One of the cornerstone phrases for recognizing a transgender child is whether or not they have been “persistent and consistent” in their cross-gender identification. This means the child has shown a consistent (“of a person, behavior, or process unchanging in achievement or effect over a period of time”) identification with the brain gender of that of the “opposite” gender than which they were assigned at birth, and that this has persisted “continued to exist or endure over a prolonged period”. This is in regards to not just gender expression and interests, but in how they relate to themselves or identify in terms of gender. More recently, I have heard “insistent” added on to further qualify how a transgender child will likely present. I have to say, I don’t agree with this one being one of the characteristics a parent or professional might look for in terms of clarification. I think if one is looking for all three of these characteristics, they might miss something. I think the level of insistence displayed by the child is largely dependent upon the child’s temperament. Not all transgender children will be insistent about their “true” gender identities. Really, if taking all different temperaments into consideration, we may want to also reconsider our thinking about the use of the word “persistent” when it comes to transgender children as well. Another definition for persistent is “continuing firmly or obstinately in a course of action in spite of difficulty or opposition”. Will all transgender children be persistent in this way or insistent in the face of opposition or re-direction from parents or other significant figures in their lives? Likely not. Just like everything, one’s personality and desire to please guardians are on a spectrum. MANY children are not insistent about anything, so they sure as heck aren’t going to be about their gender identity or desire to be recognized as a different gender than their assigned gender at birth. Some children eat their vegetables simply because they are told to. Others refuse to take even a bite despite any tactics used by those in charge of feeding them. Such is the same with gender identity: if a child is consciously aware of identifying with a gender other than that assigned to them at birth (i.e. a natal female feels like a boy or a natal male feels like a girl), how much they express this will depend upon the level of distress it brings to them as well as their temperament. Some children will scream, “I am a _______!” and insist upon wearing what they want, being referred to as they want, etc. until everyone around them is quite clear of who they really are. Others, if told the way they feel or how they perform gender is wrong or unexpected, will quickly make modifications to please those around them. When considering persistency and consistency, this is typically in regards to cross-gender identification and gender expression. This may include way of dress, interests, how the child seems to categorize themselves (in play, roles, or how they relate to others), gender of friends, bathroom behavior, etc. If these things seem to be an expression of “cross-gender” identification, that may be a sign of having a gender identity that does not match one’s birth sex. However, the individual (a child, teen, or adult) may not be consciously aware of being transgender until much later. Transgender people become consciously aware of being so at various ages and stages; some seem to know since birth, others as children, others as soon as puberty hits, still others only in late teens or adulthood. I think this largely depends on how much the individual has been exposed to knowledge of variations of gender, family environment, how freely one is allowed to express self in regards to gender, defenses, suppression, the list goes on and on. Only once the individual is consciously aware of being transgender does transition become a factor. From the child who insists on his or her true gender since the time they could speak to the adult who does not become consciously aware until much later, both are equally transgender; the age of conscious awareness was simply different. If the child is yet to be consciously aware that they have the brain gender identity of something other than their assigned birth sex, there is nothing to be insistent about. The point of my post? Don’t wait for your child to insist that he or she is transgender or needs to transition in order to open up the lines of communication. Ask a lot of questions about how your child is feeling. If you sense gender is a source of internal conflict or stress, make it known it is a topic that is welcomed in your home. Ask creative questions to find out how your child experiences his or her gender. Be honest about options that are available in regards to transitioning. (Doing so will not make your child transgender or “plant” ideas in their head. Transition is not an appealing option for non-transgender child.) If you still sense distress but they are not being open about their feelings, seek a consultation with a gender therapist trained in interviewing children. The benefits of early intervention (and transition if right for the child), are many. If you are transgender, looking back to yourself as a child: How consistently did you express a cross-gender identification? How long did this persist before you transitioned? Were you insistent about it?
Since school has started, and since my blog post on this topic, I’ve been working with a lot of schools and parents to hammer out this issue.
It seems that Power School (the computer system used by most schools in SD) will allow for a “preferred name” field, but it still prints the birth name next to the preferred name on all the rosters, etc. So not helpful! Also, there is no updated or preferred gender marker box. Guess what? Anyone in administration at the school can manually go into Power School and change the birth name and gender to the preferred name and gender. Simple as that. I’ve had three schools in San Diego do this now. Assertively ask your school administrators to do this for your child.
If your school still will not do this, ask how they will handle attendance sheets when there is a substitute.
Additionally, send emails to each of your child’s teachers. (This is for children who are about to transition or are currently transitioning, not those who have already transitioned.) One of my client’s mothers wrote this email to each of her child’s teachers, and I absolutely love it.
My child [name] is in your first period [subject] class.
[Preferred name] ‘gender-identifies’ as a male, and I would like to ask you to make very certain that you reference him (purposely, but not obviously) with his preferred name of [preferred name] rather than his legal name and that you use he/him/his pronouns at all times, modeling that for the other students in the class. One of [preferred name]’s biggest concerns in life is “passing,” being regarded and thought of on first glance as male. The kids look to their teachers for cues when they’re unsure, and with your leadership in setting a firm precedent from the beginning as to [preferred name]’s gender, there should be no confusion about it in your class.
