THE HEALTH, WELL-BEING AND SUPPORT NEEDS OF TRANSGENDER CHILDREN AND THEIR FAMILIES DURING SOCIAL TRANSITION
Newfoundland & Labrador Centre for Applied Health Research Gender & Sexuality Research Exchange Group March 5th, 2015
Julie Temple Newhook, PhD Post-Doctoral Fellow Faculty of Medicine Memorial University
Non-profit national organization for gender diverse and transgender children and youth http://www.gendercreativekids.ca
St. John’s area peer support group for parents of gender diverse/transgender children and youth [email protected] https://www.facebook.com/parentsgendercreativ ekidsnl
National, confidential, bilingual on-line peer support group for parents of gender diverse/ transgender children and youth [email protected] https://www.facebook.com/ canadianparentsofgendercreativekids
A Learning Opportunity TRANSGENDER CHILDREN: for Professionals who work with BEYOND THE MYTHS Young Children
Prepared by: Julie Temple Newhook, PhD Post-Doctoral Fellow Faculty of Medicine Memorial University
MYTH #1: “HUMAN BEINGS ONLY COME IN PINK AND BLUE”
Gender Identity: an individual's deeply felt internal and individual experience of gender1: a core aspect of an individual’s sense of self. 2 Researchers do not know the exact origins of gender identity in any person, but it appears to have a strong biological component, most likely located in the brain.3,4,5 Some people identify as women or girls, some as men or boys, others somewhere in between, as a combination of genders, or as no gender. Gender diversity is normal and healthy.2,3,5,6
MYTH #2: “YOU ARE DEFINED BY YOUR CHROMOSOMES” MYTH #3: “BEING TRANSGENDER IS A DISORDER”
Transgender: a term to describe a person whose gender identity differs from what others expect of their assigned sex.1 Some Aboriginal people use the term “two-spirited.” Transgender children may also be called gender creative, gender diverse, gender independent, gender non-conforming, or gender variant.4
Once pathologized as a mental disorder, we now know that being transgender or gender diverse Is simply a normal part of human diversity. 2,4,6 Transgender people existed throughout history and live today in all parts of the world.7 Researchers estimate that 1 in 300 people are transgender.8
DR. DIANE EHRENSAFT
Dr. Diane Ehrensaft, clinical psychologist, talks about the origins of gender diversity.
http://www.kidsinthehouse.com/teenager/sexuality/transgende r/where-gender-non-conformity-comes?qt-more_videos=1#qt- more_videos
MYTH #4: “KIDS ARE TOO YOUNG TO REALLY KNOW WHO THEY ARE”
Transgender people have long described awareness of their gender identities from a very young age. 9
Now, current research confirms that children become aware of their gender identity by the age of 3 to 5 years.10
It is often at this age that young transgender children try to express their sense of discomfort with their assigned gender.3,4
MYTH #5: “IT’S JUST A PHASE!”
YES, it could be. It is very common for children to experiment with gender occasionally in play or dress, or to go through a phase of resisting gender - stereotyped expectations. But phases end.
Researchers estimate that for 2-8% of children, gender diversity is more than a phase: they regularly express their gender differently from how others expect. 11 Most of these children would not be considered transgender: kids who simply enjoy play or dress different from gender stereotypes usually continue to identify with their assigned gender. They may just be boys who happen to love dresses, or girls who happen to love trucks.
However, these children may still need support to express themselves freely. 2,3,4
“BUT HOW DO YOU KNOW IF A CHILD IS TRANSGENDER?”
There is no way to know However, a child may for certain be considered how any child will identify transgender as an adult.5 when they
insistently,
consistently,
persistently identify as a gender other than how they were assigned at birth.3,4
MYTH #6: “THOSE KIDS ARE JUST CONFUSED”
Transgender identity is NOT confusion, or pretending, or simply wanting a perceived advantage of another gender.
Psychological research shows that transgender children’s gender identity is just as consistent and deeply held as that of cisgender children.
This research has found that on both self-reported and subconscious measures of gender identity, transgender girls are indistinguishable from cisgender girls, and transgender boys are indistinguishable from cisgender boys. 10
DR. KRISTINA OLSON
“Sometimes we hear from parents that the parent says, ‘Well, you could just be a boy who likes to wear dresses,’ and the kid says, ‘No, it’s not the dress. I am a girl.’ …That seems to be the crucial difference between a boy who likes a girly things and a boy who is saying, ‘I am a girl.'” In other words, not every kid who explores or experiments with gender is necessarily transgender, but when they do assert a gender identity, it’s a very authentic experience.”
Dr. Kristina Olson Psychological Scientist Director, Social Cognitive Development Lab University of Washington http://kuow.org/post/when-do- kids-know -they-re-transgender- younger-youd-think
MYTH #7: “YOU SHOULDN’T ENCOURAGE KIDS TO BE DIFFERENT”
Interventions that try to force children to deny their gender identity are now considered harmful, unethical, and an abuse of power and authority.2,7
Recent research shows that gender- diverse children who are pressured to conform have higher rates of behavioural and emotional health problems than those who are supported and affirmed.11
A provincial study in Ontario revealed that the majority (57%) of transgender youth who lacked parental support had attempted suicide in the previous year.12 Strong support from parents reduced attempted suicide rates by 93%.12
MYTH #8: “KIDS ARE TOO YOUNG TO TRANSITION… WHAT IF THEY REGRET IT?”
