What it's really like to be a parent of a transgender child
I've written this with the intention of providing some insight Into being a parent of a transgender child. By telling our personal story I hope to illustrate some of the challenges we face and help readers gain some understanding of what gender diversity is.
We are not neurotic attention seekers as some of the media might have people believe. We are just ordinary parents trying to get through life as best we can. We love our children and want them to be healthy, happy and have the same opportunities as everyone else. Our children are not abnormal, brainwashed by social media or by gay converting trans activists. Nor are they suffering from mental health conditions. It is true that many gender diverse children do become depressed, struggle with anxiety, self harm and that they are at increased risk of experiencing suicidal thoughts, however, these issues are largely caused by external stressors such as pressure to conform, lack of support, discrimination, bullying and becoming the victims of hate crime. When transgender children are listened to and well supported these difficulties are greatly minimised, if not eradicated.
Our children just 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 available. 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 different identities such as, amongst others, male to female (mtf), female to male (ftm), 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. This is the reality of gender dysphoria, a recognised condition (not a mental health one) whereby an individual's identity doesn't match their biological sex. In some children this causes severe distress even 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 that there is a biological underpinning, possibly due to the effect of circulating hormones during early foetal development in the womb. It is now scientifically accepted that being transgender, like being gay or being left handed is a natural expression of human diversity.
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 boys and girls state with confidence which gender they belong to long before they even 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 own 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 are perceived by others. If you listen to the narratives of transgender adults there's a common thread. A large proportion knew they were different from a very young age but didn't have the language to express it or the knowledge and support they needed. Often they suffered terribly, psychologically and physically, with irreversible body changes which can make life difficult or uncomfortable for them in their affirmed gender.
No parent would choose this path for their child. One reactionary accusation levelled at parents is that they may be suffering from the mental health condition Munchausen by proxy, whereby a parent makes up symptoms in their child. This is, however, extremely rare and it's highly unlikely that a parent could hold such a sustained influence over a child's everyday behaviour outside the home environment. If this were the case it would become evident to those working with the child. Parents take no pleasure in their 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. It can feel like a bereavement. This is often followed by a feeling of rejection when they want to change their name too. Parents are also accused of following a trend but it's certainly not trendy to have to stay up at night to keep a distressed child safe, to witness their child’s scars from self harming as a coping strategy to deal with their inner pain or to have to attend meetings at school because their child is being threatened, called a freak or has been shot with an air rifle. No parent would choose to loose close family and friends who can't or aren't willing to understand and support. 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. These are not exaggerations but things I have experienced first hand or have heard from other parents.
One of the biggest problems our 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 individuals. 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 these stories. It can be very distressing for parents and trans children, making it more difficult for them to come forward to get the support they need through fear. Let's be clear on the facts here too. No child in the UK is ever prescribed blockers without first experiencing the initial stages of puberty. 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. Not only this but not all transgender individuals even want surgery, opting only for social transition and possibly hormone treatment. Sex changes in children under the age of 18 in the UK just don't happen - this is dangerous hyperbole whipped up to make bigger profits, feed ignorance and stir up hatred.
For anyone interested to know what it's really like to be a parent of a transgender child, this is our story so far:
Our child is 11 years old now. She was female at birth and we chose a beautiful feminine name which held great meaning for us. Our daughter grew up with both brothers and sisters, wore varied clothing, some which would be considered 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 just thought she must be a bit confused so replied "you won't because only boys have one and you're a girl." Around the age of four she became more articulate and animated in expressing her identity. We noticed that she started to reject wearing dresses, skirts and anything pink or frilly. We thought.,"fair enough!" Young children do start to experiment with style and assert their preferences. It's just part of growing up and developing their personality. She was also rejecting certain types of toys, steering clear of dolls, 'pretend play' kitchens, princess dresses etc. and instead opting to dress up as Iron Man, racing Hot Wheels cars and playing police. "That's ok" we thought, "we have a tomboy!" We did, however, reassure our daughter that the clothes she wore and the toys she chose would not define her identity and that children should have the freedom to express themselves without gender boundaries.