Thank you in advance!
Email me with success stories, questions, or concerns about this issue to firstname.lastname@example.org. Thank you!
It’s that time of year… school is starting or is about to start! If you have a transgender child or teen, it’s time to be discussing with the school what name and gender marker is going to be on the rosters, computer system, and “Power School” fields if the school uses it. Only those close to transgender children and teens realize the distress that having their birth name and/or gender marker on school paperwork can cause. I’ve seen the panic in their eyes firsthand. They are often petrified of having their peers learn their birth name. They are worried about being “outed”. Every time they log into the computer system at school, every time attendance is called (especially in the beginning of school or by every single substitute teacher), every time a schedule or report card is passed out, even sometimes buying lunch and having their birth name and gender pop up on the computer letting them into the cafeteria… I can only imagine the tension and anxiety every single one of these instances brings up for them. This is an unnecessary stressor for these kids and we all need to do our part to be educated and speak up about this issue.
“The 2011 National School Climate Survey by the Gay, Lesbian & Straight Education Network (GLSEN), found that 75.4% of transgender students had been verbally harassed in the previous year, 32.1% had been physically harassed, and 16.8% had been physically assaulted. Educators play an essential role in advocating for the well-being of these students and creating a school culture that supports them.”
I believe changing the documentation that circulates around school and on attendance rosters is a crucial part of creating a school culture that supports transgender and gender nonconforming youth.
I recently learned at the Gender Spectrum conference that the school is only legally required to keep the legal birth name and gender marker somewhere in the permanent file, but they can change EVERYTHING ELSE to the preferred name and gender before a legal change.
Before spreading the word, I did a little research on this topic to back up this claim.
The following quote is from the California Safe Schools Coalition Model School District Policy Regarding Transgender and Gender Nonconforming Students:
The District is required to maintain a mandatory permanent pupil record (“official record”) that includes a student’s legal name and legal gender. However, the District is not required to use a student’s legal name and gender on other school records or documents. The District will change a student’s official record to reflect a change in legal name or legal gender upon receipt of documentation that such change has been made pursuant to a court order. In situations where school staff or administrators are required by law to use or to report a transgender student’s legal name or gender, such as for purposes of standardized testing, school staff and administrators shall adopt practices to avoid the inadvertent disclosure of such confidential information.
A student has the right to be addressed by a name and pronoun that corresponds to the student’s gender identity. A court-ordered name or gender change is not required, and the student need not change his or her official records. The intentional or persistent refusal to respect a student’s gender identity (for example, intentionally referring to the student by a name or pronoun that does not correspond to the student’s gender identity) is a violation of this policy.”
“Upon request, districts should prepare data systems to list a transgender or gender nonconforming student by his or her preferred name and gender.”
“Privacy Rights of Transgender or Gender Nonconforming Student
A student’s decision to inform the district that his or her gender identity differs from his or her biological gender is extremely personal and private. In addition, transgender and gender nonconforming students may face bullying and harassment as a result of other students or staff not understanding or tolerating the public representations of their gender identity. At the same time, the decision may potentially involve very public components if, for example, the student starts to go by a different name. Despite this potential for public awareness, districts are still legally responsible to maintain the students privacy according to the students wishes.”
The following is an excerpt from Know Your Rights – Transgender People and the Law; Name Change and Identity Documents:
“Can a person change his or her name to reflect his or her gender identity? Yes. In some states [and California is one of those states], through what is called “common law name change,” people may change their name simply by using the new name in everyday interactions. It is free and easy, but does not create the kind of solid paper trail needed to change identity documents.”
If you are interested in pursuing the legal name and gender change, know it takes at least 6 weeks to go through. Those of you who reside in San Diego can find the packet here. Click here for the Transgender Law Center’s comprehensive page with links to all forms needed.
For those of you not in San Diego, simply Google your county and “name and gender change”.
PLEASE NOTE, DUE TO AB1121, YOU NO LONGER HAVE TO PUBLISH ANYTHING IN THE NEWSPAPER. If the court is unaware of this, educate them. Filing the packet costs $435 (at least in San Diego), but the fee can be waived based on low income. (Ask for the “In Forma Pauperis“.)
Here is the Transgender Law Center’s awesome resource that includes UPDATED information on changing name, gender, etc. If you are interested in pursuing a name and gender change, start on page 9.
If you ONLY need to change your child’s gender marker (keeping birth name), and your child was born in California: click here.
Any other tips from those who have been down this road greatly appreciated!
