What it's like to be parents of a transgender child

For those interested to know what it's like being the parents of a transgender child I’m providing an account of our personal experience. It’s my hope that readers will gain insight into the many challenges we face, acquire an understanding of what gender diversity is and why support for our children is so important.

 

We’re just ordinary parents trying to get on with life. We love our children and want them to be healthy, happy and have the same opportunities as everyone else. Transgender children are not abnormal or brainwashed by social media. Nor are they suffering from mental health conditions. It’s true that many do become depressed and struggle with anxiety, however, these issues are largely caused by external stressors such as pressure to conform, lack of support, discrimination and bullying. When transgender children are listened to and well supported these difficulties can be greatly minimised, if not eradicated.

 

Our children want love and acceptance for who they are. Simple. For them it's not a trend or a phase. It's who they are. Gender has always been diverse, with many cultures throughout history having multiple genders but this has been a taboo subject in the modern western world. Society is changing now though and gender is being talked about. It's increasingly seen as a spectrum rather than in binary terms of just male and female. There's more understanding, more acceptance and better support. These are some of the reasons why it appears there are more transgender young people now, whereas, in reality there aren't - they're just becoming more visible! Transgender is an umbrella term encompassing many identities such as, amongst others, assigned male at birth (female identifying), assigned female at birth (male identifying), gender fluid (moving between feeling male and female or a mixture of both) and gender neutral or non-binary (not identifying as either male or female.)

 

It's not a choice they're making, rather they're expressing their innate sense of self. For their identity to be denied or oppressed can be soul destroying and dangerous. Young people have taken their own lives because they can't bear to live as someone they're not or with the shame they sometimes feel at not being able to live up to expectations. Tragically, fifteen year old Leo Etherington from Buckinghamshire is testament to this as he was found by his father after taking his own life. This is the reality of gender dysphoria, a recognised medical condition whereby an individual's identity doesn't match their biological sex. In some children it causes severe distress, to the point where they refuse to wash because to touch and see their own bodies repulses them. It's still not fully understood why some people are transgender but emerging research clearly demonstrates a biological underpinning, probably due to the effect of hormones during early foetal development. It’s now scientifically accepted that being transgender, like being gay or being left handed is a natural expression of human diversity. Transgender children can’t help being who they are and it’s recognised that to try to force them to identify with their natal sex, by ignoring them or attempting reparative therapy, is unethical and can be seriously damaging.

 

Everyone has a right to be themselves, whatever their age but people often comment that young children "can't possibly know what gender they are" or "they are just confused." Conversely, nobody questions the fact that the majority state with confidence which gender they are long before they start school but for those children who identify different to what's considered the norm it's automatically assumed they’re confused. Research confirms that young children are indeed aware of their identity, usually by the age of 3.  The only confusion, if any, comes from incongruence, the mis-match between how they feel inside, their physical anatomy and the way they’re perceived by society. If you listen to the narratives of transgender adults there's a common thread. Many knew they were trans from a very young age but didn't have the language to express it or the knowledge and support needed. Often they suffered terribly, psychologically and physically, with irreversible body changes which can make life difficult or uncomfortable in their affirmed gender.

 

No parent would choose this path for their child. We take no pleasure in our children suffering terrible anguish caused by inhabiting a body alien to how they feel inside. No parent wants the sense of loss they may feel when their child confides that they are not who they've always thought them to be or the feeling of rejection when they want to change their name. Parents are often accused of following a trend too but it’s certainly not trendy to have to stay up at night to keep a distressed child safe, to witness scars from self harming as a coping strategy or to have to attend meetings at school because their child is being threatened, called a freak or has been assaulted. No parent would choose to loose close family and friends who can't or aren't willing to understand. Parents can end up isolated and alone for simply supporting their child. Even worse, their marriage may break down, they can find themselves accused of abuse, subject to child protection enquiries, custody battles with estranged partners and victimised in their own homes and communities.

