trans daughter / gender dysporia - how to support without affirming?

[whoshouldItalkto]

For the last year my 13-year-old daughter has been saying she is trans and has gender dysphoria. She says she does not feel her body and voice belong to her, and she should have a male physique.

I want to take a watchful waiting approach and do not want an affirmative approach or for her to socially or medically transition at this stage. However, her distress is real, and she needs support. There seems to be a real gap for this. I have read helpful advice from the Bayswater group and Transgender Trend, but there seem very few professionals that will work with a child without affirming - I was recommended one but they were £200 / hour and made it clear it was a long term commitment! She spoke to a non-specialist counsellor for a while but did not find it useful.

I keep the lines of communication open, talk to her, discuss things, try to build her confidence etc. but really feel she needs more. She's not particularly unhappy a lot of the time (has good friends, we have a good relationship, doing well at school etc.) but the gender dysphoria is definitely bubbling under and can cause her acute distress.

Has anyone got any other ideas of how I can support her, or could suggest a more affordable counselling option that would be suitable? Does anyone acknowledge and support gender dysphoria without the assumption that the treatment is transitioning?

Bump in case anyone out there has some ideas?

Does anyone acknowledge and support gender dysphoria without the assumption that the treatment is transitioning?

That's the problem for our youth isn't it? The current cultural climate is that feeling unhappy and uncomfortable with your changing adolescent self = transgender, and the solution is medical transitioning. There's no other option on the table for them unfortunately.

We're in a similar position with our 18yr old daughter, but luckily family money means that we can afford some therapy for her (not at £200 a pop!). She's due to start seeing a gender specialist but one who is not convinced that lifelong medicalisation is the answer, we'll have to wait and see how that works out.

I'm sorry that families are having to resort to private therapy, it's incredibly unfair. As well as it being fairly difficult to find help for youngsters who will take a more moderate approach.

But talking to my GP about this, he pointed me to Mermaids and other online gender services, which I consider unethical and I would hate to have to only rely on that advice to "help" my child.

Does your daughter have any other issues? One therapist I spoke to seemed very knowledgeable about gender dysphoria, body dissociation in relation to ASD for example. But again, that would have to be paid for privately unfortunately.

I'm sorry that I'm not able to offer any suggestions

Hi - thanks. I think she possibly is on the ASD spectrum, but if so is very high functioning and by no means "typical" - I know it's very different for girls, but even then she fits with a few of the symptoms but very much not for others. I agree I would need to get her assessed privately (which luckily we could afford to do - she wouldn't reach the threshold for CAMHS) but I'm not sure what benefit there would be? She's not going to suddenly think "aha - that's the problem!" Or will she? Would it be likely to make her look at these issues in a new light? As it is I am unconvinced that a diagnosis would be beneficial for her but is is certainly something we're considering.

I sympathise OP, it’s so difficult trying to get help in this situation.
oxalisRed I hope you don’t mind but I’ve sent you a pm.

@oxalisred - I wonder if you would mind passing on the details for the therapists you mention? They probably aren't in the same area but she would be quite happy to have online support, and it would be useful to see how they advertise their approaches. Thanks

General advice to a healthy approach is to try and steer away from naval gazing. Limit online activity and get into other hobbies. Sports, baking, board games, anything to give her something else to focus on and enjoy. She does not need all her time and headspace devoted to this. Just be breezy, let her talk, don't advise but do get involved in other activities.

Yes whoshouldItalkto the amount of different counsellors/counselling styles is a bit bewildering isn’t it? It’s difficult to know which ‘type’ to look for.

I reckon a proper psychodynamic therapist would be a decent shot if you can't use a specialist. They're cheaper and generally interested in the deep seated issues that fuel our 'neuroses' to borrow a Freudian term. I'm not able to guarantee their perspectives towards the issue in question but you could ask about their approach to therapy. As you are wanting exploratory, personality stuff, it could be helpful. This is no prescription, but i'd recommend finding a locally well trained and experienced therapist via a proper register, associated with a training programme if possible, for example via this register or one closer to your area wherever you live.

Thanks for those pointers NutellaElla

I work with a lady whose daughter had gender identity issues and found that it was mainly private providers who supported children and she just didn't have the money to pay for this.

She spoke to her daughters school who were able to arrange some support and counselling and this was really helpful - it might be worth talking to them to see what they can do to support you perhaps?

Thanks for the responses - the school would be very happy to affirm and have suggested all sorts of things such as going to a LGBT youth group run by an organisation with a strong Trans rights agenda (and that is also for ages 12-21, which seems pretty inappropriate in terms of age range!). Luckily everything went on hold due to COVID, but the school really won't be on side.

