Dempsey is 8 years old and her pronouns are she, her, hers. Since Dempsey was 2 years old, she loved girl toys, sparkly things, pink things and princesses. She would point at the girl toys on TV and tell her parents she wanted them.
photo credit: Jaime Jara
When Dempsey was 4 years old, she went to therapy and months later, she came to her parents and told them, "I am not a boy. I'm a girl in my heart to my brain. I’m not a son. I'm a daughter."
"She was consistent, insistent and persistent. Always that, you know, I'm a girl," said Jaime Jara, Dempsey’s mom.
Dempsey is a transgender female. Jara knows there will be challenges in her daughter’s life, but she also knows what’s most important: Dempsey being happy, confident and living her life.
Transgender is a broad term that describes people whose internal sense of their gender is different from the sex they were assigned at birth.
A report conducted by The Williams Institute showed that in the United States, 1.4 million adults and 150,000 youth ages 13 to 17 are transgender. The youngest age group (13 to 17) has the highest estimated percentage of transgender people.
As many transgender people have experienced discrimination and social injustice in society, experts say that a supportive and caring family will improve the well-being of transgender people throughout their lives.
I set up interviews with four parents in an attempt to understand the initial reaction parents of transgender children experienced, the process they went through and the decisions they faced.
I contacted Jaime Jara via Instagram and she agreed to have a Zoom interview with me. Jara lives in Florida and advocates for her daughter and the LGBTQ+ community. Jennifer Pressey lives in Colorado with her 14-year-old transgender child. We had a 25-minute phone interview in September. Meghan Hamilton from Massachusetts has a 12-year-old transgender child. During a 30-minute phone interview, she told me her child will speak with a doctor at Boston Children’s Hospital to understand more about hormone treatments. A mother named Mindy lives with her 17-year-old child, who is a transgender male. She asked that I use only her first name since they have not told their extended family.
"Looking back on it now, she did have more male friends, and she did like doing more male types of things. I guess I just assumed she was like a tomboy," said Mindy.
When she was 12, Mindy’s child told her that he was a lesbian and wanted to change his name. A few years later, her child decided to talk about his gender with therapists. Mindy wasn’t aware that her child is a transgender male until recently when he said he wants to transition to a man.
Mindy’s child was depressed and anxious about the discrepancy between how he feels and how he looks, saying the mirror couldn’t reflect who he is. He was not happy.
According to National Center for Transgender Equality, when transgender people feel the difference between the sex assigned at birth and their internal knowledge of their gender, they are likely to experience emotional distress that affects their life and mental health. It is a phenomenon known as gender dysphoria.
Some transgender people know their gender identity at a young age, while others spend a long time figuring out their gender identity—male, female, a blend of both or neither; some transgender people come out as gay, lesbian, or bisexual before recognizing their gender identity, while others know their gender identity but decide to openly tell others years later.
Meghan Hamilton, mom of the 12-year-old transgender child who uses the pronouns "they, them and their," never thought too much about her child’s gender identity. She said her child loves cars as do many boys, but can also get along with girls and play with them. "About a month ago now, they came to me and said, 'I'm transgender. I'm a girl.' And I was surprised."
photo credit: Jaime Jara
For transgender people, they experience different scenarios in their life and come out as their true gender in various ways. One thing they share in common: Knowing the importance of parents’ support and understanding.
During the time many parents think their kids are just more "feminine" or more "masculine," transgender children are likely to feel confused and anxious. According to Human Rights Campaign, the way to determine whether a child is transgender or non-binary is to see if the child is "consistent, insistent, and persistent about their transgender identity." Simply put, if children insist that their gender identity does not align with the sex that was assigned at birth for a long time, they might be transgender.
Parents can begin supporting their transgender child by using the name or the pronoun that matches their kid’s gender identity, educating themselves about terminology, knowing all the challenges their kid might face and the resources they can get, listening to what they feel, and being their child’s advocate.
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Conversation With Gender Therapists
Questions, concerns, fear and misunderstandings might appear in transgender children and their family’s daily life. When transgender kids are questioning their gender, experiencing gender dysphoria or finding it hard to explain what they feel to their parents, a professional gender therapist can provide the help and support they need.
A gender therapist helps transgender people explore and affirm their gender, tell them how to address challenges that have come up in their life, help find resources and trans community, help parents adjust to their kid’s gender, and clarify misconceptions toward transgender people.
"One of the most important steps for Dempsey to transition was for her to talk to someone else and to get out her feelings, to finally have the confidence to come to us and tell us how she felt," said Jara. Since Dempsey talked to the therapist, changed her pronoun and transitioned, she hasn’t felt depressed or anxious. "It was literally like a light switch," Jara smiled.
Sam Silverman, a gender therapist, said not all transgender people experience gender dysphoria or need to seek help from therapists. "There isn't one trans narrative and not everyone wants those things or needs those things to be trans."
Jennifer Pressey’s 14-year-old child was diagnosed on the autism spectrum when she was 8. To Pressey, the biggest concern she has is how her child’s autism and mental health challenges would affect the ability to handle people being awful. "I just worry mostly for the mental health piece because the suicide rate is really high in this population. So, I want to make sure that she has stability, and that’s the part I worry about."
