If understanding my position on #genderidentity issues is important to you, so you can decide if I am a good fit to care for your family, know that I support people - all people - even people very different from me. I feel there is sufficient science to support a spectrum of gender, we see this in the animal kingdom as well, but more importantly, I don't believe people need to understand why to extend compassion. What the underlying reason is when one comes to identify as gender fluid or any other identity than the one assigned at birth, this is part of their journey in life. My role is to support you in your own journey, guiding you towards optimal health in anyway you seek that support.
To step out a little more boldly even, maybe peek at my previous writings on anti-discrimination, justice & equality, but I adamantly oppose any and all laws that dictate the care medical professionals are suppose to or not allowed to provide those who seek our care. If the state has determined me fit to provide healthcare and I am working within that scope, then stay out of our business. Each client circumstance is so unique and only the two of us, the client and clinician, are the appropriate person's to make such decisions.
Supporting Your Child
If your little one has questions about their gender identity and you have created a safe place that they can share this with you, then you probably have questions too. Know that I have cared for children in my practice throughout the age span, some are quite young, more are in their teen years, and I have had these conversations with some of my adult clients as well. Eden Family Practice is a safe place.
Know that the sex newborns are assigned at birth is very different from gender identity, or how they feel inside. There are a number of reasons one may not identify as their assigned sex, scientific and anthropologic, and all are quite fascinating, but those reasons aren't important to anyone but the intrigued scientist. What matters is how each individual feels about themself, how they want to show up in their community, and what they need to feel most authentic. Maybe you have noticed your child expressing themself, through mannerisms, clothing or hairstyles that may not be the societal norm for their assigned gender. This in itself may simply reflect your child not having assumed societal's assignment quite yet, but it may be that their identity is developing unique to their assigned sex. Know too that one's gender expression or their gender identity develops separate from their sexual orientation; the latter has to do with attraction.
Might My Child be Transgender?
Children who are transgender have a gender identity that doesn't match their assigned sex at birth. This doesn't mean they are taking hormones or getting surgery, so don't get overly excited when I tell you I do have #transgender children in my practice who I fully support.
As a child myself, I had cousins on both sides of the family who leaned a bit into gender identities they were not assigned. Many members of my family, back even through the generations, have been part of the LGBQT community. I didn't even know what this meant, but I knew this was authentic to my family and my cousins before it even had a name in my vocabulary. My friends growing up were largely living beyond the boundaries of societies rules, and I applaud them for it. Live authentically. Unapologetically. Work out what you need to work out. Discover your most favorite self.
Children tend to say how they feel. They may strongly identify as their assigned sex or the opposite, and sometimes they identify as neither or not fully male or female (nonbinary). When families allow for free expression, you might find children go through periods of gender exploration, role-playing, altering their dress and the toys they play with, even maybe insisting that they are a gender that differs from their birth sex. Sometimes this is just about showing them you notice them, that you'll honor them, and that you respect them. My oldest son, Noah, demanded that we call him "Ryan" for maybe two years. He never let us slip. That faded away. It may be that this preference doesn't fade away though and that it isn't a phase.
Most children between 18 and 24 months label gender groups; they recognize girls from boys, men from women, and even feminine from masculine. They start to label their own gender by the time they are three years old. Society though can really impose strict or very narrow view of gender. You see this if you wait to find out what gender you are having while pregnant. There are almost no gender neutral options for clothing or nursing decor. Children are pretty rigid about gender and preferences when they are five or six years old, but these tend to become more flexible with age.
Remember, gender identity and gender expression are different concepts. A child's gender identity doesn't always lead to a certain gender expression. And a child's gender expression doesn't always point to the child's gender identity. Some girls really enjoy trying to master standing to urinate, or so my friend tells me. Sometimes children will have a real aversion to wearing a bathing suit of their assigned sex, or even the underwear typically worn by a their assigned sex. Goodness, who didn't play with the toys of our opposite sex as a child. My sister almost never played with dolls. She was way more into transformers, gaming, and skateboarding. Don't rush to label your child. My youngest son wore rainbow sandals all summer one year. His father kept throwing them away and I kept replacing them because I really thought they were just getting lost, and he truly loved them so much. Years later he said he didn't even realize they were girls' sandals; he just loved their were rainbows. Over time your child will continue to tell you what feels right for them.
