Name and Gender Documentation in Schools: Update

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.

“Dear [Teacher],

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!

Sincerely,

[Parent]”

Email me with success stories, questions, or concerns about this issue to tandotherapy@me.com. Thank you!

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Published in: on September 4, 2014 at 10:59 am  Comments (3)  

Name and Gender Documentation in Schools

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” (or similar software program) fields. 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 following is an excerpt from Guidance for Massachusetts Public Schools: Creating a Safe and Supportive School Environment; Nondiscrimination on the Basis of Gender Identity: “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: “Official Records 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. Names/Pronouns 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 their 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.” The following are excerpts from California School Boards Association (CSBA)’s “Final Guidance: AB1266, Transgender and Gender Nonconforming Students, Privacy, Programs, Activities and Facilities“: “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 [sic] gender identity differs from his or her [sic] 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 [sic] name to reflect his or her [sic] 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!

Youth (minor) name and gender change sample packet HERE: minornamegenderchange

Adult name and gender change sample packet HERE: adultnamegenderchange

A Parent’s Post: Anti-Loss

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. ❤

Viral Video: Ryland’s Story

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.

But What If They Change Their Mind?!

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.

On Being “Sure”

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 Pronoun Corrector

Want to be a super hero? Who doesn’t? There’s a very special kind of super hero when it comes to supporting a newly transitioning, or newly out, transgender person.

Is it a bird? Is it a plane?? NO! It’s:

The PRONOUN CORRECTOR!!!

Someone in the early stages of disclosing their authentic gender or social transitioning often experiences a lot of anxiety about how they are being “read” and if they are being seen as their authentic gender. They can experience a lot of fear and anxiety about being read as their assigned (birth) gender.

When someone is already feeling unsure and a little anxious, it’s certainly hard to find the courage to correct pronouns and other clarifiers such as “sir” or “ma’am”. I’ve coached numerous clients and groups on how to do this in a friendly, confident fashion.  But it remains incredibly difficult for many individuals, and I can’t say I blame them.

I was having a conversation with one of my teen clients the other day.* When I asked how he was doing correcting pronouns in one of his classes as needed, he said, “Well, I have a friend in that class. She does the correcting for me.”  I was happy and relieved for him. I’m all about empowering someone to speak up for themselves; this client and all my other clients do plenty of speaking up for themselves.  When others intervene on their behalf it is a much-needed break!

I said to him, “Oh, you’ve got a Pronoun Corrector in that class! How awesome. That’s a special kind of superhero, a Pronoun Corrector.” He smiled because he knew exactly what I meant. I wonder if his friend even understands the power of her intervention. Perhaps one of these days my client will let her know.

Pronoun Correctors play a huge role in a friend or loved one’s transition. They model and prompt correct use of pronouns. They can be assertive and strong when the transgender individual is not feeling up to the task. Pronoun Correctors show how important it is to use the correct pronouns, and not to let the wrong/former pronouns slip by as if unnoticed or as if they didn’t matter. Typically, a Pronoun Corrector will have far less anxiety about correcting someone than the individual themselves. They are in the perfect position to speak up!

I felt this blog post was timely given the holidays are soon upon us. Many transgender people will be seeing family members and disclosing their authentic gender for the first time. Many will be seeing family members for the time since disclosure. Many will be in a room with some people who are supportive of their gender transition, and some who are not. They will be in rooms where some people use their birth pronouns and some use their correct, or authentic, pronouns. Sadly, holidays can bring an extra dose of anxiety to someone going through gender transition or trying to help others understand who they really are.

If you are the loved one of a newly disclosed transgender person, won’t you consider earning your cape?  Someone said “he” in reference to a MTF individual? Say “she”.  Someone said “her” in reference to an FTM individual? Say “him”. Someone said “he” or “she” in reference to a nonbinary individual? Correct to “they”, or whatever the individual’s pronouns are.

If you are the parent of a newly disclosed or transitioning child, you are in the perfect position to be their superhero!

If you are transgender and feel you need a Pronoun Corrector in your life or over the holidays, explicitly ask someone you trust. Send them this blog post and say “Will you be my Superhero?” 🙂

Have/had a Pronoun Corrector in your life? Let them know what it means to you.

