Gender Blog by Darlene Tando, LCSW

In my post “What are you going to do about it?”, I discuss two very separate concepts: one’s gender identity and one’s “decision” about what to do about it. However, I made it clear that “deciding” not to transition is not usually a positive choice for a transgender individual. Today let’s break it down one step further and clarify what this “decision” means. Deciding to transition often means acting upon something that already is. That is, someone can be transgender in that they feel the brain gender identity they have is different than their assigned gender based on their natal sex. Is being transgender a decision? Absolutely not. You cannot decide to be transgender, just as much as anyone cannot “decide” on their gender before birth. I think talking too much about the “decision” to transition undermines what just simply exists; one’s brain gender identity. I want to acknowledge that there are some people who are transgender and who choose not to transition. This is a valid choice and one that is completely within their right. Let’s just say, for argument’s sake and the sake of this blog post, that transitioning is the natural response to one being transgender. If that is true, let’s stop thinking about transition as a decision and more as an intervention. I suppose this distinction has become more and more clear in my work with transgender youth and how different their process can be. Adults have the tendency to overthink everything, and so sometimes my work involves sitting with a client while they agonize over the “decision” to transition. Some of this includes not just IF they are going to transition but when, how, etc. It is somewhat different with transgender children. Because of their luxury of not yet having a brain trained to overthink things, they typically know just what they want to do about it. It is their parents/guardians, those in charge of their care, who typically stall the transition. They want their child to be SURE. They want their child to know all aspects of transition prior to “deciding to do so”. I have heard this statement so many times: “I just want him to be sure he knows what he’s getting into if he decides to transition” or “I just want to be sure she is mature enough to make a decision like this”, and “I told her if you’re going to make this decision I just want you to know what the consequences could be”. (If you have made a statement like this in my office, please know it is not about you specifically. I have heard these things too many times to count or to connect to one person or family. 🙂 ) Because children don’t overthink things, being transgender and transitioning* are fluidly, easily connected. Let’s try not to infringe our overthinking brains upon them. Let’s start looking at transitioning as an intervention, not a decision. If your child had a medical condition, and a doctor recommended an intervention that could make their lives a whole lot better, or potentially save your child’s life, would you put the decision on the child? Would you present the options to your child but then warn them to consider the financial implications, social implications, family implications on said intervention? Of course not. (For a similar concept covered in a different blog post, see “Oxygen”.) We are so used to warning our children of possible outcomes that we forget some are natural consequences to a circumstance, not something to avoid at all costs. Will there possibly be difficult times ahead for the transgender child who opts to transition? Yes. Will you be there to help them through it? Yes. Given how debilitating and dangerous dysphoria can be, I can assure you any stumbling blocks post-transition will likely be easier to overcome by the distress of not transitioning at all. Adults reading this who identify as transgender, what if you were to think of transitioning as an intervention instead of a decision? Would you give yourself more permission to act on how you feel and what you know you need? Would you be more willing to assert what you need from others, knowing this is something that is necessary for you?

*I want to clarify that for the sake of this blog post I am speaking of transition in fairly binary terms, that is someone transitioning from male to female, or female to male. However, plenty of people do not identify within this binary; some are gender fluid, some are genderqueer, some are bi-gender, some are agender, some are gender nonconforming. For these individuals, the “transition” and “intervention” may be somewhat different. It could just include having those around them understand them better, possibly change pronouns, and advocate for the use of proper treatment and pronouns. Those in charge of their care/their loved ones should also look at their stated preferences as interventions to how they feel, not “decisions” they are making to be a certain way gender-wise.