I welcome parents to meet with me at the beginning and periodically during the months I see your children (ages 15+) for assessment and treatment of gender dysphoria. As a parent of a young adult I empathize with parents who often have had only a few weeks’ notice of your teen’s gender dysphoria. At the same time, your teenager is ‘coming out’ after months or even years of discomfort about their bodily sex not fitting their mental, internal sense of their gender.
Adolescents are usually extremely anxious to begin cross-sex hormone therapy in order to feel better and prevent further maturation into the “wrong” body. I respect parents’ need for answers to their concerns before they agree to their child taking hormones.
I assure you that your older adolescent in my care will not “instantly” be referred to a physician for hormone therapy. Clinical assessment precedes my making a detailed written recommendation to the proper physician to prescribe this therapy. I follow the “best practices” established as Standards of Care by the World Professional Association for Transgender Health (WPATH), of which I am a member. WPATH is an international group of gender dysphoria researchers and health providers in areas as diverse as child development, sexuality, endocrinology, pediatric psychiatry, psychology and clinical social work, as well as surgeons, mental health therapists and allied health professionals. WPATH publishes the scholarly Journal of Transgender Health based on contributions from these fields, and hosts bi-ennial symposia to share knowledge about gender dysphoria. The Standards of Care (SOC) are clear regarding careful steps in treating gender dysphoric children and teens. Please click WPATH.org to view the Standards of Care, Version 7.
I want to reassure you that I will answer your questions, guide you to resources (including other parents), and work hard at helping my young clients consider the facts, negative and positive, about transitioning to live as another gender.
FAQ I am asked by parents, and answers from the SOC and other resources:
What is ‘gender dysphoria”?
“Gender dysphoria refers to discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics).” SOC
My (born male) child never played with dolls or dressed as a girl. So how can he be transsexual?
“…many adolescents and adults presenting with gender dysphoria do not report a history of childhood gender nonconforming behaviors. Therefore, it may come as a surprise to others when a youth’s gender dysphoria first becomes evident in adolescence.” SOC
How do you make sure my child is transsexual and needs hormones?
There is no psychological or chromosome test that proves how a person feels their mental gender. Although children with intersex conditions can be examined with sonograms or have their chromosomes checked, most transgender people do not have these conditions. Trained therapists specializing in gender dysphoria use assessment skills and tools to rule out other possible but highly unlikely factors such as psychosis, using interview questions and parents’ developmental history of their child. WPATH and other international agencies have developed clinical tools such as self-assessment questionaires, and stages of the ‘coming out’ process transsexual people usually experience. I use these tools with your young adult.
Hormone therapy is only one aspect of transition that includes medical, social and internal changes.
What else does my child need?
Assessment shifts into individual and/or therapy or support groups to ensure clients gain realistic expectations about living as another gender, what hormones will and will not achieve (and medical risks) and how much “passing” matters to them and is achievable. “Passing” is slang for their ability to live undetected as transgender in society. Most of my clients aim for this goal, but some must aim to develop self-esteem to tolerate being ‘read’ or ‘clocked’. While a client is preparing for hormone therapy, parents can help by letting their young person begin these important tasks:
- Beard removal for male-to-female (MTF) teens with laser or electrolysis (see Resources)
- Voice training or vocal cord surgery if needed, for MTF (see Resources)
- Call them by their preferred name and pronouns at home, whether or not they are dressing as that gender, and always in public when they are. At home, you are showing acceptance of your child’s intentions to become outwardly who they already are psychologically and emotionally. In public, the goal is to protect your child’s safety from being “outed.” Confusing? The best guideline is to ask your child in private anytime you are unsure.
Most important is to refrain from expecting your MTF child to suddenly dress in girls’ clothing and makeup and to practice a feminine voice in your presence. FTM (female-to-male) or “transboys”/”transmen” will not suddenly act in stereotypically masculine ways, but they will appreciate being asked to come help Dad or join in healthy male-bonding activities. (Dad may have to try this a few times to get used to it!) Older teens are faced with another kind of “puberty,” emotionally and physically, with all the self-consciousness you recall from your own puberty years. Avoid pressuring your child to meet your expectations: how you expect boys and girls to behave and look is going to get in your way. Let yourself be uncomfortable, and know that this signals readiness to adapt to change. Talk to other parents—see the Resource page.
Take care of yourself!
You will feel conflicting feelings like: grief, relief, hope, fear, even joy. This means you are a loving, attentive parent. Get yourself a therapist or support group to help you vent concerns and gain perspective. Read books and websites and see films (see my Resource page) to help you understand more about positive ways to tell your family and friends and advocate at school if needed. Learn about health insurance and which ones cover expenses related to transition You’ll do your best parenting of your transsexual teen with knowledge and support. To be invited to the next Parents Meeting, subscribe to my Blog or call/email me.