Pronoun Correcting Etiquette:

  • Smile when you correct. Being friendly goes a long way. People will tend to follow your lead more when they don’t sense hostility from you or feel they need to go on the defensive.
  • Say it quietly, but assertively. State it as simply as possible, and nod as if to indicate, “It’s ok, keep going, just wanted to be sure you understand the correct pronoun.”
  • Be thoughtful about your target audience and recipient of the correction. Correcting pronouns is often most helpful to help someone understand one’s gender identity, or modeling for several people who may not be sure about the appropriate pronouns (and who then may appreciate the clarification).
  • Be gentle with loved ones. Is it necessary to correct every slip? Absolutely not. If a loved one (particularly a parent) is trying, and making a conscious effort to use the correct pronouns, let slips pass by. After a “slip”, you can subtly use a correct pronoun later when you are talking, just as a gentle reminder. If “slips” continue well into the transition, the transgender individual may need to sit down with the loved one to discuss how the loved one’s “transition” is going in regards to understanding, accepting, etc.
  • If a loved one is not ready or has expressed a strong resistance to using the  pronouns that reflect the individual’s authentic gender, don’t push it. Give them space and time. Use the correct pronouns yourself, and don’t comment on their choice of pronouns. Pushing someone before they are ready may close them off to future acceptance and understanding.

Check out my first Bitstrip below!

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*Much thanks to my client for giving me permission to write about our conversation in this blog.

Cross-Sex Hormones for Transgender Youth

A topic that comes up often in my work is the question of whether or not to treat transgender youth with cross-sex hormones. (For those of you who don’t know, this would include a Male to Female preteen/teen taking Estrogen, and a Female to Male preteen/teen taking Testosterone, in order for them to go through puberty in line with their brain gender identity. Read more about it here).  I know this is a controversial topic, and there are as many opinions about this as there are professionals, if not people.

Of course, the first step in treating a transgender child about to enter puberty is usually hormone blockers. While incredibly expensive, I think most parents and doctors are more willing to allow the child/pre-teen to go on these because a) it buys them time, b) it prevents physical changes from happening during puberty that have to be “undone” later, and c) the changes are reversible. Remove the hormone blocker, and the individual goes through the puberty of their natal sex. Not so with cross-sex hormones. Many changes are irreversible, and can have life-long impact on one’s reproductive system. I understand the anxiety parents and doctors feel about transgender pre-teens starting hormones. I’m still a proponent of it, on a case by case basis.

I recently learned that the Endocrine Society guidelines recommend that endocrinologists wait to put pre-teens/teens on cross-sex hormones until the age of 16. In my opinion, this is too late. Most of their peers will be going through or will have gone through puberty by that age. One argument I’ve heard about this is that there are “late bloomers”. Sure, there are “late bloomers”, but these teens need not be.  Being late to enter puberty means something entirely different to a non-transgender teen and a transgender teen. The former may be anxiously awaiting puberty. The latter may be close to suicide.

For those youth who do receive hormone blockers, this is a life-changer: their body is not going to go through the “wrong” puberty. However, even these pre-teens and teens struggle with gaining those important “gender markers” in order to help them pass in society; a deeper voice and facial hair for male teenagers, a more curvaceous figure for female teenagers. Without the needed physical help from hormones, passing can be very difficult. And being read as the wrong gender every day is an agony no teen should have to go through.

In my opinion, treatment before the age of 16 is medically necessary to support the mental health of transgender youth. I suppose if more people sat across from transgender pre-teens and teenagers the way I do, more people would agree. I see a sadness and a desperation in their eyes I simply do not think has to be a part of this process. I don’t have all the answers; I don’t have a medical degree that would help me understand exactly the process of cross-sex hormones in an adolescent’s body. I’m coming from a therapist’s standpoint who understands how crucial it is for teens to feel as though they fit in with their peers -as well as the need to be seen for who they really are- and the depression and suicidality that results when they don’t.

In the words of Karen, the mother of an FTM individual and author of the blog  Trans*forming Family, “When a child is as sure as my son is, I think it is senseless and really torturous to make them wait until they reach some arbitrary age guideline. I realize this is anecdotal, but every trans teen I’ve known of who has been suicidal, depressed, or has self-harmed has been in that age range where they cannot get cross-gender hormones and/or surgery and are miserable due to dysphoria[…] the negative symptoms lift after medical transition, so why prolong their suffering unnecessarily?”.

Monica Nuñez-Cham leads the family support group for families with gender nonconforming and transgender children in San Diego. She is also the mother of Isaac (now 18), an FTM individual who started medical transition (cross-sex hormones soon followed by surgery) at the age of 13. “He wanted so badly to appear male and experience the same changes his friends were having (lower voice, facial hair, etc). He was very uncomfortable in his body and hated every feminine form (hips, butt, chest). I knew that the physical changes of T would help others who knew him as a “girl” to perceive him as male. The risks (that nobody could explain with certainty to me because there is not much research) were much lower than the 100% reality of seeing my dearest child in emotional pain every day and withdrawing himself from life. […] I always tried to listen to my heart and do what I thought was the best for him, with the tools I had at the time.  

