Becoming Nicole – Dr. Norman P. Spack, Nicole Maines and Jonas Maines

Good evening and welcome to the Museum
of Science I am James Wetzel the adult programs coordinator
here at the museum, and I am extremely honored to be introducing
tonight’s program, Becoming Nicole. Before we get started please turn
off any and all electronic devices. And if you do need to leave the program
early, we ask you do so up the steps and through the exit in
the rear of the theater. I also wanna take this time to
thank Jack and Susie Reno and the entire Reno Family Foundation Fund for
making this symposium series possible. In addition, we were able to make
tonight free due to the generosity of the Lowell Institute, so
a massive thank you to them as well.>>[APPLAUSE]
>>Tonight’s program and our guests are extraordinary
testaments to the diversity and intricacies of science and
human nature that cannot be ignored. In a time where the legal rights of the
LGBTQ communities are being questioned, challenged and
revoked by government officials and institutions across the nation, the Maines’ family have increasingly
become leaders within the community. Nicole and Jonas continue to shine
as beacons of inspiration to those discovering their own selfs while faced
with acts of discrimination such as HB 2 in North Carolina which continues
to ignite social and public debate. The confidence authority and
dedication Nicole and Jonas continue to show and the efforts
that they have already contributed to the transgender community continues
to inspire me personally. As well as all of the people
that they continue to touch with their story and their voice. Amazingly, they’ve only just finished
their freshman year of college, so I am sure there’s so much more to come. As Nicole states in her recent TEDx talk,
if you are on this planet, you are a part of the trans story. And through voices of individuals like
Nicole and Jonas, this story will continue to be told and fought for
as a pivotal part of humanity’s diversity. Now it is my privilege to introduce
an internationally recognized expert and advocate for transgender individuals and
the cofounder of the nation’s first clinic to treat transgender children,
including Nicole. Please join me in giving a very
warm welcome to Dr. Norman P. Spack.>>[APPLAUSE]>>Thank you. When I got started in all this, I had
no idea I’d be driving all the way from Brookline to here and hear nothing but
transgender, transgender, transgender, bathroom, bathroom, bathroom. It’s really quite amazing. Before I get started, I just want to point
out somebody who’s in the dark right now, but when he comes to the light you’ll
see him, Dr. Mitch Rapkin is here. Anybody who knows anything
about medicine in Boston knows that the great strength of what
then was called the Beth Israel and now the Beth Israel Deaconess hospital
is its patient-centered focus. And I, who have had family members
as patients, have been a patient, had grandchildren born there, can say
that it takes a rock to make that happen. And that rock for many,
many years was Dr. Rapkin, and I’m so pleased and
I’m a little daunted because you’re an endocrinologist.>>[LAUGH]
>>So you may know.>>[APPLAUSE]
>>You can’t be in this field without starting to ask some questions and we’re
gonna ask a lot of questions tonight. But start to think about, how far back do the issues of transgender people go? Let’s put it this way,
it seems to be found in every culture that people don’t get their heads cut
off for behaving the way they feel. in some cultures, it’s absolutely admired,
like the Navajo, where people who have this dual-identity before
they have a firm identity or people who have disorders of sex
development, meaning that they have parts of one gender and parts of
the other are given the highest status. And are often involved in such
important things as marital disputes with the idea that they
probably know both sides of the issue.>>[LAUGH]
>>Now in a wonderful journal article, as she was departing President
of Endocrine Society, Maria New wrote about a pope in the Middle Ages who was discovered
at autopsy to be female.>>The way they dealt with it
from then on was to create a chair that looked a lot with a commode
with a cutout in the middle and it was a job of a senior
cardinal to go up through the hole in the chair with his hand to
verify that the pope had testicles.>>[LAUGH]
>>For any of you who saw the movie, The
Danish Girl, I’m gonna pose a question. Why do you think that
particular episode took place in the Weimar Republic
in Germany between the wars? It took two things to have that happen. Number one,
until World War I with its horrendous shrapnel wounds, there was no
such thing as plastic surgery. The field of plastic surgery grew and flowered to the point
that by the time between the wars, it became literally possible for skilled surgeons who had reconstructed
people’s everythings from the bombs and blasts to be able to do forms
of genital reconstruction. That was the first,
then it also took a public attitude. The Weimar Republic was
the era of cabaret. It was the era of Magus Hirschfeld, a Jewish physician who
practicing in Berlin, was one of the first sexologists and he saw a people for sexual problems. He also saw a people with gender identity