As our daughter grew she developed a deep interest in football. She joined a local club and started playing for the girls team and also joined the Brownies. Something wasn't quite right though. She seemed increasingly sullen and withdrawn. It seemed like she was going through the motions of life but not enjoying it. At school her work was good but she was described as being 'painfully quiet' and had no friends in the playground. She didn't fit in with the girls but was also rejected by the boys. At football she played well but had no interest in joining the girls on trips to the cinema or bowling. It was the same at Brownies and despite encouragement, in the end she gave up on both. It was difficult to witness her sadness in these social situations but we found it hard to understand.
At the age of 7 two things happened which, with hindsight, were quite revealing about how our child sees themselves. First, she spent the whole summer at football camp with her hood up, hiding her beautiful long golden hair. I found it 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 just dismissed my reply of "but you are!" Then we discovered she'd been taking her brother's underpants to wear. It was becoming increasingly obvious that being a girl was in some way distressing for our child.
To help her to feel more comfortable we agreed that she could get her hair cut shorter. That day was the happiest we'd ever seen her. Beaming smiles and admiring herself in the mirror! We then did what parents often do and buried our heads in the sand for a further two years, thinking it might just be a phase. By this time the hairstyle had become progressively shorter and she was wearing boys clothes all the time by choice, including at school. She was being mistaken for a boy and was always annoyed with us for correcting people. She still seemed quite down and lacked confidence. School tried to help by setting up a nurture group at lunchtime to encourage her to make friends and we regularly invited classmates home to play. At every possible opportunity we made a point of showing our daughter how great it can be to be a girl, pointing out successful female role models from history, science, sports and the arts. We also organised a party for her ninth birthday. She invited the whole class of 29 but only two children turned up, both boys.
Then, sadly, one of our older children died unexpectedly following an illness. This was devastating for all of us and our daughter became even more noticeably depressed. School referred us to an amazing children's bereavement charity so she started attending a support group to work through her grief. After a few weeks I got a call from one of the charity workers asking if we'd noticed that our daughter behaves differently, has masculine mannerisms, is more confident, outgoing and happy when people mistake her for a boy. The other children had automatically accepted her as a boy because of her appearance. We began to wonder whether our child might actually want to be a boy and felt there must be more to it than it than her just being a tomboy if others outside the family were noticing too. A point had come where we had to find out how she really felt and what would help her to be happy. So, we had a conversation during which I asked if she wishes she was a boy and the reply was "No, I am a boy!" She didn't really have the language to fully articulate how she felt. This wasn't surprising at the age of nine in her world of football, Krypto the Superdog cartoons and Harry Potter books. She had no idea what transgender or dysphoria meant. There were no influences from peers, the media, of television celebrities, social media or youtube stars. As far as our daughter was concerned she'd just been put into this 'girl' category by mistake, had tried to fit in because she knew that's what's expected but it was making her life miserable.
I felt awful. Upset that she'd been carrying this pressure to conform for so long and hadn't been able to tell us. Sad to think of the confusion she must have felt about her body. Anger with myself for not picking up on the clues earlier and for burying my head in the sand when we first questioned whether it was just a phase. We had no idea how to help other than to consider approaching our GP. I knew nothing about what it is to be transgender. I googled something like 'gender confusion' and was directed to the NHS Choices web page 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 serving England and Wales to provide medical/psychological assessment and treatment for children and families experiencing this. A further search took me to Mermaids, the UK's leading charity supporting gender diverse children and their families. From this starting point we were referred to the GIDS and I contacted Mermaids who have proved to be invaluable in supporting our family. At the beginning we felt totally overwhelmed, confused and isolated so discovering Mermaids and the friendship of other parents on their forum was a huge relief. The Tavistock have very long waiting times for appointments, currently over 12 months, so having Mermaids to go to for information and support is a vital lifeline for families, some of whom are trying to manage alone with deeply distressed children and often depressed, self harming teenagers.
