Trans*Forming the Dialogue

Trans*forming the Dialogue Logo

I am participating in Trans*forming the Dialogue, Simmons College’s Online MSW Program’s campaign to promote an educational conversation about the transgender community. This campaign was designed to shift the conversation away from the problematic questions that are often asked of the members transgender community and foster a more progressive dialogue. I was asked to be a “featured voice” in this campaign and provide my prospective about what TO ask and what NOT to ask trans* people. Of course, I am but one voice in the sea of many, please check out the other responses here!

The prompt: What are the do’s and dont’s when asking a trans* person about their experiences?

  • What are 2 – 3 questions that one should NOT be asking a transgender person?
  • What are 2 – 3 questions that one SHOULD be asking a transgender person?

I decided to go about this a little differently. Instead of listing specific questions one should or should not ask transgender people, I came up with guidelines for deciding which questions are appropriate and which ones are not.

Know the Basics

Before you begin asking too many questions of the transgender individual, do some research on the basics. Many times when someone is revealing their “true” gender, or their brain gender identity, others go straight for the anatomy of the individual. Anatomy is about natal sex, not gender. The transgender individual likely wants you to understand more about how they feel on the inside, not about what their body looks like. Read my blog post here for more information about Gender Vs. Sex. Additionally, it will be helpful for you to understand the difference between gender identity and sexual orientation. If you don’t, you might accidentally start focusing on the individual’s romantic life or sexual behaviors when they are trying to tell you about who they are. 🙂 Read more about this distinction here.

Use Empathy

Put yourself in the other person’s shoes. It’s important to remember the transgender person is not there simply to educate you or satisfy your curiosity. They are a person, just like you, living their life. Try to figure out what kinds of questions you would like to be asked, and go from there. Would you want to be asked details about your potentially painful past? Probably not. Would you want to be asked details about your genitalia? Most likely not. See my blog post “What’s In YOUR Pants?? (They’re called “privates” for a reason) for more on this. What would you want someone to ask you about? You would probably want people to ask how you are, how your loved ones are, and what you’ve been staying busy with. Ask!

Stay in the Now

The transgender person in front of you is not living in the past or the future, they are living in the present. Stay in it with them. What name they were given at birth, the process of their transition, their plans for medical intervention in the future, etc. do not give you a sense for what that person is about, today. Ask them about their here and now, in general terms. If the transgender individual’s gender identity or transition comes up in this conversation, that means it is relevant for them in the present.

Think in Terms of Solidarity

If you think of yourself in a different category than transgender people, a separation is created that does not need to exist. We all have gender identity, and that makes us capable of understanding it. You don’t have to have gone through something exactly as someone else has to relate to that person. Many of the problems transgender individuals face is in regards to stigma, discrimination, and lack of understanding from society at large. Since we are all a part of society, we are all capable of creating change. Make sure you are using the correct name and pronouns for the individual. Speak up if you hear someone who is not. Speak up if you hear transphobic language, practices, policies, or potentially unwelcoming spaces for transgender individuals.

Think Beyond the Binary

Society tends to operate as though there are two genders, male and female. In reality, gender is on a spectrum and male and female are but two genders on it. Every person is the expert on their own gender identity. Trust what they say to be true for them, even if you can’t relate to it or haven’t heard of it before. Some people feel male or female. Some people feel both, and some people feel neither. Some people feel more one gender than another, and some fluctuate from day to day. Operate from the standpoint that you are there to honor and respect their gender, not decide what it is or what you are comfortable with. The only way to have a relationship with someone is to honor them for who they truly are.

Happy Conversing! 🙂

Published in: on June 29, 2015 at 2:09 pm  Leave a Comment  
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Don’t Poke the Dysphoria Monster

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There may be a monster in your child’s closet. All of the reassuring you may have done when your child was little that there was “no such thing as monsters”, checking under beds and in closets to alleviate anxiety, may not have been exactly true. For transgender kids and adolescents, and even adults, a Dysphoria Monster may be lurking nearby.

When I worked in a residential treatment facility for children, I used the “Addiction Monster” metaphor to explain addiction to children. Many children who resided there had parents who were addicted to substances, and this resulted in inconsistent visits, broken promises, and time away in jail. I would explain that when someone is struggling with addiction, they have an addiction monster that is sometimes small and manageable, sometimes huge and overpowering, but never nonexistent. When it’s huge, it has them in their grip, throwing them around, banging them up, holding them hostage. When the addiction becomes more under control, the individual may have more power over the monster, like walking it on a leash. After some time of sobriety when urges have decreased dramatically and the individual is in recovery, the monster may get small enough to tuck away in their pocket. But remember: it’s always there, and they would need to take care to keep it small.

Now that I work with transgender individuals, I have met the Dysphoria Monster. For those of you who don’t know, dysphoria is the discomfort and depression that can come with having a body that does not line up with one’s gender identity, or come from not being read as/treated as the gender one is in their brain. Dysphoria can range from unpleasant to life-threatening; it’s a force to be reckoned with.

Most transgender people experience and relate to dysphoria differently. Some have very little (tiny dysphoria monster tucked in their pocket), some have debilitating dysphoria (picture the gender dysphoria equivalent of Godzilla). Dysphoria can fluctuate on an hourly, daily, weekly basis. How much dysphoria is present on a day-to-day basis can be dependent on temperament, life experience, support, stage of transition, relationship status, triggers, and much more.

