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.

Lots of children ask to go by different names.

Often it correlates with some change in life like being put in care, father going to jail, mum and dad getting divorced etc or sometimes they just don’t like their name or get bullied for it.
And of course if they’re struggling with their gender.

As long as it’s not taking the mick then myself and colleagues are happy to call them by a different name.
I have many colleagues who also go by different names because they’re separated but not divorced etc.

This small act can make a massive difference to a young person and have absolutely no impact on us (apart from trying to remember it).

However, as her parent you can speak to them and say you are not happy with this.

We have dealt with parents who are very against this yet the child will self harm or try and end their own life over it.

So we ask that we compromise.

We say we’ll keep using the correct pronouns but ask the child to come up with a neutral name often a shortened version of their own name
eg Rebecca = Reby. Or Chloe = Cee Cee (not real students or names).

This can help the students as they’re allowed to be themselves at school but also let’s the parents feel more at ease.

However we cannot police what their friends call them.

No they don't.

Honestly if you've never had any experience of a) therapeutic intervention via CAMHS and b) an autism assessment via CAMHS, please don't advise.

You don't understand the process at all.

Aargh pressed post too soon:

I wanted to finish by saying that I'm sure all of us want to help the OP. And it's not helpful giving opinions which are not based on experience in a very delicate and difficult situation.

In our area it's now all cases of ASD or ADHD. My DS also has dyspraxia and epilepsy so happily we see a very sensible paediatrician for all of them. He still can't remember his name!

Areas vary. Some places do most ASD/dyslexia assessments through educational psychologist (funded by the council) rather than CAMHS (funded by the NHS).

ADHD can be screened for at school but then goes through the NHS because there is the option of meds and obvs and Ed Psych can neither prescribe nor monitor that (diagnosis via CAMHS and then they either stay there for the medication clinic or are discharged to community paed care for monitoring). The GP usually prescribes but under ‘shared cared’ so you need a named consultant.

these conditions often come in clusters so if you are already at CAMHS for one thing (eg ADHD) they might offer the ASD assessment there (this is often the route to ASD assessment for kids who are managing to hit or exceed minimum standards in school but struggle socially - school can’t justify allocating the assessment cost from their meagre budget so it gets deflected to the NHS. Basically it’s all about scrabbling for little pockets of funding and trying to get a kid in for assessment wherever you can… hopefully a sympathetic GP will refer when a school refuses

Which is why you really want all the records properly matching up because Christ knows you can’t give the SEN department at the council even a sliver of doubt or admin cock up if you want a kid diagnosed with SEN in their teen years to get an ECHP in place before they are 30.

EHCP goddamnit!

There are all kinds of "wishes" a young person might have that a therapist will not respect and will in fact challenge. That's the job of the therapist and in some cases affirming such wishes would be outright malpractice.

Even if the therapist thinks it might make sense here it should be discussed with the parents.

This is just an idiotic argument.

When my son was diagnosed the speech and language therapist and paediatrician who carried out the assessment had never met him before, and haven't seen him since. What is all this rubbish about 'therapist' and 'therapeutic relationship'? It isn't therapy!

When my friends daughter was diagnosed anorexic her psychologist didn't need to agree she was fat in order to establish a healthy helpful relationship - it would have been harmful to do so.

When my niece developed OCD her therapist did not agree there were germs everywhere and she should not leave the house. To do so would have harmed my niece.

OP I would ask why they are doing this and if they say because trans identity ask for evidence from clinical trials.

ASD is a medical diagnosis. It cannot be made by an educational psychologist nor a 'therapist'

Thanks to everyone for all these replies. I'm a bit overwhelmed by the huge amount of responses and have been working my way through them. I really appreciate everyone taking the time to reply.

We've decided to go ahead with the second appointment but I will question the use of the new trans name and pronouns. I will make sure DD's legal name is on any documents.

One of the things I was unsure about is how much the therapist would be involved in the autism assessment process (the clinician who sent me the email was the person who spoke to both of us in the initial assessment - she is a qualified therapist, she told me at the first appointment). As some PPs have pointed out, this isn't therapy, it's an autism assessment. I wasn't sure how much of this involves actual therapy and if we will be seeing the same clinician throughout the process. These are all questions I will ask in our next appointment.

Thanks so much for everyone's help with this - really appreciate all the replies.

DD13 assessment was done when she was 11 by a therapist and consultant in two parts over a few hours.

I went private because of everything said above.

She has ADHD and ASD.

If you can afford to go private, do it.

