Was I mistreated while trying to get help with my depression?
December 7, 2011 8:57 PM Subscribe
Are these types of questions normal when seeking professional help for depression and anxiety?
-Were you abused?
-Have you ever had a homosexual experience?
-What do you need help with?(asked at least twice, when I answered depression and anxiety, he persisted in asking again)
I am a trans woman. I'm not living full time yet. I have been living with depression and anxiety for around eleven to twelve years. Recently I decide to seek help for my depression because I have been having a harder time dealing with it.
I went to the local county mental health center. At the end of my first interview I disclosed that I am transgender. I was given a history questionnaire to fill out and take back when I would be able to see a counselor.
When I went back the counselor I spoke to asked me some questions that I'm not sure are standard for evaluating someone for depression. Some examples:
-Were you abused?
-Could you be changing your gender to escape your abuser?(asked after I said I was not abused)
-Do you have more female or male friends?
-Do you sleep in the same bed as your roommate?(asked after finding out my roommate is a woman)
-What happened to make you depressed?
-Don't you think it's going to be a problem when you grow breasts?
-Why do you want to change your gender?
-Have you thought of moving to New York?
-What happened ten years ago to make you depressed?
-Have you ever had a homosexual experience?
-What do you need help with?(asked at least twice, when I answered depression and anxiety, he persisted in asking)
He asked a couple of questions to rule out schizophrenia and bipolar but most of the time he seemed focused on my gender identity.
I live in a small south Texas city. Both times that I went in I was presenting as male.
I am a trans woman. I'm not living full time yet. I have been living with depression and anxiety for around eleven to twelve years. Recently I decide to seek help for my depression because I have been having a harder time dealing with it.
I went to the local county mental health center. At the end of my first interview I disclosed that I am transgender. I was given a history questionnaire to fill out and take back when I would be able to see a counselor.
When I went back the counselor I spoke to asked me some questions that I'm not sure are standard for evaluating someone for depression. Some examples:
-Were you abused?
-Could you be changing your gender to escape your abuser?(asked after I said I was not abused)
-Do you have more female or male friends?
-Do you sleep in the same bed as your roommate?(asked after finding out my roommate is a woman)
-What happened to make you depressed?
-Don't you think it's going to be a problem when you grow breasts?
-Why do you want to change your gender?
-Have you thought of moving to New York?
-What happened ten years ago to make you depressed?
-Have you ever had a homosexual experience?
-What do you need help with?(asked at least twice, when I answered depression and anxiety, he persisted in asking)
He asked a couple of questions to rule out schizophrenia and bipolar but most of the time he seemed focused on my gender identity.
I live in a small south Texas city. Both times that I went in I was presenting as male.
Um, that doesn't sound like a counseling session, that sounds like some guy down at the diner asking a bunch of nosy ignorant questions. Is it possible for you to go anyplace else for counseling than the county? Because that is some amateur-style BS they were giving you.
posted by facetious at 9:02 PM on December 7, 2011 [8 favorites]
posted by facetious at 9:02 PM on December 7, 2011 [8 favorites]
To clarify, I don't know what constitutes mistreatment, but those don't sound like normal questions. I'd go somewhere else.
posted by oceanjesse at 9:03 PM on December 7, 2011
posted by oceanjesse at 9:03 PM on December 7, 2011
Best answer: I am a therapist (granted, I'm also politically and socially liberal and familiar with a variety of ways that people are, and I live in L.A.). No, those are not appropriate questions, EVEN IF he was just trying to get more info/clarify after you disclosed you're transgender. He sounds like he doesn't understand what that means or how to handle it appropriately without objectifying you and making you feel uncomfortable. I can't imagine asking someone some of those things in a clinical interview (however--yes, "have you ever experienced any type of abuse?" is a standard screening question... all the others strike me as straight up ignorant bullshit).
Even in county mental health services, you absolutely have the right to ask for another therapist, and you deserve one who will be respectful of both you and your concerns.
posted by so_gracefully at 9:11 PM on December 7, 2011 [20 favorites]
Even in county mental health services, you absolutely have the right to ask for another therapist, and you deserve one who will be respectful of both you and your concerns.
posted by so_gracefully at 9:11 PM on December 7, 2011 [20 favorites]
Are these types of questions normal when seeking professional help for depression and anxiety?
