When your adolescent daughter suddenly tells you she wants to be a boy

Some children struggle with their bodies from an early age. They are born a boy, but feel like a girl. Or vice versa. You notice this as parents. This is called gender dysphoria. For most, the discomfort disappears naturally as they grow up. Others don't have trouble with their gender until puberty, more or less suddenly. In such a situation, the message can come out of the blue to parents.

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What do you do when your adolescent unexpectedly indicates he or she is trans? "Listen first and foremost", responds child psychiatrist Stella O'Malley. "As a parent, you may feel overwhelmed by the announcement. Then it is wise not to say too much. Realise that your child, like you, is full of emotion. The situation can then quickly spiral out of control."

Genspect

This advice comes from an expert in gender issues, for that is what the Irish O'Malley is. Her work as a psychotherapist further convinced her that young people's gender issues are best served by a non-medical approach. In her practice, she counsels teenagers and young adults with gender dysphoria, along with their parents. Outside Ireland, O'Malley is also a recognised voice around this issue. Besides publishing and podcasting on the subject, three years ago she founded Genspect, an international organisation that advocates a "healthy approach to gender and sex" based on scientific evidence. She and two co-authors recently published a guide for parents whose child indicates they are transgender.

What O'Malley often sees happening is that a child or young person knows much more than their parents during an initial conversation. "Some have spent months-or even years-intensively exploring the topic of transgenderism online. They are given all kinds of ideas and terms there. As a result, there is often a disparity in such a first conversation."

The child psychiatrist wishes that parents and child get a good start around this difficult topic. So her advice in the first moments is not to say too much, but to ask open questions: Since when have you been struggling with this, how do you see this and why do you think that?

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Besides listening and asking clarification questions, the Irish gender expert recommends that parents ask their child for time at this stage. "They desperately need that to immerse themselves in the subject and form an opinion on something their child is already much further along."

After listening and asking for patience, the next step is for parents to read up on the subject, says O'Malley. "It is important for them to delve thoroughly into what transgender is and what transition entails. As a parent, you need to know what the thinking is that your child is full of and what the consequences are. It is not loving or healthy to focus only on the positives or only on the negatives. It is well known that a teenager's brain is not yet fully formed. This is another reason why he deserves good guidance."

The psychotherapist advises parking any concrete request at this stage. "As long as parents are not experts, it is better not to respond to the child's wishes, neither consenting nor rejecting. Time is an important element for parents at this stage. They need it to read and listen to study the subject from all sides. Parents should not be rushed into this, even though the urgency may be very uncomfortable with the child."

Once parents have sufficient knowledge, the next step is to determine how they can support their child, says O'Malley. "Educators then sit down with their child and tell them that they have read up and what guidance they can offer at the moment. Not as a dictate, but more as a guide to how the family will function in the coming months, with a review in a few months to see how things are going."

O'Malley thinks it is very important that parents stand beside their child rather than opposite him. And that the child experiences their love, even if their choices do not make them happy. "Try to sympathise with the teenager without getting too emotional, and authoritative but not authoritarian. Since every decision can have far-reaching consequences, a child does not need indulgent or thoughtless guidance, but rather careful, cautious and compassionate guidance. A parent who acts in this way never ultimately disappoints, but rather provides support and makes a child receptive to every possible option."

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Parents often find it tough that they cannot resolve their child's emotional pain. Yet they can be of great help, says O'Malley. "They can comfort, talk to their child and sometimes move with them. The latter does not mean that parents should always give in to the child's desires. Sometimes conflicts occur and the child thinks x should happen while the parent thinks y is better. The parents' role is to protect their child as much as possible. Parents are focused on the long-term, while children often think of short-term happiness."

Puberty blockers

O'Malley points out that scientific evidence around the medical treatment of children with gender dysphoria is lacking. "Administering puberty blockers is experimental because it is not known whether a medical transition improves long-term well-being. There is growing evidence that it does not. Reason why Sweden, Finland, Norway, Denmark and the UK rolled back prescribing puberty blockers to children."

Either way, a child benefits from learning to cope with adversity and grief, even if there should be chronic gender dysphoria, says O'Malley. "Whatever choice it makes. A medical transition is incredibly difficult and places a heavy burden on the body. Parents then play an important role, but talk therapy or other coaching can also help. The ability to deal with problems is a gift for life.”

This article was translated by CNE.news and published by the Dutch daily Reformatorisch Dagblad on March 22, 2024