My therapist was kinda weird today

I overshared my med situation again. So now she wants me to go to my Pdoc and my primary and she wants me to sign a release so she can talk to my Pdoc which I told her straight up I won’t do. But anyways that kinda soured our session from the start but then she and I got talking about something I forget what and she said “your pretty passable” I’m a trans man. I was kinda confused because I always thought I did pass and I am always called he and him and sir. I didn’t have my hat on because I had just gotten my haircut and I wanted to try going without the hat on. So I asked her what wasn’t “passable” about me. And she said “I don’t know. your eyes?” Then she made some comment about my hair and I said I told the hair stylist I just wanted a normal my age guys haircut. And my therapist halfway laughed and said “was she an older lady?” I honestly thought my hair looked kinda good but now I’m questioning literally everything. Plus my eyes have been bothering me physically for awhile.

Were these comments out of line? I didn’t bring up my appearance or passing as male at all. But they just really bothered me and she made me feel weird today. Plus I told her I wanted to go to every other week and she told me we should stay at every week and then I told her she was kinda expensive and she said “oh is that why you don’t want to see me every week? How much is your copay?” And I told her and she said “oh that’s not much.” And I said “when your not working it is” so she’s going to talk to billing to try to figure out things. But I felt that was kinda rude too.

Maybe I’m just being overly sensitive today. I haven’t been sleeping well recently and my med situation has been a bit out of control and I’ve had issues with my eyes before she even made that comment. But I still feel like she was being rude.

Does anyone have any helpful feedback or suggestions?

I can definitely understand why those things would bother you. It's particularly weird that she made the "passable" comment without your bringing it up. And I wouldn't want criticism of my haircut either! (Though a couple times, my T has just said, "You got a haircut!" which made me assume it was bad, or he'd have said something positive about it.)

I suspect comments like those could be particularly loaded for you, being related to gender. I'm a cis female, and it's not like anyone has ever told me that I "pass" as a woman, for example. Do you think you'd feel comfortable telling her that they bothered you? Maybe she somewhat cluelessly thought she was being supportive with the "passable" comment. Though with your hair, I'm not sure how that could possibly be taken in a positive way? That seems like a case where she could have said, "Are you happy with it?" Instead of sharing her negative opinion.

The money comment would also bother me. It's not right for her to judge what is or isn't expensive for you. It's good that you were able to speak up about that, as I find talking about billing very difficult with my T. Money is relative for everyone, and she should be more sensitive to that. I hope she might be able to work something out with billing for you.

I do feel comfortable bringing it up in the next session and I will. I think she could tell I was upset by her comment because she was trying to reassure me by saying “a lot of guys have eyes like yours” and “you have a full beard” I just already went into the session visibly angry from my bad morning and she could tell that I was really pissed the whole time. But I did talk to my trans affirming medical doctor this afternoon and I got some blood work done this afternoon so he can check my levels and I also called my Pdoc like she wanted me to and I explained that my anxiety was really bad. So hopefully I get some relief from these feelings and hopefully she’ll see that I’m trying. My mom says if I keep therapist hopping even if it’s not my fault then soon no therapist will end up taking me seriously. She did probably not mean anything bad about the passing comment and I was just being sensitive because of the other stuff I had going on. My mom said it is nice of her to try to figure out a way for me to see her every week.

So I don’t know. Maybe I was the one jumping down her throat.

I've always heard "passable" as a comment meaning that the person is goodlooking. I don't think it necessarily relates to the idea of passing. Not sure in this context but you might ask what exactly she meant by passable.

I can't comment too much on the passable part because not only is English not my first language and it doesn't translate well, I also don't get what most people think is attractive or looks well, so I am always confused by such things anyways.
But regarding the money discussion, that one would bother me too. I assume she knows you're not currently working? And even if she doesn't, what is a lot to one person is little to another, it depends on many things, not just the number after the dollar sign. Plus in my opinion the only reason a T should discourage reducing sessions is if they think it's a "coping mechanism" of running away from something, and even then I'd think the only appropriate thing would be to bring that up directly, not to just say no.

