People of diverse sex or gender face the usual mental health and other life challenges of cis-gendered people in addition to transphobia and the intersectionality of minority stress. Research tells us that living with gender dysphoria, living non-binary, transitioning or living in one's identified gender brings about many additional challenges and can be associated with high levels of psychological distress.
Some people find it helpful to talk to a psychologist about difficulties that arise in their life to reflect on their experiences and seek solutions or new skills to respond and cope with challenges. For example, conflict or rejection from family or friends, issues with employment or discrimination, coping with Transphobic attitudes or violence, reflecting on their gender identity and options around medical treatment of gender dysphoria. Psychologists can assist with advocacy and support letters in relation to legal name changes, drivers license photo changes, information, referral and ongoing support throughout medial treatments for gender dysphoria. Individuals taking hormone treatment often report fluctuating mood in the first months of treatment and professional support can be helpful in supporting good social and emotional well being in this period. Some people obtain this support from friends, family, their GP or other helping professionals and they do not wish to see a psychologist.
For others, gender dysphoria can be severe and they may benefit from the support of a psychologist to deal with feelings of hopelessness, suicidal thoughts or self harm. In addition, a psychologist can be important in the treatment of mental health conditions like major depression, generalised anxiety or panic disorder, bipolar disorder.
Tasks of the Psychologist in assessing readiness for hormone therapy.
Best resource is wpath.org (World Professional Association for Transgender Health). Go to the site and read the Standards of Care, currently Version 7.
In a nutshell, the tasks would be;
Explore the clients's gender identity and the persistence and consolidation of this identity over time.
Explore the degree of the distress and what the client feels would alleviate this.
Rule of the DDs or co-morbidities that would require a Psychiarist (ongoing dissociation, severe self-harm, psychosis, poorly functioning boderline personality) to assess identity information.
Treat any associated anxiety/depression with psychological strategies, and discuss safety.
Explore any transition tasks that may impact a person's readiness for hormone therapy, eg disclosures, workplace issues.
Explore losses and potential losses - altered relationships, loss of fertility.
Encourage healthy behavious to assist transition - reduce or cease substance of dependence, lose weight.
Provide a letter indicating that you and the client have decided that s/he is ready for hormone therapy, if this is the next step.