Treatment of transgender youngsters: Case Study 1

A mother and father have prepared separate accounts of the atypical gender identity development that their twelve-year-old child has experienced.

The Mother’s Story

I moved from my birthplace in Yorkshire, to the South of England when I was 16 years old. At 20 I met my future husband. I was living in Sussex, working as a salesperson for an office equipment company. He was a leasing salesman. We started going out together about a year later when I was 21 and he was 25. We moved in together after about a year, and bought a house a year later. When I was 24 I fell pregnant, with our first child. I continued to work until around 34 weeks pregnant.

The pregnancy was completely normal, with minimal sickness up until 12 weeks. The baby was 11 days overdue when I was taken into hospital to be induced. The baby was delivered by forceps and weighed 8lbs 2oz. The birth was difficult, and I remember being completely exhausted. I had to have quite a lot of stitches. I found the first few days after the birth very hard as I was in a lot of pain, but after that settled down everything became so much easier.

Although the baby was announced to be a boy at birth, I now always refer to her as a female. I breastfed until she was 14 weeks then stopped after repeated bouts of mastitis. The baby thrived and was completely normal in all respects of development. She suffered the normal childhood problems of coughs and colds and ear infections. At 18 months she got an infection in her leg that involved a hospital visit as she had febrile convulsions due to a high temperature, but IV antibiotics cleared that up and she had no further convulsions due to illness after that.

I went back to work part-time when the baby was 7 months old, and she was looked after by a childminder in our home. When she was around a year old we moved to live near my husband’s family. Until our child was nearly 2 years old there were no indications that she was anything other than a perfectly normal little boy. She had always shown a preference for her older cousin, who is 6 years older than her, but she also played happily with her other cousin, a boy who is 4 years older.

Our child started raiding my wardrobe and wearing my skirts and dresses whenever an opportunity presented itself. She seemed fascinated by my clothes and often wanted to play dress up. I didn’t see anything wrong with this and considered her to be exploring. When it came to making a list of toys for Christmas the year that she was 2, she asked for My Little Pony and a Barbie doll. My husband felt this wasn’t appropriate, but I insisted that we got a range of toys for girls and boys. She showed no interest in the cars, Lego and the action hero toys she got.

Her new childminder, following our house move, told me that she was gravitating to the girl toys she had at her house and showed no interest in the boy stuff. When she played dressing up she wanted the fairy wings and the ballet shoes. My childminder had a large selection of dressing up gear, and merely thought it was cute that our child preferred the girl stuff. She started nursery when she was 2 and a half, and within the first few weeks the staff told me that she was not interested in the boys’ toys or dressing up clothes, but was heading straight for the little black dress and the pinafore as soon as the doors were opened. I suggested that they simply let her get on with it, and they agreed not to say anything to her that would make her feel self-conscious.

Over the next couple of years her preference for girl friends, girl toys and girl clothes became more obvious. My husband found this very difficult to cope with and when our child was nearly 4 years old, and stated to me that he should have been a girl, my husband decided that we had to try and stop this growing obsession. He blamed me for this wanting to be a girl; he said that because I allowed girl toys that I was making our child want to be a girl. My husband told both sides of the family that our child was not allowed any more girl toys, and that nobody was to buy anything feminine or girlie for her birthday or Christmas.

At around this point I also asked my GP if she had ever come across anything like this before. She said that she hadn’t, not to this degree, but that she would look into it, and that children often experimented with cross gender role playing, and that I shouldn’t worry about this at the moment.

My husband maintained a ban on girl things for around 8 months from just before our child was 4. During this time our second child was born, when our first child was 4 years and 2 months old. Our first child also started school that year. I called a halt to the ban when I realised that far from making our first child want to be a boy, it was making her feel depressed and anxious. She recognised that her father had issues with this, so tried to hide the way she felt from him whilst seeking support from me. I felt this was wrong, and tried to persuade my husband that this was not the way to handle it.