How Might You Support Your Child Who Doesn't Conform to their Assigned Sex?
Listen to them. Create a safe place for them to really process their feelings - any and all feelings. Talk to your child and ask them questions without judgment. Allow your child to express gender in public or at family activities, even if it makes you feel uncomfortable. This is their journey to explore and your supporting them in this process will allow them to independently identify with what is truly most authentic to them, rather than this being a need to be noticed, to be understood, to rebel, or to challenge the norm. Give them access to gender-diverse friends, activities and resources.
Don't assume your child's gender expression is a form of rebellion or defiance. Maybe it is but that too is an important expression to be respected and honored. Don't try to shame or punish your child for gender expression. Admittedly, this reaction speaks more to your own issues than to your child. Don't allow others in your family to belittle or ridicule your child's gender expression. Understand that experiencing discrimination isn't your child's fault. No one deserves dishonoring treatment.
Remember to speak positively about your child. Do this both to your child and to others. Show your approval for your child's gender identity and expression of it. You'll foster a positive sense of self in your child when you allow your child to express preferences. You'll also help keep lines of communication open. Also, try to let go of expectations you might have had about your child's future. Instead, focus on what brings your child joy and security. A child living with supportive parents and caregivers is likely to be a happier child, and isn't that what we really always wanted as parents?
What Kind of Healthcare Does Your Child Need?
Your child needs a respectful, compassionate, and knowledgeable health care provider. Talk to your child's provider about your child's gender identity and behaviors. Your child's provider might recommend working with a specialist. If you're having trouble finding a provider with training in gender identity, ask a support group to recommend a specialist.
Talking to a therapist also is critical and I believe this to be true for all children and adults for simple wellness reasons, but a child enduring issues surrounding their gender identity absolutely need a safe person to help them process their thoughts and feelings. We have a few resources to help.
It may be that if you recognize this seems to be more than a phase, that your child would be behooved by trialing a social transition. This is a reversible step in which a child lives partially or completely in the preferred gender role. This can involve changing hairstyles, clothing, pronouns and, possibly, names. Limited research suggests that social transitioning might help ease depression or anxiety a child may have about gender identity.
Talk to your child and decide details about the transition. You may consider whom to tell about it. You might also plan which bathroom or locker room your child will use. You'll also need to consider whether transitioning at school or in the community will endanger your child. These are all issues we are happy to discuss with you so your family can decide the best and safest route for your child or teen.
Advocate for Your Child
Either way, advocating for child will be necessary. They may be shunned and experience discrimination. There is risk of physical harm at school and within your community. My children are autistic, my youngest son most especially, and it is astonishing how many of his teachers try to discipline or punish the autism out of him. I know this experience is worse for children who don't identify or present themselves as their assigned sex, and my experience alone makes me want to burn down cities in anger for the injustice he suffers; I can only imagine what parents may experience with gender fluid or gender non-conforming children.
Connect with other families who have gender-diverse children. Try not to isolate yourself or your child. Even an online support group would be helpful. Work with your child's school and teachers; know that I will advocate here too for your family. Talk to them about how to stop or prevent bias and bullying before it even starts. Ask for gender training to be included in staff development. Work closely with your child's school teachers to come up with a plan for how your child will be addressed in school, and which restroom they will use. It's helpful to talk to your child's school about how to interpret the rules about taking part of a team, club, and overnight activities.
If your child is being harassed or #discriminated against at school, speak to administrators. Don't hesitate to file a police report if threats are serious. The school may fail to address the problem, so a legal advocate may be necessary. I have had to do this for my own children, and I waited too long. Please know that we are here to support your family with compassion. We trust this as your journey, and we are simply here to support, advocate, and guide you in anyway you may feel is helpful and honorable.