What’s Happening with Trans Kids?

Dr. Dana Bevan

Many transgender children have had and are having different experiences from us old fogies who spent most of their lives in the closet. We spent considerable time and effort hiding our authentic selves from parents, schools, governments and the military. We also had experiences in peer-directed support groups and transgender conventions. The need for such gatherings seems to be fading away. There are many new life pathways open to transgender kids today. From a scientific point of view, we know these pathways exist although it is currently hard to measure how many children follow these pathways and how effective they are.

How Many?

We do not know exactly how many transgender kids there are but if one goes by the estimates of general population frequencies, at least 1% of birth males and maybe half that for birth females. Survey results are getting closer to the estimates made by Lynn Conway in the early years of this century for transgender males. But many of the current surveys are flawed because their primary purpose was not to count transgender people. The Williams Institute estimates are based on surveys taken by the CDC and state governments to assess health risks. The Williams estimates have been creeping upward and now stand at .7% of the population being transgender. The population frequencies may be higher than those based on surveys of adults because of self-imposed secrecy.

The number of transgender people seeking help has greatly increased over the past several years as expressed by statistics from the UK. The UK estimated that the number who needed treatment was escalating at about 3% a year but the actual numbers have far exceeded that. Since the wait time for an initial visit to a mental health professional in the UK National Health Service is now about 18 months, the backlog is even bigger.

Since emergence of being transgender occurs mainly between the ages of 4 and 7, there are plenty of kids who know they are transgender even if they don’t know the word for it. Only teenage and above are counted in surveys. Kids this young are not counted.

Secrecy and Suicide

There are undoubtedly contemporary children who follow the path of secrecy as many of us older transgender people did. They do this in order to avoid rejection by their parents and others. Judging by the rapid increase in older transgender people coming out and seeking help, some of them will come out at some later point in their lives. Secrecy may be necessary in some situations but ultimately it is injurious to transgender people in terms of loss of authenticity and expression, isolation, depression and even attempted suicide. Having experienced some of these effects, older transgender people can relate. Today, secrecy is a little more tolerable because information on being transgender is readily available on the Internet. Us oldsters had to live in secrecy without this information.

Transgender kids and young people are at risk from suicide. Attempted suicide rates for transgender youth, hover around 40%. Those are the attempted transgender suicide rates. There are probably additional transgender suicides that resulted in death but are never counted because of secrecy both on the part of the children themselves and on the part of family. There is no indication that the suicide rate for transgender children is declining despite hotlines, outreach and social media.

Social Transition

There are some children who pursue the pathway of social transition, either on their own or with help from mental health professionals. Some try to “tough it out alone” by cross presenting while ignoring rejection. Since most transgender people do not seek mental health assistance, the frequency of those following the secrecy and self directed social transition pathways must be high. But we do not have firm numbers how many kids follow these paths. Self-direct social transition is a stressful pathway and some go into secrecy at least during the school years. An indicator that there are some try to “tough it out” without help is the numerous lawsuits that are filed to permit transgender kids to do such things as go to cross present in school activities including high school proms and graduations. Many get rejected by their families and end up living on the street which is stressful and dangerous.

Some transgender kids attempt a social transition with assistance from mental health professionals. This requires that their parents are accepting, have the resources to pay for help, and that the parents encourage the child to express themselves. Many times this pathway is used as a steppingstone to hormone blockers and transition. The idea, akin to the WPATH Real Life Test/Experience is to demonstrate that the child can function in the gender behavior category that was not assigned at birth.

Puberty Blockers and Transsexual Transition

Drugs that block the ravages of puberty have been prescribed for transgender kids for the past 8 years or so. The purpose is to provide a reversible treatment that will give the child and their family time to determine whether to proceed with transsexual sex hormone treatments at about age 16 and potential genital plastic surgery at age 18. In order to qualify for blockers, the transgender kids must complete social transition to the satisfaction of their parents, mental health professionals, endocrinologists and medical providers. This means that they must complete social transition by age 8-12 when the first signs of puberty are seen.

Blockers required deep parental pockets. They are very expensive and consequently the number of kids undergoing these treatments is small. Implants under the skin require minor surgery and may only be effective for 6-12 months. They may cost upwards of $20-30K each. Injections are also expensive and require office visits.