Social Transition: Changing pronouns, name, clothing or appearance to better fit a child’s gender identity. Social transition can greatly improve a transgender child’s emotional well-being.3,5,6
A small number of children who socially transition may later decide to revert to their assigned gender. However, if these children are supported, this second transition need not cause undue distress, but can be accepted as part of the journey of clarifying the child’s gender identity. 14
Ultimately, there are no guarantees as to how a child will identify as they grow, but by listening to them, we can understand how to best support them for what they need right now.6
Children do best if they are loved and supported for who they are, not for who we expected them to be. MYTH #9: “BUT I’VE NEVER MET A TRANSGENDER CHILD!”
You may have worked with young children for a long time without recognizing a transgender child. Transgender children are an invisible population.15
Because of the lack of awareness of gender diversity in our society, transgender kids may not recognize their gender identity until later in life. Even when children are aware of their gender diversity, they may hide their identities from their schools, communities, and even their families.4,16
AND IF YOU STILL THINK YOU’VE NEVER MET A TRANSGENDER CHILD…
MAY I PLEASE INTRODUCE…
With gratitude to members of Canadian Parents of Gender Creative Kids/Parents des enfants transgenres canadiens, and their wonderful children! Sofia, 5 Mathieu, 2 Ben, 11
Emery, 4 Sarah, 3½ Ryland, 6
https://www.youtube.com/watch?v=yAHCqnux2fk BEYOND MYTHS: HOW CAN WE SUPPORT CHILDREN’S GENDER DIVERSITY?
ALL children benefit from reducing gender stereotypes. 2
Respect every child’s gender identity. Ask children’s preferred pronouns and name, and use them.
Support parents in affirming their child’s gender identity and supporting their child’s gender expression.
Develop a gender diversity policy for your organization.
Use gender-inclusive language.
Avoid dividing children by gender, e.g. into groups of girls and boys.
Avoid gender stereotyping – e.g clothes are just clothes, not “boy’s clothes” and “girl’s clothes”
Stand up to transphobia, homophobia, and sexism.
FINAL WORDS
On December 28 th, 2014, 17-year old Leelah Alcorn, of Ohio, wrote a suicide note. She revealed that her parents had refused to recognize her as a girl, and she did not believe her life could ever be worth living. After posting her note, she walked onto a highway and brutally ended her life in the path of a tractor trailer. Her final words were “Fix society. Please.” 17 RESOURCES TO LEARN MORE ABOUT CHILDREN’S GENDER DIVERSITY
Gender Creative Kids Canada http://www.gendercreativekids.ca
Rainbow Health Ontario http://www.rainbowhealthontario.ca
Gender Spectrum (U.S.) http://www.genderspectrum.org
Supporting Transgender and Gender Creative Youth (2014), by E. Meyer and A. Pullen Sansfaçon
The Transgender Child (2008), by S. Brill & R. Pepper
Gender Born, Gender Made (2011), by D. Ehrensaft
CHILDREN’S BOOKS CELEBRATING GENDER DIVERSITY
Jacob's New Dress http://www.amazon.ca/Jacobs -New -Dress-Sarah-Hoffman
I Am Jazz http://www.amazon.ca/I - Am-Jazz-Jessica-Herthel/
10,000 Dresses http://www.amazon.ca/10 -000-Dresses-Marcus-Ewert/
The Boy who cried Fabulous http://www.amazon.ca/Boy -Who-Cried-Fabulous/
My Princess Boy http://www.amazon.ca/My -Princess-Boy -Cheryl-Kilodavis/
It's Okay to Be Different http://www.amazon.ca/Its -Okay -To-Be-Different/
Be Who You Are http://www.amazon.ca/Who-You- Are-Jennifer-Carr/
When Kathy is Keith http://www.amazon.ca/When -Kathy -Keith-Wallace-Wong/
ACKNOWLEDGEMENTS
For their thoughtful reviews and encouragement, many thanks to Rob Sinnott, Cara Lewis, and members of
Canadian Parents of Gender Creative Kids/ Parents des enfants transgenres canadiens
Gender Creative Kids Canada
and
Parents of Gender Creative Kids – Newfoundland and Labrador REFERENCES
1 Ontario Human Rights Commission. (2014). Gender identity and gender expression (brochure). http://www.ohrc.on.ca/en/gender-identity-and- gender-expression-brochure
2 Canadian Association of Social Workers/Canadian Association for Social Work Education. (2015). Joint Statement on the Affirmation of Gender Diverse Children and Youth. http://www.casw-acts.ca/en/joint-statement- affirmation-gender-diverse-children-and-youth
3 Brill, S. & Pepper, R. (2008). The Transgender Child: A Handbook for Families and Professionals. San Francisco, CA: Cleis Press Inc.
