One’s “True” Gender

What defines someone’s “true” gender? Some people would say “true” gender is defined by the genitalia one had at birth. Those of us who know better know that one’s “true” gender is the one that exists in the brain.

This concept may be different for children and adults. Children are concrete thinkers, while adults are capable of much more abstract thinking. Genitalia is concrete; the gender identity in one’s brain is more of an abstract concept.

In addition to this, as a part of a child’s moral development, the importance in “telling the truth” is given much significance. “Lying” or deceiving someone is frowned upon, and children are often punished for it. As a child gets older, there is a development of the understanding of truth, honesty, and conscience. Where does “truth” come from when we are children? For things that are simple, the truth comes from ourselves. For things that are less simple, or more unknown to us, the truth tends to come from the adults who are in charge of us.

When I was at my good friend’s daughter’s second birthday party, a bee buzzed around the child’s head while she was eating her cupcake. She exclaimed “A bee!” right as it flew away. Her mother, who had not seen it, said in a playful way, “Nooooo, that was not a bee, it was a fly!”. The child looked at her mom’s face, paused and thought a second, then got a big smile on her face and said, “Yah! A fly!”. She had been right (and her mother wrong), but she didn’t care. The smile she shared with her mom and the contentment that came from their agreed-upon reality was all she needed. How many children are told their reality from a very young age? How many children are told, “you can’t wear a dress, you’re a boy!” or “of course you don’t have a penis, you’re a girl!”. Often, those “you’re a boy” and “you’re a girl” statements are absorbed by the young children as TRUTH. Anything other than what their trusted guardians are telling them must be a lie, or something to be kept to themselves. Only the minority of transgender children will be insistent and assert their truth over the protests of their parent(s).

This moral development and ability to grasp abstract concepts can influence a child’s ability to understand their own gender identity, assert their true gender, desire to transition, and/or their desire to be read in larger society as their desired gender.

Have I lost you? Let me be clear. An enlightened, insightful transgender adult may begin the process of transitioning and being seen for the gender identity that matches what is in their brain. For example, a Female-to-Male transgender individual starts the transition process and is very pleased when a stranger in the grocery store addresses him as “Sir”. Does he feel deceitful and as though he is not telling the truth? Not likely. For him, he understands his “true” gender identity is male and it is ok to be seen as male and assert himself as male.

This is a bit trickier for a child, particularly a latency-age child who is learning the concepts of “right and wrong”, honesty, and the concept of guilt. I have heard many parents say “she gets MAD when people think she’s a boy! You’d think she’d be happy”. (On the other hand, there are kids who are thrilled when they are perceived as their preferred gender and would never tell the stranger otherwise! As I always say, everyone is different. :)) Often times, if the child gets mad, parents look to this as a possible clue that their child may not be transgender. I tend to think it has to do more with concrete thinking and the desire to be “honest”. One way to help children understand it’s ok to be true to themselves is to explain the difference between anatomical sex and brain gender identity, as well as the fact that their brain gender identity is who they “truly” are. This gives them the green light to relax and know that when they assert their preferred gender, they are in fact, telling the truth.

Some of my transgender kids, after they transition, are told by peers, “but you’re really a girl” or “you’re really a boy”. These peers aren’t necessarily being mean; they are simply asserting what they know concretely (body) and enforcing what they think is the TRUTH. Part of my work with my young clients is then to help them understand that who they “really” are is who they are in their “brain” and their “heart”, and give them language to help their peers understand as well. Of course to help everyone (kids and adults alike!), the focus has to be on a societal shift of understanding what someone’s gender really is. If gender continues to be defined by bodies, then confusion, misunderstandings and stigma will continue.

How comfortable are you in your own “truth”? Did it take you a while to fully understand who you are on the inside is who you “really” are? Was there anything that helped you come around to this understanding?

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,, 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.