CAHMs therapist using trans name for DD

[kinfauns]

My 14 yr old DD is undergoing assessment for autism with CAHMs. We had our first appointment recently. My DD has recently told me she believes she is trans. I am aware that many children with autism identify as trans. My child has very black and white thinking - her reasoning is that she feels she doesn't fit in with the girls, therefore she must be a boy. I am GC and have been gently trying to explain that just because she doesn't conform to gender stereotypes, doesn't mean she is a boy.

The assessment consisted of a conversation (10 mins) with both of us together, then the therapist had a separate conversation with DD followed by a separate conversation with me. Following the conversation with DD, the therapist then referred to her by her trans name and pronouns in her conversation with me. I was not happy with this and said so at the time (my DD was not in the room).

We are now at the next stage of the assessment - filling in forms and a follow-up appointment - and the email I have been sent refers to DD by her new trans name and pronouns.

I really want to continue with the assessment - I believe my DD has high-functioning autism and a diagnosis would be useful to her now and later in life. However, I am very wary of the instant affirmation of her new identity. Has anyone else experienced this? Should I carry on with the assessment? We looked at going private but it is horrendously expensive.

Run!!
CAHMS made our situation a whole lot worse

I would cross it out and write her actual name if possible.

and then tell the staff that you want her name on the CAMHS paperwork to match her school paperwork and for both to match her NHS paperwork because your daughter is potentially going to need any diagnostic paperwork to in future scenarios (eg applying for PIP as an adult) and even if your daughter were to legally change her name at 16 it makes no sense for half her 2022 paperwork to be in one name and half in another.

hit them with admin arguments and if they push back point out that a nickname isn’t a legal name and they can use the nickname verbally if they must.

It’s your parental responsibility to name your child and no one has the right to change that name but you (until 16 when the child can legally call themselves dumb shit like Axel RoseMotherf**ker and you can’t stop it 😬)

www.gov.uk/parental-rights-responsibilities

Thanks for the replies.

@Littlemissprosecco would you mind telling me your experience of CAHMs?

@TheClogLady thanks, those are good ideas.

I'm so torn between wanting her to be assessed and not wanting affirmation from a medical professional on the whole trans thing.

TheClogLady beat me to it. Its a safeguarding failure as well.

This.

But…

You want your dd to feel comfortable with the therapist. Otherwise she won’t properly engage or relax with the assessments. It was interesting that the therapist began to use the new name after speaking with your dd alone - so your dd has obviously made it clear that the new name is how they want to be referred to.

I do understand the difficulties of autism - my son has autism and attends an autism specific specialist school, but at the end of the day you want your dd to feel happy and comfortable at these assessments etc so I would be careful not to make a huge deal out of it - also just incase it isn’t a temporary thing or anything related to autism and actually maybe your dd IS wanting to change / be called that name.

Or alternatively do this ^

if you can afford a private diagnosis you will likely find they are a lot more willing to write the correct name on the bill, seeing as they need you to write their name on a cheque.

(I realise that’s a big financial stretch for most of us, so feel free to ignore if unrealistic)

@Afterfire yes, a friend said the same thing to me - that it might be to build trust with DD. But I need to trust the therapist too!

@Thelnebriati this is what I worry about - how can I trust the therapist not to encourage DD on the path to transitioning?

Thanks all for the replies.

Lots of people think they're bi, gay, straight, trans, non-binary at 14. What people decide as adults is often different.

There's nothing like telling a teenager they can't do something to strengthen their determination.

The therapist has to build a relationship with your daughter that your daughter wants to continue. A pretty fundamental part of that will be respecting what your daughter wants to be called, regardless of what that is.

I'd also bear in mind that your child has to have a relationship with you now. You are currently laying the ground for any potential relationship at 18 when your child will be able to choose whether it's one they want to maintain.

My own mother made the mistake of believing my sibling would continue a relationship with her regardless of her attitude to their gender identity - they didn't.

You want your dd to feel comfortable with the therapist. Otherwise she won’t properly engage or relax with the assessments

I agree with this. If your child's time with the therapist ends up being a battle about names or pronouns it will be a waste of time.

And this a million times!
There's nothing like telling a teenager they can't do something to strengthen their determination.

Try to remember being a teenager and how you reacted to your parents laying down the law.