Therapists can’t but where I am the vast majority of autism assessments are carried out by Ed psychs (who are part of an MDT overseen by a clinician)

I’m definitely not saying that’s ideal but in a world of budget cuts and wait lists, you work with what you have.

@Clymene I’d love to know your extensive experience and related qualifications in mental health/ NDD to justify your statement of “get it wrong 90%of the time. I’d love if you would post your evidence.
Being a parent of a child attending a CAMHS service is not extensive experience and using one CAMHS service in the UK can not be used as an example for all others.
OP for what is worth in Scotland consent is granted at 14 so if your child wishes to be sen alone and deemed to have capacity then you would not be involved in any therapy sessions.
Parents need to be involved at some stage for developmental history for a NDD assessment whic of course is very different from therapy.
so much bullshit and CAMHS haters of MN which is a real shame although I accept that some families have very different experiences.
D
Of tour 14 year old has asked to be addressed as their chosen name then any professional will have to follow their lead. That in no way is assisting them with transition as has been suggested. In fact my own experience is that our CAMHS service have nothing to do with gender identity , this is provided by another service and accessed through GP referral.
Again my own experience is that CAMHS clinicians are very aware of the correlation between gender identity and ASD teena (girls in particular)
my own child went through this as well as identifying as being trans, we rode the storm out and now two years later she’s settled in her own chosen sexuality and gender from birth.
My experience as a parent with CAMHS has been excellent.

Children are deemed to have capacity at 12 not 14 in Scotland but parents still have parental rights regardless of how much the Scottish Government would wish they didn't.

Using a male name for a girl is very much part of social transitioning - which is NOT a neutral act.

My experience of CAMHS, as a parent, has been awful. I would advise private if you can afford it.

@giggly my experience has been 10 years of dealing with them. I'd like to say that my experience is peculiarly awful but my friends in other areas have had similar experiences. And that's the general experience of people in parenting autistic children support groups I'm in.

Obviously people usually talk more about their bad experiences than their good ones but I'd say your experience is pretty unusual.

I've had to lodge formal complaints against two members of staff. In my experience (which is what I said in my post) the service is not fit for purpose.

And I don't have any qualifications in mental health. I don't have to be a chef to know that the food in a restaurant is awful.

I'm quite concerned by your post suggesting you work at cahms?

I don't think your comment on suicide (suggesting failing to use preferred pronouns /name caused suicide in young people) was appropriate or accurate.

From the Samaritans: "Speculation about the ‘trigger’ or cause of a suicide can oversimplify the issue and should be avoided. Suicide is extremely complex and most of the time there is no single event or factor that leads someone to take their own life."

Run.

Your daughter isn't getting assessed. They've already decided what her issues are BEFORE the assessment is completed.

This is not OK. They haven't assessed her vulnerability and how if she is autistic this might affect how she is responding to social media.

They have already decided on how they will treat her BEFORE assessment. That's not good clinical practice and not ok.

I wouldn't trust them one bit to do what's in your daughter's interests. Rather than being of benefit to her as high functioning, this could end up being the problem rather than the solution.

Thank you for picking up this awful post by SunnyD44. The use of suicide as a tool to coerce parents is unethical and dangerous.

The simplistic post and suggestions suggests that the person is not a qualified professional in working with children and their comments should be safely ignored.

I’m sorry but when we complained to CAHMS, they eventually admitted that my DD had been seen on a few occasions by staff who were not trained to deal with her issues. I have a letter in which CAHMS apologised for this but blamed it on being short staffed!!

The use of suicide as a tool to coerce parents is unethical and dangerous

People should be utterly ashamed of this behaviour, it is repulsive.

OP I would be retreating from this person, I would not be comfortable with them taking affirmative steps like name changing at this stage.

This small act can make a massive difference to a young person

So which is it? A small act or a massive intervention that single-handedly stops a child Killing themselves? A child who, according to TRA wisdom, is both suicidal but also not suffering from mental illness and therefore has capacity to make profound decisions that would affect them for life?

and have absolutely no impact on us

This isn't true is it? When the rest of the world is required to lie to support your fantasy about yourself it has a huge impact on all of us.

Give them whatever title you wish, clinician/practitioner/therapist, they are still a professional who needs to be able to have an honest, respectful dialogue with OP's DD. This will be made a lot harder if he/she goes in and rides roughshod all over her request for her preferred name to be used.

I understand OP's concerns, I really do. But if using her preferred name means that she engages more honestly and openly with the assessment process, then so be it.

Why would using a made up name help a person engage more openly and honestly?

that’s nonsensical.

Lying to or about people isn't helping this situation.