problems, referring them to surgeons, it wouldn’t surprise me at all if
The Danish Girl had seen Dr. Hirschfeld, who had to flee the Nazis, of course,
who had two reasons to wanna kill them. One was religion, and
the other was his crazy ideas about reconstructing
People especially undesirables, who were only thought of for
the German death machine. So he went to Bishee
where he set up a clinic. He went to London, he set up a clinic. He trained the late Harry Benjamin who
worked until he was 100 years old, and s some of you know
the standards of care for treating transgender people was originally
called the Harry Benjamin standards. Because Harry, practicing in his
general practice in Time Square had so many transgender people who
have been taken advantage of by charlatans who said they could do
this that and the other thing for them. And so he set up a standards of
care which still revised but they go on in his name to this day. I got into this in a somewhat unusual way it took an n of one. That means when running
an adolescent medicine practice, one patient happened to
be a 24-year-old Harvard graduate who had never been treated but
arrives at Harvard. And said, my parents, he knew his parents never really accepted
the fact that born a female, that he affirmed a male identity and
he calls himself Mark, not his birth name. And everyone at Harvard
played along with it, including the three roommates and
including the registrar who, this is 1985 when I saw them so
we are talking early 1980s. The registrar knew there was an issue
because he spoke with the senior people at the health service. They said we’ve got to do
something because everything was all computerized then and
it would be easy now. But what the registrar did
was check he brought him in. He said Mark I want you to come see me before two to three weeks
before every semester. I wanna know every class you’re taking,
I want to know at what time, and I want to know what teacher. Why? Because the registrar then
re-wrote the class list so no professor would say his birth
name which would have been very likely would have
been printed out instead. Takes so little to make people
feel comfortable, right? It doesn’t take a lot. It doesn’t surprise me that Harvard has been particularly
helpful to trans students. And it has written policies for its university health services
that have allowed for care to be provided and covered for
over five or six years now. And that, when it’s Harvard University
health services, that means faculty and it means students and it means
children of faculty and employees and children of employees. A lot of people who can guarantee
that they would be cared for and it would be paid for
well before the more recent things. So, What started Mitch, I just wanna tell you that,
one of the things that happen was that, we, and
when I went to the endocrine division. The children have discovered that it was
common practice and necessary for boards. For adult endocrinologist who rotate through the pediatric clinics
of children’s and vice versa. And a number of the people who
are now on staff who take care of transgender people got their
feet wet coming to our clinic. But So why did when we ask a question, because I didn’t invent any of this stuff. What I did was really
get to know the Dutch who had been doing what I ended
up doing a good ten years before. And why did they take a step
that ended up in the kind of treatment that Nicole received,
a kind of treatment that we consider to be ideal and still difficult to get for
enough people? This came from my dear friend, now
retired Lewis Goran who was the founder of the Dutch clinic for
as they say for transsexual people. It was really for adults. And Doctor Goran if you wanna
know anything medical about this field just look him up because
he wrote 90% of the articles related to the medical consequences
of treatment etc., etc. But in this case what he did,
can you imaging how difficult this would be to do today? It’s the advantage of holland. Holland is a small country,
anybody can get to the center for care. In the center provides the care for
all the trans people in Holland. And they are on a total
national health service, total single payer plan
that is the government, and everybody is on that plan. There’s no going out of plan,
there’s no private care. This is it. And they don’t take people
from other countries. So it’s a pure population capable
of being followed forever. And, and all they care is free,
prepaid for. And so he look up over his life
experienced with 3500 patients. And ask a question we would
have a hard time doing. Because of the mobility
of the US population. Of what did they die? After all, we’re in Holland! It’s one of the most sexually liberal countries in the world. It cares for their trans people. It respects and apparently they thought,
respected their trans people. It seemed like the ideal place
to be if you were trans. So then they looked at what
1200 of the 3500 had died. And then he asked why? And they have those records cuz all they
had to do was look up a central record. And lo and behold, they didn’t die of all
the things that doctors talk about and worry about, well, hypolipidemia. Or they had hypertension,
taking testosterone or whether they had strokes or