 

One of the biggest difficulties families face comes from the negative, misleading and often blatantly transphobic stories in the press. Stories which blame and judge parents. Stories which ridicule and question the identities of transgender people. Reports which are inaccurate at best, citing discredited research and 'expert' opinions. The media readily provides a platform to those with bigoted views rather than representing the voices of the people behind the stories. It can be very distressing for parents and trans children, making it difficult for them to seek the support they need through fear. Reading today’s press about transgender individuals is like going back 30 years to the moral panic surrounding gay rights. At that time it was declared “the world’s gone mad!” Being gay was seen as a mental illness, a ‘phase’ and something which needed to be ‘cured.’ The media told us children were at risk of corruption or could be targets for these ‘sexual predators.’ The same arguments are now being used about transgender individuals. The reality is trans people have no ulterior motive when using public toilets or changing rooms, they just need a wee, want to go for a swim or to try on a new pair of jeans. Transgender girls aged 5 and up on Girl Guide camps are not male sexual predators pretending to be girls so they can access the girls dorms. That’s absurd! They’re little girls who just want to be accepted and included. They’re highly unlikely to pose any threat since they’re often terrified of or disgusted by their own bodies. Let’s be clear on the facts about transgender children too. No child in the UK is ever prescribed puberty suppressing blockers without first experiencing the initial stages of puberty. Ten year old children are not being given drugs that will make them infertile. No child in the UK is prescribed cross sex hormones on the NHS until around the age of 16 when they are legally able to give consent for themselves and then only following diligent assessments in accordance with strict guidelines. No child in the UK ever has gender reassignment surgery on the NHS. Not only this but not all transgender individuals want surgery, opting only for social transition and possibly hormone treatment. ‘Sex changes’ in children in the UK just don't happen - this is dangerous hyperbole whipped up by the sensationalist press to make bigger profits, feed ignorance and stir up hatred.

 

This is our story so far:

 

Our child is 12 years old. We thought she was female at birth and chose a beautiful feminine name. She grew up with both brothers and sisters, wore clothing traditionally appropriate to her birth gender and played with whatever toys she fancied. One day, aged three she asked  "when am I going to grow my willy?" A little taken aback I thought she was confused so replied "you won't because only boys have one." 

 

Around the age of four she became more animated in expressing herself. She started to reject wearing dresses or anything ‘girly.’ We thought, "fair enough!" Young children do experiment with style and assert their preferences. It's part of growing up and developing their personality. She was also rejecting certain toys, steering clear of dolls, play kitchens, princess dresses and instead opting to dress as Iron Man, racing Hot Wheels cars and playing police. "That's ok" we said, "we have a tomboy!" We did, however, reassure her that these choices wouldn’t define her and she was free to express herself without gender boundaries.

 

As our daughter grew she developed an interest in football so started playing for a local team. She also joined the Brownies. Something wasn't right though. She was sullen and withdrawn, like she was going through the motions of life but not enjoying it. At school she had no friends. She didn't fit in with the girls but was rejected by the boys. At football she played well but had no interest in joining the girls on trips to the cinema. It was the same at Brownies and despite encouragement, she gave up on both. It was difficult to witness her sadness.

 

At the age of 6 two things happened which, with hindsight, were quite revealing about how she felt. First, she spent the summer at football camp with her hood up, hiding her beautiful long hair. It seemed strange because it was hot so I asked why and the reply was "because I don't want anyone to think I'm a girl." She dismissed my reply of "but you are!" Then we discovered she'd been taking her brother's underpants to wear. It was becoming apparent that being a girl was in some way distressing for her.

 

To help her feel more comfortable we agreed to buy boxer style underwear and said she could get her hair cut. That day was the happiest we'd ever seen her. Beaming smiles and admiring herself in the mirror! We then buried our heads in the sand for a further two years, hoping it might just be a phase. By this time the hairstyle had become progressively shorter and she was wearing boys clothes exclusively. She was regularly mistaken for a boy and preferred it if we didn’t correct people. Her mood was still low. School tried to help by setting up a nurture group to encourage her to make friends and we invited classmates home to play. We made a point of showing our daughter how great it can be to be a girl, pointing out role models from history, science, sports and the arts. We also organised a party for her 9th birthday. She invited the whole class but only 2 children came, both boys.

