Transgender and gender diverse teens: How to talk to and support them

Transgender and gender diverse youth have become more visible than ever. How does transgender history inform us about where society is at in the United States?

Jules Gill-Peterson: A lot of the rhetoric around [trans] kids frames them as totally new – most people are getting to know that there are trans youth for the first time. The visibility that we’re dealing with today is pretty unprecedented. But that doesn’t mean [transgender] people themselves haven’t existed before.

One of the challenges that anyone who’s trans faces is coming to an understanding of yourself in a culture that fundamentally doesn’t recognize that you exist. One of the most remarkable things about trans youth is that they’re able to stand up in this world that we’ve created, that gives them no reason to know who they are, and say, “Hey, actually, I know something about myself that none of the adults in my life know.”

I think history can be a really powerful grounding force to give young people a sense of lineage. It’s not like you look back in time and you see yourself reflected, by any means. But I think it can be profoundly reassuring, in a moment of not just political backlash but the general isolation that trans people face in a cis-normative society, to be able to [see] that you’re not the first person to ever go through this. [I think] that is just kind of a powerful message and one that I certainly subscribe to as an adult too, but I can imagine it’s especially important for young people.

What does “cis” mean and where does it come from?

Jules Gill-Peterson: This is actually a term from chemistry. It’s a prefix that you can put in front of words. So is the word “trans.” Trans as a prefix means across – it’s the spatial metaphor moving across something. Cis means on the same side of. At some point on the internet, people started using that word; they were looking for a word to distinguish between people who are trans and people who are not. Cisgendered came to mean that your gender identity matches what was assigned at birth. That being said, it’s not a totally kind of innocent or uncomplicated term. I’m not sure how helpful it is to think of cisgender as something that people need to own up to, for example, in a pronoun circle (when people introduce themselves by name and by the pronouns they prefer).

I think often the pressure for people to [identify] as cis doesn’t make any sense, either. It’s like, well, what makes you cisgender? Did you really go through that long process of deciding if your gender matched what’s on your birth certificate, like trans people have to deal with? I tend to use the word cis in my work to describe large historical structures that created that very obligation in the first place.

Guest Blog: Puberty Blockers, Trans Youth, and Bone Loss

Another thought-provoking article from Open Minded Health, this time a review on an article that examines a possible down-side of puberty blockers.

Puberty blockers (“GnRH agonists”) can be extremely helpful for transgender (trans) and gender non-conforming (GNC) children and their families. They are used to “pause” puberty. The pause allows time for negotiation, thought, and discussion. Schools need to be contacted and negotiated with. Families may need time to ask questions and do their own research. The trans/GNC young person is relieved from the distress of an unwanted puberty.

Simply, puberty blockers work by telling the body “It’s not time for puberty yet — stay as a pre-puberty body”. That message keeps ovaries and testes from producing their sex hormones. For young people just beginning puberty, it’s like pressing “pause” on puberty. But they can also be used post-puberty to reduce overall sex hormone levels. So “puberty blockers” can be used as testosterone blockers in trans women. They’re not used often in the United States that way because they’re expensive, but they’re very effective.

Puberty blockers are generally safe. They have been in use for a long time for children with precocious puberty. However there is one unknown that’s been a concern for both parents and their children: Bone health.

GUEST BLOG: Trans Folk, Hormones, and Stress

In the wake of the suicide of a trans youth, I offer this article from the excellent blog, Open Minded Health. It provides evidence that trans people have a better quality of life when their physiology matches their gender identity.

Article Review: Hormonal Treatment Reduces Psychobiological Distress in Gender Identity Disorder, Independently of the Attachment Style (used with permission).

Summary: Research now indicates that cross-sex hormone therapy is associated with a lower cortisol awakening response in trans people, regardless of attachment style. Many confounding variables, however, were present in this study.

Transgender people have long asserted that gender dysphoria can be extremely distressing and that transition, including hormone therapy, helps relieve that dysphoria. Hormone therapy is known to improve self-reported quality of life, as measured by questionnaire. To my knowledge no other study has looked at stress-related biological factors in trans people. Biological factors are important because self-report is notorious for validity problems. This study looked at one such biological factor, called the cortisol awakening response.

REVIEW: ROVING PACK by Sassafras Lowrey, or Why Every Straight Parent Needs This Book

This novel, told in the form of diary entries and email, offers a glimpse into the life of a young person who is gender*-fluid, marginalized, at tremendous risk for suicide, homelessness, and victimization by hate crimes, and who finds a tenuous stability in a loosely-woven community, where individual relationships are fragile but the group itself endures. It's extremely well executed, with a strong narrative voice, easy prose, smoothly handled nuances, and action that moves right along. Ultimately, it's a hopeful story, with resourcefulness and loyalty as well as despair. But it's also a disturbing book.

*Gender (as opposed to sex, which is the plumbing and genetics you're born with, or sexual orientation) affects so many aspects of our lives and how we see each other and the world. We grow up being told we're a boy or a girl and what those mean. (Whether we turn out to like boys or girls or both is another matter.) When a person experiences who they are as the opposite sex from the body and identification they've been given, we call them trans-gendered, as opposed to cis-gendered, when it matches. Some people are neither trans- nor cis-gendered; how they see themselves changes, not only from one sex to the other, but neither, something that does not fit into the tidy binary division. One such person is the narrator of Roving Pack, who over time changes name and gender as well as address.

When I made my way through this story, I became aware that I could not read it dispassionately. I could empathize, using my imagination and my past conversations with gay and trans-gendered friends and family. But everything I myself experience is colored by my own gender identification, which is fixed (as opposed to fluid) and congruent with my biology. I waded through the coarse language, the drug addiction, suicide, disease and promiscuity, trying to reserve judgment, trying to listen to what these kids were trying to tell me, to understand their lives in their own terms.