Transgender Teen Survival Guide

Lee says:

I don’t have any personal experience with the website or their providers, but I looked it up and the PrideCounseling FAQ page says:

“PrideCounseling is not the right solution for you if any of the following is true:

How much does it cost?

While I don’t know much about their reliability or the quality of the treatment provided, I didn’t look into it because it seems that if you’re under 18 then you can’t see a therapist there at all, which means you wouldn’t be able to use the website and should look for an alternative place to get your counseling from.

So if you are an adult (not a minor under 18) then HIPPA would mean your parents wouldn’t need to be informed or involved so if that’s the case I would look further into whether or not people recommend them, but I’m guessing that’s not the case based on your question, so I’d start looking elsewhere. 

Our Mental health page has a Getting a therapist and being in therapy as a trans teen post that you may find helpful in finding a therapist! 

Followers say:

anon says: anything linked to betterhelp is bad as a whole though, the tos says it all "We do not control the quality of the Counselor Services and we do not determine whether any Counselor is qualified to provide any specific service as well as whether a Counselor is categorized correctly or matched correctly to you,"

Lee says:

A non-affirming therapist, I would assume, is someone who doesn’t support trans people and their identities. That could mean any number of things; maybe the therapist thinks that being trans is a choice you can un-choose, or that you’re mistakenly identifying as trans and are actually cis, or that being trans is a mental illness that can be cured and curing it would turn you back into being cis and so on. 

Basically, it can be anywhere from someone who isn’t supportive of your transition to someone who is practicing conversion therapy and is actively trying to make you identify as cis (which won’t work and can be harmful to your mental health).

Definitely talk to her more about what she meant by those terms, but it sounds to me like your mom doesn’t want you to go to a therapist who will support your transition. 

If I were you, I’d choose the gender affirming option and make sure you do have an active role in who you see- try to get involved by helping to research therapists and make a short list of your options and even see if you can call them to see if they accept your insurance and so on.

And remember, if your mom brings you to have a session with someone you don’t like, it’s okay to try to stand up for yourself and say you don’t like that therapist, you aren’t going to be getting anything out of your sessions with them, and you want to go to someone new. 

Check out our Getting a therapist and being in therapy as a trans teen post for more info on finding someone you like! 

Lee says:

Any therapist can write the letter- I believe the WPATH standards doesn’t specify any particular degrees they need to have. 

You can see the general format of what a letter for hormones looks like here:Sample Referral Letters for Hormone Therapy and Gender-Confirming Surgeries

And you can see a real-life example of an actual letter for hormones here: Lee’s testosterone letter

You should be direct about what you want when you contact a therapist- say something like “My primary goal in my sessions with you is getting a letter to start HRT/get surgery. Here is the relevant portion from the WPATH-SOC on writing the letter. How long will it be/how many sessions do you think it’ll take before you’re comfortable writing this letter for me?”

Our Therapists and therapy post has more info on getting a therapist.

Lee says:

That sucks but as our Ask guidelines say, please only send us questions and not “bad vibes” statements. 

The time it takes to get a letter depends on which therapist you see- some people have gotten letters for testosterone within just a few visits, and you don’t necessarily need to do “gender therapy,” any therapist can write the letter.

Our Therapists and therapy post has more info on finding a therapist, and our Here is how to get hormones in the US post has info on informed consent so you might not even need a therapist.

Again, you can send vents to other blogs, but we only answer questions here so vents/statements sent to us tend to be deleted.

Devon says:

I would definitely recommend finding a new therapist. Here’s a post about finding a trans friendly therapist.

You could tell your mom that you don’t feel comfortable with this therapist, or that this therapist just isn’t a good fit for you. Lots of folks see multiple therapists before finding one that works well for them.

Here are our mental health resources which you might also want to check out.

Hope this is helpful! Best of luck.

Devon says:

It might be most effective for you to ask her to go to a therapist for other reasons, and then after meeting with the therapist a couple times, have the therapist help you talk to your mom about T or even have the therapist just talk to your mom about T themself. Here is a post about finding a trans friendly therapist.

Question 2 of our FAQ might be helpful to you as well:

Here are some other resources that you might find helpful:

I hope this helps, and best of luck!

Kii says:

PsychologyToday has a mental health specialist search, and they do have specific LGBT+ categories! My local LGBT center also has a list of LGBT-friendly medical professionals and mental health professionals in my area, so a local resource of yours might be able to help as well.