high dose estrogen. No. The overwhelming causes
of death were suicide, drug abuse, alcoholism, homicide, homelessness, detachments from family. In other words, they died a psychosocial
death, which means their life sucked. And it wasn’t a Garden of Eden for them. Life was rough, even in Holland. Therefore, Dr Goren
assembled a team of people, Psychologists, Pediatric Endocrinologists
and said the problem is we’re getting
to these people too late. We’re getting these people when
they have already lived in one life and are being challenged by
having to live in another. And the people around them from
the first life may not be that particularly supportive to
the life in the second gender. And therefore for many of them
life is no longer worth living. And lest you think this only goes
on in Holland because I’m trying to pre answer the question,
why do we go so actively involved to try to help
the kids at a very young age. Well folks it goes like this if
you’re 16 to 25 years of age and your parents do not accept you for who you really think you are and
do nothing to help you find someone
who can help them. You have a 45% chance of attempting suicide between the ages of 16 and 25. This is why the NIH came chasing
after us saying, do you want a grant?>>[LAUGH]
>>They helped us for two or three years,
then we got a $6 million grant, divided among between four institutions,
so the numbers will be high. To try to look at the difference between
early treatment and regular treatment. But I wish it were Holland because we know
we’d be able to follow these people for the rest of their lives because
that’s what this needs. So, they decided, okay,
here’s the problem. The physical attributes that make it so
difficult for some people to adjust are the attributes
associated with puberty. Because I’ll show you a picture
soon of how easily it is for kids to look exactly
the same gender if you just dress them that way prior
to the onset of puberty. It’s almost like recreating
ourselves from our prenatal state, when we started out as
an undifferentiated gonad. And didn’t know which
way it was going to go, how the chromosomes and
conscription factors would influence it. And here we are again,
kid’s looking basically the same. And in fact we could,
if we dress them that way, they can go to whatever bathroom
they want and no one would say boo. Maybe that’s what we should do,
is just make everyone look prepubital, and send then them wherever we want. But the whole purpose was
to use the GnRH analogs, the analogs that actually
block puberty at the highest levels between the hypothalamus and
the pituitary. Which is where pulsatory release of
hormones is responsible for puberty and menstrual cycles and
everything else related to sex hormones. That ‘s another interesting Boston story,
by the way. The first treatment for that was for
girls with sexual precocious puberty. What we didn’t know why they were
getting puberty at three, four, five. What could be worse, right? Everything, including menstrual
periods would happen. And then they’d be this tall because all
the growth would have to take place in such a short period of time. So when the GnRH analogs came out, they were the ideal treatment
because up until then, high dose progesterone was being used,
and it had side effects. And in a wonderful collaboration between
two Harvard institutions that rarely collaborate with each other,
the Mass General and the Children’s. Bill Crowley and John Crigler together to pull enough patience to
study the use of GnRH analogs. And this day made it possible for
the Dutch to see that they’re safe because this was done in the 70s,
the late 70s. And the girls who are exposed
to it shut their periods and everything down immediately
puberty stopped for about 7 to 10 years they were on
that drug until they reached age 12. At age 12 the drug was taken away they
went into puberty within six months. And then they went into
normal menstrual cycles, they went into normal fertility,
they got into normal motherhood and nobody’s found a damn
thing wrong with them. A total success story. So the other thing is that if you use,
if you started when people are starting puberty,
boys at 12 to 14 and girls at 10 to 12. And you started by giving them
the hormones of the other sex, well that’s a heavy thing to
do to somebody that young. Can you really trust that age that
they can do something irreversible? And develop sexual characteristics
of the opposite sex that young? So this buys time. And you don’t have to, at least you’re
dealing with a middle adolescent. When you’re talking about using
the hormones of the affirmed gender. Okay. So this is the nine year
old that I talked about. Genetic male, this could have been Nicole. Maybe we’ll have a picture
that was you in that age because by that point you
were dressing that way. And I dare you,
in clothing I dare you to tell me that there’s any difference between her
and any of the other girls at school. But, to block her when she
started to go through puberty, she went on the GnRH analogue to shut
them down, same thing we used with Nicole and now she’s at 15 to 16 and
she has a shape. And that shape didn’t
come just from stopping. Remember if we had just stopped. These are the Dutch. All Dutch patients who
