IN ALL THE POLITICAL and social battles over sex and gender, one thing is clear: Transgender kids have it rough. More than 80 percent of teens who think their gender doesn't match up with their genitals contemplate suicide.
Jenn Burleton, the director of Portland-based TransActive, the only transgender youth nonprofit in the country with actual office space, says suicide prevention means working with transgender kids long before they hit puberty. And that means LGBT groups need to get over the fear of being targeted for "recruiting children."
MERCURY: At what age do people actually know they're transgender?
JENN BURLETON: Parents have told us that as early as 18 months, when they would say things like, "Good girl," their kid would say, "Nooo, good boy." But the average age kids know their gender is about four, and the modal age for kids to recognize that the way they're experiencing their gender identity is different than the way everyone else thinks they are is about seven. All kids have a pretty strong sense of whether they're a boy or a girl or some mix of the two. If the way you experience your gender identity matches your birth-assigned gender, then there are no surprises for anybody and when you affirm that, no one says, "Whoa whoa whoa." But trans kids, what they express at that same time gets a lot of cultural pushback. Especially transfeminine kids. Tomboy is not a dirty word in our culture. Sissy is.
But a lot of kids play around with gender nonconformity—I have some great photos of male friends in princess dresses. How can parents be sure their kids are transgender?
There's a big difference between kids who are saying, "I like to do these things, I like to wear dresses or play with dolls," and kids who say, "No, I'm not a boy, I'm a girl." To an adult, that might sounds like the same thing. But it's important to listen and realize they're not just expressing their gender in a nonconforming way, they're experiencing it differently. This is not a whimsical thing for these kids at all. In an age group where kids are changing their minds about everything else, this is the thing that remains constant. While these kids are telling us that one day they want to be a Ninja Turtle and the next day they want to be a Power Ranger, what they're saying about gender isn't changing.
What steps can families take once they know their kid is transgender?
The cultural approach to trans care has always been reactive, rather than proactive. Now, the kids we work with have the chance to not go through puberty, [which develops] the secondary sex characteristics of the gender that doesn't match. Little trans girls don't have to grow up and develop deep voices and facial hair and all these things that really limit their ability to be accepted by their culture. Trans kids can take puberty blockers, which are completely reversible and have been being used for years to treat the condition called Central Precocious Puberty. It's perfectly safe, and it puts puberty on hold for a couple years so they don't get the negative effects. When trans kids go through these changes that they know aren't reversible, their suicide and depression rates just shoot through the roof.
What are puberty blockers, exactly?
There are a couple different forms. They're mostly injections or an implant which block the start of hormone production until they're old enough to move on to cross-sex hormones and surgery, assuming they desire those steps and can afford it. The major issue is that it's not covered by insurance—it costs $18,000 a year for the implant. The American Medical Association and American Academy of Pediatrics are all on board with this being the preferred course of treatment for kids who are trans.
That sounds like a scary leap for families. How do parents decide this is the right choice for their kids?
Eighty-three percent of transgender kids who don't get support and begin to go into puberty that doesn't match their gender ideate suicide. Forty-one percent attempt suicide. Doing nothing is not the same as doing nothing. Doing nothing actually leaves these kids in trouble. Statistically speaking, based on prevalence estimates, there are about 3,200 trans kids in the Portland metro area alone. We're currently working with 70 families. So we're short by about 3,100 kids