 

Then, sadly, one of our older children died. This was devastating for all of us and our daughter became noticeably depressed. School referred us to a wonderful children's bereavement charity where she attended a support group. After a few weeks I got a call asking if we'd noticed that our child behaves differently, has masculine mannerisms, is more confident and happier when people treat her as a boy. It was then the realisation hit. Our daughter might actually feel that she should be a boy.

 

We had to find out so we had a conversation during which I asked if she wished she was a boy. The reply was "No, I am a boy." She didn't have the language to fully articulate it. This wasn't surprising at the age of 9 in her world of football, Scooby Doo cartoons and Harry Potter books. She had no idea what transgender or dysphoria meant. There were no influences from peers, the media, television celebrities, social media or youtube stars. She'd just been put into this 'girl' category by mistake, had tried her best to fit in but it was making her miserable.

 

I felt awful. Upset that she'd been carrying this pressure to conform. Sad to think of the confusion she’d felt about her body. Anger with myself for not picking up on it earlier. We had no idea how to help. I knew nothing about what it is to be transgender. I googled 'gender confusion' and was directed to the NHS Choices webpage on 'gender dysphoria.' Here I found information about the Gender Identity Development Service (GIDS) run by the Tavistock and Portman NHS Trust. This is the only clinic in England providing assessment for children experiencing this. A further search took me to Mermaids, the UK's leading charity supporting gender diverse children and families. From this starting point we got a GP referral to GIDS and I contacted Mermaids who’ve proved to be invaluable in their support. Initially it felt like we were the only ones experiencing this so discovering Mermaids and the friendship of other parents was a huge relief. The Tavistock have very long waiting times, currently up to 16 months, so Mermaids is a vital resource for families, some of whom are trying to manage alone with deeply distressed children and sometimes depressed, self harming teenagers.

 

We decided then to allow our child to socially transition. After all, it's reversible and something which, to a large degree, had already occurred. The immediate difference was striking. Knowing we were aware of her feelings took a huge weight off her shoulders. Explaining to family wasn’t easy. One older sibling found it hard. Having experienced the death of an older sister a short while previously it may have felt like another loss. Our youngest child cried for almost two hours but later made a card which read  "I'm sad you won't be my sister but I'm glad to have you as a brother." Reactions from immediate family were quite positive, with most not being entirely surprised. Rejection can be upsetting for a child so we try to shield any negativity. We acknowledge that some people find it hard to understand but at the end of the day, the health and happiness of our child matters most. No individual, child or adult should suffer oppression to please others.

 

So, 3 years ago at age 9 our daughter became our son. We did feel sadness and a sense of loss, although this has diminished with witnessing how happy he is. He changed his name by deed poll for his 10th birthday. This hurt deeply because we loved the name we’d chosen but we accept he needed to do it. He uses male pronouns and male changing/toilet facilities. This worried me initially but he had no reservations and hasn’t encountered any problems. He's attended camps and school trips where he's shared accommodation with other boys and had a wail of a time I can add! It's like there's no trace of the beautiful baby girl I gave birth to 12 years ago and yet this is the same child. He’s still a cute, cuddly, pasta loving monkey with a mischievous sense of humour. Critically though, he’s immeasurably happier. 

 

His final 2 years of primary school were difficult because he experienced some bullying and felt it wasn't safe to be 'out.' Every day he attended, suppressing his identity through fear. It must have been an awful burden and it certainly took it's toll. He'd return home exhausted from the stress of trying to fit in. Teachers described him as "sad," "uncommunicative," and "lethargic" but at home he was becoming a very different person - lively, energetic, confident and adventurous. This is the difference it makes expressing his identity freely.

 

Now at high school in a different area our child is known only as a boy since he prefers to keep his gender history private, as is his right to do so. Even at this young age he understands that gender represents identity, not sexuality and his identity is separate from the fact he has female anatomy. He’s just starting to explore who he feels attracted to romantically. As parents we worry for the future about how he’ll manage relationships and having recently discovered he has a girlfriend we’ve had to open a discussion about respect and informed consent. He’s aware of the issues, especially being in stealth (presenting exclusively as his preferred gender and not disclosing that he’s trans) but he’s young yet and will need extra guidance to negotiate what can already be a complex time for adolescents.

