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| Alexis and Me in Montreal, Spring 2016 |
This was my Facebook memory today:
If you don’t know what this means, it’s simple: For the last two years, Alexis, our
transgender daughter, has been receiving a hormone blocker to suppress male
puberty.
She’s been getting an injection every three months since coming
out at the age of 11, when she was found to be in active puberty. The drug blocks
testosterone in a sciencey-wibbly-wobbly-timey-wimey kind of way, ensuring her
body doesn’t keep going in a direction she doesn’t want it to go in. (Yes, I
actually do know exactly how it works, but figured it would bore the pants off
of you. And maybe you like pants. I hate them, for the record.)
You would not believe what a ruckus this causes online. Or
maybe you would, depending on your view of medical interventions like this one.
Lots of people are not okay with it. In fact, if there’s one
well-meaning comment I see more than any other, it’s along these lines:
“I’m fine with parents supporting their trans children, but I draw the line at giving them hormone treatments this young. They’re doing permanent things to a child’s body. It seems dangerous and irresponsible. They’re kids; what if they change their mind?”
Every time I see this comment directed towards my family or
another in a similar situation, I want to address it. Not because I’m feeling
defensive (I’m not), but because it’s a well-meaning concern steeped in
misinformation. And, as we know from the whole trans-bathroom-laws-will-stop-pedophiles
argument, misinformation can be downright dangerous.
The problem is, I simply don’t have the time or energy to
explain the same thing over and over to people who don’t understand why kids
like Alexis sometimes need these medical interventions.
Instead, I’ve decided to write a post that I – and maybe
others – can direct people to whenever they see this concern in their own circles.
I know. Super smart, right? It should be noted that I AM NOT A MEDICAL
PROFESSIONAL. If you have serious questions about this stuff, please speak to an
endocrinologist who specialises in gender.
First, let’s discuss some unfortunate facts:
Trans kids have one
of the highest suicide rates of any marginalized group in the world. The
stats vary depending on where you live, but it’s estimated that in my home province
of Ontario, Canada about 50% of trans
youth seriously consider suicide, with roughly 20% attempting it. Put
another way, one out of two seriously think about ending it, and one in five
actually try. Yikes. This rate is much
higher than the cisgender (non-trans) population.
Trans people face
many obstacles that can contribute to thoughts of self-harm and suicide.
One of the major issues is gender
dysphoria, which is a deep discomfort over the belief your psychological and
emotional self does not match your physical self. Another major factor is social stigma and lack of support from
family, friends, society, and the medical community.
So with those things in mind, let’s break down that comment
I see pop up over and over on the internet. Here it is again:
“I’m fine with parents supporting their trans children, but I draw the line at giving them hormone treatments this young. They’re doing permanent things to a child’s body. It seems dangerous and irresponsible. They’re kids; what if they change their mind?”
*rolls up sleeves*
*sits down with fresh cup of coffee*
“I’m fine with parents
supporting their trans children…”
That’s great, because
it’s been shown those kids do incredibly well. In fact, more and more studies
are showing youth whose transitions are supported by their families are not
only just as happy as the general population, but sometimes even happier. So they go from the bottom of
the despair pit to the top of the rainbow, all thanks to supportive parents. Amazing.
On the other hand, those who are not supported are far more
likely to face those abysmally high rates of depression and suicide. It doesn’t
take a rocket scientist to see why it’s imperative
to support transgender youth. (Which is good, because I’m definitely not a
rocket scientist.)
“… but I draw the line
at giving them hormone treatments this young.”
Hold the phone, my well-meaning friend. I hear you, but you’re
looking at this the wrong way. For trans
kids who want and need medical intervention, helping them access it is part of
the parental support package.
Puberty often throws a transgender tween or teen into a
direction that feels completely wrong.
Things happen to their body that can be very hard – or even impossible – to reverse
later in life.
For a trans boy (assigned female at birth but feels male) growing
breasts, menstruating, and developing that hourglass figure can be a traumatic
experience. It takes them further away from how they see themselves.