I regularly get asked how I got into the gender work I do. Here’s how it all went down:
In early 2006 I was establishing my private practice while I was still working at the Naval Medical Center San Diego. As a way of getting new clients, I advertised on Craigslist. I was a little leery of doing this, for fear it would attract people not exactly looking for therapy. True, I got a couple of off-color inquiries, but thankfully these were easy to screen as not legitimate. Since I had never before worked with gender nonconforming clients, my ad said nothing about that. Here is a snippet from that ad:
“Although I specialize in working with children, I also work with adult individuals and couples. I find that my warm and empathetic approach that works so well with children also helps to create a safe, therapeutic environment for adults which promotes progress in therapy.”
Perhaps it was the way the ad was phrased that made someone struggling with their true identity reach out to me?
“Hello, I was wondering if you offer any type of therapy that deals with gender reassignment[…] If you don’t, and happen to know of someone please send me their name. Thanks.”
Unfortunately, I don’t have the response I wrote back to him, but this is the return email:
Thank you so much for responding to my message. You are right it was a hard step as it will be the first talking contact for me. I appreciate your honesty in telling me that you have not worked with any transgendered [sic] patients. Doesn’t bother me one bit. In all honesty, I feel like I know where I am at as far as how I feel about the situation. Where I am having my biggest doubts and fears are when it comes to telling my family and friends about my issue/feelings. The fear of their reactions is kind of holding me back. […] For some reason I feel like we can work together, and you can help me a lot. […] I have a few other questions regarding my letter for T, and top surgery, but I’m sure we can discuss these at a later time. Which name would you like? My birth name or what I plan (at this moment) to go by? Thank you.”
I don’t have my response but I do know it included this question: “What is T?”. This always makes me smile thinking back to it. “T”, referencing Testosterone, is now a standard (almost daily!) part of my vocabulary. I also know that even though I hadn’t been “trained” yet in gender therapy, I knew to of course ask for his preferred name. That is the name I have called him ever since, and have never once called him his birth name. There are SO many things I had to learn after I started working with him and soon thereafter many more transgender individuals. However, the concept of being transgender never confused or fascinated me. It just seemed so simple, pursuing alignment to match one’s gender identity. As I’ve said before, some people “get it” and some people don’t. I got it.
Our first session focused on a psychosocial assessment and discussing his goals for gender transition. He needed to educate me about some things, but I also made it clear I would be doing research and pursuing my own education about this. I knew that just because he was my first transgender client it wasn’t his job to teach me everything I needed to know in order to give him the best care. He left me with his copy of “Testosterone Files” by Max Valerio which I promptly read. After all the books I’ve read on this topic, I’m always glad that was my first. I felt it was a very informative and well-written account of someone transitioning from female to male.
Here is part of the email I received after our first session:
I just wanted to say thank you for taking time out to talk with me today. I admit I was really nervous before we started, but I ended up more comfortable than I thought I was going to be. I also want you to know that you are very easy to talk to, and I believe you are going to be able to help me figure out what I need to do. I actually left your place with a feeling of relief for the first time. Somehow I feel as if things are going to be all right eventually for me. Thanks. Looking forward to our next session!”
This client was traveling quite a way to see me, which was my first clue there were not a plethora of other therapists working with this population. He connected me with his case manager from the former S.T.A.R. program, “Supporting Transgender Access to Resources”. The care manager reiterated the lack of therapists for this community and was soon sending me MANY more transgender clients. I did my best to get equipped for the details of my newfound duties; writing letters for hormone treatment and surgery, helping clients access resources, assisting them in the coming out and transitioning process. I read books, attended conferences, and attended monthly FTMI (Female to Male International) meetings at the LGBT Center here in San Diego. Soon I was leading a weekly support group for FTM individuals in addition to the clients I was seeing one-on-one. I am so grateful to all the people and clients I interacted with during that time; I learned so much from them and became more committed to and invested in my work than ever.
At first my gender therapy was only with adult clients. Soon, my name was “out there” and I began seeing gender nonconforming and transgender children. Since my specialty had always been working with children and my newfound specialty was gender therapy, this was a beautiful and serendipitous melding of the two.
When I first found out about the substantial lack of gender therapists in San Diego, I didn’t understand why. Why weren’t there more if the need was so high? Was there something I was missing? Was I looking at this too simply, that these people coming to me knew their true gender and just needed some help getting there? Over 8 years later, I can answer: no, I wasn’t missing anything. This work truly is that cut and dry; the clients are the experts on their own gender identity. I am just here to help and support them along the journey.
My first client has told me many times how I “changed his life”, but I can honestly say he changed mine in much the same way. He gave me a specialty that I am deeply passionate about; I am absolutely inspired and energized by my work. In an amazing “parallel universe” kind of way, entering into this particular niche has helped someone very significant to me discover their true gender identity and therefore transition. Because of this, gender transition is a part of both my professional and personal life, and I wouldn’t have it any other way.
To my “OG” client: THANK YOU. Thank you for giving me a chance. For trusting me with such a huge undertaking in your life even though I had no “experience”. Thank you for blessing me with this amazing work I get to do. And, thank you for letting me share part of your emails here. :)
Many parents of transgender children (youth and adults) express sadness about feeling like they’re going to lose their child in some way when their child transitions. I’ve heard several parents say this impending loss feels like a death, and they prepare to grieve accordingly. It’s never really that they are feeling that way; usually they are scared they are going to feel that way when their child transitions.
