The Battle Over Gender Therapy: a supportive mom’s P.O.V.

After the 6th friend sent me a link to the article in last Sunday’s New York Times magazine entitled, The Battle Over Gender Therapy, I decided it was time to take a careful read.

While I am grateful to reporter Emily Bazelon for her excellent reporting, I nevertheless feel that one group got less attention than is warranted: the parents. Well, that’s not entirely true. Bazelon does discuss parents who fail to support their transgender children, but she doesn’t give nearly enough consideration to parents, like me and my husband, who do support their kids. And this is a pretty grave omission, because when push comes to shove, this issue is all about parents.

We are the ones making the doctor appointments; researching options; gnashing our teeth; wondering if there is such a thing as a right choice. We are the ones who are holding our children close as they voice their radical depression over what is, ultimately, your fault, especially as a mother. “Why did you make me like this in the first place?” is a phrase I have heard more than once.

A tip for those of you who think the gender therapy issue is easy for the supportive parent— it isn’t.

Any parent who is supporting their transgender teen through puberty via blockers or hormones, and in some cases, surgery, is doing so only after the greatest amount of focused conversation, deep research, deeper self-scrutiny and the deepest scrutiny of their child.

My husband and I are parents to a thirteen-year-old transgender girl. We first affirmed her, socially when she was six after several years of persistent, consistant and insistant declarations by our child that “he” was in fact “she.”

The process of switching genders at a young age, while emotionally fraught, was relatively easy: new name; new hairstyle; new outfit, and we all got on with our lives. That is, until precocious puberty hit at eleven.

Gone was the joy we felt in purchasing a pair of pink leggings, or watching our ecstatic daughter donning a purple bow. Panic set in. Our child returned to the near-suicidal state that compelled us to begin our gender journey in the first place.

My husband and I were incredibly relieved when we found a way to press the pause button.

By having a puberty blocker implanted into our daughter’s arm, our doctor reasured us that we could buy ourselves time to think things through in a calmer state since panic isn’t the best jumping off point for major decision-making.

We weren’t sure what to make of the blocker. Would it stunt our child’s growth? Would her development in other areas be hindered? Our fear over our daughter’s upset at the onset of secondary male characteristics outweighted our fear of the unknown. We went ahead with it.

To our tremendous relief, once the blocker was implanted, our daughter’s voice stopped deepening, her nascent facial hair diminished and her penis stopped growing. We relaxed. For a while. But time marches on.

It is two years later and a new (very difficult) decision is being decided. We may choose to remove it, despite the risks that action may incur. We are concerned, having weighed Dr. Marci Bowers’ observations, as quoted in Emily Bazelon’s article: “Trans girls who don’t go through male puberty may find it difficult to have an orgasm after they have genital surgery as adults. They also could have less penile tissue with which to create a vagina, which could lead to more complication after surgery.” Dr. Bowers goes on to say, “Talk about it.”

And herein lies the tremendous pressure that every parent of a transgender child must bear, particularly the parents of transgender girls. We are forced to decide whether or not our child — still a minor (if 18 counts as an age when one can make good decisions, which, in and of itself is questionable) — should be able to reproduce using their own genetic material.

Perhaps of even greater significance, we must choose whether or not our child will be able to feel pleasure one day during the same act many of us used to make our transgender child in the first place, and most certainly during our own private moments of self-pleasure.

Talk about it?

Discussing masturbation, orgasm, a micro-penis that might lead to a vagina made from parts of your child’s colon or intestines—not to mention the complexity of raising children of their own sometime in the very far off future— are not easy chats to have with a young teen.

Now, add into the mix the fact that our child, like a percentage of all transgender kids, is on the autism spectrum and struggles with a processing disorder, and the discussions become even more difficult. Even if you’re a super-open parent, like me. Which is why we turned to a gender specialist to act as a moderator.

This helped, but it was still hard, not only for us as parents, but also for our child. She broke down in tears of mortification when forced to admit that she wants to be able to ejaculate when she masturbates with a penis she hates. Those tears switched in nature to ones of unfairness and loss when we discussed certain infertility if she continues to repress male puberty. She went dry eyed with horror at the thought of not being able to have an orgasm one day with her future, impossible-to-imagine-right-now vagina.

I’ll take, “Subjects not taught in school for $100, Alex.”

Of course, even the seemingly simplest decisions in the teen gender space are met with unexpected conflict. Having arrived at the conclusion that we need to gather more information, I booked another appointment with our gender doctor. Easy, right? Wrong. Our specialist is so besieged with patients, her next opening is six months away.

Should we find another doctor with a more flexible schedule? Perhaps, but we can’t seem to find a gender doctor with a shorter wait list.

Why are the waits so interminable? The reality is, there are a lot of transgender kids out there who need care and they’re all racing for an appointment because they are following politics and writhing in fear.

These teens are asking themselves: Could I be removed from my home if my parents support my desire for hormone intervention? Will I be put into foster care and forced to live in my former “dead” identity? Many of these kids have legally changed their names on their birth certificates and passports; their former self no longer exists. Who will they become? they wonder. What will happen?

What these terrified kids and their families need — just like our kid and our family needs — are options, not draconian laws.

They need frank discussion, and if they can’t have those frank discussions without prompting from a trained moderator, they need to find one. If these moderators are busy fighting fines, or are worried about going to jail or losing their license to practice medicine, these conversations won’t be happening. And without the conversation, the consequences will be, well—

Some of these kids will harm themselves from fear, alone, of lack of options. And if they live in a state where they truly have no options, some will turn to self-mutilation. Others may choose suicide, or will become one of the transgender teen runaways who make up scary statistics.

Bazelon points out in her article that all 70 participants in the initial hormone experiments in Amsterdam benefited positively from treatment. She also points out that a second study of 55 patients showed positive outcome with hormone intervention during puberty.

This is significant data. And we need to keep collecting it to better understand this developing field. How can we continue learning if our clinics and clinicians are obliterated? How can we make informed decisions when the participants in the studies, themselves, are obliterated?

I speak from the gender trenches, with mud under my nails and the threat of potential tear gas coming my way soon, forcing me to keep a metaphorical gas mask in my cupboard just in case. Parents need support, not punishment, because our children need support, not punishment. How can we pivot without options? How can we offer hope without even the potential for opportunity?

None of us is choosing hormone intervention on a whim. None of us thinks it’s like buying our kid a new pair of Air Jordans.

Child abuse, the haters say? When did the agonizing decision process of figuring out how to keep our children alive become abuse?

Would it be better for us to have no choice at all? To answer that, I look back at that all-important statistic, so well-known to all parents of trans kids: “40 percent of trans people will attempt suicide.” And one of those could be our kid, each one of us parents has thought next.

Let’s keep our children and teens from becoming the wrong statistic. Let’s let them become positive statistics instead. Let’s keep the options on the table. Let’s choose the safety of making hard choices in a climate that isn’t so fraught. Let’s choose choice.

Isabel Rose