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?

Stop Trans Pathologization*: Some People Are Transgender, and Some People Are Not

Just like any variation of the human condition, some people are left-handed, and some people are not. Some people have two different colored eyes, and some people don’t. Some people are allergic to dairy, and some people are not.

Some people are transgender, and some people are not.

In some of the trainings I do, I ask the question: when is gender pathological? It’s basically a trick question, because gender isn’t pathological. Gender just is. It has neither good nor bad qualities. Yes, distress can come from feeling like your exterior presentation does not match your brain gender identity, and distress can come from society not understanding your gender, but gender in and of itself isn’t distressing. It just is, and we all have a gender identity even if that gender identity means not having a gender at all.

Some people are transgender, and some people are not.

Parents come to me with various theories for why their child may be transgender, or at least “presenting” as transgender. I’ve heard many different theories over the course of my years in working with transgender children, and many similar ones. I think space needs to be held for these parents wondering “why?”, and their theories should be listened to and considered. However, sooner rather than later there needs to be a time to take the “why?” and replace that with “OK, now what?”. In the end, the “why” doesn’t really matter. What matters is the child’s happiness.

My theory?

Some people are transgender, and some people are not.

Some people wrongly believe that being transgender is some form or sign of mental illness. In fact, even some professionals will use the term “co-occurring” when they speak of someone being transgender along with having a mental illness. Being transgender is not a mental illness. There is not a certain “type” of person with a certain set of presenting problems who is transgender.

Say it with me:

Some people are transgender, and some people are not.

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*This blog post is going live on October, 24, 2015, the International Day of Action for Trans Depathologization, an annual day created by Campaign Stop Trans Pathologization. Let’s stop pathologizing gender… because simply some people are transgender, and some people are not. 🙂

Legal Name and Gender Change: Detailed Information with SAMPLE PACKETS (California)

UPDATED 5/16/18: This blog post was originally published 3 years ago. While the general information remains relatively current, the forms and some of the links are outdated. I will update soon; in the meantime please visit your local court’s website for forms. If you are in San Diego, there is a free clinic to help with name and gender marker changes, held once a month. Please email TransClinic.SanDiego@gmail.com. Thank you!

I have been meaning to post this for quite a while, but I have been shorter on time than I have on good intentions. 🙂 I know this is something that many people need assistance with, as filing a name and gender change (for yourself or your child) can be a daunting undertaking. Please keep in mind it typically takes 6 weeks from filing the documents to court date with a completed court order.

I want to give a huge “thank you” to Emmett for putting together a list of step-by-step instructions for filing a name and gender change and providing me with the court paperwork for an adult. Also, special thanks to Britt for providing the sample paperwork for a name/gender change for a minor.

I took the paperwork and filled out “sample” packets for each. The areas you need to fill out are highlighted. These didn’t scan well, so I apologize for the poor quality. If you have any trouble reading them, please let me know and I will either re-scan or I can answer specific questions. The files are too large to email. I know these are specific for San Diego, but I hope they will be useful to those in other parts of the state as well. If you are one of my clients and see me in my office, please ask me for a copy of the sample packets- I have several on hand!

Click here for the Transgender Law Center’s page with links to forms needed. (San Diego County link listed below.) For those of you not in San Diego, simply Google your county and “name and gender change”. PLEASE NOTE, DUE TO AB1121,  IF YOU ARE CHANGING YOUR NAME TO REFLECT YOUR GENDER IDENTITY, YOU NO LONGER HAVE TO PUBLISH ANYTHING IN THE NEWSPAPER. If the court is unaware of this, educate them.

Here is the Transgender Law Center’s awesome resource, “ID Please” 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.

Filing the packet costs $435 (at least in San Diego), but the fee can be waived based on low income. (“In Forma Pauperis“.)

Youth (minor) name and gender change sample packet HERE.

Adult name and gender change sample packet HERE.

BEFORE YOUR COURT DATE

(Thanks again to Emmett for these detailed notes!)

Print all necessary forms and fill them out (or have them filled out, as is the case for the doctor one, NC-210). Here is the website for printing the forms for San Diego.

