Patient Story: Gender Dysphoria

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Transgender Non-Conforming Youth: One Experience of Many

My fourth child is a transgender boy, and I love him. At 2 he climbed up on the kitchen counter when his dad and I were doing the dishes.

“I am so angry at you,” he said.

“Why?” we asked, confused.

“I should’ve been born a boy,” he answered.

He refused to toilet train until we bought him boxers. Desperate for him to toilet train so he could start preschool at 3, we did. We were dismayed to see him freeze when he was asked to use pink scissors or line up with the girls in PE, and mortified to overhear other parents ask each other, “What kind of parents would name a boy Samantha?”

In third grade, when Sam’s teacher asked us if he could please start referring to Sam with male pronouns because he learned better, we reluctantly agreed, because we knew it was the right thing. After all, his classmates already were. In fourth grade, we worked with Sam’s school to put out a letter to his classmates’ parents, announcing his social transition into male pronouns and bathrooms.

After his social transition, Sam’s life blossomed while our anxiety over his impending puberty escalated. On the one hand, it felt unreal and surreal to try to medically block and possibly ultimately change his gender. On the other hand, it was not clear that there was a choice. Accepting the need for medical intervention and then making the decision for this intervention, along with my husband, child and experts, was traumatic and heart wrenching. The barriers to accessing this care in 2011 after the decision had been made added insult to injury. Parenting a transgender child is a long, difficult journey, and not one that any parent would choose. For a million dollars, we would not have blocked our three older children’s puberty even for one month! But for Sam, we felt we had no choice.

Recent research is on our side. The first longitudinal study of transgender children, “Young Adult Psychological Outcome after Puberty Suppression and Gender Reassignment,” found that treated transgender youth are at least as mentally healthy as the general population. And in fact our son today is a happy, well-adjusted, and popular eighth grader.

Our son’s story is a typical textbook case of what psychiatrists would call “insistent, consistent and persistent” identification with maleness. However, in my eight years of attending or facilitating parent support groups, I’ve come to learn that when children cannot fit inside a gender box, their story can take many different forms. Experts might label all these children “gender non-conforming,” but in reality they can vary greatly from one another in terms of their gender identity and the way they express it to the outside world. It is critical for therapists, families and support groups to give these children a safe space to explore and articulate their feelings and to also refer them for appropriate medical intervention if and when necessary.

About the Author

Athena Edmonds, writer and advocate for LGBTQ Youth, currently serving on the Board of Greater Boston PFLAG and on the Massachusetts Commission on LGBTQ Youth

For more information

Visit PFLAG (Parents, Families, Friends, and Allies United with LGBTQ People to move equality forward)

Christine’s Story

Christopher, a 52-year-old salesperson, has begun a legal process to change her gender to female. Her new name is Christine.

Christopher had been born with male genitals and was raised as a boy. Nothing unusual was noted by Christopher’s parents until childhood, at which point Christopher was viewed as a “sissy” by other children. Christopher sought out female friends in school and chose activities and clubs that mainly involved girls. He did not wish to play contact sports, much to the dismay of his father. Christopher did well in tennis and competed in the sport to please his father.

Christopher began to sense that his feelings and thoughts were those of a girl’s. He felt he was “Christine” instead of “Christopher.” He knew his strict father would never accept such an idea, so he never spoke about it.

Christopher did well in college and became very fond of a longtime girlfriend. Although he did not feel sexually drawn to her, he wanted to very much please his father, so he married her after college. He was fairly content with his married life, but he knew he was living mostly to please his family. The way he was living never matched the way he felt inside. He felt much more at ease when he could think of himself as Christine. When his wife was not at home, he would often wear her clothing.

Over the years of marriage, Christopher felt more unhappy and upset with himself that he was not being honest with his own life goals or honest with his wife and family. He sought treatment from a mental health provider. After he talked about his life at length, he began to talk about his sense that he is Christine and his fears of letting down his family. As Christine, he began to share more private feelings in therapy. He became more secure in describing himself as a woman and began to ask some of his closest friends to refer to him as “she.”

Over time, Christine began to realize that she was not going to have the quality of life that she wanted unless she began to live openly as a woman. Over the next several months, she worked with her mental health provider to gain courage to tell her wife that she wanted to separate. She also sought a referral to a specialist who could inform her about hormone treatments and surgeries. She might someday explore these options if she wanted to change her physical appearance to female, but she knew this would be a big decision. The first step would be to learn how to discuss her condition with all of her family and friends, and decide how to begin changing her life to match the female role. She sought out a specialist who works with people who have gender dysphoria to help with this process, as she know that it would be a very hard transition for her wife. Christine’s father also would have trouble accepting the diagnosis and why it was crucial to Christine to be able to live her life as a woman.