I am in the same position as you with my DD. School happy to affirm, counsellor arranged by GP also happy to affirm and has encouraged DD to exclude me from the counselling process. Desperately seeking a counsellor or psychotherapist who will explore the reasons behind this (very sudden) gender identity crisis. It's terrifying how eager the education and medical professionals seem to transition children.

whoshouldItalkto If you think she might be on the ASD spectrum it really can help to have an assessment and diagnosis. I work with adults with a range of differences but its certainly the case that some people on the autistic spectrum find it very helpful indeed to understand that about themselves. That's as least as much part of an autistic person's identity as gender, and "finding yourself" is one of the great tasks of adolescence! Where issues connected to unknowingly being on the spectrum are causing anxiety and stress it can certainly help, both psychologically and with access to strategies and a community, to have an ASD diagnosis if its the correct diagnosis.

@Carravacas and @whoshouldItalkto I've PM'd you both.

Thank you oxalisRed

Someone has mentioned it upthread, and I agree that this really needs a psychodynamic approach - not a surface level CBT esque approach.

Lisa Marciano is a Jungian Analyst and has written and spoken in some depth about the issues at stake.

Here is a selection:

www.feministcurrent.com/2017/06/22/lisa-marchiano-trouble-transing-kids/

She is particularly focussed on trans'ing girls

There's a group called Thoughtful Therapists, they have a twitter account, not sure if a website, but they are composed of experienced therapists from a range of perspectives who all are committed to working in ways which help clients explore broader reasons for gender dysphoria. Established by Lisa Marchiano, a growing group. Might be worth contacting them?

Just in case you were not aware OP, children under 16 can no longer be prescribed puberty blockers and over 16 need either parental consent or a court order so you do not have to agree to any treatment that you have concerns about should your dd get that far along the process.

Some science for you:

www.jaacap.org/article/S0890-8567%2816%2931941-4/fulltext

"Conclusion: These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety."

Thank you @Shizuku for joining a support thread for parents of trans-identifying children. What's the point of you posting a link to that report?

From your linked article:
Results
Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096). Parents similarly reported that their transgender children experienced more anxiety than children in the control groups (p = .002) and rated their transgender children as having equivalent levels of depression (p = .728).

I'm not able to pay to read the full report, perhaps you could précis it for us, to support us on this thread? Bear in mind that this report is from Nov 2016 and a lot has changed since then.

Just jumping on to say I feel your pain. Can't work out the quoting thing, but how to support our kids through, without assuming they should be transitioning. I cannot work out how it is kind to simply agree that there is something wrong with their bodies. Common sense and parental instinct is screaming out that we need to understand better why our kids feel this way. Surely the bubble will burst soon. Sorry no advice available.

@oxalisRed

Thank you *@Shizuku* for joining a support thread for parents of trans-identifying children. What's the point of you posting a link to that report?

From your linked article:
Results
Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096). Parents similarly reported that their transgender children experienced more anxiety than children in the control groups (p = .002) and rated their transgender children as having equivalent levels of depression (p = .728).

I'm not able to pay to read the full report, perhaps you could précis it for us, to support us on this thread? Bear in mind that this report is from Nov 2016 and a lot has changed since then.

The report finds that affirming a trans child's gender identity with social transition has beneficial effects on their mental health. This is relevant to a thread where someone has asked how to avoid allowing a trans child to socially transition.

Thanks to everyone, and particularly to oxalisRed for the PM.

In the interest of clarity, I'm pasting the summary Result and full Conclusion from your cited report Shizuku:

"Results
Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096). Parents similarly reported that their transgender children experienced more anxiety than children in the control groups (p = .002) and rated their transgender children as having equivalent levels of depression (p = .728).
Conclusion
These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems."

I understand the Conclusion to be saying there is a "striking contrast to previous work" which had found very high rates of depression and anxiety, whereas in this report "Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers".

So previous work suggested not socially transitioned children experienced high levels of depression and anxiety, but this report finds that there's no actual difference in depression against their peers.

So whether a child socially transitions or not makes no difference to their levels of depression.

But Shizuku says
"The report finds that affirming a trans child's gender identity with social transition has beneficial effects on their mental health"

Are we reading the same summary? Perhaps the full report does contain information contrary to their summary which supports your claim?

It is unethical to join a support thread with false information to what, guilt? parents into acting against their parental instincts and against what they believe is right for their child?

This is not a discussion sub forum, it is a support sub forum. The OP asked specifically for help, not a debate. On that note, this is my last interaction with that particular poster.

@whoshouldItalkto , @Carravacas and many others I would guess, we are all in similar positions with our children. The difficulties of navigating adolescence compounded with ideas that actively encourage them along a medical path, I imagine it's a difficult for you as of us for me, living on a knife edge of fear that our child will do something irreversible to themselves that will come to regret