Not long ago, I received an interesting request from a reader interested in starting a transgender support group. She said that she appreciated the Support Groups resource article I submitted for Transgender Tapestry's Fall, '95 issue. It contained valuable start-up and group maintenance information. However, she also said that many people come to support groups seeking reliable information, and asked if I could provide her with a list of "frequent professional suggestions." Particularly those I typically pass on to help others gain self acceptance, and avoid the dangers and misconceptions associated with the transgender experience.

The following suggestions are valuable for self-education and group discussions for persons at any stage of transition or of any transgender self-identification:

Having a transgender identity or needs is not in and of itself pathological, mentally disordered or medically diseased. All transgender persons have the /right to self-determine their gender identity and presentation.

Transgender persons are continually portrayed as mentally ill by social stereotypes. There is also an abundance of out-dated professional literature that is denigrating. Subsequently, strong identity-affirming messages need to be brought to the attention of all transgender persons, their loved ones, helping professionals and the general public. Self-determination of gender identity is a human right every individual should benefit from, including the transgendered.

This information is particularly relevant to long-term members of our community who view part or all of their transgender identity as disordered. They do so because early on these are the messages they heard from others who were misinformed, and now they pass these same negative messages on to others.. Denigrating statements and negative portrayals can leave a person repressed and stigmatized. Stigmatization leaves individuals susceptible to low self-esteem, depression, harsh self-judgments and hinders positive advancement. Those in the "coming out" process or who are new to the transgender experienced do not need to hear such debilitating messages from their role models, loved ones or helping professionals.

Learn to enjoy your crossdressing, transition and other transgender experiences for what they are: a natural part of your gender-identification and internal needs.

Many times that suggestion is easier to read than follow, this should not, however, undermine its importance.. Far to frequently I counsel persons so wrapped up in guilt and shame they have become immobilized and are incapable of experiencing joy or happiness. Some persons feel guilty that they are not living up to their spouse or family's expectations, and need to learn how to redefine their own self-perspective and relationship role. Others mistakenly feel guilty because their transgender needs may inconvenience others.

There are also persons who get so caught up in guilt and shame that they become uncomfortable each time others act ashamed to be seen with a transgender person or talk about "that transgender thing." Although it is no easy task or habit to break, building up self-acceptance requires learning not to adopt projections of others. This point is well illustrated by one of my clients, who stated that he felt so guilty about being closeted that he felt uncomfortable attending local support groups. It appears that each time "closeted" crossdressers were mentioned, he felt as if they were making fun of him. Having crossdressing or transgender needs is not wrong. Nor is it wrong to want to protect one's family and employment situations. I encouraged this individual to either inquire whether the group's comments were being directed at him or to ignore the comments.

Most of the time being a crossdresser or transgender person requires ignoring ignorance and stereotypes. If you encounter rudeness from a person you will likely meet again, then provide them some brief gender issue education if it feels correct. If you encounter rudeness from someone you are unlikely to ever see again, it sometimes is best just ignore their behavior. Choose your battles and educational efforts wisely. If you are in the process of coming out or are undecided about your gender identity, slow down and appreciate the uniqueness of your own situation. If you spend most of your time caught up in guilt and shame, this does not leave much energy for enjoying your experiences and learning your likes and what works for you.

If you have a history of purging or stopping and restarting transitions, put your previous identity or "en femme" clothing into storage. Or, ask a good friend to hold on to your belongings.

This suggestion is in no way original, however it continues to be valuable. While going shopping has been often called "great therapy," it seems senseless to repetitively having to buy clothes and work through the same issue again.

Speak to at least three careproviders before consenting to undergo any surgical procedure, or becoming involved with a gender program or therapist. Also, if at all possible speak to three individuals who have received services from a careprovider you believe may suit your needs.

It is important that transgender persons recognize that they are consumers. Surgical procedures, hormone administration, electrolysis and counseling services are costly, and for most persons are out-of-pocket expenses. Frequently persons in the coming out process are so grateful to receive support that they do not recognize that the first careprovider they select may not be the most beneficial. This is particularly true for persons in crisis or who had difficulty locating support.

Be a good consumer by asking questions. How many patients or clients has a careprovider supported? How does the careprovider's support or product differ from his or her competitors? Does the careprovider offer a sliding scale fee or a discount for repeat business? During your business relationship, should you find yourself dissatisfied with a careprovider's services, state so and why. If you find your negotiations to no avail, speak with a supervisor or take your business elsewhere. Private providers usually do not have supervisors. This is why it is important to speak with satisfied customers before committing to receive non-refundable services.