Unfortunately, he could not accept our first child’s preferences. If he caught her wearing girl clothes he would shout and tell her to get them off and to stop being ridiculous. This was a major bone of contention between us and, if I tried to defend her, I was accused of making her a girl.

Our second child was a healthy 9lb 3oz, and I was only in hospital for one night. Our first child was delighted to have a brother, although she did tell me she wanted a sister. I was very aware of trying to make sure that she didn’t feel left out, and although we had some minor problems with jealousy, she was never hostile towards her brother in any way. She was more worried that having a new baby would mean we didn’t love her as much. We reassured her, of course.

Our first child started school around a month after her brother was born. She liked school, but gravitated towards the girls for making friends. When she was in reception she decided one day to leave school and walk home as she felt that she wanted to be with me. She managed to get out of the grounds and was returned by an elderly couple that found her walking home.

The staff at school told me that she seemed isolated from the other children, and anxious to be accepted. She told a couple of the girls that were closest to her that she wanted to be a girl, which they found odd and therefore called her names. I told the school that this was a longstanding issue, and they supported her as best they could. They didn’t understand and, to be perfectly honest, at that point neither did I. I encouraged her to accept that she was a boy, whilst stating that liking girl stuff was fine.

However, she said that she was very cross with God for giving her boy bits when she was really a girl. That Christmas, even though she wasn’t allowed girl toys, I knew she was fascinated with mermaids, so I wrapped a sheet around her legs in the shape of a tail. She wouldn’t move for nearly an hour and a half. She regularly wrapped a towel around her head to simulate having long hair.

Her new brother was a very easy and straightforward baby, and she settled down into school. Her need to be a girl never wavered. Examples of this cropped up several times during her first year at school. When she was invited to a friend’s house for tea one time, the mother was very embarrassed when I went to pick her up as she was dressed in a bright pink fairy outfit, complete with wings and wand. I had to reassure the other Mum that this was fine. Our child had begged to be allowed to wear this outfit, and the Mum didn’t feel able to refuse.

Our marriage was suffering by this point, not because of our first child, but due to other issues. However, this was all put on hold when I discovered that I was pregnant again. Our first child was 5, and the second wasn’t even a year old when we found out I was expecting twins. At one point, when our first child was 6 years old, she asked me if she could have the operation to get rid of her boy bits. She stated that she really needed to be a girl, and that she knew she could get her willy chopped off. I started to research gender dysphoria at this stage, because I had begun to accept that this was not going away. In fact, as time went on, she became more upset at the reality of living in a boy’s body whilst she felt like a girl.

It became apparent from early in the pregnancy that there were issues with the babies due to twin-to-twin transfusion. I was monitored carefully for the duration of the pregnancy, and when I was just over 6 months pregnant I went into premature labour. In preparation for the arrival of two babies we had employed a nanny to look after the children so I would have some help at home when they were born.

Thankfully, she had already started work so was able to look after our first two children whilst I was in hospital. Although my husband brought the children in to visit I was away from home for over 3 weeks, which they both found extremely difficult. His family helped out during this period, but it didn’t alleviate our older children’s anxiety.

Both older children became extremely clingy and were afraid to let me out of their sight when I got home. The twins were born at 29 weeks, and were only 2lbs each. One had heart problems and wasn’t expected to live. However they both recovered from the effects of such a premature birth and by 7 weeks old they were 4lbs each and I was able to bring them home. Both twins were remarkably settled babies.

Our first two children were very protective of their younger brothers, perhaps because they were so small and fragile when they came home. Also, because I had a full time nanny, and I only worked part time, I managed to make time for all my kids. Unfortunately, my marriage didn’t fare so well, and we separated in August 2000, when our first child was just 7 years old.

I was isolated from my husband’s family as they had to try support him through this period, and money was extremely tight. Eventually I decided that my best way forward was to move back to Yorkshire where I would have the support of my family, and with the equity from the house in the South I would have a better chance of finding a house big enough for my family. My mum lived on her own in a council flat, and she had already offered to look after the kids for me when I was working so that I wouldn’t have to pay a childminder.

