Transgender Youth

Having your child tell you at a young age that they are not the gender biologically designated may be one of the most difficult experiences to handle as a parent. Where do you turn for guidance and resources? Is it just a phase? How young is too young to seriously consider sexual reassignment, hormone therapy, or "coming into your own?" These are all questions I will try to answer in my blog today. It may spur more questions, and I encourage your feedback.


I experienced a child, my child, asserting she "was a boy", and "wanted to be a boy." I must admit to the underlying gut feeling of "Oh, No! Is she, will she, be heterosexual?" I have spent my mental health career working with many transgender, transexual, gay, lesbian, bisexual and questioning youth and adults. Being a therapist with unconditional positive regard for individuals, I have remained non-judgmental and accepting of their decision, or the confusion about themselves. It was a phase, I think, as she is now into bows, long hair, and even boys!


I recently came across an organization, Trans Youth Family Allies (www.imatyfa.org). This organization seems tremendously helpful to youth and their families going through the various stages of transition (male to female or female to male). Trans Youth Family Allies (TYFA) encourages families to accept their child or adolescent identification with the other sex, provides resources on what is needed to proceed with the legal system, their education system, and with medical practitioners to ensure smooth transition. They offer to meet with the school personnel to educate them on "trans" issues.


Whether gender confusion or curiousness is a phase or not depends on the child's individual behavioral persistence of the fact. It does not dependent on the length of time the child holds the belief.  The criteria to decide if a person has the diagnosis of Gender Identity Disorder (GID) is outlined in the Diagnostic and Statistical Manual for Mental Health Disorders, Volume Four, Text Revised (DSM-IV-TR).  The criteria does not address length of time required to report or sustain the belief but only a strong and persistent cross-gender identification (not only a desire for cultural advantages).  In children, the disturbance is manifested by at least four of the following:  "a repeatedly stated desire to be, or insistence that he or she is, the other sex; in boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing; strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex; intense desire to participate in the stereotypical games and pastimes of the other sex; strong preference for playmates of the other sex. The next stage of the criteria is a persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex.  The disturbance is not concurrent with a physical intersex condition.  finally, the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning" (2000).


Several medical professionals may disagree on whether or not to provide puberty blockers.  Controversy for each side is high. Can parents make this decision for a child? Is a child mature enough to make this decision on her/his own? I can see each side of the controversy. Each side of the argument has valid concerns. Parents want their child to be happy. No child needs  to put up with bullying. Early intervention significantly lower the potential for bullying. No one would argue when a parent who wants to thwart their child's suicide. Youth suicide is very high in young people who struggle with transgendered or gender non-conforming  issues. Most parents will do whatever necessary to help their child becoming a healthy  level-headed adult. 


This issue is rarely, if ever, discussed in mental health counseling circles that I have been a part of. I think it is time to begin conversations about this issue.  I would invite your responses and feedback.  I walk the path to better understand transgender youth and provide support to them and their families. 


Resources
American Psychiatric Association (2000). Diagnostic and Statistical Manual, Fourth Edition Text Revision (DSM-IV-TR)


www.imatyfa.org Trans Youth Family Allies