• Category Archives Child
  • What are Issues faced by Transgender Teens?

    This explores some of the issues faced by Transgender teens who are not “out” and are presenting in the ‘natal’ gender.

    Gay or Trans?

    Teenage years are a time when one struggles with identity questions, and for Transgender teens the struggle has added dimensions of complication.  In past times, when the concept of ‘Transgender’ was not as well known, many Trans individuals thought of themselves as Gay or Lesbian, only later coming to the realization that that identity wasn’t quite right.  (Chaz Bono is a famous trans man who identified as Lesbian as a teen).  Nowadays, Teens are more aware of there being Transgender people in the world  – thanks to brave people like Chaz and TV shows like ‘Glee’ that depict out-trans characters.

    Body Issues

    Transgender Teenagers who have not had the medical intervention of Puberty Blockers (see my earlier post) are now feeling the full effect of their bodies changing in ways that are in conflict, or dissonant to who they feel themselves to be.  There can be increased depression, desperation and bewilderment at what is often thought of as a ‘betrayal’ of their bodies.  There has often been ‘magical thinking’ as a younger child that one is the other sex, but with the physical changes, this is no longer possible.


    Trans teens who had not had medical intervention and who are without family are at risk for: HIV/AIDS, substance abuse, depression, violence and harassment, homelessness and suicide.

    What you can Do

    The best possible intervention is to begin a supportive dialogue with the teen.  Be open and accepting about what they are saying about their gender.  Educate yourself about Transgender issues and treatment options and be an ally with them to find a therapist, a doctor and a support group for yourself and your Teen.   Talk to the school about the Teen’s needs, or find a school situation that would work for them.  Don’t criticize or shame them about their gender.  One’s gender is not a choice, it’s part of who we are.

    see also What are some of the issues faced by Pre-Teen Transgender children?

    transgender teen

  • What are some of the issues faced by Pre-Teen Transgender children?

    Decisions about Puberty Blockers

    The Pre-Teen years (approximately 9-11) are a particularly important time in the life of a Transgender Child, (and Family) because this is the first time that a possible medical intervention could be started.  Decisions about using use ‘Puberty Blockers’ or ‘Puberty Inhibitors’ are typically made at this time.

    Puberty can be intensely stressful and uncomfortable for a gender variant child – as their body would acquire typically male or female attributes.  Many Transgender people report having felt desperate, depressed and hopeless when their bodies began to change in the ‘wrong’ way.  A child might have been able to put their gender-variance out of their minds for long periods of time, but if puberty starts this is no longer possible.

    The ‘blockers’ serve to block or delay these characteristics so that 1. The child doesn’t have to experience the discomfort of acquiring body characteristics that are unwanted, and 2. A later medical transition to the other sex would be easier and require less medical intervention – especially for a Male-to-Female transition.

    for natal boys they block:

    • Testosterone and its effects
    • facial hair growth
    • the growth of adam’s apple
    • male angularity and musculature
    • growth of body hair

    for natal girls they block:

    • feminizing hormones and their effects
    • menstruation
    • breast development
    • fuller hips and typical female fat distribution

    Puberty blockers would be prescribed by a Pediatric Endocrinologist (M.D. Doctor), familiar with Transgender medicine after the child and family had worked with a knowledgeable gender therapist.  They would typically be administered by a monthly injection or by an implant method.  The effects are believed to be reversible should the child stop taking the blockers.   Some interventions can be made with Puberty blockers even if the child has already reached puberty (such as stopping menstruation in natal girls).  Most insurance companies do not cover this type of treatment, although that has been slowly changing and it can be expensive.

    Transgender Teens, medical issues, Puberty Blockers

  • Issues faced by transgender children of elementary school age (5-11) (Part 1).

    Deciding how the child will present outside of the home

    Children of this age are leaving the sphere of the home and family and venturing out into the world for much more of their day.  For many hours a day now they are in the company of other children and teachers.   They will be faced with decisions of how to present themselves to the world in regards to their gender.  It’s important for the parents to decide what is in the best interest of the child before they begin school (or before each school year)  and to communicate with the child about how they will present.  There is no right or wrong decision here, only what is best for the child and family overall.  Some things to take into account are

    • How dysphoric is the child?  Meaning how severe is their gender variance?
    • How able is the child to respond to questions or negative comments?
    • How accepting is the school environment?
    • Will the child be in danger?
    • Is there an ally (a supportive teacher, adult or friend) who knows about the situation and is with the child for most of the day.
    • Will presenting in the natal (born) gender be too emotionally difficult for the child?
    • Will a responsible person be picking up the child from school each day?
    • Is the child likely to tell you if they are being mistreated or bullied?