Transgender persons are not immune from the HIV virus simply because they come from a particular background or are exploring a heterosexual fantasy. Use safe sex protection

I recognize that some persons are tired of hearing about AIDS and safe sex protection. However, for every HIV-negative person that believes AIDS does not affect them or feels prevention messages are redundant, there is an HIV-positive person who finds this subject not so easily dismissed. At present it is clear HIV is primarily transmitted through unprotected sex and sharing drug needles.

Some HIV-positive individuals contracted the virus because they did not believe it existed in their community or social class. This notion is wrong. I routinely receive inquires from across the United States by infected persons who are looking for support resources for their special needs. Others now live with AIDS because they "forgot" to use protection. Prevent this from happening by keeping protection available, knowing how to use it, and discussing its use before engaging in sex.

"Disclosure" of your transgender identity or needs is not required in every situation. Do so only when it will increase the quality of your relationship with another person, or when necessary for medical or legal reasons. Disclosure does not always equate to validation. Sometimes a person must look elsewhere for that.

Many transgender persons feel an overwhelming desire to disclose their personal secret once they have discovered they have a transgender identity. A good proportion of these individuals are often desperately seeking validation of their new identity and for the pain they have suffered. They also are hoping to find acceptance through disclosure. I know it sounds harsh, however, most non-transgender persons are not going to be able to fully validate your identity and experiences unless they are familiar with gender identity issues.

This can be particularly true when disclosing to associates, neighbors, co-workers and distant relatives. Except for those who enjoy hearing sensational stories, the vast majority of persons may really not be all that interested in hearing about your personal business. In some circumstances people are accepting and offer their support, other times people really could not care less since it does not personally affect them. Do not take indifference as a rejection. If you are looking for validation, seek it from your transgender peers and close friends who support your process.

Avoid unnecessary difficulties by learning how to educate others about transgender issues and objectively discuss your needs before disclosing to important parties. This includes family members, significant others, close co-workers and your employer. Workplace transitions are best initiated only after having substantial experience disclosing and living "in role" (part-time).

This advice is useful to all transgender persons, including closeted crossdressers. Routinely, I counsel persons whose relationships are falling apart or whose employment is in jeopardy because of how they went about disclosing their transgender needs. When disclosing to important parties, it is imperative you recognize that disclosure has equally to do with their needs and not just yours.

Persons who are close to you need assurance that you appreciate their loyalty and sensitivity. Make certain to convey that your commitment to them remains stable, and that you want the relationship to continue.

Place forethought into understanding how others are affected by your disclosure. Learn how to provide basic information about crossdressing or gender identity issues without making your situation appear shocking, sensational, desperate or unstable. Ask how that individual feels about the situation. Be prepared for rejection, denial, anger, indifference and even acceptance.

Recognize that when you encounter questions you cannot answer, that it is perfectly acceptable to set answering the question aside until you are better prepared to respond. For example, if you are uncertain whether you are a crossdresser or transsexual, you can state that you are carefully exploring your identity and will keep them informed of any changes affecting them.

Some disclosures may require the assistance of a third-party such as a counselor, mutual friend or business associate. Make certain the party you are disclosing to feels that the third-party is a neutral resource. Also, try to incorporate easy-to-understand printed literature about crossdressing or gender identity issues into your disclosure. This provides the party with further information that they can reference later as they reflect on the situation.

"More hormones" is not always better, and self-prescribing can be dangerous and deadly. Efficient and successful hormone administration is based on periodic blood laboratory testing and individualized prescriptions.

It is not uncommon for transgenderist and transsexual persons to avoid seeking out a doctor's assistance when taking or trying to obtain hormones. In some circumstances it is because they feel uncomfortable discussing their gender issues with others or fear being turned down by the physician. Others who swing between denial and experimentation, much like those who purge their "en femme" clothing, are fearful of asking for hormones because they are not interested in making a commitment.

If you are a person taking hormones without a physician's prescription or without periodic blood laboratory testing, you are taking a significant risk with your own health. Hormone administration and laboratory testing are routine medical procedures. In many circumstances general practice physicians may not familiar with supporting transgenderist and transsexual health-care. If that is your situation, ask your referring counselor or therapist to include prescription/laboratory testing information in his or her referral. If that is not possible, supply your physician with a copy of Sheila Kirk, MD's book, "Hormones."

Note. Dr. Sheila Kirk's book, Hormones is available from IFGE.