have given us approval. So this is a Dutch girl at 15. And of course if we had just
stopped everything I would have had giving her female hormones,
she would have actually developed male characteristics cuz she
still has male gonads. And in here she is at 19,
she’s already had her surgery. She’s done and I think you would agree
she’s a lovely looking young woman.>>[APPLAUSE]
>>And when I say, she looks female I’m not just
talking about her breasts. I’m talking about the subtle things. The softness of the skin. The body of the hair and particularly,
the lack of angularity of the brow, the zygoma, which is the cheek bones,
and the mandible, the chin. All of which are so
identifiable that a forensic pathologist is capable of picking up a skull and
say this is male, this is a female. And this doesn’t come with growth. This comes with the hormones
associated with puberty. So we decided a lot later
to put a clinic together. The Dutch trained us. The Dutch gave us their
testing methods and we decided to be as strict as they because
they were having phenomenal success, and they were running seven
to eight years ahead of us. So we could go, as they say,
we could go to school on that pie. That in order to be accepted for
pubertal suppression, they had to be in the earliest of puberty,
which means a doubling or tripling of testicular size or
breast budding. They had to be in counseling with a gender
therapist for at least six months because that person had to make
the referral and the letter. This isn’t easy in many places and
I have many friends who can’t treat people because they can’t get
the support of both custodial parents. And if it’s a non-custodial
parent who is a problem, we sometimes ended going to court. And there can be no severe
psychopathology, but believe me, there’s plenty of anxiety, depression and minor things that are secondary
to the non-treated state. So my first patient from
overseas came because, Jackie, at age 12,
previously untreated, a genetic male, had been totally abused in
her city in middle England. On top of that,
she had had four major suicidal attempts. And that was because in her mind,
and that the policy of the only program to evaluate and
treat trans kids happens to be in London. And their philosophy was no to no
medical treatment until 16 in spite of the fact that they had phenomenally
good psychometric testing at age 12. So the kids thought, well they’re never gonna treat me
if I prove that I’m qualified. Well, Jackie was also a challenge because
she had a predicted adult height of 6’5″, which is a challenge that they
don’t play basketball even. So we started her on analog, but we also, to cut her height down,
we treated her with estrogen at 13. And on the far right, she is 18 or 19, and a runner up, a semi-finalist in the Miss England competition. And she ended up being 5’11” and then tweaked me about it because she said
she missed out on a modeling contract. They wanted it’d be 6’1″.>>[LAUGH]
>>But then in a wonderful turn of phrase she
said, but those models are all vacuous.>>[LAUGH]
>>And it wasn’t for her. But it really was interesting that
no big brouhaha came over the fact that this person was born genetically
male was winning beauty contests. But it all had to do with one
of the judges who said but she has more of her standing
equipment than anyone else. So, okay, this is Nicole at around 2. Do you wanna hit the video, yeah. Now, Look at some of the toys, okay.>>[INAUDIBLE]
>>All right. [NOISE] Now, I don’t know if this is female, as in putting the dress over the head,
or what. But, it all
>>[NOISE]>>So, a couple of things that we see in children who are really committed and make a political statement about their
gender at a relatively young age, is quite commonly,
as is the case with Nicole, is attempting to imitate hair,
the longer hair of women, by wrapping towels around the head and
that was certainly done here. No one encouraged this and besides, Nicole has a brother who was not
that we miss at the same time. [COUGH] This is at what age did we say this was? Three, this is age three. So you might say, well, you know, it’s
a boy’s hair cut and a boy’s T-shirt and whatever but look at the dolls
being clutched close to the chest. And remember,
still going by a male name at that point. This is now nine years of age. By this point, Nicole may not yet
legally had her name become Nicole. They hadn’t yet used it at school. But I’d met them for the first time
two years behind this, at age seven. It was the first time that I had met them. And I remember quite vividly,
the male name that was affixed to the medical record at that time
although I’m trying to remember whether you asked me to call you Nicole or
not. That was kind of a planning
session of what we might do if. And this is the famous
picture from that Sunday, December 2011, Boston Globe above the fold first with their story as
told by Bella English. Now if anyone needs an idea,
if anyone says it’s okay to wait, it’s okay to wait till they’re 16 and
don’t mess around. Well, this is 14. Look at how physically mature for
14 Jonas is. Why, he has a beard,
he’s got an Adam’s apple, he’s got prominent cheek bones,
mandible the whole bit. Okay, in fact he may be 14, he looks 16. But the point is that’s exactly what