The Gender from a Wider Lens podcast on YouTube has some great episodes for parents around maintaining relationship/gender identity and autism/therapy for gender questioning teens etc.
You might find some helpful and relevent insights in there?
Their interview with the detransitioner - Helena- and what she thinks teens need from their parents during potential transition is very insightful.

www.bayswatersupport.org.uk/about_us/

'Social transition – this may not be thought of as an intervention or treatment, because it is not something that happens within health services. However, it is important to view it as an active intervention because it may have significant effects on the child or young person in terms of their psychological functioning.64,65 There are different views on the benefits versus the harms of early social transition. Whatever position one takes, it is important to acknowledge that it is not a neutral act, and better information is needed about outcomes.'

cass.independent-review.uk/publications/interim-report/

genspect.org/

It was honestly a nightmare, barely saw the the same person twice. Self harming worsened, even under crisis care. My DD was just given worksheets on ‘feelings’ and how to manage them. I don’t know much of what was said in the sessions as I wasn’t allowed in. But I was expected to provide any support she needed ( but they wouldn’t say what was needed as that confidentiality!) when she didn’t improve it was due to lack of family support!!
in the end we went private, I was present for all sessions and slowly we started to unravel what was going on. She’s 20 now, lovely and thanks us so much for getting her out of CAHMS and got guiding her through the ‘sludge’ of her life

Using the wrong pronouns and a new name for a child is not a neutral act - it is affirmative and pushes them down the path towards transition. It is absolutely appalling that the person you saw (what were their qualifications incidentally?) socially transitioned your child without your approval.

www.transgendertrend.com/teenager-says-theyre-transgender/

There are also resources and a report on children - particularly girls - with autism identifying as transgender www.transgendertrend.com/autism-gender-identity-introduction/ which you might find useful

The therapist has to build a relationship with your daughter that your daughter wants to continue. A pretty fundamental part of that will be respecting what your daughter wants to be called, regardless of what that is.

There is a difference between that and putting her nickname and incorrect pronouns on official paperwork.

If it were me, OP, I think I'd speak to them about why are they socially transitioning your daughter without this being part of an agreed treatment plan (or even a diagnosis). If the answers you get are not constructive I would not engage with them- a therapist with an agenda is a terrible idea.

That said, I think you should accept the name change (as a nickname) as a way to show you support her.

I would not go back to that person under any circumstances.

Here is the link to part 2 (advice for parents)
Might be worth listening to part one first though as I think it goes into what happened between Helena and her mum. Part two goes into what advice she would give to parents based on her experience. She is very wise.
Lots of other great written links given above, but just in case personal anecdote and audio are helpful to you too:

Put yourself in the therapist's shoes.

If your child says they want to be referred to by a certain name, then of course the therapist is going to respect that. It's a very basic level of respect to call someone what they ask you to call them. Your child is the therapist's client, not you.

Sure, you may be able to find a private therapist who would call them something else, but I have serious doubts that they would be of any help to your child. They would struggle to form even a basic therapeutic relationship.

This is so concerning but not surprising from Camhs .

I agree would go private if you can

I'm so torn between wanting her to be assessed and not wanting affirmation from a medical professional on the whole trans thing

How would you propose your child be 'assessed' if the therapist does now accept the way they are currenlty presenting?

Any assessment of this type is going to involve a pretty emotional and deep level of questioning.

If your child going to open up to that when the starting point is that the therapist doesn't accept them?

What type of "assessment" do you think could be done in this circumstant where your child's basic wishes aren't respected? The walls and barriers are going to go straight up and you will get nowhere.

*does not (sorry typo)

Also, plenty of women have boy names as nicknames (or even legal names) whilst still being boring, old fashioned vagina-women (see Lionel Shriver or Stevie Nicks for starters!) so it’s entirely possible to find a middle ground of a new chosen name and same old pronouns, or you could opt to use a non-gendered childhood nickname, or the child’s initials, or a nickname based on a short form of the girl name, or the boy version of the girl name (if one exists).

That way you can demonstrate that you are listening to the child without completely buying into the child’s rejection of the self.

it’s really not the black and white situation some protransing-of-adolescents transadvocates would have you believe.

but hold your ground re: always having the legal name on the paperwork (and scribble a ‘preferred nickname’ in a notes box if necessary.

A lot of the kids trying on these identities don’t actually want 100% immediate buy -in from all the adults in their lives, they want to find a bit of resistance, even a boundary. My child was using a boy name in her friendship group and a teacher found out and went straight into Allsorts-ToolKit-Mermaid-Training mode and my daughter was beyond horrified that name change snowball had been pushed down the hill and was gathering speed. She was relieved when we put a pause on it (and hates that one particular name now anyway, it’s too ‘stereotypical transman’ apparently!)

Can you ask (demand) another CAMHS psychologist if the strategy of objecting on admin grounds doesn't work?

I don't believe autism assessments are necessarily as emotional as others are painting, and I don't think called your daughter a male name is necessary to make a diagnosis.

My daughter had high functioning autism and I have been professionally involved in ASD assessments in younger children.

Good luck,

Any assessment of this type is going to involve a pretty emotional and deep level of questioning.

ASD assessment is mostly puzzles and observation, actually. Plus taking a detailed clinical history from a parent and possibly a report from the teacher.
It’s nothing like psychotherapy or counselling.

www.childrensresourcegroup.com/a-brief-overview-of-the-ados-2-an-assessment-for-autism-spectrum-disorder/