    In making the decision these things, as well as the maturity of the child must be taken into consideration. transgender children It is OK to delay having the child present in the felt- gender outside the home until there can be reasonable assurance of their comfort and safety, especially in the elementary school years when the child is more vulnerable and has fewer internal resources due to their young age. However, if the environment and other factors are favorable enough to allow the child to present in their felt-gender, it will help the child feel authentic and accepted and do away with the anxiety and tension of having to pretend they are someone they are not.

  • Young Transgender Children, (Part 1).

    How old does your child have to be to know their true gender?

    There is no set age.  Most of the Transgender people I’ve worked with over the years knew as young as 4 years old that they were really the other gender.  A small percentage did not know till later in life and some knew they were not the natal gender but didn’t feel exactly to be the other gender either.  There can also be some confusion in a child about their gender and the confusion can last a long time.  It may be that over time the child will come to feel themselves to be one gender more than the other and it may be that the child will feel more comfortable somewhere between male or female, or even shift back and forth.  It’s also possible for the child’s confusion to be a reaction to feedback and wishes of the parents or other adults close to the child to be the gender they were born into.

    What things might a young (under 5 year old) child do or say about their gender?

    They might say things like “I’m really a girl”, or “I’m really a boy”, or wish for long hair, or not to have a penis (in boys).   They might ask when they will be “fixed” or if a “mistake” was made when they were born.   They might want to dress as the other sex and play with toys typically associated with the other sex.

    When signs are visible, natal (born as) boys might wear a towel or shirt to simulate long hair, might want to play dress up as a princess, play with dolls, wear sparkly shoes, and berets.  There are also many transgender (male to female) adults who never did these things and presented as stereotypical boys as young children.

    For transgender girls (Female to male), they may wear boys clothes, play rough and tumble games typical of boys (wrestling, etc), simulate war games, be comfortable playing with other boys, not want to wear dresses or play with dolls.  Also, as with boys, there are many transgender adults who as young girls did not appear particularly gender a-typical.

    Young children of course don’t have a vocabulary to describe who they are, but they might think in terms of “the same as”, as in “I am the same as Mommy”, or “I am the same as Daddy’.


  • A Parent gets some bad advice on Transgender Child

    How can things go wrong?

    I was browsing the web recently and came across this exchange on a forum for Catholic Families. (You can read the whole exchange here).  This is an example of bad advice readily available on the web by un-informed people regarding an adult transgender child.

    A Parent wrote:

    “Hello,  My daughter is 21 years old and today she announced to the family that she is transgender. She has always been athletic and not so feminine, but my wife and I had no idea that she was contemplating this. We just found out that she has already legally changed her name to a male name. She also said that she is taking testosterone injections and is planning to undergo a sex change procedure in July. We are a dedicated Catholic family and do not know how to handle this. She says that she believes in God, but at the same time how can she. My wife and I are very confused about what to do. Do we just blindly accept this, do we ask her to leave our household if she refuses to come to terms with this. We have 2 younger sons and I don’t know how to maintain a God centered life in our household with a blind acceptance of this. On the other hand I do not just want to kick her out of the house. We are planning on making her go to counseling, but what does a parent do if she refuses to accept that she is a woman. I am a very confused parent right now. I don’t want to rush into anything for fear of possibly doing something wrong. Anyhow, I would appreciate any feedback that anyone may have. Take care and God Bless “ April 2012.

    While some of the responses did suggest finding a support group, prayer (I have nothing against prayer), and finding resources, most responses were negative and alarming and were along the lines of “this is horrible, fix her, banish her, take control”  These are some of the responses that were listed: (I’ve edited them down)

    R1: “She announced this to her younger siblings too??? That should not have happened, and she should be chastised for doing that if in fact, she did announce in front of her younger siblings.  Who is going to pay for these hormone shots and her operations?…[]…She should go no further into this unless she has counseling to help her figure out what is driving this desire to become a … well…a mess!“

    R2: “[]…I would definitely say that you should have her leave your home if you have younger children at home. []… What a horrible situation!”