Nothing you've listed strikes me as inappropriate or abnormal, at least to a degree worth remarking upon. I can understand where several of them may across as insensitive, and it definitely sounds like you're not a great fit. You should seek counseling with someone who makes you feel comfortable, whatever that requires.
But yeah, to the extent that you're asking about a more objective analysis ("mistreated"), I'd say no. I have some experience dealing with professional-licensure issues and inappropriate behavior by therapists (mostly separately) and while I might describe some of these questions as insensitive, tone-deaf, etc., there's definitely a line between abuse/misconduct versus not-necessarily-malevolent incompetence; and thinking about some of the things I've seen that did cross that line, I don't really find resonance in anything you listed. Not all professionals understand every circumstance, or are able to work with them constructively. Not all professionals are excellent. Location and culture is relevant.
I'm sorry for your situation, and I hope you're able to find the help you seek with someone who feels right. Good luck.
posted by red clover at 9:21 PM on December 7, 2011 [2 favorites]
Nothing you've listed strikes me as inappropriate or abnormal, at least to a degree worth remarking upon. I can understand where several of them may across as insensitive, and it definitely sounds like you're not a great fit. You should seek counseling with someone who makes you feel comfortable, whatever that requires.
But yeah, to the extent that you're asking about a more objective analysis ("mistreated"), I'd say no. I have some experience dealing with professional-licensure issues and inappropriate behavior by therapists (mostly separately) and while I might describe some of these questions as insensitive, tone-deaf, etc., there's definitely a line between abuse/misconduct versus not-necessarily-malevolent incompetence; and thinking about some of the things I've seen that did cross that line, I don't really find resonance in anything you listed. Not all professionals understand every circumstance, or are able to work with them constructively. Not all professionals are excellent. Location and culture is relevant.
I'm sorry for your situation, and I hope you're able to find the help you seek with someone who feels right. Good luck.
posted by red clover at 9:21 PM on December 7, 2011 [2 favorites]
As grouse said, the issue isn't whether to label those questions "standard." The issue is that you're not comfortable with this therapist. So, get a new therapist.
posted by John Cohen at 9:38 PM on December 7, 2011
posted by John Cohen at 9:38 PM on December 7, 2011
Everything so_gracefully said in spades. I am a post-op TS woman. Depression is not uncommon among LGBT people who are not fulfilled in their lives. I mention this because you mention that you are not full time as yet. Depending upon where you live you may have great difficulty finding a therapist experienced in these kinds of gender issues. I suggest either networking with your local LGBT center, if your city has one , to get a referral. Alternatively you might try one of these recommended forums where you can tell people where you are located and get a possible referral.
posted by Poet_Lariat at 9:43 PM on December 7, 2011 [3 favorites]
posted by Poet_Lariat at 9:43 PM on December 7, 2011 [3 favorites]
I went to the local county mental health center.
Unfortunately, yes. I'm assuming that you mean by "county mental health center" that you mean low-income. The last time I went for that sort of help, in what prides itself as a progressive state, I was asked if I had guns in the house, among other horribly offensive questions. When I wrote "decline to answer" by that on the form, I was quizzed heavily by the doc, and referred for psychiatric care, when all I wanted was a pap smear.
And don't get me started on low-income ideas of care for depression.
Good luck to you. I hope you have other options in your neighborhood.
posted by thelastcamel at 9:50 PM on December 7, 2011 [2 favorites]
Unfortunately, yes. I'm assuming that you mean by "county mental health center" that you mean low-income. The last time I went for that sort of help, in what prides itself as a progressive state, I was asked if I had guns in the house, among other horribly offensive questions. When I wrote "decline to answer" by that on the form, I was quizzed heavily by the doc, and referred for psychiatric care, when all I wanted was a pap smear.
And don't get me started on low-income ideas of care for depression.
Good luck to you. I hope you have other options in your neighborhood.
posted by thelastcamel at 9:50 PM on December 7, 2011 [2 favorites]
It sounds to me like this counselor was trying to help, maybe, but is very inexperienced with transgender people and has some prejudices besides.