I tell them most parents end up not feeling that way, as their child will still be here, but they won’t know this until they go through it themselves. Really, the parent is not losing their child. The child (again, I’m talking about “adult children”, too) is going to be the same person they always were. The parent is only now beginning to understand what pronouns and gender identity go along with who their child really is. The main loss is that of pronouns and a mental image of who the parent thought they were.
Recently, a father made it clear he had not experienced loss as a result of his child’s transition. I wanted desperately to bottle up his words and give them to each parent I see who is struggling with a sense of impending loss in regards to their transgender child. So, I did the next best thing; I asked him to write a blog post about it! Without further ado, please read these words from a father who has gained so much.
“Anti-Loss – By Peter T.
Emma was our second child, born from the love her mother and I shared and wanted to manifest in the world. In the days after we learned she was pregnant, my wife and I had no idea if she would give birth to a boy or a girl – and to both of us, it made no difference, whatsoever. Whether our baby, our child, our young adult was a boy or a girl was pretty much irrelevant, as long as they grew up happy, strong, knowing they were deeply loved and accepted for their unique and beautiful self.
Our baby was born in the body of a girl… but in this baby, nature decided to do an interesting thing. Somehow, the heart and mind and spirit of a son was inserted into the body of a girl. We as parents, being such literal and visual creatures, took the visual presentation of our baby to be all we needed to know about gender. The doctor said “It’s a girl!” and we believed. We went about dressing our baby and our child as a girl… giving “her” girl activities… and investing in our expectations about what “she” would grow up to be.
As our child grew up and was able to begin to make choices in clothing, friends and activities, it was gradually apparent that our ideas about “being a girl” weren’t really fitting this small person. Still, we took our child to ballet lessons and set up tea parties with classmates, bought cute dresses and imagined the life-ahead for “her” – and our child seemed to participate in these things happily… up to a point, but beneath the seemingly-accepting exterior of this small person, inner turmoil was brewing.
We, as parents of transgender teens, all have our stories of how our child made their truth known to us and how we initially – and then eventually – reacted to their needs. I won’t lengthen this writing by sharing mine in detail, but I will acknowledge that I definitely had to go through my own reprogramming… adjusting in some fundamental ways, how I perceived my child. The child I had known for 13 years as Emma now was to be called Andrew… “she” was to be “he” and a whole new world of concerns for his welfare appeared – in addition to the ones that come standard with every teen.
I have been so very fortunate to be included in my son Andrew’s counseling sessions. All sorts of truths rise to the surface there that “real life” often doesn’t allow time or space for. A few weeks ago, I said something to Andrew in counseling that I’d said several times before – but this time, he finally made it clear that what I’d said was hurting him. What I’d said was that he was at something of a disadvantage in passing as male, because, as a girl, he was quite pretty – and that gave him an obstacle to overcome in looking masculine. Andrew shared with me that when I said things like that, he felt as though I was saying I had lost something – that I had lost my “pretty daughter”… and clearly, it hurt him to feel that who he truly was inside – and now, outside was something “less” to me.
I was very sad to know that my observation about “what he used to be” caused him to feel I had lost something along the way. The truth is so entirely opposite – for me it has been “anti-loss” – ONLY gain – as I have seen my child stand up and speak his truth and claim his real life – against all odds, despite peer pressure, despite fear of ridicule, in the face of the certainty that his road ahead would be so very hard. I told him then… and I will remind him often… that he is so very much *more* than I ever could have hoped for in a child, in a son, in a young man who I am so entirely proud to have in my life.
What was it again? What did I wish for… back in those days before his mother and I knew his eye color or his name? What was it that we had hoped for, above all? I had wished for a child who would be able to grow up happy and strong… who would face difficult challenges with integrity and intelligence… who would know himself deeply – and from that knowledge, live a life filled with love and joy and passions-abounding. In my lovely son, I have found examples of all those things that I, myself, can only hope to aspire to. His process of becoming himself is such an incredible honor to participate in and I hope, as he grows into the amazing man I know he will be, that he always knows that his parents accept him and love him deeply and completely.
There is nothing here but gain.”
Thank you, Peter, for your beautiful words and sharing your perspective. Thank you also to Andrew for letting me share part of your story. <3
A very important video has gone viral with over 4.5 million hits in one week. It’s the story of young Ryland, a transgender boy who was allowed to socially transition at the age of 5. To see the video, click here. As a gender therapist, and a gender therapist who also works with transgender children, I’m thrilled to see this video in mainstream media: Huffington Post, People.com, Upworthy.com. It’s bringing awareness to an extremely important issue: not just that transgender children can transition, but it drives home the point that transgender people are born transgender. The age that one is consciously aware of being transgender or transitions can vary widely, but an individual does not become transgender over the course of their lifetime.