Lee says:

No, therapists aren’t required to out you to your parents as LGBT unless you’re in some sort of awful conversion therapy program (and conversion therapy is increasingly becoming illegal). 

Therapists are generally required to keep what you tell them confidential unless they’re concerned you’re going to hurt yourself or someone else or if a child is being harmed or abused (which isn’t the case if you’re just coming out as trans). 

Technically minors can’t consent to treatment themselves, so a parent who consents on the minor’s behalf could be told the content of the their child’s treatment. This is usually discouraged by the professional guidelines therapists follow, but it isn’t illegal.

You can always verbally confirm that, and say “If I have something to tell you, you won’t tell my parents right?” and they’ll probably tell you “I won’t tell them unless you’re in danger” or something similar, but even though you know what they’ll say it cans still help your anxiety about telling them if they confirm they’ll keep it on the DL.

The Therapists and therapy post has a link on coming out to your therapist! Also see Client Confidentiality in Therapy.

Lee says:

Yes! You are entirely welcome to show our blog/our links/our resources to whoever you want. We’re happy to be a source of information for all :)

I’d also say (maybe don’t show her this part) that if you can’t convince her to understand your identity, or at least respect it even if she doesn’t understand it, you should look for a new therapist. It sucks to have to leave someone who has been helpful to you in the past and who you may have a connection with, but if they won’t validate who you are and don’t believe you when you say that you’re transgender, finding someone who is more accepting will probably be good for you in the long-run. It can be hard to develop confidence in your identity when the person who you’re supposed to be able to discuss that stuff with insists that you’re mistaken when you aren’t. 

So yes, give her a chance and try to educate her, but if it doesn’t work then check out our Getting a therapist and being in therapy as a trans teen post for info on finding a new therapist.

Lee says:

Our Therapists and therapy post has a Telling a therapist you’re trans link! 

And links on discussing hard topics with a therapist:

We also have a Coming out page with info on coming out in general.

Lee says:

If you want a trans-friendly therapist before you’re able to come out to your family as trans, say you want to go to therapy for depression or anxiety (which often accompanies being a closeted trans person anyway so it’s likely not a lie) and then if the therapist you see isn’t trans friendly, you should ask to see another and say the one you went to isn’t helpful in developing real coping strategies you can use.

You can also do some research online and find trans-friendly therapists in your area then see if they’ll take your insurance, then ask your parents to see that particular therapist bc a friend recommended them.

Here’s a post with a lot of info about finding a therapist!

Followers, any advice for anon?

Lee says:

I’d tell them at the start of your sessions about what you want to get out of seeing them, yes. Coming out sooner means you get an idea of their reaction sooner.

If they react negatively or aren’t supportive of you being trans, then you’d want to know sooner rather than later so you don’t have to waste your time seeing them and you can switch to another therapist who will actually help you with what you need their help with. 

It’s okay to “therapist shop” and switch providers if the therapist you’re seeing isn’t helping you. 

More info: Therapists and therapy

Lee says:

You can try getting testosterone through informed consent. That means you don’t need a letter from a therapist to get T.

If you can’t do that, you should be direct about what you want when you contact a therapist- say something like “My primary goal in my sessions with you is getting a letter to start HRT. Here is the relevant portion from the WPATH-SOC on writing the letter. How long will it be/how many sessions do you think it’ll take before you’re comfortable writing this letter for me?”

If they aren’t willing to write you a letter, ask for a referral to someone who will. Info on finding a trans-friendly therapist is here.

Lee says:

I’d give the therapist’s name a Google, once you know who they have picked out. If their website mentions being LGBT-friendly, that’s good- if they mention being religious, that’s not necessarily bad but it’s something to be cautious about. 

But while their websites can help you get a feeling for how accepting their are, you can’t judge a book by it’s cover. I’ve been to therapists who say on their websites that they’re trans-friendly, but then proceed to misgender me over multiple sessions. And I’ve been to therapists who don’t mention trans stuff at all on their website, but then ended up writing letters for me anyway. 

Once you’ve actually met the person, you can judge for yourself how comfortable you feel with them. If you get really bad vibes, then it’s worth talking to your family and finding someone else. You don’t have to stick with the first therapist you see- there’s plenty out there, and it’s okay to “therapist shop” and keep looking until you find someone who is respectful of your identity.