We decided to allow our child to socially transition. After all, it's a completely reversible process and something which, to a large degree, had already occurred. Explaining to family wasn’t easy. One older sibling found it very hard to accept. Having already experienced the death of their older sister a short while previously I think it felt like losing another sister. Our youngest child, aged 7 at the time cried for almost two hours but later made a card which read "I'm sad that you won't be my sister anymore but I'm glad to have you as my brother." Reactions from immediate family were positive on the whole with most not being entirely surprised. Extended family responses have varied from being very supportive to ... well, pretty much ignoring us. One grandparent has spoken to other family members about their disapproval and we've been informed that they've changed their will. We don't know for certain that it's related to our child being transgender but suspect that it is. The rejection we sometimes feel is upsetting but at the end of the day, it's the health and happiness of our children that matter most to us. If people can't accept our son for who he is then it's their loss. No individual, child or adult should suffer oppression to please others.
So, two years ago aged 9 our daughter became our son. We decided to fully support him in becoming the person he knows himself to be because it was clear that this was needed for the sake of his future. We did feel sadness and a sense of loss, although this has diminished now we can see how happy he is. He changed his name by deed poll for his 10th birthday which hurt me deeply because I loved the name we had chosen. It still hurts but I accept it was something he needed to do. He uses male pronouns and uses male changing facilities and toilets whilst in public. This worried me initially for his safety but he had no reservations at all. He's been on summer holiday camps where he's shared accommodation with other boys his age 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 11 years ago and yet this is still the same child. Nothing has really changed except the name and pronouns. He's still a cute, clever, pasta and chocolate loving monkey with a mischievous sense of humour who loves cuddles. Critically though, he is now immeasurably happier. One thing I am thankful for is that he doesn't get upset seeing old photographs. Some parents have to remove all pictures in their homes because it's too distressing for their children to see themselves as they were. In our case he says that to him, it's a different person in the photos. He doesn't relate to that person but understands they're important to us.
His final two years of primary school were difficult because he experienced bullying and therefore felt that it wasn't safe to be 'out' at school. His teachers were aware of how he felt about gender and tried to help but they also respected his decision. Every day he attended, suppressing his true identity through fear. It must have been an awful burden for him and it certainly took it's toll. He suffered regular headaches due to dehydration because he would deliberately not drink during the day to avoid having to use the girls toilets. He'd return home exhausted from the stress of trying to fit in. His teachers described him as "sad," "uncommunicative," and "lethargic" but at home and socially he was becoming a very different person - lively, energetic, confident and adventurous. This is the difference it makes to him being able to express his identity freely.
Now at high school in a different area our child is known only as a boy because he prefers to keep his gender history private, as is his right to do so. He doesn't identify himself as being transgender or belonging within the LGBT community. He simply thinks of himself as a boy. Children often see things with more clarity than we do as adults. Even at such a young age he understands that gender represents identity, not sexuality and that his identity is separate from the fact that he was born with female anatomy. He doesn't yet know who he might feel attracted to when he's older. As parents we do worry for the future about how he will manage to negotiate mutually respectful relationships but, for now at least, that's a conversation for another time. He's currently thriving at school, has friends for the first time in his life, plays football with the boys, participates in boxing, wrestling, weight training and is learning to play the drums. He is so much happier. I really can't overstate the difference in him. He's beaming, chatty and confident like an 11 year old should be. Our biggest worry at the moment is that he could be 'outed' at any time either deliberately or inadvertently and we don't know how he would cope if that happened. He is aware of the risks and that we personally feel he'd be better off if he could be open about his gender history but ultimately it's his decision to make and, for the time being at least, it's working well for him.
Over the last two years our son has had multiple assessments at the Tavistock GIDS with a psychologist and a specialist family therapist. As parents, we are also assessed as part of this process, rightly so, to ensure that we are in no way directing our child. It can be an unpleasant experience for parents though as it's easy to feel you are being judged rather than supported. The clinicians' professional opinion in their report on our child is that he does have gender dysphoria. They've not identified any co-existing psychological conditions or autistic spectrum disorder. After very careful consideration and establishing that he was already at Tanner stage 3 of puberty, they referred him to UCLH endocrinology where he’s been prescribed blockers, a GnRH analogue, a peptide, not a hormone, which acts to temporarily stop the secretion of pubertal hormones. This was his own choice, enabling him to have extra time to explore how he feels without experiencing distressing symptoms and permanent body changes that come with puberty. At its onset he seemed so distraught that he deliberately restricted his eating and lost over 5kg. I believe his thinking was that if he lost weight then breast development would diminish. Gender diverse children often take drastic and potentially harmful action when they feel desperate and can't face going through the wrong puberty.
