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Accepting, supporting a child with gender dysophoria

Irene Sills, MDTransgender children who identify with the gender opposite of the one with which they were born face additional challenges as they enter adolescence.

“Kids say they‘ve known for a long time that something‘s not right. However, they often can‘t put it into words until they‘re older,” says Irene Sills, MD, a pediatrician at Upstate specializing in endocrinology. Sills cares for children and adolescents with gender identity issues. The medical term is gender dysphoria, and the cause is unknown.  

“These kids sometimes are troubled because they don‘t know where they fit in. Some see suicide as the only solution,” Sills says. “The good news is that with greater recognition, they‘re getting medical and psychological care earlier and becoming happier, better-adjusted adults.”

Treatment may include counseling, hormonal therapy and surgery. Hormone blockers that block puberty in the “wrong gender” give children time to consider whether they are truly transgender, with the help of a mental health professional. Trans hormones are used to help the child through puberty and into the “right gender,” but only after a long mental health assessment and confirmed diagnosis of gender dysphoria. Many children in treatment don‘t think of themselves as transgendered, Sills explains, “they think ‘Now I‘m finally right.‘”

How can family and friends be supportive?

Two parents whose male teens are transitioning into females share their experiences and advice:

A Binghamton father thought his son might be gay— at 14, he was enamored with My Little Pony, collectible toys aimed at girls. So he asked him. “I‘m not gay,” came his son‘s reply. “I‘m transsexual.” The parents didn‘t know what that meant. They quickly learned – and learned that their church was in opposition.

“It took us three months to come to grips with this,” he says. “It was tough. We talked, just between us, and for us, it came down to love.”

dysphoriaThey learned that their child wasn‘t going through a phase, or being impulsive or rebellious. They began treatment and agreed on a female name. They spoke to school administrators for accommodation: their child uses the bathroom in the nurse‘s office and will start classes as a female student in the fall. They removed photos from their home in which their child appears boyish and made plans to replace them with more current images.

The father regrets that he and his wife didn‘t know sooner. Hormone treatment is best begun before puberty is underway. Also, he is sad that the child‘s older sister has refused to acknowledge this change while the younger sister is fine with it.

Today the father refers to his child as ‘she‘ and readily takes her shopping for dresses. “That helps her feel good about herself – that she‘s being looked at as the sex that she feels.”

A Syracuse mother says her 16-year-old son approached her a year ago to tell her he was transsexual. “It takes an awful lot of courage to say something,” she says.

Her mind raced after the child‘s announcement. She thought about how to help her child, how to help her child get through it, and about the future. “Then you realize nothing matters but ‘what can I do to help my child feel better?‘ There‘s nothing to think about. You just do it.”

She worried whether her child – who still needed reminders to put homework in the backpack – was mature enough to understand gender identification and make such a life-altering decision. After all, “that is a more powerful decision to make than most people make in 90 years.”

As they shared the news, people would inevitably ask some version of “Does he realize how cruel people can be?”

The mother was quick in her response. “That‘s irrelevant,” she‘d say. “She can‘t be what she‘s not. If people are mean, it‘s better to be happy on the inside and feel like yourself.”

summer cover

This story appears in the summer issue of Upstate Health.

Her child will start the new school year as a female. Yes, that creates stress, but the mother says, “I think it‘s more stressful to pretend that you‘re a boy when you‘re a girl inside.” Regarding transgendered teens she adds, “There‘s no sense in delaying what they need. They have to be able to show their truth on the outside.”

She says since that first conversation, and since the family has begun using feminine pronouns, “I see a more relaxed kid, more at ease with life.” The mother doesn‘t have all the answers, but she has one guiding principle: “You just have to love your kid.”