4 Ehrensaft, D. (2011). Gender Born, Gender Made: Raising Healthy Gender Non-Conforming Children. New York: The Experiment.
REFERENCES
5 Erickson-Schroth, L., Gilbert, M.A., & Smith, T.E. (2014). Sex and gender development. In Erickson-Schroth, L. (Ed.) Trans Bodies, Trans Selves. (pp. 80-101). New York: Oxford University Press.
6 Pyne, J. Rainbow Health Ontario. (2014). Fact Sheet: Supporting Gender Independent Children and Their Families. http://www.rainbowhealthontario.ca/admin/contentEngine/contentDocu ments/Gender_Independent_Children_final.pdf
7 WPATH (2011). Standards of care: For the health of transsexual, transgender and gender non-conforming people. 7th edition. World Professional Association for Transgender Health.
8 Gates, G. (2011). How many people are LGBT? Los Angeles: UCLA School of Law, Williams Institute. http://www3.law.ucla.edu/williamsinstitute/pdf/How-many-people-are- LGBT-Final.pdf
REFERENCES
9 Manning, K., Pullen Sansfaçon, A., and Meyer, E. (2014). Introduction. (pp.1-12) In E. Meyer and A. Pullen Sansfaçon (Eds.), Supporting Transgender and Gender Creative Youth (pp. 111-127). New York: Peter Lang Publishing.
10 Olson, K. (2015). Transgender kids show consistent gender identity across measures. Association for Psychological Science. [News Release]. http://www.psychologicalscience.org/index.php/news/releases/transgen der-kids-show-consistent-gender-identity-across-measures.html
11 Moller, B., Schrier, H., Li, A. and Romer, G. (2009). Gender identity disorder in children and adolescents.
12 Hill, D.B., Menvielle, E.J., Sica, K.M. & Johnson, A. (2010). An affirmative intervention for families with gender variant children: Parental ratings of child mental health and gender. Journal of Sex & Marital Therapy. 36(1): 6-23.
REFERENCES
13 Travers, R., Bauer, G., Pyne, J., Bradley, K., Gale, L. & Papadimitriou, M. (2012). Impacts of strong parental support for trans youth: A report prepared for Children’s Aid Society of Toronto and Delisle Youth Services. http://transpulseproject.ca/research/impacts -of-strong-parental-support- for-trans-youth/
14 Edward-Leepers, L. and Spack, N.P. (2012). Psychological evaluation and medical treatment of transgender youth in an interdisciplinary “Gender Management Service” (GeMS) in a major pediatric center. Journal of Homosexuality, 59(3): 321-336.
15 Hellen, M. (2009) Transgender children in schools. Liminalis: Journal for Sex/Gender Emancipation and Resistance. 81-99.
16 Susset, Françoise. (2014). Between a rock and a hard place: The experience of parents of gender non-conforming boys. In E. Meyer and A. Pullen Sansfaçon (Eds.), Supporting Transgender and Gender Creative Youth (pp. 111-127). New York: Peter Lang Publishing.
REFERENCES
17 Pyne, J. “Fix Society. Please.” Now Toronto. https://nowtoronto.com/news/leelah-alcorn-fix-society-not-trans- people/ PROPOSAL: BUILDING A RESEARCH PROJECT RESEARCH PROPOSAL: WHAT DO WE KNOW SO FAR?
Growing numbers of parents appear to be affirming their
children’s gender identities, and searching for health and 1,2,3,4 social supports.
There is very little known about the health and well-being of young transgender children in Canada, particularly from diverse socio-economic and ethnic communities. 5
Parental health and well-being is rarely examined in this field, yet may be a significant concern. In shielding their young transgender children from social rejection, parents may themselves face transphobia: social exclusion, rejection by their former peer support networks, fears about safety, and discrimination. 1
Parents of transgender children may require support of their own in order to provide affirmation to their children. RESEARCH OBJECTIVES
Proposal: A nation-wide study of transgender children under the age of 12 and their parents/caregivers.
Main objective: To assess the health, well-being, and support needs of transgender children and their families, particularly through the process of social transition, and to work towards building knowledge to improve supports for this population.
THEORETICAL FRAMEWORK
This project is shaped by a theoretical framework focused on the social determinants of health6,7 in the context of the intersectionality of privilege and oppression.8,9
This research project will explore health inequities in the lives of transgender children and their families by examining the intersections between gender identity, gender expression, sexual identity, age, ethnicity, religion, and socio-economic class.9,10 METHODS: FEMINIST PARTICIPATORY ACTION RESEARCH
1. Advisory Stage: Gender Creative Kids Canada
1. Research Stage
(a) National questionnaire survey of parents of transgender children, examining determinants of health and well -being
(a) 30 in-depth interviews with parents, to identify the most important health concerns and support needs
(b) Art-based project, involving the creation of and narration of a self-portrait, with the children of the interviewed parent
3. Feedback Stage
NEXT STEPS… FUNDING?