding scale if you cannot afford it.

To get a psychiatrist, you will need a referral from your doctor because under the Health Care System, the Psychiatrist is a specialist. This can make finding one a bit more difficult.

So let's start with your GP (family doctor). You absolutely have to come out to him or her. There is no choice if you want to see a pdoc. If your GP isn't comfortable with this (and you have the right to ask) then you can look for another one. You really should have your GP on side though because your basic health care needs will still have to be taken care of. One of the main reasons your GP will need to know is that s/he is going to get the referral for you and if s/he knows the issue, can be a great help in selecting the right pdoc. This can save you a lot of heartache. In my case the first pdoc I was sent to was unacceptable to me. The second was exactly the right one. Yes, you read it right, the doctor was unacceptable to me.

Now as I said before, the medical community gets very little training in gender. In my case I lucked out both with my current GP and my pdoc. My GP has worked with transpeople before and my pdoc is well experienced with gender. In most cases, you will know more than the doctor and will likely have to educate him or her. As far as the GP goes, it is primarily basic health care anyway.

Interviewing The Pdoc.

You will need to ask questions as well as answer them. If you are to find a good fit, you will have to be totally honest and up front with the doctor. If you are not, you will not get to evaluate his or her reactions and they will tell you more than words.

Does the doctor see the difference between sex and gender? No? Leave.
Does the doctor use behaviour modification for treatment. Yes? Leave.
Does the doctor treat the whole person? Yes? Excellent. A good doctor will use a Humanist Existentialist approach.
Does the doctor treat gender? Yes? Leave. Gender is not, and should not be an issue; ever.
Does the doctor have experience with gender? No? Leave. Yes? How much?
Has the doctor ever followed a patient through transition?
Does the doctor believe that unless you are driven to transition you cannot be a transsexual? If this is his or her train of thought, leave.
Does the doctor "test" for transsexualism? Leave. There is no test, only your feelings.
Does the doctor see Gender Identity Disorder as a disorder defined in the DSM-IV, an anxiety condition or as a label? Some progressive pdocs see it as a label, and some as an anxiety condition. Either can be an acceptable response.
Does the doctor see the Harry Benjamin Standards of Care as rules or as a guideline? If s/he sees them as hard and fast rules, then leave. They are a guide and are stated as such but many physicians see them as rules.

In the end, it is the "fit" that counts. You have to feel totally safe and nurtured with your pdoc. The same holds true for the doctor. If either loses that feeling then it is time to move on.

The problems we face are generally the culmination of years of hiding the truth about ourselves. We erect barriers to protect ourselves and even lie to ourselves. If any trans person is to "get better" then these are the barriers that must be addressed. Yes they are the result of gender but more importantly they are truly the result of our own protections. To address gender, these barriers must be torn down so that as a client, an understanding of past behaviour as it relates to the present is achieved. Anything less is insufficient. The end manifestations of all this are depression and anxiety disorders. Treat those, then the gender issue can be looked at.

As I said, I lucked out. Please do not ask me to make a recommendation. I will not do this. It is up to you and your GP to find the right fit and I really cant emphasize enough how important that is. Without it you will go nowhere fast.