A Letter to the Parents

Dear Parents:
Welcome and thank you for taking the time to visit our website!

We understand that you might be feeling overwhelmed right now, looking for answers, and in need of some support. We would like to offer that to you in the same way that we have offered that to your son/daughter who might have recently come out to you as being transgender. Not only do we invite you to come take part in a session with your child, but warmly welcome and strongly encourage you to take part in sessions so that we can extend that support and offer information to you in person.

Here are some Frequently Asked Questions that can assist you in your understanding and facilitate some comfort to you.

1) What does it mean to be transgender/transsexual?
A transgender/transsexual person is someone who is born with what we call “right mind, wrong body”. For example, someone who is designated male at birth but identifies as female is a transgender person. A way that I explain it to folks that has helped gain understanding is as such: You identify as male (or, substitute “female” accordingly). Why? Suppose a mad scientist were to club you over the head and abduct you, keep you in a coma-like state for 2-3 years and subject you to hormone treatment therapy and the necessary surgeries and you woke up being a female from head-to-toe. Would you then identify as female because that’s what your body said you were? Most likely not. That’s because there are many other aspects of your gender identity and gender expression than your body parts and hormones. I realize that my example is sensational and please understand that I am not minimizing or demeaning the situation. I only seek to offer a better understanding of what your child is going through and have found that this explanation has provided a “light bulb” to many.

2) What does it mean to “transition”?
A transition, in this sense, is the process of transitioning one’s gender. For example, someone who is born female but identifies as male will typically want to start Hormone Replacement Therapy and will begin a regimen of testosterone. This is a lifetime process but initially starts out with blood work and a lot of monitoring to determine any health risks. For this person, you will gradually begin to see changes in the face, shift of weight distribution, and changes in hair growth patterns. You might notice changes in behavior, such as heightened irritability. Both instances (FTM and MTF) are similar to what teenagers undergo through puberty. Later on in the process, the person might want “top surgery”. For females transitioning to male (FTM, or transmen), this would involve breast removal. For males transitioning to females (MTF, or transwomen), this would involve breast implants. At some point in the transition, a person might undergo “bottom surgery”. Many transmen choose not to undergo this surgery for financial and technological reasons. Transwomen may opt for “bottom surgery”, which involves the conversion of penile and scrotal tissue into female genitalia. Transwomen may also consider Laser Hair Removal, to eliminate facial hair growth, hair transplantation, voice coaching, and Adam’s Apple reduction. A lot of transwomen do not feel the need for breast augmentation because their breasts develop with the hormone treatment. Each person’s experience is unique and it is up to the individual in terms of what stages in transition they feel they need to have in order to feel “whole”.

3) Why was I the last person to know?
Because you are probably the most important! For the majority of our clients, telling the parents is the hardest thing to do. They are worried about not being accepted, supported, understood, or loved. We recommend to clients to build momentum, get the practice to gain the confidence, and start small. Coming out to friends they feel sure will accept them, or coming out to those where the stakes are lower, helps to build that momentum and gain that confidence. It is extremely difficult for some to relay this information to parents. Some worry about being disowned. Others worry about rejection. Some worry that the news might literally KILL a parent. In saving you for last, the intention was not to keep you in the dark, but to be able to talk to you in a way that would worry you the least.

4) How could I not have known?
Don’t feel like you were stupid or out of the loop. A male-to-female transgender person, for example, has tried SO HARD, for many years to convince themselves that they are male, to fit that role for everyone around them, and has probably gone to extremes. You might see someone who has shaved their head bald, grown a full beard, bulked up in muscles, and worn the most masculine clothes possible. This person might have gone overboard with “masculine” activities such as hunting, fishing, motorcycles, and/or extreme sports. Transgender people have tried to convince themselves, as well as others around them, for many years, before they come in for therapy. You didn’t know because THEY DIDN”T WANT YOU TO KNOW and, for a long time, didn’t want to know it for themselves.

5) Shouldn’t my child be assessed for other potential mental illness or mental health issues before being diagnosed with Gender Dysphoria or Gender Identity Disorder?
At BHC, we not only specialize in transgender/transsexual mental health. We also specialize in depression, anxiety, schizophrenia, dissociative identity disorder, ADHD, PTSD, schizoaffective disorder, bipolar disorder, and many others. Our treatment methods are designed to treat any and all mental health issues. The transgender population, in particular, commonly suffers from depression and anxiety and many cases have shown that, the process of transition can actually CURE depression and anxiety. Being transgender is NOT a mental illness but can certainly cause mental health issues. However, having a mental illness is not likely to create symptoms of being transgender.

6) Isn’t it too early/too late to start Hormone Replacement Treatment?
No, in both cases. People who have identified as transgender and don’t do anything about it have a 42% suicide rate. As this becomes a more mainstream and recognized aspect of our society, we are finding people at younger ages realizing what is happening, but we also have older clients who did not know that transition was an option for them until recently. In either case, transition is a medical necessity for those with gender dysphoria and has been proven as such in court cases around the country. Having gender dysphoria and NOT transitioning has damaging effects on the individual’s mental and physical health.

7) Will my child have a shot at being happy/successful/stable/accepted in the community?
If your child is a client of ours, the answer is most likely to be yes. Not because we are brilliant masterminds, but because your child has sought out therapy in order to seek help in their decision making process and would like a “second opinion”. Someone who makes the time and commitment and has found the financial means to participate in therapy is a responsible adult who is carefully thinking out his/her steps and is trying to make an informed decision. Therefore, it is logical to believe that such an individual is responsible and insightful and committed enough to be happy/succeed/have stability/find acceptance in the community. If you still feel doubtful, do a google search on well-known transgender people. Lana Wachowski, director of The Matrix and Cloud Atlas, is a transsexual woman. Ben Barres, MD, PhD, is a transsexual man who is also a well-known neurobiologist, a professor and Chair of the Neurobiology Department at Stanford University. These are just two examples, but I could write an entire section on this topic alone.

We hope this helps answer some of your questions and put your mind more at ease. Dr. David Baker-Hargrove, our President and CEO, has been specializing in transgender/transsexual mental health for over 20 years, has assisted over 1,000 clients with successful transitions, and has co-written a book on the matter with an ex-client, due to come out in 2016. Our only goal within the transgender community is to 1) help, 2) educate, 3) support, and 4) advocate on behalf our clients. We know that once a person comes into our office to speak to us, they have already been through the denial stage, have tried desperately to live out the role of the gender they were born into, and have grappled with, fought against, and opposed the possibility of being transgender, before they come to terms with it and accept it. We understand that the parents and loved ones of transgender people go through these stages, too, and we equally seek to offer comfort and facilitate understanding in that regard. People come to see us when they are tired of fighting and want to know what to do about it. And we are happy and proud to provide that support and information.