For a trans girl like mine (assigned male at birth but feels
female), developing facial hair, an Adam’s apple, a deep voice and a tall
stature can be emotionally scarring in a way those of us who are cisgender can’t
possibly comprehend. Some of those things are irreversible, like big hands and
feet, height and broad shoulders.
All of this can be
avoided if hormone blockers are used at the onset of puberty. If I support
my child, if they don’t want to move into that direction because it is not who
they are, and especially if doing so could cause them a lifetime of pain and
lead them towards poor mental health, I have a duty as a parent to stop that from
happening, if at all possible.
This treatment is not being done “too young.” It’s being
done exactly when it needs to be done.
“They’re doing
permanent things to a child’s body.”
Puberty is irreversible,
puberty blockers are not.
Most people don’t know this, but it’s true. All the blocker
does is hit the pause button so puberty doesn’t take hold more than it already
has. Should the youth decide they don’t want to continue on them (a very rare
thing, but let’s go with that idea for a minute), the blockers are stopped,
puberty revs up again, and off they go to stinky teen town. No harm, no foul.
Blockers are often
confused with hormone replacement therapy. They’re often used simultaneously
in trans adults, particularly if said adult has not had any surgery to remove
the bits and pieces that produce the hormones they don’t want. So you block the hormones you have, then add in the
hormones you really need. Some of the changes from the new hormones can be irreversible,
so starting them is a big decision.
My daughter will follow a similar path, but it’s slower for
her because of her age. She’s been on blockers for two years. Once she’s at the
age where her doctors feel she can make an informed consent, she’ll start
taking estrogen.
And you know what? We’ll celebrate that day just like we
would have celebrated the day a cisgender daughter got her period for the first
time. It will be her entry point into womanhood, and that’s something she’s
been excited about for a very long time.
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| Alexis and her moms. |
“It seems dangerous
and irresponsible.”
Let’s go back to the suicide statistics for a minute: One in
two think about it. One in five attempt it. Many of those who do make the
attempt don’t survive.
The stats drop to far lower levels when we support trans
kids in their transitions, including providing them good medical support.
When you’re in middle school or high school and all your
friends are developing typically while you’re either developing in the wrong
direction because your parents won’t consent to blockers, or you’re not
developing at all because you can’t take hormones, your mental health can be
impacted in a huge way.
At this point, the
risks associated with not starting hormones are greater than the risks
associated with taking them.
Yes, hormone therapy carries risks. Virtually all medical interventions
do, and trans kids aren’t the only ones who need medical support. Why point a
finger at them and not, say, a kid on insulin, or one who needs chemo?
Because of stigma,
that’s why. We stigmatize trans issues. We see transition as a choice. We
see it as a mental illness or a perversion. It’s none of those things, and the
sooner we can get our collective heads around that, the better off we’ll all
be.
“They’re kids; what if
they change their mind?”
The likelihood of a child who meets the requirements for a
diagnosis of gender dysphoria ever “changing their minds” or “de-transitioning”
is virtually zero.
Someone doesn’t
become trans, so they can’t un-become it. It’s not a choice. It’s not
something you decide to do one day. “Oh,
I think I’ll dye my hair blonde.” “Oh! I think I’ll be a dude now!”
Nope.
Trans is something
you just are. Some people realize it sooner than others. Alexis was eleven
when she realized she’s a girl. My wife, Zoe, was 42 when she came out, but had
known since she was 6 or 7. Some people figure it out when they’re 60. Some are
3.
So we’ve done what any parents should do: we met our child
where she was at, and did what we needed to do to save her life. Like most trans people, her emotional state has already improved so much because she's able to be her true self.
Could she change her mind and decide she’s a boy? Sure,
anything’s possible. I could win the Powerball. You could adopt a talking
monkey. But the likelihood is negligible, unlike the 20% chance we could lose
her if we chose not to help her in every way possible.
So there we go, well-meaning internet naysayers. I hope this
helps you better understand where parents of trans kids are coming from when we
consent to medical interventions.
But no matter what you might think, I know, beyond a doubt,
that we’re making the right decision with Alexis. And seeing her thrive is the
only thing that matters to me.