During this period, before I moved North, I took our first child back to my GP as my husband was adamant that I should not be allowing her any freedom of expression regarding her feelings of wanting to be a girl. When we split I had bought girl clothes for her to wear at home. I told her that, if it made her happy, it made me happy, but I also explained that she may change her mind about wanting to be a girl so we had best keep it indoors for now. She accepted this, and was, frankly, ecstatic at the opportunity to express herself in a safe environment.

I had researched extensively, and asked my GP to refer me to the Portman Clinic in London as I knew they were the experts in dealing with children with gender dysphoria. I was referred to the local Mental Health Team, and met with a pychiatrist who had worked with the consultant child and adolescent psychiatrist from the Portman for 18 months.

The local psychiatrist diagnosed our first child with gender dysphoria, and referred her to the Portman Clinic. He also told me that allowing her to dress in girl clothes at home was fine, and that allowing her some freedom was supportive, and would help restore her feelings of self-esteem. He said that she needed to know that I loved her and always would, regardless of her gender. I was in tears by the end of the session, as although I knew that I was doing the best thing, it was heartening to hear it from a professional in view of the disapproval and censure I was enduring from others.

We managed to get to the Portman Clinic for 4 visits before we moved to North. In August 2001 I moved up to Yorkshire. It was a difficult move for all of us. I was leaving behind friends I had made, and our first child was doing the same. The younger boys were more insulated from this as they had not started school or nursery.

Our first child started school at primary school in Yorkshire in September 2001. She started with her boy’s name and went into school in boy uniform. She was very unhappy. She missed her Dad, she was having to cope with a new environment, and a whole new school. She was also becoming more adamant that she needed to be allowed to be a girl all the time. She was devastated every time she had to have a haircut.

When we moved to Yorkshire I had visited my GP and asked for help and support in dealing with our first child’s gender dysphoria. I was referred to the local CAMS team, and met with a psychologist, who was lead caseworker for our child. As this psychologist was not familiar with gender dysphoria she contacted the Portman Clinic for help with managing our child’s difficulties.

In the second term at school her teachers called me in to discuss the fact that our fist child was telling the other children that she had a girl brain in a boy body. She sent emails to other children during an IT lesson telling the other kids she was really a girl. The school asked me to stop her doing this. I told them I couldn’t, that although she had agreed to be a girl indoors only, this was obviously becoming too much.

Over the next year she grew her hair and began to wear more feminine clothes to school. She endured a lot of bullying and teasing, and we went though a period when she had lots of tummy aches and sickness due to anxiety. She was very reliant upon being close to me and feeling safe at home. Eventually things calmed down and, in the last year of junior school, she was settled.

In September 2004, our first child started senior school. She started school looking like a girl in all aspects. The situation quickly became extremely difficult. The word got around that a ‘trannie’ had started school, and she was subject to teasing, taunts and physical bullying. With help from the Portman Clinic and the local psychologist we tried our best to help our first child deal with this, but she became depressed and isolated, and I pulled her out of school in January 2005 after she took 2 overdoses of paracetomol to escape the situation.

During this period I also had an incident were she complained of extreme pain in her testes. I took her to hospital and they kept her in, and eventually did an exploratory op on her left testicle. During the consultation with the surgeon prior to the operation she asked him to remove her male genitals and make her a girl whilst he was there. We discussed at length that this was not possible, and that surgery would not be an option until she was much older.

The operation found no problem with the testes, the pain this has not recurred. Following 3 months of home schooling she agreed to try school again, and over the last 6 months has progressed to the point where she is once more in full time school. One of the things that contributed to her confidence was the fact that she entered into a talent contest for the whole of her year, and came 2nd. She has a lovely singing voice, which she is very proud of.