    R3: “Dr. Nicolosi…he is the only “long ball hitter” that I know of…he is on CA Radio nearly every month…practices in SOCAL area…he covers all aspects and all forms of sexual orientation issues…SSA primarily but I have heard him speak on Transgender orientation also.”

    [fyi Nicolosi does ‘reparative’ therapy on gay men – which 1. Doesn’t work  2. Is harmful  3. Is now illegal in California and 4. Has nothing to do with being Transgender]

    R4:  “Your daughter, clearly, is being advised and is receiving support from outside sources if she is already this far. But having had some contact with kids with gender issues, she is NOT in control nor is she feeling OK. She most likely is confused and freaked out, even if she is being defiant. “

    R5: “[].. If I were in your situation’ I’d try my hardest to convince my child to stop the hormone treatments right away and move heaven and earth to find a way for her to be able to live as a woman…”

    The responses (which are from April 2012!) point to a serious lack of information about what Transgenderism is.  The forum thread is now closed so this is my response to the parent – I hope it gets to him somehow.

    Dear Parent,

    I understand that your child just came out to you as Transgender.  This can be a confusing and scary time.  I think first off you are to be commended for reaching out for support and for information.  You realized you don’t know enough about this topic and so you are asking for information and advice – good for you.  You clearly love your “daughter” (I’ll refer to her as your daughter for now for clarity sake) and your sons and your family, again good.  You have a faith community – I think that’s great.  However, the responders seem to have responded out of fear and lack of information about Transgenderism.

    Your question of “Do we just blindly accept this” is a good one.  It implies a certain lack of information at the present time.  I think you already know the solution here – and that is to inform yourself as much as possible about what Transgenderism is.  Learn about it.  It is not a lifestyle choice; it is not something that anyone can influence another person to become.  It is a condition that one is born with, which causes great anxiety and turmoil and at some point – hopefully, that person is strong enough to grapple with it and make certain decisions.  No one could ever influence you to become the other gender – because you know yourself to be your gender – that’s how it is with your child – they know what their gender is – it’s just not the same as the biological sex they were born into – this is Transgenderism – and it’s a real condition.

    Another question: “do we ask her to leave our household if she refuses to come to terms with this.”  I think she has come to terms with it – alone, and has progressed to make some decisions about her life- in other words she has decided to transition.  For someone who is Transgendered – and living in the wrong gender – this is a reasonable and healthy solution.  In fact it is the only good solution for someone who is transgendered.  This is the consensus belief that the World Professional Association of Transgender Health WPATH has come to over many decades. (these are Doctors, Researchers, Therapists and other specialists working in the field today).

    It takes a lot of courage to share who she is with you and to have started on this road without your support and the support of your family. I mean no disrespect, but the “coming to terms with” is going to be more about your thinking and acceptance than your child’s.  Transgender youth have the highest suicide rates of any group – 49% have reported having thoughts about killing themselves.

    As to the issue of kicking her out of the house – why would you want to do that?  I imagine she was a pretty good child/sibling all these 21 years – yes?  She was also Transgendered all those years – you just didn’t know about it.  Why create a homeless young person and add to the issues she is facing at this point?  You write “We have 2 younger sons and I don’t know how to maintain a God centered life in our household with a blind acceptance of this”.  There are other Catholic Families that are dealing with this issue – they have support groups and information here:  Fortunate Families.

    You write “What does a parent do if she refuses to accept that she is a woman”?  She’s not.  He has told you that he’s a man.  This is the nature of Transgenderism.  One is born into one sex but is really the other sex.  I know it’s a lot to wrap your head around at first – but given your concern and questions – I think you will come to understand more about this and be able in time to accept your child for who he is.

    So my advice to you is – keep gaining knowledge and information, find some books, join a support group, take your time and go slow (as you have said).  Your child has had a long time to think about this and sort things out – you have only just learned about it and you can take your time too.  Your child has not done anything wrong or bad – he is just dealing with a little understood condition the best he can.  In the meantime – don’t try and force anything on your child – he is an adult and knows who he is, and it will only upset him and you.  Your younger sons are in no more danger than if they had a diabetic older sibling in need of appropriate treatment.   Good luck to you all.

    adult transgender child