“I’ll call on the little boy in the back”: Advice from a Therapist
PITT is written and edited exclusively by parents with children that identify or have identified as “trans”. We were born of parent support groups and have pooled our efforts to bring our stories to others, in the hopes that we can help our children and other children that have been swept up in gender madness — and also so we can help other parents, like ourselves, as they delicately pick their way through the gender insanity maze.
In our secret support groups, we are constantly on the lookout for information about how we can best help our kids and each other. Maybe one of us has the secret map to escape the labyrinth, and if so, we want to spread that information far and wide. We are fortunate in that many dedicated people without a dog in the fight (or a child, in our case) have been stepping up behind the scenes to lend their insights and expertise to parents.
The following essay is advice from a therapist. It’s an important reminder that therapists and medical professionals are not necessarily the enemy, even if it feels like that at times, especially to those of us that have experienced the dreaded “affirmative approach” from our healthcare professionals and therapists. There are “good” and “bad” actors in every field, and they are just people like us. Many are trapped by the cultural and regulatory environment that we exist in today, the same as parents are. We are choosing to present this article in the spirit of passing on valuable information from someone in the field who is in a position to help parents.
“I’ll call on the little boy in the back”
I raised my hand to my ear where a petite diamond stud was barely visible. The substitute teacher in my fourth grade class realized her mistake- I am almost certain one of the other children said something to her- and quickly corrected herself. “I mean, the little girl.”
I smiled, demurely, and answered her question.
I was not embarrassed; I was flattered.
In today’s cultural terms, I would have “passed”.
In today’s trans culture, it would have been a badge of honor.
And I did feel honored. I had always wanted to be a boy but had settled for “tomboy” since that was the cultural language of the 90s.
It never once occurred to me that my body parts don’t fit my “gender identity” because no one told me so.
The concept of “trans” was most exclusively for adults at the time, no one tried to address my clothing, hair, and play preferences. Sure, I was teased, but I saw that type of conflict as a role in my peer group that I didn’t mind fulfilling. Just being part of my peer group meant something to me, even if that role was that of “different”.
Let me remind you what life was back then.
This was the decade when the internet was becoming more accessible, but not like it is today. I could use the dial up school computer on computer lab day, or I could make sure the phone line at home was free to use our family computer that was visible to everyone. Google was just launching that decade, and this novel search engine had to prove itself before we’d all make the switch from Ask Jeeves. During the 90’s, reality TV was also incredibly new and mostly consisted of college kids attempting fame. Seatbelt laws were also new in the wake of Princess Diana’s death- yes, it wasn’t that long ago that we were allowed to ride in a car without a seatbelt. Glitter parents were getting nervous with the Jon Benet Ramsey case shedding light on the abuses of forcing children into the limelight. Essentially, I didn’t have the luxury of researching on my own about anything regarding my body, and there were no catchphrases or buzzwords to stick in my mind since the same news was the same with everyone.
Looking back on my own experience, I see a very lonely 9 year old girl who had undiagnosed ADHD. I see her observing the male-complex dynamic of her own mother and how she wanted to be just as adored and admired as her brother and the older men in her life. I also see the unhealthy dynamics in her family due to codependency with a father who has a substance abuse disorder. And while I want to go there and be with her and tell her that her worth is not tied to how she identifies, I know I don’t have to. I am just grateful that the supportive adults in my life were helping me succeed in school and navigate social situations. I am grateful for the mantras of the time that being a girl didn’t mean anything about you and for the old adage to “not judge a book by its cover”. I am grateful for the message I got that I could accomplish anything if I am willing to learn, be curious, and set goals to work toward it.
Now, I am a clinical social worker living in a liberal state. I work with women and adolescents and primarily treat anxiety and ADHD that manifests in self-harm and suicidal ideation.
In my practice, I will tell you what I see— I see sick, scared, and confused children who are being told they are victims of society. I see children who have seen internet pornography that no person should ever have to see because it causes “secondary trauma”. I see children who have been the recipients of abuse of all kinds. I see young adults who have developed personality disorders like Borderline Personality Disorder because of unhealthy thinking patterns or untreated bipolar disorder that has gone haywire. I see them being told that to feel comfortable, they have to change their innate, biological self instead of being educated on the neuroplasticity of the brain and our own ability to change our own worldview if we so choose. I see them being told that adults are the enemy unless those adults are “progressive”. I see them being indirectly told to use self-harm and suicidal ideation as ways to compel others into “seeing” them. I see them viewing completely different “news” than their parents or other adults because they are all spending time on different news modalities.
From a clinical social worker perspective, I will tell you what isn’t fair: Not one of my professors trained me in “affirmative therapy” because it isn’t an empirically supported type of therapy, and YET I am in a constant state of eggshell walking with my trans identified clients due to this expectation. I am expected to diagnose children and teens with ADHD, anxiety, and depression (among many other adolescent specific disorders) after having parents and other adults fill out the assessments—but if a teen tells me they suffer from gender dysphoria, I could lose my license for asking the parents what they observe about their child, or asking what THEY think their child needs. I see parents very carefully hand their child into my care and pay for that care, all while knowing that I will not be allowed to discuss their child’s sessions with them. I admire their bravery and do not take that amount of trust lightly.
I do use the requested pronouns (or at least try to avoid using pronouns entirely if I don’t have to use them) with my trans identified clients. This isn’t because of affirmative therapy, it’s because I am supposed to build rapport with a teen, and nothing drives them away faster than if they can put me in a box with their parents. This is mostly to show that I am not a threat to them and there to help them feel better. However, when a teen client brings up their “goals” for transitioning, I am honest with them about my limits. I tell them that I am not an expert in the trans culture (I am always sure to use the words “culture” and “philosophy” when talking about gender identity), but that I am trained in CBT and DBT and would like to help them with their bigger goals of feeling better emotionally and socially. Every time that I’ve had this discussion with a teen client it has gone well.
I’ve also observed other therapists who seem to care only about “progressiveness” without even taking a beat to discern what the long term effects of new strategies could be. I see them claiming to specialize in gender identity even though they’ve received no training to treat it. I have seen therapists who fall in line with the Drama Triangle as rescuer all the while solidifying the teen as victim and parent as persecutor.
However, I have also seen other therapists, like me, who view gender identity confusion for what it is—a symptom of something much deeper going on. They are there and they can help. Here is what to ask if you are looking for a therapist for your child:
Do you use affirmative therapy, and why?
What is your philosophy as a therapist?
What types of therapy do you use to treat teens?
If I check in with you about my child, are you willing to talk to me or help me brainstorm ideas to help them?
Do you offer groups or other supportive options for my teen outside of their sessions?
If I were to give any sort of advice to any parent who has a child who has adopted the trans philosophy, I would say the following:
First, consider family therapy. The family therapist will focus on strengthening the bond between you and your child, and yes, he or she may even give you some advice on parenting which you are free to take or not. Research shows that kids who are not as impressionable to peer influence have strong bonds with their parents and are not indoctrinated through social media use. The purpose of this is to train your child to feel more attached to YOU than to ideologies and to help you find ways to invest in the emotional bank account between you and your child.
Second, look for a dialectical behavior therapy group. DBT was designed to help people who suffer from Borderline Personality Disorder (which one of the symptoms manifests in identity confusion) adopt more dialectical thinking. The exercises give the participants a more open mindset to the feedback of others, particularly parents and teachers.
Ultimately, you are the greatest expert on your child. My hope is that more and more of the social work and mental health community will revert back to empowering families and focusing more on strengthening the child through this powerful resource.
Thank you for being here and for your stories, every one of them.