She has been incredibly brave, and due to persistence and determination she has managed to overcome the hurdles placed in front of her. The school has changed her name to her girl’s name on the register, and the teachers address her by female pronouns. She has a group of girlfriends who have known her from junior school and support her, and she has settled back into school. The other children in her year accept her as she is, and the older years appear to have forgotten about her and moved on. There have been a few incidents of name calling or whispering behind her back, but she has been much more confident in dealing with these issues without resorting to running away from school or self harming.

At home, her brothers are now calling her by her female name. There is a normal amount of sibling rivalry between them all, and she often acts as self-imposed boss to the younger children, but this is all completely normal. I take the children down to London once a month to see their Dad, and he comes up on occasion between these visits. He has accepted that our first child is not, and never will be, a typical boy. He has come to terms with the fact that she needs to be a woman, and that to allow her to endure a male puberty would not be in her best interests.

Our first child has never wavered from her conviction that she should be a girl. She accepts that she has a male body, but she hates it. Over the last 8 months she has been suffering from spontaneous erections. She finds these extremely distressing. During these erections she has been scratching the back of her neck as a way of distracting herself from the feeling.

She told me over the summer holidays this year that she wants to cut her penis off as she finds it so disgusting. I explained that, if she still feels this way when she is older, she will need her penis for constructing her female genitalia. She and I have discussed the fact that if she has blockers before she experiences a full male puberty that she will not be able to produce sperm, and therefore have her own children. She is adamant that facing puberty and living with the changes, such as a beard, Adams apple, and losing her voice, would be far worse. She has said there would be no way she could live like that, and is terrified of these changes occurring.

I do not believe that early treatment will mean that she will live a problem and pain free life. However, now that she is in the beginning stages of puberty I believe that the Dutch approach to treatment by blocking at Tanner Stage 2 is appropriate for my child. I do not believe that making her endure puberty to give her experience of living in the male body will do anything other than push her into depression and anxiety, culminating in self harm, probably suicide.

The Father’s Story

I recall the birth being very difficult. It was very exhausting for my wife and she had to have a lot of stitches. As I recall, the baby was absolutely fine once delivered. But there was some anxiety over the effort and the later stages of the delivery. But the infant was okay and I was absolutely thrilled to have a bouncing baby boy. I guess that initial feeling is part of why accepting the gender issue was so difficult for me. I think as a parent the first-born has a very special impact.

Well, naturally we all went home within a day or so, and we adjusted and settled into parenthood.

It was probably as soon as my child could display preference that my wife started to see a preference for girlie toys over boy toys. This would have been when visiting friends and families houses. I have one niece who, at the time when our baby was 18 months, was about 6/7 years old and very much a girlie little girl with dolls and cuddly toys and pink everything. Our youngster very much latched on to her and her toys, especially dollies. My wife started to buy Barbies for our child, which I was strongly opposed to. I felt it was a phase and that my wife was pandering to it. I knew my wife had wanted a little girl and felt she was just wrong to allow this behaviour to continue. Obviously in hindsight I can see my stance was wrong.

I found the whole situation very difficult. I hated seeing my son dressing up in girls’ clothes and playing with girls’ toys and never wanting to play with a ball or anything more masculine based. But mostly it was the dressing up I loathed. And I used to get very angry about it &ndask; with both my wife, and with the child who was always getting his mother’s clothes out of draws and cupboards and trying to put them on. I wish I had been able to accept then what I have accepted now. Trouble being I was not prepared to accept I had a daughter, and not a son. I didn’t appreciate that mother nature could screw up so royally.

I was lucky enough to have very flexible working hours and was able most days to drop off and collect our child from the minders, and later on nursery and school. I recall being very fed up when child was in the dressing up clothes of the childminder’s daughters. I was never accepting but got to a point that I just tried to ignore it as best as possible. Bottling up for periods and then losing my rag at some point eventually.