 

He's currently thriving at school, has friends, plays football with the boys and has been learning to play the drums. In his spare time he attends a wrestling class and has just joined the Cadets as he’s interested in a future career in the Navy. He’s so much happier. I can't overstate the difference. He's beaming, chatty and confident like a 12 year old should be. Our biggest worry is that he could be 'outed' either deliberately or inadvertently and we don't know how he would cope. He’s aware of the risks and that we personally feel he'd be better off being open about his gender history but ultimately it's his decision to make.

 

We’ve had multiple assessments at the Tavistock GIDS with a family therapist and specialist psychologist. As parents, we’re assessed as part of this process to ensure we’re in no way directing him. The clinicians' have diagnosed gender dysphoria (distress at the mis-match between his physical body and his internal sense of self.) They've not identified any co-existing psychological or autistic spectrum disorder and thankfully he’s not currently experiencing depression or heightened anxiety. After consideration, he was referred to UCLH endocrinology where it was confirmed he was in puberty and he’s been prescribed blockers, a GnRH analogue which acts to temporarily stop the secretion of pubertal hormones. This was his own informed decision, enabling him to have time to explore how he feels without experiencing distressing symptoms and permanent body changes. Around the time of the initial onset of puberty he’d seemed upset and said he couldn’t swallow properly. This restricted his eating and he lost over 5kg. No physical cause could be found and I believe he thought if he lost weight then breast development would diminish. He started eating normally again once he was referred for blockers. Gender diverse children sometimes take drastic and potentially harmful action when they feel desperate at the prospect of experiencing what they believe to be the wrong puberty.

 

It's never easy weighing up the potential benefits against the risks of treatment for a child but not acting could’ve caused more harm and this was a risk we weren’t prepared to take. We also bought him a binder so he can safely flatten his chest. Children who don’t have access to these often bind in secret, using tape which can be a dangerous practice leading to broken ribs and breathing problems. Blockers are not hormones as is often misleadingly stated and all the evidence suggests they're safe. In fact, they've been used for decades to treat children experiencing a precocious puberty. Bone mineral density is generally lower in children who are prescribed blockers but we’re assured this is closely monitored and will return to normal once treatment is stopped to allow continuation of natal female puberty or once cross sex hormones are introduced to begin male puberty. 

 

Whilst blockers are reversible, one concern is that children receiving treatment are more likely to continue with transition into adulthood. This argument may come from a genuine concern for the wellbeing of children but it might also suggest ignorance of the facts or a transphobic premise that being transgender is an undesirable outcome. It's really not! An undesirable outcome would be a desperately unhappy child with an increased risk of mental health difficulties, substance abuse, self harm and poor educational outcome. With proper support and appropriate health care, transgender young people have as much potential to lead happy, successful, fulfilled and productive lives as their peers.

 

If our child changes his mind then a normal female puberty will ensue. We will support him if he decides to do this. Young people do sometimes change their minds and social transition is completely reversible in terms of name change, pronoun use, hairstyle etc. We acknowledge that de-transition can be more emotionally challenging but can be achieved with support. Desistance is, however, far rarer than portrayed. The 80% figure often quoted is based on scientifically unsound and discredited research carried out by, amongst others, Dr. Kenneth Zucker, head of paediatric gender services in Canada. He was fired in 2015 after an investigation found his research flawed and his methods unethical. I’m not aware of the statistical difference between children who persist and those who desist, if indeed any reliable data exists. I do, however, know from my experience over the last 3 years of the 1000 plus families I’ve been in contact with, only 3 children who’d socially transitioned have subsequently reverted back to their birth gender and they were fully supported to do so.

