This past Sunday, Dateline aired a report on transkids. If you are anything like me, you don't normally pay attention to Dateline, so you missed the report. So my job is to share the information it it.
The report focused on Josie Romero, 11, who has been living socially as a girl since she was 6. She is one of an estimated 10,000 children American children with significant gender identity concerns. The number of such children has seen a sharp increase in recent years. Children's Hospital in Boston used to see about 5 new cases a year, but since 2007, the average yearly number of new cases has risen to 20.
It is likely that the rise is due to the fact that there is more information available to both parent and children than there was formerly. It would not be surprising to see a corresponding reduction in the number of new cases of adults seeking treatment in the near future.
While the increase of children who may believe that they are transgender is newsworthy, the attention is pegged more to the medical issues associated with being transgender as opposed to what it is like simply being transgender. Indeed, the story of the transgender child has changed noticeably through the years. In the past, articles and television programs saw the very existence of transgender children as headlines. And if there were any in-depth reporting, it often focused on the social conflicts surrounding them - i.e., if this young boy is wearing a dress, how will he fit in with his family, on the playground, at church, or with the values of society?
But to more and more parents, doctors and mental health professionals these days, the problem of a boy wearing a dress -- and what other people think about that -- has become child's play by comparison. It's the internal conflicts raging in the heart, mind and body of transgender children and what their parents are willing to do medically to solve these problems that have become the more intriguing story of their already unique lives. The Dateline documentary report about 11-year-old Josie Romero and her mother, Venessia, which we began in the summer of 2010, is part of this new kind of reporting.
Dr. Norman Spack, an endocrinologist at Children's Hospital says that puberty is a traumatic experience for transkids, with "fairly significant psychological ramifications."
There is tremendous anxiety, often depression, sleep disorder and, potentially, self-harm and even suicidal behavior.
Spack's research has revealed that 20% of his patients have engaged in bodily harm and 10% had attempted suicide.
Reports from other sources have revealed:
- Thirty-five percent of transgender adolescents have attempted suicide, 5.5 times higher than reports of all adolescents surveyed in the 2009 Youth Risk Behavior Surveillance (source: Children's Hospital Los Angeles).
- Forty-five percent of transgender young people ages 15-21 had serious thoughts of killing themselves; 25% actually attempted suicide (The American Association of Suicidology).
- The prevalence of attempted suicide among the 515 transgender people interviewed was 32% (Journal of Homosexuality, 2009).
Attempting to combat these trends, sympathetic doctors have now trying puberty suppression drugs, called blockers. Their use is not new, having been developed for the use of delaying puberty in children with early onset. Surgery for transkids will not be available until they are 18, in most cases. But delaying puberty until the children are old enough to make decisions, in a totally reversible process, makes sense.
It's a richly complex narrative because the world of the transgender child is more time-sensitive than most. If the child truly wants to live as the opposite sex in adulthood -- with the most desired physical results possible -- then parents have to make medical decisions for their child at a time when many people would question a kid's ability to understand what he or she is asking for. But when people feel that the child may be old enough to make that kind of decision -- age 14? 16? 18? -- it may already be too late, and that's especially true for boys who want to be adult women. The child now has all the conspicuous physical attributes of the sex they don't want to be, and many of these features, such as height and voice, are irreversible without very costly and invasive surgery. Experts say that the mental health and overall happiness of transgender adults have a lot to do with their ability to pass visually for their desired sex. Not being able to pass could result in a lifetime of depression, or worse.