The Transgender Child

 What does transgender mean?

Transgender is a common umbrella term you will hear used to describe a wide variety of people. Trans is another common umbrella term.  A trans person does not identify with the gender that was put on their birth certificate when they were born. You may hear statements such as, “I should have been born a boy,” or “I always knew I was a girl since before I could talk,” or “I never quite fit in when I was young, but I’ve only recently understood that had to do with my gender,” or “I’m not male or female, I’m another gender that English has no framework for.” All these statements reflect various forms of trans identity.

In some Native American cultures, such people were honored and referred to as “two spirit” people. This was one path toward becoming a Shaman. Unfortunately, mainstream U.S. culture has a much more negative view.

Does this mean my child is gay or lesbian?

The short answer is, no. Sexual orientation is about who you are attracted to, who you fall in love and have long-lasting, meaningful relationships with. It is about your relationships with others. Gender identity is about your relationship to yourself. When you’re looking in the bathroom mirror in the morning, all alone, you see a reflection back at you that others will see as a man or woman, boy or girl – is that okay with you? Are you comfortable with the gender assigned you at birth?

Whether that reflection is seen as a man or woman says nothing about who you are attracted to. For example, maybe you are attracted exclusively to men. If your reflection is seen as female, you will be seen as a straight woman. If your reflection is seen as male, you will be seen as a gay man.

If my child isn’t lesbian or gay, why are trans people so often grouped with the lesbian and gay community?

Trans people are often grouped with the lesbian and gay community because gender identity is often confused with sexual orientation. Some trans people may be perceived as gay or lesbian based on their gender expression. In addition, they share with gay people the feeling of being ostracized by the people in their lives and the world around them.

Gay, Lesbian, and Bisexual are all sexual orientations, while Transgender is about gender identity. Some transgender people also identify as gay, lesbian or bisexual, while many identify as straight. While this creates some overlap in community identity, it also makes social support trickier; what ‘support’ means is different if you are transitioning than if you are coming out as gay, lesbian or bisexual. But politically, it’s a natural fit; the same people who oppose gay human rights movements are also going to oppose human rights movements for transgender people.

I want to be supportive, but I’m really upset and confused!

Parents of people who are lesbian or gay often go through a grief stage, letting go of the perhaps-unconscious expectations they had for their child’s life. Perhaps they had always expected a formal wedding and grandchildren, a seamless continuance of their family. In earlier times, this wasn’t possible for those children who turned out to be gay or lesbian. In more modern times, however, with the legalization of same-sex marriage, the formal wedding and eventual appearance of grandchildren is a much more realistic outcome. Nevertheless, parents still go through a big adjustment in their view of their lesbian or gay child. The same holds true for a bisexual child, if that child’s life partner turns out to be of their same sex.

Families with trans children have an even bigger adjustment to make: changing names and pronouns. If you have a sister, how easy would it be for you to see your sister as your brother, changing from Angela to Andrew, or some such? How easy would it be if your father said, “I’ve always felt like a woman inside and now that my kids are all grown, I’m finally in a position to do something about it”?

This is a BIG LEVEL OF CHANGE. It would be abnormal to feel like this is business as usual and life is just going to go on, but with a new name and pronoun for a family member. Parents in particular need to go through a grief process, letting go of what has been in order to make way for what is to come in the future. You can’t be expected to embrace the future if you don’t let go of the past, and that entails some kind of grief process. Uncertainty of the outcome also makes parents more anxious, not knowing what IS to come in the future.

How can my child be sure?

One PFLAG mom says of her male-assigned child, now her daughter, “When she was 18 months old, we couldn’t keep her out of my make-up and wardrobe.” That same child said to her mother, at the age of four, “Mommy, am I a girl and you’re just not telling me?” That child is now a happy 26-year-old transwoman, long-transitioned. Gender seems to emerge as an identity that young for all of us, but it only draws attention to itself when the gender being expressed doesn’t match our expectations of who we thought our child was.

The mainstream U.S. culture view of trans identity is highly negative, leaving many children unsure how to express who they really are, is it going to be okay to tell anyone, etc. So, when they finally tell you who they are, they may have been hiding for a long time. Some parents then feel guilty for not having known earlier, but look at it this way: your child was doing their very best to hide, especially from the people whose reaction mattered most to them.

You may still be wondering, “But how can they know for sure?” It might help if you look back to your own childhood. As you grew up, you gravitated toward certain toys, certain  modes of dress, certain games – the place inside yourself that caused you to claim “boy” or “girl” for yourself, that was your own gender identity emergence.  But if you are happy with the gender assigned you at birth, neither you or those around you saw your maturation as a process of identity emergence. Yet that’s exactly what it was, as it has been for your child.

Why does my child dress or act differently?

Your child may be acting or dressing differently from what you expected based on their birth gender assignment. Your child is trying to express their gender identity through their clothing and behavior. They have observed, “I’m a girl, and this is how girls dress and behave.” If they are male-assigned, this draws attention. If your child is female-assigned and feels like a boy inside, it is more difficult for them to make their gender identity known just through wearing clothes or behaving in a certain way. Many female-assigned children prefer wearing pants and enjoy what are considered boy activities. One four-year-old child crawled into mom’s lap one day and said, “Mommy, I know you think I’m a tomboy, but I’m really a boy.” Mom would never have realized that through her child’s choice of clothing and toys. She did think tomboy.

