Transfigurations – Trans Children and Trans Youth

The special needs of a transgender child – a guide for parents of trans children and trans youth

Jazz Jennings - inspirational trans teenagerAs the public grow more and more aware of the existence of gender dysphoria because of television shows, newspaper and magazine articles, the frequency of which young people are declaring that they are transgender or gender variant is increasing exponentially – and at an increasingly younger age. Coupled with this is an increased knowledge of the condition by their parents means that the child’s declaration that they should really have been born a girl (for people assigned male at birth) or a boy (for people assigned female at birth) will be listened to and acted upon. Only as far back as ten years ago, the Tavistock and Portman Clinic in London (the only place in the UK that treats trans children and trans youth, although they do hold satellite clinics in Exeter and other cities) had just a handful of cases on their books.  This has risen dramatically over recent years and they are now dealing with around 1000 new cases per year. As one mother put it when she was questioned about if she was doing the right thing in allowing her child to transition at a young age “I would rather have a transgender daughter than a dead son” – and that is the very stark reality for many transgender people.

Transgender Youth/Transgender Children:
Whilst we welcome trans children and trans youth attending our group meetings, in the case of children under the age of 13, we would only allow you to attend meetings if at least one of your parents attends those meetings with you. For trans youth between the ages of 13 to 16, then we would insist that a parent comes with you to your first and second meetings and then, subject to your parent’s written permission, you may attend on your own.
If you cannot obtain your parent’s consent for any reason but would like to talk to somebody about how you are feeling, you can either contact us via the help and support line or send via our contact form for parents and trans children.
Some sections of the far right media in the UK like to demonise trans children (and their parents) as was shown in a recent Mail on Sunday article (see my blog here – however a brilliant piece of writing by a mother who has a transgender child was published in the Sunday Observer today (25th May 2014) under the title “Transgender children know their identity. Bigots in the media don’t” which tells the truth about the treatment and care of transgender children and trans youth and I would urge everybody to read it thoroughly.
Not all of these children will go on to want to transition completely and permanently to the gender that they state they are, indeed some statistics show that only a minority will do so. However, it might be gender dysphoria if the child or youth shows behaviour which is:-

  • Persistent
  • Insistent
  • Consistent

The data which formed the basis of these statistics has been questioned recently. Nevertheless, if a child persistently identifies opposite to their birth gender, the majority of these children will still identify as transgender when they get older. For those children who do not identify persistently as being a transgender child or a trans youth will more often revert.  This ‘reversion’ could be caused by societal pressures and/or constraints such as bullying at school by their peers (and, very sadly, by the parents of their peers and indeed teachers at their schools) and other societal pressures or whether it is down to something different remains to be seen.  Hopefully though, these children will still continue to be monitored into adulthood and beyond and then maybe a much clearer picture will emerge. An article has since been published elaborating on my suspicions. Another article, by Julia Serano, has been published recently about the desistance myth which you can read here.  California Healthline has also recently (Aug 2016) published another article on puberty blockers.

One of the most contentious issues has always been which toilet/bathroom facilities should transgender people be allowed to use and here it would be appropriate to show one of the videos that Katie Couric made for National Geographic on the subject:

The good work of people like Natacha Kennedy and others who go into schools to talk to head teachers and staff about transgender issues will help – but it is slow work for there are thousands of primary schools and only a few organisations who do this. However schools (all schools) have a duty under the Equality Act of 2010 and the Public Sector Equality Duty to make sure that the rights of transgender children and trans youth are protected and that any bullying of the transgender child must be stopped.
A really good guide to how schools should be accommodating trans children has recently been released by Brighton and Hove City Council. Please feel free to download it from our Filestore by clicking here.
For parents of trans children and trans youth, an e-learning resource has been released by GIRES and the Surrey and Borders Partnership NHS Foundation Trust (SABP) which you can access here.
All children will go through stages of exploring who they are when they are young, this is a completely natural and normal development. However, when a child shows prolonged periods of wanting to be of the opposite gender to their birth sex , then the stress and anxiety which are all too often the side effects of gender dysphoria can be devastating – and long lasting. Recent studies have shown that transgender children, when supported by their parents, peers and wider family, are at no higher risk than other cis-gender normative children.

A very good booklet on gender dysphoria in children is available from the Children’s National Medical Centre which you can download from here. Another excellent article on the treatment of transgender children entitled “Medical Care of Gender Variant Children” can be downloaded here. However, it is a little outdated in places as treatments with hormone blockers to halt puberty are now allowed in the UK. I have included a series of videos on transgender children on the video page of this web site, please use the link button to ‘Trans Videos’ (which is in the “People” menu at the top of this page).
Sceptics often ask “How can a child as young as four or five know that they are a girl (or boy)?”, But I would turn that round and ask them “How old were you when you knew that you were a girl (or boy)?”. Various research documents show that children are aware of gender differences from a very early age, but by the time they are 5 or 6, their gender perception is fixed.
The truth is that many people confuse gender (who you are) with sexual orientation (who you are attracted to). Sexual orientation often does not fully develop until puberty whereas gender is a mixture of nature and nurture. Many second wave feminists such as Germaine Greer and Janice Raymond (the author of The Transsexual Empire) argued vehemently that gender is purely a social construct and the idea of transsexuality is at great odds with their theorising on the subject. The very sad case of David Reimer actually tends to suggest that gender cannot be purely a social construct and is very likely to have other causes, including having its roots in utero.
These same sceptics believe that it is child abuse to allow a child or young person to transition and take puberty blockers (which they refer to as ‘hormones’ – but in fact they aren’t, they are peptide molecules which bind to the normal hormone receptor sites in the pituitary gland and so block the hormones from binding there – this suppresses the release of luteinising hormone (LH) and follicle stimulating hormone (FSH) from the pituitary. In males, this reduction in LH subsequently leads to rapid suppression of testosterone release from the testes; in females it leads to suppression of oestrogen release from the ovaries). They argue that the long term side effects are not known – when in actual fact they have been in use since the early 1980’s to prevent young girls entering puberty at a very young age). The Tavistock and Portman Institute actually conducted research about this which resulted in their early intervention programme protocol. What is known is that their effects are completely reversible and if the child decides that they don’t want to continue with transition, then if they are stopped, the body will go through the normal puberty of their natal sex.

Below is a video of a speech given by Dr. Norman Spack, who is a Paediatric Endocrinologist and the founder of Boston Children’s Hospital’s GeMS Program, the first medical clinic for transgender adolescents in the USA. As stated previously though, the Tavistock and Portman Institute in the UK now carries out hormone blocking treatments on transgender youth when they first start entering their puberty.

Recommend switching to HD mode if you have a fast broadband connection

Important Note:
NHS England has just released the new (August 2016) service specification for the treatment of transgender children and adolescents. This document can be downloaded from here.

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