I had the honor of speaking about this issue on Good Morning America. To see the clip, click here. I said a lot more than what was aired, but there’s only so much they could fit into a 4-minute news segment. I’d like to take this opportunity to address some of those things now. These points are in direct response to the questions I was asked by Good Morning America about the video. Regular readers of this blog are probably well-versed in the answers below, but in case this post is read by someone seeking more education or to understand young transgender children, I wanted to be thorough.
Many people were surprised to read that 41% of transgender individuals have attempted suicide, while the rate of the general population is 4.6%. That staggering statistic, I believe, applies to transgender individuals who transition later in life and meet with familial/societal resistance, rejection, or shame. “New analysis of responses to the National Transgender Discrimination Survey (NTDS) shows that transgender respondents who experienced rejection by family and friends, discrimination, victimization, or violence have a higher risk of attempting suicide.” I strongly believe that number will plummet in the coming years with increased awareness, education, and accepting, responsive families like Ryland’s. To read the full report from the Williams Institute, click here.
I was asked questions about what interventions are recommended for transgender children. For a transgender child as young as 5 or 6, the first step is social transition. This means changing pronouns, sometimes name, and some societal markers of gender such as haircut or dress. No medical interventions happen at this stage, contrary to some sensationalistic beliefs. The first medical interventions would be just before the onset of puberty, at which time hormone blockers would be introduced to prevent the body from going through the “wrong” puberty. As the teen ages, cross-sex hormones would be administered to initiate puberty of the preferred sex, which would produce some much-desired “gender markers”.
When a child has been clear about their gender identity and not transitioning causes distress, transitioning young can be incredibly beneficial to the individual. While not all transgender people are focused on “passing”, it is hugely important to many. “Passing” means being read in society as the gender with which you identify in your brain. Going to the grocery store and having the cashier address them with the correct gender pronouns… that is “passing”. Transitioning early and intervening before puberty takes over will allow that individual to pass as his or her “true” gender without question.
One thing I want to say is that I know many people worry that a very young child is too young to make such a big “decision”. I want to remind you that gender identity is not a decision. We all know very early on what gender we are. A transgender child of Ryland’s age is not making a “huge decision” to be a boy. He IS a boy. His parents were faced with a huge decision about allowing him to transition, and they made it based on Ryland’s asserted gender identity.
I thought Good Morning America did a good job of covering this video. I was pleased about the input from ABC’s Chief Health and Medical Editor, Dr. Richard Besser. “The more we’re learning about gender, the more we’re learning that this is really hard-wired. It’s hard-wired in the brain. And from very early, from the first couple years of life, children will recognize gender and then start to identify with gender.” My only feedback would be that he should have used male pronouns when referring to a transgender boy.
One thing that didn’t sit right with me was the way they worded the “teaser” for the upcoming segment on the video. “True Identity: The incredible story being shared coast to coast of one little girl who just wanted to be a boy. Why her parents encouraged her to change gender.”
This statement is misleading at best. First of all, this child is not a little girl. This child did not “want to be a boy”, this child has the brain gender identity of a boy. As the video said, this child did not say “I want to be a boy”, he said “I AM a boy”. Now, I understand those snippets are meant to be short and can’t cover it all, and they are geared to having people tune in to watch the segment. The part that got me the most was the last sentence: “Why her parents encouraged her to change gender.” If you are the parent of a transgender child, you probably understand why that sounds a little silly. Do these parents have some sort of ulterior motive to have a transgender child? Doubt it. Was this in their master plan? Likely not. Many of the parents of young transgender children I work with struggle extensively during the process of understanding their child’s true gender identity. It takes time to accept their child is transgender, and naturally, parents tend to agonize over allowing their child to transition. Supporting and responding appropriately to their child’s gender identity is not encouraging something that wasn’t there; you can’t make a child transgender. However, supporting and encouraging the child to live life as their true selves, that is selfless, unconditional love. For more reflections on how difficult and intense this journey can be for parents, see my blog post “Feelin’ The Love: Watching the Journey of Parents”.
In the video, the song fades from “Hallelujah” by Jeff Buckley to “Good Life” by One Republic as it shows Ryland transitioning. I think it was the perfect song choice. So many parents worry whether or not their transgender child can have a good life. The answer is: ABSOLUTELY. Thank you to Ryland and his family for being selfless and strong enough to share your story so that many more transgender children can have good lives, just like you.
Consider this post a close cousin to my last post, “On Being ‘Sure’”. Related to loved ones’ fears about a transgender person being “sure” about transitioning are the fears that they may one day regret the transition or “change their mind” about being transgender. Yes, I hear this a lot. From doctors, from parents. It’s a valid concern, although I’m not sure the frequency with which it happens is correlated with the amount of concern about it.
It seems that at first parents hope their child (either a youth or their adult child) will change their minds when a transgender identity is first revealed. Later, this thought turns into a fear as transition nears or progresses.