It's never easy for parents having to weigh up the potential benefits against the risks of treatment for their child but in our case it was clear that not acting could cause more harm and this is a risk we're not prepared to take. We'll do whatever we can to help him feel comfortable with who he is. This has included buying him a binder so he can safely flatten his chest. Children who don’t have access to these often bind in secret, using bandages and tape which can be a dangerous practice leading to broken ribs and breathing problems. Blockers are not hormones as is often misleadingly stated in the media and all the evidence suggests they're safe. In fact they've already been used for decades to treat children experiencing a precocious puberty. The only real side effect of significance is that bone meneral density is generally lower in children who are prescribed blockers. We are, however, assured that this is closely monitored and will return to normal once the treatment is stopped to either allow a continuation of natal female puberty or once cross sex hormone treatment is introduced to begin male puberty. Whilst it’s medically proven that blockers are 100% reversible one concern is that children receiving the treatment are more likely to continue with transition into adulthood but this concern in its self suggests a transphobic premise that being transgender is an undesirable outcome. It's really not! A desperately unhappy child with an increased risk of homelessness, poor educational outcome, mental health difficulties and self harm is an undesirable outcome. The recent tragic deaths by suicide of UK teenager Leo Etherington and Jay Griffin in the US are testament to this. With proper support and access to appropriate health care, transgender young people have as much potential to lead a happy, successful, fulfilled and productive life as any of their peers.
If our child changes his mind at any point and stops the blocker injections then a normal female puberty will ensue. We will of course fully support him if he decides to do this and he is well aware that this option is always open to him. Young people do sometimes change their minds but social transition is completely reversible in terms of name change, pronoun use, hairstyle etc. We do acknowledge that de-transition can be more emotionally challenging but this can be sucessfully achieved with support from family, friends, GIDS and schools. The reality of desistance is, however, that it’s far lower than generally portrayed. The 80% figure often quoted is based on scientifically unsound and discredited research carried out by Dr. Keneth Zucker who had been head of paediatric gender services at a clinic in Toronto but he was fired in 2015 and the clinic shut down after an independent investigation found his methods were unethical and his research seriously flawed.
For now things are going well for our child. 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 very fortunate to be in the position we are right now because some families are facing a constant struggle to get the support they need. Gender services have unacceptably long waiting times for assessment as the service is under immense pressure due to increase in demand. Schools often have no experience, training or access to guidance on how to support gender diverse children in education but hopefully this is about to change with an anticipated publication from the Equality and Human Rights Commission. GPs sometimes refuse shared care with UCLH due to a lack of understanding, support or resources. Discrimination and abuse is still experienced in everyday life and it can all 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 yet know what the future holds for our son but whatever it entails we intend to support him as best we can. Sometimes other people have a problem with this and seem to think they have a right to be consulted, to have an opinion, to want to debate the issue, but why? A person’s private life is just that, private! Whether you are black, gay, disabled, left handed, transgender, Jewish etc. Nobody has the right to question someone elses’s identity. Instead of judging through lack of understanding people could take the time to look at the evidence and perhaps talk to some of the young people and parents experiencing this.
I have included some links below for anybody interested in gaining more information.
Thank you for taking the time to read this.
American Academy of Paediatrics - Supporting and Caring for Transgender Children
Endocrine Society Clinical Practice Guideline
Equality Act 2010
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
Stonewall - School Report 2017
Women and Equalities Committee report on Transgender Equality
World Professional Association for Transgender Health - Standards of Care
NHS Gender Dysphoria
Transgender Children and Youth - The Basics
Growing up transgender - A parent’s blog
If you feel you need support for yourself and your family contact Mermaids
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.