But getting a therapist can be useful- they can help you find coping strategies to deal with dysphoria, write you the letter you need to get HRT and surgery, and so forth. So I’d go along with it, at least for now- hopefully you’ll find it helpful. 

And again, if you later don’t like it, you can always try to get out of it then and say that you want a therapist to help with your mental health but this particular one isn’t helping you, and you aren’t comfortable with them so you aren’t gaining any benefit from your sessions together so you want to find someone else who will actually help you.

Kii says:

A psychologist should start using your name and pronouns as soon as you ask them to; it shouldn’t be dependent on whether you pass or not. If you have a psychologist that isn’t respecting you, try to find someone else to work with.

Lee says:

I’d tell her directly “If you can’t use my name and pronouns, I’m going to have to see another therapist who can respect my identity.” It’s hard to be up-front, but sometimes people need an ultimatum to see how much it means to you and how serious you are about it.

And if they don’t change their behavior after that, we have a Getting a therapist and being in therapy as a trans teen link with info that might help you find a new one!

The TTSG mods say:

Hi anon! Unfortunately, your ask has been sitting in our inbox for awhile now and none of the mods are quite sure how to answer it or don’t have enough time to give your ask the answer it deserves.

However, we really like your question, so we’re going to hand this over to the followers and hope that one of them can help you. You can also check out our Other trans resource blogs page and re-ask your question to someone else, as different blogs have different specialties.

We’re sorry we couldn’t be of more help, but we have over a three thousand asks in our inbox, and we have to clear it out for a fresh start in the new year. We hope a follower or another blog can provide more assistance.

Devon says:

I would work on managing your anxiety if you aren’t already. Seeing a therapist has been helpful for me personally, but therapy isn’t right for everyone. Here is a post about finding a trans-friendly therapist. Here are our mental health resources, which includes a page about anxiety.

Check out our testosterone FAQ if you want more information about the changes that come with T. This post has information about similar changes that you can achieve without going on T. Try thinking about how you would look on testosterone and see how that makes you feel.

Talking with a therapist (or a supportive friend/family member who is willing to help you with such a big decision), physically writing down pros/cons, and looking online for decision making exercises/worksheets could be helpful to you in deciding whether T is right for you.

Hope this helps!

Lee says:

I agree with what Devon wrote 100%, I’m just adding on a little more:

“If T didn’t have permanent changes involved I’d be a lot more open to it” 

You should consider why you’d be more open to taking T if the changes weren’t permanent. Is this an extension of your anxiety, so you don’t want to make permanent changes because of your worry about regretting it? Or do you not picture yourself as looking masculine when you’re an adult, when you’re elderly? 

“I don’t have dysphoria so I don’t know if it’ll actually be worth all the trouble”

If you don’t want to medically transition because you feel it wouldn’t make you happier, that’s 100% vaid and totally a fine and dandy choice to make. But if you feel that you don’t “deserve” to transition because you don’t have enough dysphoria as compared to other people, or that spending time/money on transitioning would be a waste because you don’t feel “bad enough” that you need it, you might want to reconsider how you’re thinking about it. If a medical transition would make you happier and more comfortable in your body on the overall then you shouldn’t stop yourself from pursuing it. This post says something similar in different words if you need that rephrased.

So it’s okay to decide that your dysphoria isn’t worth the medical transition, but it’s also okay to decide to transition because there isn’t a certain threshold of distress required to justify transitioning- transitioning is solely justified by the desire to do so.

“Do you have any tips on deciding whether to transition”

If you are really unsure about whether medically transitioning with testosterone is right for you, you may want to wait. Even low-dose T can cause permanent changes, so you don’t want to do something that you aren’t sure about and regret it later.

If you aren’t sure, then waiting is okay- you aren’t missing out on the optimal period to transition because if you’re already done growing and your growth plates are fused, it doesn’t matter when you start T since you’ll get the same effects at 19 as you would at 50. 

So there’s plenty of time for you to contemplate what the right decision is and you don’t need to rush into it because you’ll be able to “catch up” later if you do decide to start T.

“Because of my anxiety I constantly worry about making the wrong choice”

Again, like Devon said, therapy might help with that! This is where I’d reiterate everything they said about looking into treatment or finding strategies to cope with and manage your anxiety.

Followers, how did you decide whether HRT is the right choice for you if you’re nondysphoric or anxious?