Hormones and surgery were the best decision we could have made. Isaac as a little boy was a happy one, always singing, talking, making friends and very easily expressed his feelings by kissing, hugging and verbally. Close to puberty he stopped being happy, to the point of not allowing me to touch him. After the T, he came back, not little by little, suddenly he was the same happy kid. After the surgery I was very surprised to see him just BLOSSOM in a spectacular manner.

I attribute his success as a person (academically, socially, emotionally) to the fact that we acted as soon as we knew how.”

 The Harry Benjamin (now WPATH) Standards of Care were revised 7 times. In my opinion, the first version was hopelessly damaging to transgender individuals seeking treatment. By the 7th version, it is finally coming around to the way it should be: professionals supporting and making life easier for transgender individuals, not harder. Additionally, the Standards of Care were only created to be general guidelines to give those who are inexperienced some semblance of a plan. They are not laws that govern how a professional chooses to treat a transgender individual. Such is the same as the guidelines for the Endocrine Society, in fact it says so in their disclaimer statement: “Clinical Practice Guidelines are developed to be of assistance to endocrinologists by providing guidance and recommendations for particular areas of practice. The Guidelines should not be considered inclusive of all proper approaches or methods, or exclusive of others. The Guidelines cannot guarantee any specific outcome, nor do they establish a standard of care. The Guidelines are not intended to dictate the treatment of a particular patient. Treatment decisions must be made based on the independent judgment of health care providers and each patient’s individual circumstances.”

Wondering what the latest version of the Standards of Care say (in part) regarding prescribing hormones to transgender adolescents? “Refusing timely medical interventions for adolescents might prolong gender dysphoria and contribute to an appearance that could provoke abuse and stigmatization. As the level of gender-related abuse is strongly associated with the degree of psychiatric distress during adolescence (Nuttbrock et al., 2010), withholding puberty suppression and subsequent feminizing or masculinizing hormone therapy is not a neutral option for adolescents.”

I know of two gender clinics in all of Southern California who medically treat transgender youth.* These clinics, as you can imagine, have long waiting times due to the high demand and sheer number of patients in need. 

I’ve said it before, and I’ll say it again. I see my role as helping individuals live their lives as the gender they are in their brains. Most of the time this is not about helping them figure out their gender identity, but figuring out what they are going to do about it. For those children/pre-teens/teens who know who they are, and what they want to do, let’s help them do it.

Most people will doubt your judgment because of your age. It may take a lot more talking to convince the ‘adults’ that you really know who you are.  -Chris, 19 (From the Advocates for Youth pamphlet, “I Think I Might Be Transgender, Now What Do I Do?”.)

*If anyone reading this has more information on endocrinologists who treat transgender youth in California, please private message me or include in the comments.

Simply Put: Worksheets for children about gender identity and transition

When I was asked to help a child understand the gender transition their loved one was about to go through, I created a one-page overview of the process in simple terms. I also created a little “worksheet” that would encourage the child to think about how this change was going to affect them, and their loved one, specifically. The worksheet facilitates conversations between the child and adults; fill-in-the-blanks are a great way to find out what is on a child’s mind. While I was at it, I created a one-page summary for gender nonconforming children, complete with a brief fill-in-the-blank portion at the bottom.

These summaries/worksheets have come in very handy when working with transgender youth and the young loved ones of my transgender adult clients. I thought others may benefit from using them as well, so they are attached below. Please feel free to use, copy, and distribute as needed to assist children on their journey to understanding. (Who knows, sometimes concepts stated in simple terms can help adults, too. ;)).

For those of you not in the field of mental health or well-trained in interviewing children, here are a few tips for completing this worksheet:

  • Don’t make a big deal of the sheet. Just say you’re going to do a little something and do it. Act like it’s no big deal and you’re not nervous, even if you are.
  • Don’t look at the child being interviewed. Look at the worksheet.
  • Poise your pen or pencil over the blanks and begin asking the questions. Write the answer in the blank as soon as they are stated, without a reaction (facial expression, question, anything!) Children are incredibly in tune with others’ responses to what they are saying, particularly if the “other” is a parent.
  • When the worksheet is completed, go back and ask questions for clarification.

If you have any trouble with the way they are opening on your computer or printing out, please email me at tandotherapy@me.com and I will email you copies.