In my opinion, some of the fear and anxiety comes from good intentions, trying to use their own perspective to understand. If they put themselves in the transgender person’s shoes, they would imagine not only would they “change their minds”, but they would want to “switch back” immediately. It’s really important to try to not use your own perspective in this situation if you have never once struggled with your gender identity. For as sure as you are about your gender identity, your transgender loved one is likely just as sure about their gender identity.
But what about the studies?? Oh, the studies. The studies that scare everyone. There are plenty of studies that show gender nonconformity in childhood doesn’t persist. That even those who insist they are the “other” gender do not go on to transition. Keep in mind some of these studies were written by doctors who were actively trying to get the child to conform to their birth gender. Additionally, all the dynamics at play with the child’s gender identity are not known in those studies.
Not everyone follows the same path. Not everyone has the same personality, confidence, support system, encouragement, discrimination, access to resources, parents, communities, ego strength, temperament, role models etc. All of these factors, and many more, can affect whether or not someone chooses to transition.
Someone may decide that having their body be different from their affirmed gender identity is more distressing than having their birth gender identity be different from their affirmed gender identity. Everyone is different. People experience distress in different ways and because of different things. Just because someone chooses not to transition, or later “de-transitions” does not mean they are not transgender. It means that they (or others in their life) decided transitioning was ultimately not the best choice for them.
I believe that most of the children/teens/adults who say they are “sure” and then transition do not live to regret this decision. I have anecdotal evidence with my own clients. Don’t believe me? In 2011, a man named Colin Close conducted a survey about how medically-assisted transition affects the lives of transgender people. The study examined the experiences of 448 individuals to identify the impacts transition on gender dysphoria, quality of life, emotional well-being, personality traits, and sexuality. The outcome?
- 94% of trans* people reported an improvement in their quality of life due to transitioning
- 96% answered that their sense of well-being improved
- 9 out of 10 responded that their overall personality improved due to transition
- 85% described their emotional stability as “improved” (11% reported no change)
- 96% reported an overall satisfaction with transition
- 97% reported a satisfaction with hormone therapy
- 96% reported satisfaction with chest surgery
- 90% reported satisfaction with genital surgery
You can download the full report here.
Are there those that do change their minds and regret transitioning? Yes, there are. I can’t speak to exactly what dynamics led to this, as only they know everything that went into all of their decisions. However, I believe they deserve just as much support “de-transitioning” as they did transitioning. It is their gender. It is their life. It is their journey.
We as humans (probably as self-protective measure) tend to look at the “worst case scenarios” and feel scared by risks associated with choices, no matter how small. It’s natural. However, those small percentages of things often scare us from taking the leap to do something we want to do.
Let me use this as an example: what if the ratio of successful airplane flights to the number of airplane crashes was roughly equivalent to the ratio of people who are satisfied about transitioning to those who regret it?
If we all based our sense of safety on thinking about the small percentage of airplane crashes, none of us would want to fly again. There a risk to much everything we do, and there are no guarantees. Yet with risk often comes adventure, new possibilities, fulfillment, joy! Think of transitioning as your loved one spreading their wings to fly. :)
What about the kids, you say? They are not adults. How can they POSSIBLY make such a huge decision as this? Well, gender identity is not a decision. It is a way one is. For children who have shown a persistent and consistent cross-gender identification during childhood and express a strong desire to be seen as the gender with which their brain identifies, they should be allowed to do so. Transitioning is something one does about one’s gender identity if it doesn’t match one’s body. Parents and professionals need to help youth access the resources they need to do so; that is the vehicle for supporting one’s true identity, not just a “big decision”.
Bear with me for a moment while I expand upon the decision about marriage as a metaphor of sorts for gender transition as I did in my last blog post. I don’t know what the current percentage is, but last I heard 50% of marriages end in divorce. 50%! That’s HALF of the people who decide to commit themselves to someone for the rest of their lives, and essentially “change their minds”. I can tell you that is FAR higher than the number of individuals who will regret their gender transition! Now, does this mean we should increase the hoops one should jump through in order to get married? Should one’s mental health be evaluated before entering into marriage and signed off by a licensed therapist?Does the person who is performing the marriage have to have some sort of guarantee that this marriage will last forever before conducting the ceremony? Of course not. If both parties are entering into the marriage willingly and are able to make sound decisions for themselves, they should have every right to do so. Informed consent is the name of the game when it comes to getting married, as it should be with gender transition.
Is there a chance your loved one may regret the decision? Yes. Is there a chance you may die the next time you get in your car or the next time you take an airplane flight? Yes. There are no guarantees. But I can say this: there are more risks associated with not transitioning or allowing your child to transition that there is with transition. Acknowledge your fear but don’t let it hold you (or your loved one) back. Soon you’ll all be ready for takeoff.
One of the first things that comes to most loved ones’ minds when told about someone’s transgender identity or plans to transition is “Are you sure??” In fact, this is often a question many of my pre-transition clients are asking themselves; “Am I sure??”. The question is worth asking, but the answer may not be a simple “yes” or “no”.
