In 2017, when I began seeking help for Gender Dysphoria, I felt scared and overwhelmed with the amount of information everywhere. The first psychologist I spoke with seemed to be building rapport. As it turns out, he felt wholly unprepared to diagnose and treat me. Fortunately, instead of dismissing me entirely, he helped me find someone who could actually help.
Psychologists all learn differently, but they kind of all follow the same script initially. Knowing what they are looking for, can help you get the help you need by cutting through so much red tape. It also allows you to build a real working relationship with your therapist and gives you the foundation for growth.
Common Script For Building Rapport
Regardless of which guide your personal psychologist/mental health provider follows, they usually begin with some historical lines of questioning. The following comes from Counselling and Mental Health Care of Transgender Adults and Loved Ones by Dr. Walter Bockting, Dr. Gail Knudson, and Dr. Joshua Mira Goldberg. A particular favorite of mine, because it allowed me to see behind the curtain, and understand what my psychologist wanted to know. Without it, I would probably have overthought everything.
During the initial evaluation, psychologists attempt to build therapeutic rapport, figure out mutual goals, and build a snapshot of your health status and history. This process can take anywhere from one to three hour-long sessions, and you can help it along by preparing your thoughts ahead.
Your psychologist should initially try to establish trust by asking you easy questions like your pronouns. Prepare to let them know how you prefer to be addressed, whether they may contact you at work, leave a message, and how you present in public. By having those answers, you can save some time initially. That also allows your psychologist to see that you thought this through.
Next, prepare to discuss your health history and any concerns you may have. By thoroughly preparing your answers here, you can streamline a lot of time, helping your psychologist get to a point where they can see a holistic picture of your health needs.
Finally, your psychologist will want to know about your gender concerns. This portion might help you bring up your goals as well, since it fits nicely in.
Sample Questions Used to Build Rapport
The following questions might help build your answers. You may skip any sections or questions that just don’t apply to you. Your psychologist may circle back to them, but you’ll already know they’re coming.
- Does anyone in your family have a history of chronic physical or mental health concerns?
- Do you have any chronic physical or mental health conditions, and if so, what are they?
- Have you ever been diagnosed with a physical or mental health condition? If so, when and what was the diagnosis?
- Have you ever been hospitalized? If so, when and what for?
- Are you currently taking any medication (including illicitly obtained hormones), vitamins, or herbal supplements, and if so what is the name, dose, and length of time you have been taking it?
- Have you ever had any injuries or surgeries?
- Do you smoke, and if so how much per day?
- Have you ever had any concerns relating to drugs or alcohol?
- Has anyone else ever expressed concern about, or objected to, your use of alcohol or drugs?
- Have there been any unpleasant incidents where alcohol or drugs were involved?
- Do you have any concerns about drugs or alcohol now?
- People define ‘family’ in many ways. Who do you define as being in your family?
- How would you characterize your relationships with your family members when you were a child, and now?
- Do you have any concerns relating to your family?
- Do you identify in a particular way in terms of your sexual orientation? Are you attracted to men, women, and/or transgender people?
- Are you currently involved with anyone romantically? If so, how do you feel about your relationship?
- Have you had any concerns about relationships or sexuality in the past? Any current concerns?
- Have you ever had any concerns about sexual abuse or sexual assault?
- What are your social supports? When you are under stress, who do you turn to for help?
- Are you currently working/in school/volunteering? Do you have any concerns relating to work, school, or community involvement?
- Do you feel connected to any particular communities – e.g., transgender community, cultural community, lesbian/gay/bisexual community, youth groups, seniors’ groups, Deaf community…?
- What are your hobbies or social interests?
- What is your primary source of income?
- Do you have any current financial stresses?
- Are you worried about future financial stresses?
- Are you satisfied with your current housing? Any concerns about housing?
- Do you have any concerns about work?
- Have you ever had any concerns relating to your gender? Do you currently have concerns or questions relating to your gender?
- How do you feel about being transgender? Are there any cultural or religious conflicts for you as a transgender person?
- Have you ever pursued any changes to your appearance or body to bring it closer to your sense of self? Do you have any concerns relating to this now?
- Have you ever sought to change your body through hormones/surgery? Is this something you have thought about pursuing in the future?
- Are there any kinds of supports you feel might be helpful as a transgender person?
Beginning Psychological Therapy
Hopefully, this helps you prepare to meet your psychologist. Building rapport goes a long way towards getting the help you need and reaching your personal goals. Once you complete your initial evaluation, your psychologist will begin evaluating your capacity to make care decisions.
- Barbara, Angela M., et al. Asking the Right Questions, 2 Talking with Clients about Sexual Orientation and Gender Identity in Mental Health, Counselling and Addiction Settings. Centre for Addiction and Mental Health = Centre de toxicomanie et de santé mentale, 2007. Open WorldCat, http://www.deslibris.ca/ID/427458.
- Bockting, Walter O., et al. “Counseling and Mental Health Care for Transgender Adults and Loved Ones.” International Journal of Transgenderism, vol. 9, no. 3–4, Sept. 2006, pp. 35–82. DOI.org (Crossref), doi:10.1300/J485v09n03_03.
- Standards of Care – WPATH World Professional Association for Transgender Health. https://www.wpath.org/publications/soc. Accessed 25 Mar. 2021.
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