"Do you and your roommate sleep in the same bed?" to me is highly inappropriate and unprofessional unless you were talking about a relationship you two had. It seems like he only asked that because he was objectifying your gender identity; I mean, why would someone ask that question??
posted by bearette at 9:53 PM on December 7, 2011 [1 favorite]
"Do you and your roommate sleep in the same bed?" to me is highly inappropriate and unprofessional unless you were talking about a relationship you two had. It seems like he only asked that because he was objectifying your gender identity; I mean, why would someone ask that question??
posted by bearette at 9:53 PM on December 7, 2011 [1 favorite]
A friend of mine in another Bible Belt state told me that she had some stress with her profs (fairly recently) because she did not agree that a patient who revealed that they were gay needed "treatment" for teh gay.
So who knows what you are dealing with here, but it doesn't sound good. Another therapist seems like a good idea.
posted by bunderful at 10:04 PM on December 7, 2011
So who knows what you are dealing with here, but it doesn't sound good. Another therapist seems like a good idea.
posted by bunderful at 10:04 PM on December 7, 2011
Not by any means normal questions. This would have been rude coming from a 9-year old kid. From a supposed therapist, it's downright scandalous.
posted by Gilbert at 1:40 AM on December 8, 2011
posted by Gilbert at 1:40 AM on December 8, 2011
I've had difficult-to-treat anxiety and depression since my teens. I'm doing better now, but I saw a range of mental health workers in my day, including world-famous doctors, therapists at free clinics, and providers I found randomly in the phone book.
My opinion is that there is a significant number of bad clinicians in the field of mental health. By "bad," I do not just mean "inept," though they are often that as well -- I mean people who actively harm their patients. Such people exist at all levels, but in a state-run system they can hang on forever like barnacles. Remaining with providers like this can have very bad outcomes. Trust your instincts. You may be anxious and depressed, but chances are your intuition works perfectly well.
Being trans may actually work somewhat in your favor when it comes to weeding out therapists. A good provider would not be ignorant of trans issues, even if gender identity stuff is not their specialty.
posted by gentian at 2:50 AM on December 8, 2011 [5 favorites]
My opinion is that there is a significant number of bad clinicians in the field of mental health. By "bad," I do not just mean "inept," though they are often that as well -- I mean people who actively harm their patients. Such people exist at all levels, but in a state-run system they can hang on forever like barnacles. Remaining with providers like this can have very bad outcomes. Trust your instincts. You may be anxious and depressed, but chances are your intuition works perfectly well.
Being trans may actually work somewhat in your favor when it comes to weeding out therapists. A good provider would not be ignorant of trans issues, even if gender identity stuff is not their specialty.
posted by gentian at 2:50 AM on December 8, 2011 [5 favorites]
Have you thought of moving to New York?
Is this a real counselor, or someone who's listened to too many Lou Reed albums?
Nthing the above: it's a waste of your time and energy to diagnose this counselor, because whether they're legit or not, they're not right for you.
Texas sounds like a tough draw, but call the closest LGBT group (probably in the closest major city) and ask for some recommended therapists/counselors. It's better than a crapshoot.
posted by rokusan at 3:56 AM on December 8, 2011 [5 favorites]
Is this a real counselor, or someone who's listened to too many Lou Reed albums?
Nthing the above: it's a waste of your time and energy to diagnose this counselor, because whether they're legit or not, they're not right for you.
Texas sounds like a tough draw, but call the closest LGBT group (probably in the closest major city) and ask for some recommended therapists/counselors. It's better than a crapshoot.
posted by rokusan at 3:56 AM on December 8, 2011 [5 favorites]
I've been asked some odd questions by my psychiatrist, and when I made a funny face and asked what the deal with that was, he said that a lot of times people will be coy and circular about what they want and how they feel. Sometimes odd questions weed that out.
Like for example, someone may refer to their "roommate" because they are partially closeted and are just used to saying "roommate" to strangers.
Another thing is that he might have been asking some of the questions to make sure you are actually transgender and not [something else] and using transgender as a shield/crutch/mask.
-What do you need help with?(asked at least twice, when I answered depression and anxiety, he persisted in asking)
He might have been looking for specifics. He might be from a more formal school of thought, where "depression" is a diagnosis that comes after you relate your difficulties.
Or he's an ass. Or both!
posted by gjc at 4:33 AM on December 8, 2011 [2 favorites]
Like for example, someone may refer to their "roommate" because they are partially closeted and are just used to saying "roommate" to strangers.