According to Mental Health Match, mental health concerns often occur in tandem with gender dysphoria because it is pervasive and affects all aspects of life. Mental health concerns can also be a result of the negative societal attitude that stigmatizes transgender people. Studies show that suicidal thoughts and attempts among transgender adults are way higher than for the U.S. general population.
It’s important to know that gender dysphoria itself is not a mental illness, but many transgender people need to deal with mental health problems due to the discrimination and stigma existing in society. Many reports pointed out that when transgender people are supported by their family and have a connection to the trans community, they are able to live healthy and fulfilling lives.
Decision: Medical Intervention
Puberty can be confusing and cause intense distress for transgender children. Many trans children might consider medical options for transition which include hormone blockers, hormone therapy and gender-affirming surgery.
When children are early in puberty, they can choose to use puberty blockers to suppress hormones–testosterone or estrogen to pause physical changes that don’t match their gender identity.
Marvin Belzer, a professor at USC’s Keck School of Medicine and the director of the Division of Adolescent and Young Adult Health, said if transgender children start treatment with puberty blockers early into their puberty, they may never need the chest surgery or the facial feminization surgery. "You will have the gift of basically deciding whether you want to disclose to people at work or at school, whether you have gender dysphoria or not by starting earlier."
Feminizing hormone therapy and masculinizing hormone therapy help transgender children’s body and appearance align with their gender identity. For transgender females, they can take estrogen by pill, a patch on their skin or an injection; for transgender males, they can take testosterone by injection, skin patch or gel.
Many experts say that hormone therapy is safe for transition, while it does have some side effects. Estrogen can cause headaches, migraines, nausea, gallstones, blood clots or moodiness; testosterone can cause headaches, migraines, heart disease, stroke and weight gain.
Hormone therapy is partially irreversible and the gender-affirming surgery is irreversible and both can affect fertility, so before making the decision, the conversation among transgender children, parents and doctors is critical.
"Hair and clothes are easy to change. But when she starts with hormones and things, yes, she may not want a baby, she may think she never wants a kid at 21 or 22, but then she does all the hormone stuff and realizes she doesn’t want it then her body is going to be a mess," said Pressey.
Pressey and her family are open-minded and all support her child, but she wants to make sure her child is well-informed and understands the long-term consequences of those choices before making the decision. "It’s not my job to push her in any direction. She has to make the decision about who she is and what direction she wants to go into."
"I don't have concerns about hormone blockers because I know that puberty blockers have been used for years and years and are very safe and are very reversible. I am concerned about the side effects of starting on hormone replacement,” said Hamilton. “I want to know, like, what is the potential damage to the body for that? And is that something that is an acceptable risk?"
"If this is truly the route that Alex wants to take, I'm going to help find the doctors that will do it. But again, I want Alex to completely understand anything that they may be giving up because I know some of the hormone treatment can make you infertile," said Hamilton. "What if down the line they want to have their own biological children and if they just can't because of this, you know, stuff like that concerns me."
Belzer doesn’t like to tell parents and children what they should do, but he does believe that parents should think about what decisions can make their child happier.
"Their puberty is in action. … if you do nothing, what are the risks? More anxiety, more depression, more facial hair. Especially for trans women, harder to pass as they develop facial features that are more masculinized, body hair that's going to have to be reversed."
Support And Love
The survey from the National Center for Transgender Equality showed that transgender people are more likely to face harassment and bullying at school, face violence, be fired or denied a job, be refused access to critical medical care and be targeted by law enforcement. Living as transgender people in a society where transphobia, widespread discrimination and aversion still exist everywhere, parents play the roles that are extremely critical in transgender people’s life.
Raising a transgender child is something many parents are not familiar with or prepared for. It’s normal that parents might feel sad, anxious, helpless at the beginning, and they may also have a hard time explaining everything to their extended families, friends and even coworkers. When the extended family or friends are religious or conservative, this can be another challenge.
photo credit: Jaime Jara
Jara and her husband have spent some time explaining her daughter’s situation to the extended family because "in the Latino culture, everything is very gendered, even the language.” Jara also mentioned that she has lost some close friends because “they did not agree that we were doing the right thing."
She said no matter what, her child remains the priority. "For the people that have left our lives, we gained new people, we find more help and support." She told her child that sometimes people just don’t like you, and it’s possibly because you’re transgender, but it’s probably not that reason. "It’s just really finding the people that you belong to, you feel comfortable with. And, standing up for yourself."
Just as transgender children face a lot of emotions and fears and frustration, parents are also in a new journey self-educating themselves and adjusting to many changes.
"I was devastated in the beginning when I first found out. A lot of that was fears and anxiety on my part,” said Mindy. "There is also a piece of me that I think was grieving the loss of my idea of my daughter."
"I’m still walking around like in a movie," Mindy said. "It feels very surreal sometimes. Like I’m watching a movie of someone else’s life. It’s not my own."
Mindy said she and her husband are still processing, but she says fears and anxiety give way to joy whenever she sees her child’s overall demeanor changes in a positive way.
Said Mindy: "When I’m with my child and my child seems happy, then I feel a sense of peace."