Community Roots Counseling, LLC
Jes Dimas, LCSW, LICSW, LSSW
(They/He)
SPECIALTIES:
GENDER, GENDER IDENTITY, AND TRANSGENDER SUPPORT
You have found a safe and supportive space. The space and place to explore, process, and normalize what you have been feeling inside for so long. You are not alone.
Finding a safe and affirming place to discuss gender and gender identity in a small, rural community such as ours can be a challenge. When it comes to my work with individuals and couples exploring their identity, I often hear how isolated and unsupported people feel as they navigate how to be true to themselves and what they are feeling inside.
One of the driving forces of me making the move from community mental health to private practice was so I could address a gap in care for our community. I have years of training and established relationships with local providers and major medical centers in the region who will provide the care you need, wherever you may be in your process. I do my best to reduce barriers and minimize gatekeeping in accessing services. I may be able to help with:
The coming out process
First or second mental health evaluations for surgery
Mental health counseling for individuals aged 18 or older
Relationship therapy for couples and multiple partners
Resources and guidance in establishing identity
Hormone therapy letters
Surgery support letters
Case coordination with other providers
This practice is a member of the Gender Affirming Letter Access Project (GALAP). If you are seeking hormone therapy or gender-affirming surgery, you may have been told by a healthcare provider or insurance company that a letter (or two) is needed from a mental health professional before making an appointment with your provider.
To reduce gatekeeping and lower financial barriers to accessing gender-affirming health care, I offer letter-writing services on a donation or pay-as-you-can basis for residents of Oregon and Washington. With a few exceptions, letters can usually be written after a single session. If you have private health insurance, we ask that you use your insurance for this service so that those who are uninsured can utilize the GALAP program.
For those who are able to donate for this service, the donation is used to offset the cost of sessions where the fee presents a barrier for someone in accessing gender-affirming health care.
GENDER-AFFIRMING ASSESSMENTS AND LETTERS OF SUPPORT
NOTICE:
We no longer participate in the GALAP program nor offer pro bono (free) assessments.
What the assessment involves
Our mission is to reduce barriers to obtaining letters for hormone therapy and gender-affirming care. Although therapy is highly recommended while transitioning, we do not require counseling as part of this process. Transitioning, especially socially and with hormones, can often bring about unexpected experiences where talking with an experienced therapist could be helpful.
The assessment is a collaborative, interview style discussion, conducted over 2-3 appointments. Generally, the first appointment will be a collaborative interview about your history. A second appointment may be needed to obtain additional information. If not, the second appointment time is used to review the letter and make any changes before sending it off to the primary care provider and/or surgeon. You may also have the opportunity to setup ongoing therapy.
Preparation for the assessment is an imperfect process. While we use gender-affirming language during the interview, some questions have to be asked in a specific manner, which may feel uncomfortable. You are encouraged to let your therapist know when things feel overwhelming. We are here to support you. You will be asked to complete questionnaires and discuss your experiences of gender, including your gender identity, gender development, gender incongruence, and gender dysphoria*, if any. You will also be asked about your overall psychosocial history and about your mental health across your lifespan. The assessment is conducted in line with the standards of care set out by the World Professional Association for Transgender Health (WPATH) and differs depending on the type of affirmation being sought (e.g., hormones or surgery). The WPATH standards of care are available here: https://www.wpath.org/publications/soc
The assessment does not "decide" your gender identity, and your therapist will not decide what your gender identity is for you. Your gender identity is always your personal journey and understanding to reach. In general, the assessment is designed to explore the impact of gender in your life, the impact of other challenges, psychological and otherwise, that might negatively impact outcomes of affirmation/transition, and the presence of any obstacles that might present with gender variance (please see the WPATH standards of care above for a full overview). This does not mean that if you have a mental health condition or are experiencing psychological distress that you would not meet the criteria for affirmation. It may just mean that your therapist will work with you to ensure these challenges are well managed to decrease the chance they will negatively impact your affirmation.
The assessment also explores readiness for affirmation, expectations, and supports. If required, there may also be elements of therapy included in the assessment process as deemed necessary. As part of the assessment, and with your permission, the assessing therapist may need to speak to other healthcare professionals involved in your care. Once the assessment is complete, the therapist will be required to write a report to whichever medical professional is supporting you in your affirmation.
Availability and access
Assessment sessions can be done face to face at the office (dependant on COVID restrictions) or via TeleHealth. Please contact us at (503) 583-2121 or hello@communityrootscounseling.com to check availability. Please note, we no longer participate in GALAP nor offer pro bono (free) assessments.
*Gender dysphoria is the feeling of discomfort or distress that can occur in people whose gender identity differs from their sex assigned at birth, or sex-related physical characteristics. It is important to note that not everyone experiences dysphoria about their gender.
ANXIETY / LIFESPAN TRANSITIONS
I specialize in helping people ADJUST to challenges like:
instability and uncertainty as the new norm
workplace issues and changes in employment
changes in household composition, roles & relationships
cross-cultural adaptation with immigration / work relocation
leaving home to attend college
conflict arising from attachment or communication styles
a new diagnosis
suicide attempt by a close friend or family member
... and COPE with situations and feelings like:
self-doubt/stigma, discrimination, racial stress
excessive worry
shame
MARITAL, PREMARITAL, AND COUPLES / RELATIONSHIP COUNSELING
Relationship dynamics evolve over time -- with career changes, financial stress, starting and raising a family, aging, and life transitions, to name a few. Sometimes a major disruption or break in trust, like, an affair, hidden financial transactions, or habitual lying can bring things to a crisis point.
While many relationships can navigate problems on their own, others may feel stuck, overwhelmed, hopeless, and unsure of what to do. Counseling may be useful in that an experienced therapist can provide an outside perspective to help people hear and understand each other’s thoughts and feelings about the situation, even if it means a major transition or end to the relationship.
My approach in working with people is tailored to each individual relationship and circumstance, but typically includes a systemic and attachment-based perspective. Some of the work may include concepts from Gottman Method Couples Therapy and Emotionally Focused Couples Therapy. Over time, I have found these frameworks useful in addressing past experiences that have unintentionally been brought into relationships, improving communication, and setting a foundation for a successful relationship in future years.
I see clients who represent a spectrum of relationship types.
My practice is a balanced mix of heterosexual couples and those in LGBTQIA2S+, mixed-orientation, polyamorous, and ethically non monogamous (ENM) relationships.
A note to prospective clients:
Our therapists do not bill insurance for couples/relationship therapy. Insurance does not cover the diagnostic codes that pertain to relationships, known as "Z codes."
While we are aware there are therapists in the community who bill insurance for this service, nearly all include naming what's known as an "identified patient." In this practice, one member in the relationship is given a mental health diagnosis that's treatment is covered by insurance because it has been deemed medically necessary. If a therapist elects to bill insurance using this practice, they are obligated to explain the risks of doing so, which can include, but is not limited to: difficulty obtaining life insurance, an inability in securing a security clearance, disqualification from joining the military, challenges securing a job in law enforcement, or denial in obtaining some healthcare licenses.
It is the policy of this office not to participate in such billing practices; therefore, our office does not bill insurance for couples/relationship counseling, nor provide superbills for reimbursement. We can, however, bill select Employee Assistance Programs (EAPs) and/or accept payment for services using FSA/HSA benefit cards, which are subject to more liberal criteria.