Kidworksheet

kidinfotrans

transitionworksheet

Your Gender-Expansive Child: Teasing

Most children get teased at one point or another in school. Sadly, teasing has become part of the social culture at schools and often goes on away from adult supervision. A gender variant child is even more susceptible to teasing given that they tend to behave or dress in a way that can be unexpected by other children or deemed by other children to be “different”. As most of us know, those that are “different” or in the minority are more likely to be teased, get teased more often, and often more severely than other children.

You know that one tone of voice children use when tattling? “MOO-ooomm, Johnny HIT Meeee!”. It’s universal. I’m convinced kids are born knowing how to use this voice, without ever having it modeled for them. Parents have a similar standard tone/cadence when warning their child about natural and logical consequences to choices. “Okaaayy, you can go on that water ride, but you’ll probably get soaked and feel cold the rest of the day!”. It just comes with the parenting territory. Letting your child choose behaviors while warning possible ramifications is a parenting basic.

Warning about being teased for being gender nonconforming gets tricky, however. Being gender nonconforming is not a behavior; it is a way a person is. Warning about teasing that may come from displaying a core characteristic/something the child cannot change is dangerous territory. Yes, the child can choose to act on or express their way of being, or choose to inhibit it. But they cannot change being gender nonconforming or transgender.  While I can appreciate and recognize a parent’s urge to warn and possibly prevent teasing that may come from a way of dress, behavior, or interest, this can quickly be translated to shame and self doubt. The problem is, in these scenarios we’re not talking about nose-picking or some other minor social infractions that a child can learn how to avoid. We’re talking about children being who they are, and who are doing absolutely nothing wrong. “Warning” the child  by saying something like “If you choose to play with ‘boy things’, you might get teased at school”, “Girls don’t usually have really short hair, so you might get teased,  but you can cut it if you want”, “Boys don’t usually walk or talk like that, but if you want to go ahead. Just know you might get teased” may not have the protective nature parents are going for.  In fact, it may teach the child to prescribe to what others say is the best way for them to be. Remember my Oxygen blog? Much like you wouldn’t “warn” a child about being teased for wearing an oxygen tank to combat oxygen deprivation, try not to warn your gender nonconforming child to avoid their natural gender expression.

I want to again acknowledge that most parents are coming from a very loving place when they explain what may lay ahead. My worry is that this can instill fear and dread in the place of blissful innocence. It may make the child LESS equipped to deal with the teasing that may come with being gender nonconforming.  If my parents had sat me down as a child and said, “Just so you know, little girls with hazel eyes sometimes get teased. Some people think hazel eyes are wrong and some people just don’t like kids with hazel eyes.  You can go ahead and wear those hazel eyes to school, but just know you might get teased”, I would have experienced childhood differently. I may have been fearful to let my true eye color show, even though I couldn’t change it. I may have looked at (or looked away from) everyone I met with just a little bit of suspicion or mistrust. I may have thought, “Is this one of the people who hate kids with hazel eyes?”. I may have chosen to grow up wearing sunglasses, even indoors. Many parents warn their children about being gender nonconforming much in the same way, even though it’s not something the child can change. Yes, the child could change their behavior to HIDE who they really are, but that’s not what we want for our children, is it?  Children become inhibited based on the response of others soon enough.

So, what’s a parent to do? Parents can help their child by unconditionally supporting who they are on the inside so they know without a doubt I AM AWESOME JUST THE WAY I AM.  This won’t prevent the pain associated with teasing, but it will help build the ego strength in the child so that they understand their basic worth doesn’t change based on what others say.

If your child asks you if you think they may be teased for wearing something, doing something, etc., be honest. Say “maybe”, and then discuss how the child might best handle it.  Communicate (even if you have to “fake it”) that you know your child will be ok even if they are teased. This energy is something they will absorb from you.

If your child comes home and reports being teased, ASK QUESTIONS; you don’t have to be the one with all the answers. This will help you get a feel for how much understanding your child has about the reasons behind the teasing. “Why do you think they teased you about wearing a skirt?” “Why do you think they said that?” (Not what they are used to, they don’t understand, they feel differently, etc.)

At dinnertime, bedtime, etc. ask your child about the best and worst parts of their day. If they report teasing, process it with them. Talk with them about how it made them feel, and how they can take care of themselves when they have that feeling. Discuss and practice possible responses based on the teasing so they feel more equipped should it happen again.

Last but not least, take care of yourself and your own feelings! Listening about your child being teased can be a very hard thing for a parent to take. Talk to your friends, talk to other parents, talk to a therapist. Remind yourself this is not something you can “fix” or prevent, but you are doing right by your child by nurturing his or her true self.