This was a very common theme. When we changed childminders again our child went straight for the daughter’s dressing up clothes and even at nursery followed the same pattern. Whenever we went anywhere, our child was the same. It was girlie everything. At both childminders and obviously nursery there were boy influences, boy toys, and games but never did our child take to anything but the girl stuff. Despite what must have been terrible ridicule, this behaviour never wavered.

I think primary school was very difficult. Our child was with a much bigger mix of kids and age range, and whilst most of the classmates accepted things there were one or two who didn’t and there was a whole school beyond the classroom as well. Despite all this pressure our child advertised himself as a herself and would not keep it secret. This added to the pressure exerted and a few times it got too much for her.

On a couple of occasions she ran away from school, and we are quite lucky I feel that she didn’t have an accident or worse. At this point I was still very un-accepting of the situation, and hated the fact she was getting bullied and in my opinion bringing it on herself. I didn’t accept that she just couldn’t be any different. That she just couldn’t fight her natural instinct. I felt very at odds. On one hand I was as against the behaviour as were the kids and people judging her, but on the other hand I felt I was unable to protect her from being bullied. It’s a very tough life being different. And this gender issue is probably the most difficult “being different” there is.

On top of all this our child then had to endure the breakdown of our marriage and the subsequent divorce, and the move to another city. I sometimes think it’s a wonder she has been able to cope at all. But she does, and with great determination. Having said that she has no choice. She is who she is and has the courage to be herself. And we will do everything we can to help her be comfortable and happy.

Bullying incidents – a very small example of the abuse that our child has endured at school

In class and older boy came to the door and shouted out to the class ‘oy, kids, there’s a trannie in here isn’t there, where is it’. The other children didn’t respond, but our child was humiliated and ashamed.

Our child was sat at lunch with a friend and another girl walked up and said to her friend ‘what are you doing sitting with that freak?’ Her friend told the girl to get lost.

An older girl, Donna, repeatedly called our child a he-she, or freak, including one time directly in front of a teacher who was escorting our child to lessons as the abuse was so constant that she was afraid to be in the corridors alone.

Several boys shouted out to her as she was waiting to go into lesson, asking if she still had a dick, and asking her to get it out.

Our child was walking from pastoral to her lesson and an older boy called her a man beast. He then saw her outside reception about an hour later and spat in her face and called her a freak.

A boy threw an apple core at her and called her a trannie.

A boy from her year repeatedly called her names. Trannie, freak, man beast. This became so bad that the police were called in to warn him he faced a police caution, and, if he continued, possible prosecution.

A boy from her year called her trannie, he stopped after he was warned it would not be tolerated and we were prepared to involve the police.

Walking home from school our child heard a group of boys behind her shouting out ‘show us your dick’ and ‘trannie, get your cock out’. She ignored them and hurried on with her head down, and one of the boys ran up to her and tried to pull her skirt down in front of everyone. She ran away.

At break, our child was walking to her lesson and a crowd of boys were talking outside the entrance. They spotted her and started shouting out for her to ‘get your cock out, let me suck it for you’ and other comments like that. She turned around and headed away. They followed her until she went into another building in the school.

Boys from her year shouted out to her ‘have you still got your dick, trannie, or has it been cut off yet?’

Our child was walking towards the Music block and a boy pushed her from behind whilst saying ‘trannie’, knocking her into a wall and hurting her arm.

Walking from pastoral to the science block, an older boy (not dressed in uniform) called her a trannie, and kicked her.

Standing outside her classroom, waiting to go into lesson, and a couple of girls barged into her and called her a freak.

A girl constantly harasses our child, calling her names and shouting abuse. After she was called into the school office a couple of times, one of her friends confronted our child about getting her friend into trouble, and said ‘I will kick the shit out of you, you f***ing trannie’.

Two boys shouted out ‘oy, you f***ing freak’ as she walked into the main foyer at school.

This is by no means a full account of the abuse that Jackie has suffered. She has things said to her on an almost daily basis.