When you decide you want to pursue medical transition, and want to be prescribed hormones you first need a referral letter from a clinical psychologist. This can seem like a daunting task, especially for nonbinary folk who are worried about gate keeping. But as a nonbinary trans male I will tell you my exact steps and some alternate routes that may also work for you. This is specific to Sydney, NSW.
You can just see a psychologist without a referral from your GP, but its usually more expensive, and honestly why not save yourself some money while you can. This process adds up, and being trans doesn’t come cheap. So go to your GP, have them write for you a Mental Health Care Plan. This entitles you to 6 sessions with a psychologist that you can get a rebate for. You can get 4 more sessions if you go back to your GP for a review, this makes a total of 10 sessions in a year. Explain to your GP that you are trans and wish to see a psychologist, it should be very simple.
You will now need to see a psychologist, have one in mind when you ask for your mental heath care plan as the GP will address it to them specifically.
Transgeneral lists two psychologists who are trans friendly:
- Dr Michael Scott from Neutral Bay- Also listed by Reddit TransgenderAU
- Dr Matthew Davies from around the Hurstville/Kogarah area.
ANZPath also recommends some psychologists and psychiatrists:
- Dr Elizabeth Anne Riley who works primarily out of West Ryde
- Dr Patrick Toohey in Darlinghurst- Reddit TransgenderAU has him listed that he may be gate keeping towards nonbinary identities
- Catherine Wilson works out of Mascot and Redfern
- Dr Stephan Koder in Bondi Junction- Also listed by Reddit TransgenderAU
- Rainer Jardin in Summer Hills- He is listed by Reddit TransgenderAU as someone who has an in depth understanding of gender identity. He has also been recommended to me by word-of-mouth by many trans people.
- Dr Yolandi Goodyear in Cooks Hill- I believe she is only a child and adolescent psychiatrist
- Georgina Whelan in Bondi Junction
- Dr James Morandini in Hurstville
Reddit TransgenderAU is a great resource, although some articles are a few years old. Users have compiled some pages on transition information, and many of the psychs already listed are supported by users in TransgenderAU.
When I began my transition journey I was recommended a fair few of these psychologists, but I ended up going to Imanadari Counselling, as their values made me feel very secure. They are based in two locations, Ultimo in Sydney and Murrumbeena in Melbourne.
I saw Janet Doubleday, I found her very nice and professional, I saw her twice before I got my referral for hormones. I intend to see her after I have started hormones, and will hopefully also see her to pursue a referral for top surgery. She provides a sliding scale of payment based on income and circumstance. I paid $160 and will be rebated $124.50, so I’ll be out of pocket $35.50 per session. It has been two weeks since the first appointment and I have am still waiting for the rebate, so I’d advise to not be budgeting for the rebate money to come through very quickly.
Janet was understanding of nonbinary identities and didn’t gate keep me even though I don’t fit the “criteria” of a traditional trans male. The first session we spoke mostly about my past, how long I had been questioning my gender, how long I had been living publicly as my gender and general information about me. It was not a hindrance to have previous mental health issues. I told her about my history with depression and borderline personality disorder, but stressed that due to not pursuing hormone treatment I felt that my mental health was declining. I stated that I have a good support network at home and that my mental health is otherwise managed and under control. I have history of self harm and I was asked about it, I honestly said that I hadn’t self harmed in over 3 years.
The second appointment, which was only a week after my first appointment, we went through the DSM-5 Criteria for Gender Dysphoria, she was empathetic that some terms within this criteria, and even the criteria itself is out of touch/not up to date with what the trans community use.
That being said she said I would need to meet 2 of the criteria out of the list of 6:
- A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics
- A strong desire to be rid of one’s primary and/or secondary sex characteristics
- A strong desire for the primary and/or secondary sex characteristics of the other gender*
- A strong desire to be of the other gender*
- A strong desire to be treated as the other gender*
- A strong conviction that one has the typical feelings and reactions of the other gender*
Of these 6, I met the criteria for 5. I believe that there are trans people who do not experience gender dysphoria and instead experience only, gender euphoria, although not listed in the criteria I believe many of the criteria express a gender euphoria, I asterisked (*) them.
I spent the last half of my session talking about coming out at work and how I would go about it. I intend to come out this week so again, I’ll keep you updated.
I was advised on my first appointment that I should research who I would want to go though to get prescribed hormones, I decided to go with Dr Rick Franklin at Taylor Square Private Clinic in Surry Hills. Janet wrote my referral letter to Dr Franklin, and sent it to me via email, five days after my second appointment. I was then able to print it out and give it to Dr Franklin at my first appointment.
Seeing Janet was a very comforting experience and I look forward to seeing her again as new things come up in transition.
I hope this post helps! And if you would like to recommend any psychologists please comment, I’ll add a word-of-mouth recommendation list.