Another thing is that he might have been asking some of the questions to make sure you are actually transgender and not [something else] and using transgender as a shield/crutch/mask.
-What do you need help with?(asked at least twice, when I answered depression and anxiety, he persisted in asking)
He might have been looking for specifics. He might be from a more formal school of thought, where "depression" is a diagnosis that comes after you relate your difficulties.
Or he's an ass. Or both!
posted by gjc at 4:33 AM on December 8, 2011 [2 favorites]
Those are mostly terrible questions. They're not standard and not standardized. They reveal a very clear agenda. Even mediocre counselors learn that having an agenda is counter to creating a therapeutic relationship.
I am very sorry that in your time of need and vulnerability you've been faced with an unhelpful person working at cross purposes to your health and wellness.
Wow--that was a very wordy polite way of saying --I'm steaming mad on your behalf!!!
posted by vitabellosi at 4:34 AM on December 8, 2011 [1 favorite]
I am very sorry that in your time of need and vulnerability you've been faced with an unhelpful person working at cross purposes to your health and wellness.
Wow--that was a very wordy polite way of saying --I'm steaming mad on your behalf!!!
posted by vitabellosi at 4:34 AM on December 8, 2011 [1 favorite]
That is a terrible set of questions. My partner is trans, and I have found more than once that a medical provider--one of them a psychiatrist--gets so sidetracked by finding that out that they can't think about anything else. And this is in appointments for me. They have used their position to ask me questions as invasive as "what do his genitals look like?" and "how do you have sex?" Sometimes they hear you're trans and their shock and curiosity overcomes their professionalism. The solution is to find someone more professional--that doesn't necessarily mean someone who has experience with trans issues, but it can just mean someone who is able to set aside their own preconceptions and prurient curiosity and hear what you really need.
Best of luck to you. And seconding this:
Wow--that was a very wordy polite way of saying --I'm steaming mad on your behalf!!
posted by not that girl at 7:49 AM on December 8, 2011
Best of luck to you. And seconding this:
Wow--that was a very wordy polite way of saying --I'm steaming mad on your behalf!!
posted by not that girl at 7:49 AM on December 8, 2011
This guy isn't working out for you. Whether or not these are "appropriate" questions isn't really a useful avenue for you to work towards getting help you need, is it? Find another guy.
posted by Meatbomb at 8:02 AM on December 8, 2011
posted by Meatbomb at 8:02 AM on December 8, 2011
The abuse question and the what can I help you with are really the only ones I find remotely normal. Unfortunately it doesn't sound like the abuse question was asked for the normal reasons even: are you currently in danger,can I help you find additional resources that will put you out of danger so we can really dive into therapy? Go somewhere else or see someone else, that sounds terrible. Also if you are so inclined send them some literature on trans issues to show how deeply wrong they are.
posted by boobjob at 8:14 AM on December 8, 2011
posted by boobjob at 8:14 AM on December 8, 2011
Not-treated terribly well... yes. Incompatable with the therapist... oh yes. Going to get anything out of seeing same person? Almost certinaly not. If you can make it up to Houston, there are quite a bit more resources, some even more specalized in gender/LGBT issues. Nthing asking LGBT sources for recomendations, and if Houston doctors arent possible, find the best doctor you can in the best driving range possible. Also, your general practitioner doctor can often perscribe antidepressants; therapy plus AD is best... AD, while sometimes frustrating to get right on the first few tries, is probably better than nothing.
posted by Jacen at 8:36 AM on December 8, 2011
posted by Jacen at 8:36 AM on December 8, 2011
Best answer: It is a sad part of the "get therapy" advice that choosing the therapist is among the highest-stakes operation you have to perform, and you have to perform it when you're at your lowest and most vulnerable.
Treat it like choosing any other very important personal relationship in your life: if your gut is saying something's hinky, get out of there and try someone else. They have to feel like they fit you well, or it's going to be a disappointing, expensive burden of a relationship.
posted by ead at 8:57 AM on December 8, 2011 [5 favorites]
Treat it like choosing any other very important personal relationship in your life: if your gut is saying something's hinky, get out of there and try someone else. They have to feel like they fit you well, or it's going to be a disappointing, expensive burden of a relationship.
posted by ead at 8:57 AM on December 8, 2011 [5 favorites]
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posted by grouse at 9:01 PM on December 7, 2011 [9 favorites]