Forms needed for an both an adult or a minor name/gender change:

CM-010

NC-220

NC-230

NC-200

NC-210

NC-110

-Make a copy of signed/filled out paperwork for your records. Bring the original packet and a copy of the packet to 330 W. Broadway. (Downtown San Diego).

-Once you pass the security check, take the escalator up to the second floor & the Civil Business area.

-It can be a little confusing, so ask someone if you are lost.

-Get in line on the far left of the room and wait to file your forms with the clerk.

-They will go over all your forms, stamp them and give you a case number.

-They may try to tell you that you need to publish your name change, REMEMBER that AB 1121 went into effect July 1, 2014 that states that a person changing their name for gender purposes is not required to publish.

-They will give you a court hearing date and time.

DURING YOUR COURT DATE

-Show up early.

-Bring both copies of all the documents and a pen.

-Give yourself time to find the court room.

-Sit down and wait outside.

-A lot of people will likely start showing up because people legally change their names for a variety of reasons (marriage, divorce, etc).

-Someone will come out and point to a list that is up on the wall. The list has everyone’s name on it and a number next to it. Find out what number you are and write it down. They call out cases by number and sometimes last name (so don’t worry about your birth name being called out!)

-They sometimes call in everyone that is getting both a name and gender change first because there are fewer people and it’s a more private matter than a marriage.

-You will get called in, you will be seated, the judge will come in, they will review your documents, and if everything is in order: declare your new legal name. (Congratulations!)

-After that they will tell you to go wait outside and they will bring you four signed copies of the court order.

-Do not worry about your physical appearance or gender presentation. If all the forms are filled out, especially the physician form, the judge does not care.

-You can leave and celebrate. 🙂

AFTER YOUR COURT DATE

Your work is not done! There are more documents to change that had your birth name on them. These documents are supposed to “match” in the system, so this is important. Here’s the order you must go in.

1) Social security

-1333 Front St, San Diego, CA 92101. (855) 820-0097

-Fill out this form for a CORRECTED social security card

You’ll need to bring your court order (form NC-230), identification (driver’s license, ID or passport) and the form above filled out.

-No need to make an appointment, just walk in and take a number.

-Allow 4-6 weeks for the card to come in the mail.

-IMPORTANT The form does not include a specific gender change. So in the “sex” section mark the gender that you legally changed to (transmasculine folks mark male, transfeminine folks mark female) and make sure to point it out on the form when they call you up. It doesn’t say your gender marker on the card, but it does in their system, and that’s how the DMV verifies your gender when you go there to change your documents. Confirm they have changed it in their system.

2) DMV

-Go to whichever DMV is closest to you. Make an appointment, or get there early.

-Fill out this form with your doctor BEFORE going to the DMV

You’ll need to bring your court order (form NC-230), identification (driver’s license or ID) and the form above filled out.

-You will also need to fill out form DL 44 (name change), but they give you that when you show up.

-They’ll call you up, review your forms, tell you everything is good and send you over to get a new photo taken.

-Allow 4-6 weeks for you Driver’s license to come in the mail. They will send you an ID card sooner than that.

3) Bank

-IMPORTANT you must have your updated ID or driver’s license BEFORE going to your bank. They use it as proof that you are who you say you are.

-Go in and ask to see a teller.

-Bring your court order (just in case), and your new ID or driver’s license.

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In the near future I will be posting more detailed information about how to change your birth certificate and password- stay tuned!

If you have any information that would be helpful to add to this blog post, please email me at tandotherapy@me.com

One more time, here are the sample packets!

MINOR PACKET

ADULT PACKET

Private Vs. Secret

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When it comes to disclosing one’s transgender status, I encourage my clients to think about it in terms of PRIVATE or SECRET. Some people are more private in general than others. Some people will tell others pretty much everything about their lives, while others try to keep most things private. Both are ok, as long as the individual is the one doing the deciding about what to keep private and what to share. Just as most things land on a spectrum, so does one’s feelings about exactly how private being transgender is. Some are “out and proud”, being the first in line to wave the transgender flag in the Trans* Pride parade. Others, on the other end of the spectrum, guard it like a deep, dark secret; one they feel could devastate them if others were to find out.