Most people are pretty darn sure of their gender identity. Cisgender and transgender alike, most are pretty darn sure. What confounds things is that only transgender people have to navigate through having a brain gender identity that differs from their birth sex, and having to first understand and then explain this to others. Still, most are pretty darn sure. Remember, gender identity is different than making the decision to transition. Often times, knowing one’s gender identity is the “easy” part. Pursuing a life to align one’s gender presentation with one’s brain gender identity? Now that’s the more challenging part.
So, “Are you sure?”. If you are a loved one who finds yourself asking this question, try to clarify what you are asking about. Are you asking about your loved one’s gender identity or plans to transition? If you separate the two, you may find more confidence in the first than the latter. If your loved one is sure of their (trans)gender identity, asking if they are sure about their transition may contribute to fears and anxieties surrounding this “decision”. Instead, ask “How can I help? What’s the first step?”.
Many clients I’ve met with who are contemplating transition have said to me, “I want to be 100% sure”. My clients tend to be intelligent, high-functioning individuals who are used to doing things well, and they want this to be no exception. They research, they inquire, they ruminate, they agonize, they weigh the risks and benefits ad nauseum. After all this, they are still “not sure”. Why? Because there ARE risks, and because the process isn’t easy. Therefore, anxiety about this huge undertaking can be interpreted as not being “sure”. Again, not so much about the gender identity- if I can bring them back to that aspect of themselves instead of just the “decision” to transition, they are much more sure about their gender identity. A good example might be left-handedness. People are born left-handed, no? It used to be lefties were encouraged to use their right hands until it became habit. Gender identity is similar in that it is inborn. It can be stifled to present differently, but that doesn’t mean it’s good for the person. And what gender one presents as is far more pervasive than which hand is dominant!
One of my clients, a happy and insightful trans man, made mention to not feeling completely sure until AFTER he had transitioned. I later contacted him to write a little blurb for this blog post, and he delivered beautifully. Here is what he had to say:
“To be honest I wasn’t 100% sure about transitioning until I was already pretty far into it. One day about 4 years in I looked in the mirror and for the first time in my life I recognized myself. I don’t think you can ever be 100% sure about anything in life, any decision, any path…it’s all educated guesses wrapped up in a hope for happiness.”
Isn’t this the case for most things? We make huge decisions all the time that will affect the rest of our lives: where to live, where to go to school, the career path to follow, to marry or not to marry, if yes who to marry, to have kids or not have kids, if yes how many, etc. Yet these decisions typically aren’t as agonized over as much or as misunderstood as gender transition.
I’m reluctant to compare gender transition to getting married, but the analogy really sticks in my mind. How many people are “sure” when they get married that they will be with the other person “forever”? Of the couples who eventually divorce, if you could ask them “but were you SURE when you got married?”, most of them would unequivocally say “yes”. Some may argue that gender transition is a more “serious” decision than getting married, but is it? Marriages often result in children, who are thereby affected by a divorce if it were to occur. If a capable individual decides to get married, they get married. However, if a capable individual decides to go through gender transition, the issue of being “sure” is one they will have to answer over and over again. I guess it’s because other people can understand marriage, but have a harder time wrapping their brains around gender transition. However, this should not matter when it comes to others and their decisions about their own lives. Not to mention the rate of transgender individuals later “changing their minds” about transition is FAR, FAR less than the current rate of successful vs. unsuccessful marriages!
I suppose feeling more at ease with one’s decision comes down to trust. If your loved one is telling you who they are what they have decided to do, trust them. If you are transgender and have decided to transition, trust yourself. If the person making this decision is of sound judgment and mind, there is no real reason to think this is an irrational decision that will ever be regretted. Additionally, if one has come to the decision to transition, it has not come lightly. Many transgender people agonize about the decision to transition long after one’s true gender identity has become consciously aware.
Perhaps being “sure” is an evolutionary process, and one that can only happen after the first step. I do know that trusting yourself is a good idea… of that I am sure. ;)
For those of you how have transitioned, how “sure” did you feel before? After?
The day Assembly Bill 1266 was signed into law by Governor Brown was a very good day in my books. A.B. 1266, otherwise named the “School Success and Opportunity Act”, requires that California public schools respect students’ gender identity and ensures that students can fully participate in all school activities, sports teams, programs, and facilities that match their gender identity. The issues affected by this bill are not just concepts to me, but things I think about and talk about on a very regular basis. More importantly, I see and hear about the impact this issue has on many different kids and teens all the time.
In my practice, I have heard about a student being told they may not participate in everyday activities at school like changing for PE with the rest of their peers, making them clearly stand out. I have seen kids who feel rejected and ostracized at school because they are forced to use the nurse’s bathroom and may not use the bathroom with their peers. I have had my teen clients tell me they dehydrate themselves and “hold it” all day to avoid having to use the bathroom at all. I have had teen clients have to mask their true gender identity in order to be allowed to continue to play a sport they love and at which they excel. Therefore, you can only imagine my elation when I heard about the bill that will protect students like this. However, not long after the celebration of this victory came the opposition. People speaking up who adamantly oppose the existence of this bill. I (again) find myself surprised at the ignorance and discrimination I hear and read.