Things got really bad last night so I set up an appointment tomorrow through zoom at 11. I am struggling like **** right now and I basically have an idea of what the issue is but I’m not 100% sure. Right now I’m waiting on some lab work to come in and a call from my endocrinologist and a call back from my Pdoc about some stuff. My gynecologist ruled out some stuff. But in the meantime she’s all I have right now and with the weekend coming up I need as much support as I can get at this point. I’ll just have to budget and have one specific credit card I use only for medical things including her. And I’ll have to tell her her comments yesterday bothered me. But based on how I’ve been feeling these past couple days, I have no other option. I hope she doesn’t call me a hypocrite for saying I can’t afford therapy and then scheduling a second appointment. I don’t know. Maybe I’ll cancel the one next week. I kept looking at myself in the mirror today and taking selfies and seeing if I passed or not. My weight at the doctors made me happy at least.

I just get scared of being alone on the weekends because I sometimes get really bad S thoughts especially on Saturday nights. So I like having support on Fridays if I can get it.

Ugh! That would bother me a lot. T and I have a very long and strong relationship so I would most likely ask what his damage was. Yeh, all of that totally rubbed me the wrong way and it wasn’t even about me!

(((( Mountaindewed ))))

So sorry to hear that you've had a rupture with your T.

What your T said seemed very insensitive, and it reveals the lack of cultural competency by the way the remark seemed almost tantamount to gender role stereotypes and therefore a microaggression.

When my T states something that hurts my feelings deeply, because of her lack of cultural competency training (which most T's lack because a. they haven't included an in-depth training for the LGBTQ+ community, non-white racial communities, nonbinary communities, etc.; and because b. most higher education institutions and some red states are outright banning the teaching of such, sadly). So, when T's are trying to be inclusive, they might say something really harmful, really microaggression-y, and really ignorant. It's UNFAIR for us to have to go through these iatrogenic effects of non-culturally-sensitive treatments in talk therapy sessions, as well as to have to be the ones to "educate" our T's on something they should already know, given that we live in a pluralistic society (not a unilateral or binary society, but rather a very diverse one).

I expressed anger to my T, and I shared a bunch of resources via email with my T. My T is super sweet, and she's left-leaning, so she completely apologized and is open to helping me. I was able to work with my T on many issues, and she has helped me. She might not be the expert we need in diversity issues and related mental health harms, but she's willing to learn, read, and help me. She's willing to listen to me through multiple lenses, and I'm willing to understand her and heal on a level that is now understanding how hard it is for some people to understand us. It does take communication, and with that comes the spreading of the word for a need for this, which will help.

So, consider discussing these issues with your T, and seeing if your T is willing to learn more about how certain things are considered an insult to certain cultures, such as the LGBTQ+ community. If your T is someone you trust and someone you think cares about you, then it's worth salvaging. Otherwise, if you've had nothing but personality clashes with your T as well as ruptures, it might be time to find a more competent T. But first initiate the conversation with your T so that you can at least get closure.

Hang in there. Keep processing with us here on the forum. You're not alone in the struggle.

PS: I admit that I don't know much about the LGBTQ+ community, but I do have a mentor who teaches on this in terms of military inclusion and VA care. He's a veteran and reservist who is a gay man, and he has advocated for the LGB (when the T was dropped during the last administration) and now LGBT (when the T was allowed during the present administration) in both military and veteran settings. I'm learning a lot myself, when I have a chance to speak with him, since I'm the "+" part of the LGBTQ+ community, so sometimes I don't fit in and I definitely don't know the lingo or what's appropriate. But I do know that my pronouns will shift, depending. So, forgive me, if I've said or suggested anything offensive.

I talked to her about it today. I said to her to “you know that comment you made about my eyes? It really bothered me.” She apologized and said she shouldn’t have said it and she looked really very upset that the comment upset me so much. I’ve had therapists apologize to me before but I’ve never had them look like they actually meant they were sorry the way she looked. So we talked about it and worked through it.

I'm glad she apologized and that she seemed like she meant it. I feel that's an important quality in a therapist--the ability to truly apologize (not the "sorry that you were upset" sort of nonapology, either, which I've gotten from some before). Also glad that you were able to work through it.