In my opinion, one can land on this spectrum based on temperament, upbringing, personal background, etc. I will say that those on the “secret” end of the spectrum seem to experience more intense dysphoria and internal distress than those who have a healthier relationship with being transgender. Sometimes it does seem to be in the client’s best interest to shift from “secret” to “private”.

This entry was originally written as a Social Skills Group topic, so the wording may seem relatively elementary. It is for that reason that this can be shared with both kids and adults! If you have a child who is either very private about their transgender experience or is contemplating who to tell, this would be good to read together and process.

For the purpose of this post, here is what I mean by “private” and “secret”:

PRIVATE: Something about you not everyone needs to or should know.

SECRET: Something you don’t want anyone to know.

Secrets can be fun, like you what you are going to give someone for Christmas. Or, if someone is throwing someone a surprise party, they will want you to keep that a SECRET from the recipient. Secrets like these are important because they are about doing something nice for someone else. Other secrets are not healthy, such as an adult asking a child to keep a secret from their parent. Other secrets are not good or bad, but might be important to others. For example, if your friend tells you who they have a crush on, they might ask you to keep it a “secret”. Of course, what you look like under your clothes is private! Only a child’s parents, guardians, or doctors should see their body for the purpose of keeping them healthy and taken care of. For older individuals, they can choose with whom to share their bodies in a more intimate setting.

An important qualification I want you to keep in mind is that personal information about you should be considered PRIVATE, and not necessarily SECRET. I believe this results in less stress, more self-acceptance, less anxiety, and more confidence. Mainly this has to do with how you guard the information in your head and in your heart. If you feel like there are some things about you which you would rather not have everyone know, or would choose only a few people to know, that’s okay. If you have a secret that you feel like “I would just DIE if anyone knew!”, that can affect your mental health negatively. If you feel you have a secret like this, it’s time to do some self-exploration. Do you feel this way about being transgender? If yes, why? Do you consider it a bad thing? If yes, begin working on having a more positive relationship with yourself and your history. Talk to a therapist, parent, or trusted friend about it. Try to figure out why this feels so secretive to you and how you may be able to evolve into considering it private information instead.

The truth is, no matter what information you have about yourself, it won’t ACTUALLY be the end of the world if others find out. You might feel exposed for a little bit, but you would be ok. If you feel like the “secret” getting out would be the end of the world, you might be spending more time feeling more worried or unhappy than you need to. Feeling like it is “private” instead may help you feel better about it in general and less worried about others finding out.

Here’s a visual for you: think of personal (private) information as being kept behind a fence with a gate. There is a boundary around the information, and not everyone can get in. YOU get to decide for whom to open the gate, or who gets to know your information. Remember that everyone you tell your private information to now has a key to the gate, and can let others in without your permission. This is why you want to stop and think before you share private information . Also, you can remind yourself that if others you had not intended to know find out, “It’s ok, I can handle this”.

Think of having a secret as guarding it like a castle with a tall wall, drawbridge, and moat with alligators around it. You are guarding it very aggressively, making SURE no one finds out. The problem is, having such walls around you and guarding your secret can eventually make you feel very alone. This is why having a fence with a gate (private information) is better than having secrets (castle with many guarding factors).

If someone asks you a question about your personal information, STOP AND THINK if you would like this person to know your personal information. If yes, share with them and then ask them to keep it private. Remember, you have no control over whether or not they actually will keep it private. If you do not feel comfortable sharing, or don’t want to risk others sharing this information, you can say something like this:

  • “That’s personal.”
  • “I don’t want to talk about that.”
  • “I’d rather not say.”
  • “That’s private”.

You don’t need to apologize about not sharing; it’s your gate, you get to decide for whom to open it! 🙂

If you are transgender, where do you land on the “private vs. secret” spectrum? Do you have some shifting you can do?

If you are sharing this blog with a child, please feel free to complete the attached exercise with them. (Some adults may find it useful, too!). Ask them to write down in the column next to the listed information whether the information is “private”, “secret”, or “open”.

Private/Secret/Open Worksheet

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! 🙂

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?

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.

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. 😉

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. ❤