I realized that I was transgender after attending therapy for over five and a half years, so when I came out as transgender to my therapist, we didn’t look at my transition process in relation to sessions, but instead in relation to what would be best for me. Along with talking with my current therapist, I went and saw a second therapist for four sessions to prepare myself/help work out my fears.
When people come out as transgender and begin to look at the transition process, oftentimes before beginning on hormones, the doctor who prescribes them will ask for a letter from a therapist. For clients who have had a longstanding relationship with a therapist, this may be easier than for clients who have not seen (or just started seeing) a therapist.
In the past, therapist would say they need to see a client for three months for 12 consecutive sessions prior to writing a letter of support. This guideline was part of version six of the World Professional Association for Transgender Health Standards and Guidelines (abbreviated as WPATH SOCv6). In 2011, WPATH released version 7 or (WPATH SOCv7) which has removed the requirements of three months or 12 consecutive sessions. This means now, that when working with a therapist, your decisions and transition path should be guided on how you feel and what the therapist sees as concerns that would prevent them from writing the letter of support.
Therapist concerns may be valid or they may be based on lack of understanding or education around working with transgender clients. It is important for us all to know that there is not a gender specialization certificate or formalized training program that has been professionally vetted that certifies therapist in working with transgender clients. So oftentimes transgender clients may experience road blocks in accessing care.
Advocate for your health and point misguided professionals to the new and updated resources.