Should my child undergo psychotherapy?

Trans children can benefit from a supportive therapist.  It is important that the therapist supports your child’s gender identity and helps them become more comfortable – an unsupportive therapist will be mentally damaging to your child. Gender is an innate identity, and attempts to change it will only reinforce low self-esteem, shame and guilt, and feelings of hopelessness. The mental health profession now views reparative or conversion therapy as unethical treatment. A supportive therapist is one who will help your child clarify their gender identity and then help you understand your child better.

Even more than your child, you will benefit from a supportive therapist. The younger your child is, the more mystified they will be if others don’t see them as they see themselves. They know perfectly well who they are, and don’t see what the fuss is about. Children learn social prejudices and societal shortcomings as they age; they aren’t born with such beliefs. You, on the other hand, need support as you embrace your child fully for who they are. PFLAG is a good source of support, as you will meet other parents who have been in your position. There may be other organizations in your area, or a trans-knowledgeable therapist, that you can also turn to for your own support.

Should my child undergo medical procedures to change their gender?

Before your child reaches puberty, transition is a social process. Changing names and pronouns at school, for instance. No medical intervention is needed. If your child has been expressing a consistent gender identity that runs counter to what’s on their birth certificate, the time for considering a medical intervention is at the beginning of puberty. For example, if your child has been saying all along, “I’m a boy, not a girl,” or vice versa, there is medication that can be taken to prevent their bodies from developing along the wrong lines. Some insurance plans now partially cover the cost of this medication.

This medication can make a big difference in how your child handles puberty. One way of looking at trans identity is that the brain is expecting one hormone balance and it’s getting a different one. Before puberty, hormones are not a big deal; at the inception of puberty, the body is suddenly subjected to large doses of either estrogen or testosterone. For the developing trans person, the result is often anxiety and depression; the hormone balance is the wrong one. Blocking those birth hormones from kicking in can help tremendously. Blocking the birth hormones also means the body won’t develop in ways that are expensive (or impossible) to undo later. For instance, the male-assigned child who blocks testosterone won’t develop a deep voice, Adam’s apple, or the body hair associated with adult men. This will make her transition much easier down the road.

The next decision to make is, “Should my child take the hormones most appropriate for their actual gender identity?” For the child who feels female inside, should they take estrogen? For the child who feels male inside, should they take testosterone?

This decision is affected in large part by the direction of transition. The child who feels female inside can block testosterone, and then dress and live female for a good long while before deciding to take estrogen. She will probably feel more “complete” once she begins taking hormones, but her social experience of living female will help her have a reasonable time of it during adolescence.

The child who feels male inside has a tougher time of it. Blocking the birth hormones from kicking in means this child won’t grow breasts or have a menstrual cycle. However, the longer they wait to take testosterone, the more difficult adolescence will be for them. He will be a boy who doesn’t get a deep voice, stronger muscles, or body and facial hair to match his male friends. The older he gets, the more this disparity can cause social problems for him.

It may be that your child is expressing a gender identity that is non-binary, not saying, “I’m not a girl, I’m a boy,” or vice versa. If this is the case, it’s harder for your child to say from personal experience of identity, “Yes I need a different hormone balance to feel complete.” Blocking the birth hormones may still feel like a good thing to do, but administering estrogen or  testosterone may be a decision your family decides to hold off on. Every path is unique and determined by individual and family circumstance.

Even if you don’t use the puberty blocking medication or administer other hormones, it’s wise to establish a relationship with a pediatrician who has some knowledge of trans identity. They can help keep your family apprised of what to expect. This is one more avenue of professional support that can be helpful to your family.

What risks will my child face?

Oregon and especially Portland are two of the most trans-friendly areas of the USA. Portland has many options for youth who are GLB and/or T. SMYRC (Sexual Minority Youth Resource Center) is a wonderful organization that provides a drop-in space and counseling. Many middle and high schools also have GSAs or QSAs (Gay/Straight or Queer/Straight Alliance), usually with reasonable knowledge about LGBT identities of various kinds. For adolescents, these are the best forms of support. They are starting to develop lives outside their families, often centered around their school social life. Finding support among their peers at school can be one of the best ways to mitigate the risks they face from growing up in a trans-hostile culture.

At younger ages, whole-family activities are more appropriate. Prior to puberty, a child’s life is more centered around their family than is the case for adolescents. Though it is still primarily word of mouth to find each other, there are many families in the Portland area happy to support a family new to the idea of having a trans child. If you develop a relationship with a trans-knowledgeable therapist and pediatrician, they can probably provide you with contact information of other parents with trans children.

This publication, from our Straight for Equality program, will help you learn more about what transgender means, develop competency around talking about the issue, become better informed about the challenges that many trans people face, and know specific ways that you can be a strong trans ally.