Many opponents of this bill have inaccurately named it “The Bathroom Bill” because they seem to ignore the other aspects of equality that are being offered by the bill going into law and focus solely on what it means for transgender students being allowed to use the appropriate bathroom. Therefore, I will focus on that part of the bill in this blog post, for now.
So what are we talking about here? We are talking about girls being able to use the girls’ restroom, and boys being able to use the boys’ restroom. It explicitly states a student may use the facilities consistent with his or her gender identity, irrespective of the gender listed on the pupil’s records. It does not say “all students” can pick which bathroom they want to go in, depending on their mood. We are NOT talking about boys using the girls’ bathroom and girls using the boys’ bathroom. We’re just not. If someone says we are, he or she does not understand what makes someone a boy or a girl.
Having a penis or a vagina does not make someone a boy or a girl. Being a boy or a girl references one’s gender identity, which exists in one’s brain. Talking about genitals only references one’s natal sex. (For more information on this, re-read my post “Gender Vs. Sex”.) For those people who insist having a penis or a vagina is what determines whether someone is a boy or a girl, why?? WHY must genitals trump brains? I don’t understand. What is this focus on genitals? Why do some people act as though what someone has in their pants is more important than what they have in their heads?? I mean, you could function and lead a productive life without a penis or a vagina (provided there were modifications made for the elimination of urine), but you can’t function or lead a productive life without a brain. Brains trump genitals, as they should in the gender debate and many other issues I won’t mention here!
Speaking of being hyper-focused on genitals, people seem to be confused about how transgender people use their genitals in the bathroom. Some seem to think it will be a transgender person’s goal to show off their genitals in the bathroom. I recently read a quote in the LA Times: “What if a kid with a penis is standing at the boys’ urinal wearing a dress and a pretty hair bow?” This is not quite how it’s going to go down, guys. First of all, if this quote references a transgirl and being allowed to use the restroom that matches her gender identity, she would be in the girls’ restroom. There are no urinals in the girls’ restroom. Additionally, transgender children and adults are typically going to be incredibly careful to stay covered when using the restroom. You’d probably have a greater chance of being struck by lightning than seeing a transperson’s genitalia in a public or school restroom.
Others seem convinced a transgender person is going to be interested in looking at other people’s genitals in the bathroom. That whole “man in a dress in the women’s restroom” argument? Only serves to prove the ignorance of the opponents. A transgender woman is not a man in a dress, she is a woman. She likely has the same interest in seeing the genitals of the other women in the restroom as the general population. (How high do you think that is? Pretty low, I would imagine. I’ve not seen a lot of girls/women trying to catch glimpses over the bathroom stalls in all my years of using school and public restrooms, but I digress.)
Want to know how I think a transgender child, teen, or adult uses their genitals in the bathroom? To eliminate urine. Surprise! Oh, and thanks to social stigmatization and ignorance, that same individual will probably do their business and then hurry out of the restroom as fast as possible. Not what I want for the people I care about.
Lastly, I’ve heard and read concerns that a male child or teen may “pretend” to be transgender just to get to use the girls’ restroom. (The fact that no one is worried that a “girl” is going to “pretend” to be a boy just to get a peek in the boys’ bathroom says other negative things about society at large). Let me tell you, I just don’t see that happening. Bear in mind this is not about “I feel like a girl today” or “I feel like a boy today”. This is about a consistent, persistent cross-gender identification that will likely be discussed and explored at length by parents and professionals prior to a child transitioning and therefore using a bathroom different than that in line with their natal sex.
To the opponents: please, sit down. Be quiet. You know not what you do. You are protecting children who do not need protecting and harming children who do. As a professional who has cared for and worked with many transgender kids/teens/families/adults, I know more about this issue than you do. I understand what it means to be transgender more than you do. I understand the bathroom behavior of transgender individuals better than you do. I care about this issue more than you do, and I’m on the other side.
This is about being treated like a decent, normal student along with one’s peers. This is about being able to play on the team in line with one’s gender identity and be included with same-gender peer for activities such a P.E. This is about not forcing a GIRL to play on a boys’ team or not forcing a BOY to be in a girls’ group for P.E.
Even if this bill “sticks”, and I hope it does, everyone is not yet safe. Transgender individuals being “allowed” to use the restroom that matches their brain gender identity is not enough. The understanding of gender identity needs to be increased in the general population. Please, if you care about this issue, speak up. Urge those around you to avoid signing petitions in opposition to this bill. Educate others who may misunderstand what this bill is all about. Consider signing this pledge to support transgender youth. https://www.change.org/petitions/i-support-transgender-students
For more in-depth information about this bill and to read more about “myths” about this bill, please visit: http://www.americanprogress.org/issues/lgbt/news/2013/08/23/72800/californias-new-protections-for-transgender-students/. It’s one of the better articles I’ve read.