 

The issue of future fertility is a concern but recent headlines have claimed that young children are being given drugs which make them infertile. This just isn’t true. Blocker treatment is completely reversible and has no impact on fertility. For those approaching the age of 16 who wish to continue with transition and on to cross sex hormones, fertility counselling is provided and all options are considered. Our child is too young yet to fully understand the implications but it will be explored as he matures. During initial discussions he’s identified that he would like to have children in the future but he’d prefer to adopt rather than have biological children. His perspective may change though and it’s certainly possible for transgender individuals to have biological children. The chances of success are increasing with advancements in fertility treatment too.

 

For now things are going well for our son. He's in a school that supports him 100%, is receiving care from a wonderful GP and the teams at both the Tavistock and UCLH. We feel fortunate to be in the position we are because some families face a constant struggle to get support. Gender services have unacceptably long waiting times as they’re under immense pressure. Schools often have little experience or access to guidance on how to support gender diverse children. GPs sometimes refuse shared care with UCLH due to a lack of understanding, support or resources. Discrimination is still prevalent in everyday life and it can become a real strain for parents trying to advocate for their children, negotiate support and educate others whilst simultaneously witnessing their child's suffering and coming under attack for just doing the best they can.

 

We don't know what the future holds for our child but we intend to support him no matter what. Sometimes other people have a problem with this and think they have a right to be consulted, to have an opinion, to want to debate the issue, but why? A family’s and an individual’s private life is just that, private! Whether you are black, gay, disabled, Christian, left handed, transgender, Jewish, whatever ... nobody has the right to question your identity. Instead of judging, people could perhaps take some time to learn and talk to some of the young people and parents experiencing this.

I have included some links below for those interested in gaining more information.

Thank you for taking the time to read this

 

 

 Publications

American Academy of Paediatrics - Supporting and Caring for Transgender Children

https://www.aap.org/en-us/Documents/solgbt_resource_transgenderchildren.pdf

Endocrine Society Clinical Practice Guideline

https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2017-01658

Equality Act 2010

https://www.legislation.gov.uk/ukpga/2010/15/contents

 

Mental Health of Transgender Children Who Are Supported in Their Identities 

Kristina R. Olson, PhD, Lily Durwood, BA, Madeleine DeMeules, BA, Katie A. McLaughlin, PhD 

http://pediatrics.aappublications.org/content/pediatrics/early/2016/02/24/peds.2015-3223.full.pdf

Stonewall - School Report 2017

https://www.stonewall.org.uk/sites/default/files/the_school_report_2017.pdf

Women and Equalities Committee report on Transgender Equality

https://www.parliament.uk/business/committees/committees-a-z/commons-select/women-and-equalities-committee/news-parliament-2015/transgender-equality-government-response-published-16-17/

World Professional Association for Transgender Health - Standards of Care

https://s3.amazonaws.com/amo_hub_content/Association140/files/Standards%20of%20Care%20V7%20-%202011%20WPATH%20(2)(1).pdf

 

Websites

Gendered Intelligence

http://genderedintelligence.co.uk/

GIDS

http://gids.nhs.uk/

GIRES

https://www.gires.org.uk/

Mermaids

http://www.mermaidsuk.org.uk/

NHS Gender Dysphoria

https://www.nhs.uk/conditions/gender-dysphoria

Transfigurations

http://transfigurations.org.uk/

Transgender Children and Youth - The Basics

https://www.hrc.org/resources/transgender-children-and-youth-understanding-the-basics

Growing up transgender - A parent’s blog

https://growinguptransgender.wordpress.com/

 

If you feel you need support for yourself and your family contact Mermaids

Email: info@mermaidsuk.org.uk

Helpline Telephone: 0344 334 0550

For families with children and teenagers up to their 20th birthday and any professionals working with them. Mermaids provide information, resources, parents support forums, a web chat facility and a teens group. In addition there's a helpline Monday to Friday 9am to 9pm and groups that meet regularly at various locations for face-to-face support They also run numerous weekend residentials at locations across the country and day events where possible. As well as these much needed support services Mermaids also liaise with the media to promote truthful information about gender diversity and to reduce stigma and discrimination. They lobby the government to promote transgender rights and provide talks and training in schools, colleges and bodies such as the police, social services and the NHS.