Thoughts on getting a diagnosisPosted: November 6, 2014
Last week in therapy, I talked briefly about planning ahead for top surgery one day. I said that I might want to do this, maybe as early as this coming summer. That’s the most concrete thing I’ve ever said about the subject. She asked what some first steps would be, and I replied, “look into whether it would be covered by my insurance.” That’s kinda something that would really help frame it in my mind, the answer to that… She asked me how I’d do that, and I really floundered with the actual words I would use if I were for real making a phone call to insurance people.
It’s too sensitive and too hypothetical in my mind still, and I could barely even say, “female to male chest reconstruction surgery” out loud, just to her. She got it and said, “what you could do is find out the code for that type of surgery, and when you make the call, you can just ask about the code as opposed to using the words.” I said, ok, yes, I think I could do that. She said she would look it up for me and email me the code.
She ended up finding out a ton more info than just the code, on her own. She said certain info led to more questions and she ended up just calling. Basically, she got all the information for me, for which I am so grateful because it would have felt too emotional for me to do on my own, at this time. It is NOT covered by insurance. I’m not surprised. I told her that doesn’t change much – I’m still considering it.
We briefly talked about it again this week, and about gender identity in general. She said that some surgeons require a diagnosis of gender dysphoria for X amount of time in advance (glad she is doing the relevant research!), and should she be diagnosing me with that? This turned into a heated discussion (on my end), with the conclusion that I do not care about that, but I am OK with that, if it’s in order to help along a process. And that, again, I don’t really care to know what she is doing in that regard.
The idea of being diagnosed with a mental health label is contentious in my mind, and she knows this. She gets it. I’ll be writing about this further in my next blog post, probably next week. A teaser for what is to come: I was misdiagnosed with bipolar disorder at the age of 17, and held onto that belief strongly for about 6 or so years. That’s a heavy duty label to be grappling with, unnecessarily.
My therapist is not a gender therapist, but she is doing right by me more than any other therapist I’ve ever had (and some have been gender therapists). There was a time where I thought – we both thought – I would need to go to a different therapist in order to progress with any medical transition steps (I did this in order to access testosterone, kinda unnecessarily in the end). I don’t think that anymore. Why can’t she be that person? I think she is getting on board with, she can be that person. We concluded recently that a big goal for therapy is to make some progress with transgender-related issues and decisions, and I said I would send her some more general information to get her started. I sent her the following resources:
Anyone have other essential resources?
More than once, she has said, where is the data? Where is the research that says this and this and this are best practices? And I just keep responding, There needs to be more research. And I just keep shrugging. IT DOES NOT EXIST. (Yet.) I don’t know whether she believed me initially, but she may be starting to realize it by now. It’s maddening how little is out there.
Do I think that I have gender dysphoria? Whoa. That is going to take way too long to pull apart right now. That’s probably for a future post! Do I mind being diagnosed with that for the purposes of having a wider selection of surgeons to choose from if I do decide to move forward with top surgery? Not at all! It’s close enough. (Although I do strongly, strongly wish more surgeons would get on board with the informed consent model.)
Edit: Now that I think about it, I’m sure I’ve already been diagnosed with gender dysphoria by my primary care physician (for my testosterone prescription) and probably at least one other therapist. To me, it all feels so arbitrary.