Transgender Youth: Beyond Pink & Blue

For transgender children, puberty isn’t a milestone, it’s a cataclysm. The anxiety that surrounds this naturally occurring, biological transformation, is enough to send even the most resilient, into a dark place. The impending doom of coarse spears of facial hair breaking through a transgender girl’s soft fleshy cheeks, or of a chest inflating on a transgender boy’s once sexless frame sounds more like grind-house horror, than a biological rite of passage. These changes are not-so-subtle reminders for these children, that their bodies and minds are not in-line.

Transgender children in America are at a high risk for depression and suicide.  While the issues facing transgender children are often covered by the news media, there is tendency to favor sensationalism, rather than sensitivity. The news media has a societal duty to focus on the vast and complicated emotional issues transgender children experience, more than just the scientific and physical aspects. Furthermore, they should aim to create a safe, empathetic and informed environment for these children and their families or they risk perpetuating the problems facing these already vulnerable youths.

Puberty is the peak crisis age for transgender children. The laws and regulations controlling hormone therapy can either help or hinder a transgender child, depending on their age and emotional maturity. A child might be too young or not yet psychologically qualified for the treatment, unable to afford it, or might be unsure if they want it. Close to 70% of transgender adults, become aware that their anatomy does not match their biology before even entering kindergarten. That’s to say, the amount of pressure that lies on a non-conforming child and their family to detect it, accept it and chose a permanent plan for correcting it, might happen at a very early and gradual rate with room to explore and discuss. Now consider the children who are unsure, the children who are unable to seek support from their family, the children who are ashamed, and the children who are scared.

How is a child expected to make decisions for itself, when the repercussions of that choice will inform and define the rest of their lives, having no help from a parent? Now, consider the parents who don’t want to alter their child’s body, the parents that are scared for the child’s mental health, the parents that refuse to see their child’s preferences as more than a phase–the parents who live in denial. And on the other end of the spectrum, the parents who hoped to have a child of the opposite gender and inadvertently, raise that child against their gender grain and cause them to develop a transgender identity. Or, parents who over-cater to their child’s gender identity and push them towards a transition that they later reject. What’s more, all of these heavy decisions are trumped by one heartbreaking statistic: more than 40% of transgender children will have attempted to take their own life by their 20th birthday. 16% of that percentage will report suicidal thoughts in the early stages of identification and development of identity.  I can’t help but think: when death becomes freedom and not a sentencing for certain members of our population, it’s our duty to take a look at our efforts and adjust.

Many argue, it’s too much too soon. We’re just getting around to legalizing gay marriage, give me a minute to process that before I start thinking about gender-neutral bathrooms. That is a dangerous attitude and it spreads too easily. Gender non-conforming children are nothing new to the populous. There is evidence of their existence as far back as the rest of the population. In our earliest civilizations, exalted figures were drawn and sculpted with duel gender expressions. These figures were believed to hold great wisdom and were wholly honored.

Now, gender identity variances are becoming mainstream. They have made a home on Amazon with the debut of Transparent. MTV is in their second season of Faking It. Orange is the New Black heads into their third season with a slew of nominations and awards in tow. On the silver screen, Elle Fanning has begun filming her role as a young transgender male in Three Generations and Laverne Cox took home the woman of the year award at the Glamour Magazine ceremony last week. The assimilation of transgender characters in media has increased the population’s awareness of the transgender community tenfold. Transgender characters are becoming less notable as pawns for controversy and LGBT brownie points and more noticeable for being human. This shift in the media’s support has not only encouraged those members of the transgender population to step forward but also find a support system and invitation to a full life.

When we look to statistics we have to keep in mind that a majority of that population does not have the confidence or means to step forward and identify themselves as so. The statistics we have only relates to the people who have made themselves known, to be counted. The more room we make for transgender characters and awareness in the media, the more steps we take toward a more accurate statistic.

We’ve become somewhat used to reading about controversial medical advances and restrictions for transgender youth. Hormone counseling and treatments makes regular appearances in medical journals, day-time television and Sunday magazines, but the stories we hear are told by the lucky ones. We hear the stories of the children of parents who support them, who love them unconditionally and are able and willing to support the process financially and emotionally. These are the children who have a choice. But what about the children that don’t have support? They don’t have a voice. They’re a countless statistic.

I was really moved by a documentary series, Living a Transgender Childhood, featuring a transgender female, Josie, formally Joey. The taping began when Josie was only 9 years old, though she had been living as a girl since she was three years old. After an attempt at self mutilation, Josie’s parents took her to see a gender specialist to see about putting her on estrogen. Josie’s anxiety around impending masculine puberty was enough to leave her and her family in despair. All her mother could do is attempt to calm her with hugs and reassurance when each morning Josie inspected her face in the mirror looking for unwanted signs of hair and checked her neck for signs of an Adam’s apple. Josie was terrified of becoming a man. She knew that if she started taking estrogen, she might develop, biologically as a female. The clock was ticking and the doctors agreed that she was was too young for hormone treatment.

A year later they grant Josie a prescription for blockers. Hormone blockers are used to block puberty, these blockers, GnRh agonists, inhibit the pituitary gland from releasing Gonadotropins (protein hormones). Blockers can be administered for years. They buy time while the child matures emotionally, until they are in a place where doctors can be sure that their gender identity is consistent. In fact, the majority of gender non-conforming children are not transgender, they just experience gender variances which don’t require medical intervention. While in Josie’s case, it’s unlikely that her identity is a phase, it’s possible that she might chose to live her life as a man.

While blockers buy time, they also leave the children at a disadvantage, they’re not going to go through puberty at the same rate as their peers and they’re going to have more time spent in the in-between, which for some is intolerable. So is suspending the crisis of puberty the safest route? Hormone treatment is irreversible and will leave patients sterile. It’s a heavy choice to leave to a child. But with suicide statistics where they are today, can these children afford to wait?  We must continue to make it easier for them by making the waiting room a more comfortable place.