Here is an example of how the Dysphoria Monster can work: picture a female-to-male individual walking down the street with a female friend. He’s feeling good; confident, content, enjoying the day. His monster is quiet; he doesn’t really notice it. Suddenly he and his friend enter a restaurant and they are greeted with, “Hello, Ladies!”. His monster is awakened! Growling, breathing down his neck. The monster sits with them at the table for the rest of the meal as he agonizes over being misgendered.

Ever heard of the expression “don’t poke the bear”? It’s important as the loved one of a transgender person that you don’t “poke the Dysphoria Monster”. Be aware of the fact that this monster is lurking nearby and that it is in your loved one’s best interest that the monster stays docile. Unfortunately, parents and partners (and other loved ones) can fairly easily poke the monster because they are usually the ones who are around the individual the most. This can happen in any number of ways: misgendering (using wrong pronouns), using birth name, commenting on body parts, commenting on appearance, giving tips on how to be masculine/feminine, the list goes on.

Do you want to know how big and unruly your loved one’s Dysphoria Monster currently is, and how to avoid inadvertently awakening it? Here are some tips:

  • Educate yourself on dysphoria. Don’t expect your loved one to do it all for you. Understand what can be the most distressing parts of being transgender. Use compassion to fill in the blanks you don’t understand.
  • Check in. Don’t be afraid to ask, “How’s your dysphoria?” (or whatever word they would like you to use). Usually they will know exactly what you mean, and you will get the most direct answer that way.
  • Ask them what triggers their dysphoria the most. This will help you not only learn to avoid causing these triggers yourself, but will be alerted to check in after you witness one of these triggers happening.
  • Ask what helps lower their dysphoria. Ask when they feel the least dysphoric, and then try to increase or replicate these experiences/situations.

How big is your or your loved one’s Dysphoria Monster? Would you describe it differently?

Published in: on June 8, 2015 at 1:55 pm  Comments (8)  
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Shake It Off Video Montage

I had a lot of fun creating a music video montage to Taylor Swift’s “Shake It Off” song. My goal of this video is to raise awareness and acceptance of transgender youth and adults. Being transgender is NOT a mental illness, it is just a variation of the human condition. We need more understanding and more allies!! Those who are transgender should not live in shame or in fear of coming out. And for those who face adversity every day, here is my reminder to try your best to “shake it off”. For any one person who is against you, there are more people who will stand for you.

A sincere thanks to everyone who contributed videos for this project, and to my sister Emily who sang the modified lyrics.

Enjoy the video below, and feel free to share! 🙂

CLICK HERE TO WATCH “SHAKE IT OFF” VIDEO
Published in: on April 12, 2015 at 1:42 pm  Comments (13)  

Transition is an INTERVENTION, Not a Decision

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.

Published in: on March 20, 2015 at 1:18 pm  Comments (5)  
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Overthinking: Saboteur of Transition?

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Picture source here.

There’s something happening, folks, in the teenage and adult minds across America. It’s an epidemic. It can cause anxiety, distress, and indecision. What is it? It’s overthinking.

“We are dying from overthinking. We are slowly killing ourselves by thinking about everything. Think. Think. Think. You can never trust the human mind anyway. It’s a death trap.” ―Anthony Hopkins

Sometimes a client will ask me a question that causes me to pause and wonder how in the world they ever ended up at that question in the first place. My friends, some of these questions have to be the result of overthinking, because they seem to transform a somewhat simple concept into something very complicated and convoluted. If you are my client, you may have heard me ask the following question a time or two during our sessions together: “Is it possible you’re overthinking things?”.

“Some thoughts should never be conceived. Some questions should never be asked, because they have no answer, and the questions themselves serve only to haunt with grinding guilt and second guessing.” ―Bobby Adair, Slow Burn: Dead Fire

So, how does this concept relate to gender and gender transition? My argument is that overthinking can be a transgender person contemplating transition’s worst nightmare. All steps, stages, and possible outcomes are analyzed to death, creating fear and hesitation. This is the beauty of a transgender child being allowed to transition: overthinking is not part of the process. They just are, and therefore they just do. Adults seem to have the impression that the more they think about something, the surer they become. In my experience, both personally and vicariously, the opposite is often times true.

“The more you overthink the less you will understand.”  ―Habeeb Akande

Children, and adults, know their gender identity. The difference is that knowing what to do about it is either subject to overthinking or not. Given a child’s pure mind, you can rest assured they will have more simple answers than we do, and sometimes simple is exactly what you need. For adults contemplating transition, what would the child inside you say to do?

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Other interesting articles related to overthinking:

http://lifehacker.com/how-to-stop-overthinking-everything-and-find-peace-of-m-1609850688

http://themindunleashed.org/2014/09/8-ways-stop-thinking-find-peace.html

Random side note: I did a fair amount of overthinking about whether or not the word overthink should be hyphenated. In the end I just went with the majority on the internet and how my iphone auto-corrected. If you think the word should be hyphenated, sorry. Don’t think about it too much. 😉

Published in: on February 17, 2015 at 10:14 pm  Comments (14)  
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CONSISTENT! PERSISTENT. INSISTENT?

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 some other gender, or a natal male feels like a girl or some other gender), 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 their 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 they are 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 their 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?

Published in: on January 19, 2015 at 4:15 pm  Comments (18)  
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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!

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

Published in: on August 25, 2014 at 2:42 pm  Leave a Comment  
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How This All Began

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:

“Darlene,

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:

“Hey Darlene,

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.  🙂

Published in: on August 19, 2014 at 7:04 pm  Comments (2)  
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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. ❤

Published in: on June 30, 2014 at 2:40 pm  Comments (2)  
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