WPATH guidelines indicate that sex hormones can be started at age 16 but these are only guidelines. There are many children who start sex hormones at earlier ages. There is a trend towards starting sex hormones in parallel with puberty blockers in order to ease the impacts of hormone treatment that can be scary. Some children, like TV Jazz, did not tolerate the blockers and go to sex hormone treatment (which also block puberty). Some, like Kim Petras (who is a German songwriter and performer) have started hormone therapy even earlier and have had genital plastic surgery as early as age 12. The WPATH guidelines allow such flexibility. Gone are any requirements in most countries that specify a particular sexual orientation or sterilization. Some older transgender adults may have encountered these requirements.

We should be getting a progress report this month from Johanna Olson at UCLA who leads a research team concerned with blockers and hormones in kids.

School

Schools vary widely in their acceptance of transgender behavior. Some schools tolerate bullying and harassment by students and even teachers. In general, the more accepting schools are found in states on the US coasts and the least tolerant in the South. In order to deal with intolerance at school, transgender kids may choose home schooling or parents may move their family homes. While home schooling may be effective scholastically, it does not offer beneficial student interaction and may not result in a diploma. The effectiveness of home schooling has been greatly improved through online courseware but in order to get a diploma the local school system must kick in money to the online purveyors. Many parents cannot arrange for home schooling due to work. In some locations, home-schooling parents arrange meet-ups for their children to play and interact. That does not work for transgender kids in the South where the majority of the home schooling families are less tolerant of transgender kids. They home school for religious reasons. Getting a diploma is sometimes difficult which means that it is more difficult for transgender kids to be accepted to college.

Some parents of transgender kids move their family homes. If the new district is more tolerant, they may tell the new district officials that the child is transgender and should be referred to in the child’s transgender name and pronouns. If a more tolerant district is not available, the parents may arrange for the transgender child to change their identification with regard to name and sex marker and then move districts. Success of this strategy hinges on the availability of restroom and locker room privacy. One wonders what these approaches teach transgender children.

Genderqueer and Gender Fluid

Older children may announce that they are genderqueer or gender fluid. I count these children as being transgender, although some may disagree with me. In fact some regard being transgender as genderqueer. I count genderqueer children as transgender because they are not following the gender behavior category that they were assigned at birth, based on sex. I acknowledge that they may not completely follow the behaviors in the other binary category. I will count them as transgender until we have enough science to distinguish them as a useful grouping. To clear all this up, what we desperately need is a science of gender behaviors to base our assignment to gender behavior category and transgender/genderqueer groups and for other research. This exactly what we do in human factors psychology to catalog and deal with the behaviors inherent in such jobs as nuclear power plant operator and aircraft pilot behavior. Some scientists have started down this research path.

Outcomes

We have no good studies that tell us what the outcomes will be for transgender kids. Early claims that they will become transsexual, or become homosexual are unsubstantiated. Claims that most transgender kids stop being transgender as they grow up are incorrect and not based on evidence. Many investigators who have done pertinent studies deny that their research shows such a “desistance” rate. Most kids (indeed most people) drop out of long-term or longitudinal a study, which makes such studies hard to interpret. Some studies are biased because of aversive reparative therapy that uses operant conditioning and jawboning. After being battered by aversive treatments in reparative therapy, do you really think that transgender kids would continue to say that they were transgender?

Genetics Research

The parents and grandparents of transgender children are now at the right ages to be self-identified as transgender. It may now be possible to establish transgender genetics through family trees. Parents have benefited from the improving attitudes toward transgender people and may more readily come out or at least admit being transgender. Grandparent baby boomers are old enough to be retired and be relieved of the economic impacts and social stigma of being transgender. They have also benefited from recently improved attitudes toward transgender people.

Conclusion

The two biggest problems facing transgender kids are suicide and being rejected by family. We need to keep transgender kids alive and keep them off the streets.

There are new pathways available to transgender kids that should improve adult outcomes but no adequate longitudinal studies have yet been done.

Before us oldsters jump in and try to give transgender kids advice, we need to consider the differences between our experiences and theirs. Listen first to their experiences and try to relate them to ours only where we can.

Tags: featured, Identity, trans kids, Transgender

Category: Transgender Body & Soul