Nicole would have looked like had we not done anything. Because what you’re seeing in the right
is a normal male puberty of being a bit early. And on the left you’ll see an identical twin who had puberty blocked at 12. It has not yet gotten any estrogen in any
sexes, just on lactating at this point. Although it was just around this
time that we added estrogen in. So the dutch did have followed enough kids
who’ve gone through the whole protocol. Blockaded 12,
cross sex steroid around 15 and surgeries all all completed at 18. And then, these 55 patients about equally
divided between genetic males and females, they did a careful psychosocial
evaluation of how these kids were doing at two to four years after
completion of all surgeries. How were they? Did they fit Louis Gurn’s population? Hell no. These kids were as good or better than psychosocially at that point than a control group of
the same age Dutch kids. So far it appears yet the results are, well, expected but still phenomenal. I’m gonna call Nicole and Jonas up and engage in a little by play here. [APPLAUSE] Well how the hell,
how are you doing? They just completed their first
year of college and Nicole has had, has been speaking a variety of
the glad award ceremony in California. I should say in deference to the whole
family including Jonas for sure, it was no accident that the family
was invited to the Whitehouse. On something that maybe you don’t
all know that our president does. And every spring he has a Saturday
luncheon for heroes of the GLBT community. And the family was honored
as they were by the ACLU. But that had to do with the bathroom
issue in Maine a number of years ago and
well actually since I’m digressing you wanna just explain in a nut
shell Nicole what that was about.>>The bathroom?>>Yeah.>>Well, I began my transition
when I was in first grade. We decided to do more
of a gradual transition rather than sort of like
an abrupt thing like that I know a lot of trans kids do this
sort of like burst into school one day. Skirt, pearls, heels, purse,
hair done, face beat. And it ruins kind of like what? So we decided to do more of a gradual
transition starting with growing my hair long, wearing pink and
that grew into bathrooms and name change, skirts and ending with the use of
the mouthpiece stall girls back room. And everything was going really great
because we had eased not only myself into it, but also the administration, teachers,
and all the other students at the school. So no one was really expected to abruptly
just sort of understand everything. It was really great and
everyone was cooperating. We had a question we could
all deal with it together. The only problem with the gradual
transition though was that a new student wouldn’t have been there for
sort of that ease into it. And that’s what happened. A student had come in fourth grade,
he wasn’t in my class so it wasn’t a deal. But in fifth grade he was,
found out that I was trans, and he told his grandfather
who was part of a radical right religious group.>>[LAUGH]
>>And so that wasn’t really okay with him. And so on behalf of his grandfather, he followed me into the bathroom
to sort of make a statement. Carrying on his back the weight of
a lawsuit threatened by this group. So to cut a long story short they
pulled me out of the bathroom. And they were just like, you know what? We’re just going to remove the problem. We’re going to put you in
this private staff bathroom. And they sort of tried to glitz
it up by saying there was even my own private mirror to like play
up my vanity or something. And of course, it was a staff bathroom so
the mirror was too high for a fifth grader and
I should have known that.>>[LAUGH]
>>I should have known that. So that bathroom sucked.>>[LAUGH]
>>And on top of that, as a complete isolation from all of my friends
>>And after a while I’d really
overheard my parents talking a lot about how unfair it was that I was
being punished and I sort of agreed. And so, in my almost like fifth
grade rebellious sort of action I started using the girls bathroom again and
everyone was fine until it happened again. And again I was in the principals
office with her giving me a look, and saying I wasn’t
supposed to be in there. And so from that point on they’d given
me a body guard to follow me around, make sure that I used
their isolation chamber.>>[LAUGH]
>>And basically keep me in a place
where I couldn’t cause trouble.>>And so for
obvious reasons this wasn’t working out. And we gave the school every
opportunity to help us, to work with us just like they
had done for the past five years. But in sixth grade we ended up having to leave that school
because they weren’t cooperating.>>And we ended up filing suit
against them on grounds of unlawful discrimination based on my gender
identity and that went to the.>>State Supreme.>>First it went to the state court and
that was and we lost. Then we appealed thank you, and
it went up to the state supreme court. Where after about what five years-
>>Sure.>>Five years it finally won. It finally won after five
years of being in court. And that was the first case I
got in the country actually. And so what it did,
because everyone was really afraid and this it wasn’t like a new thing. This was something that’s been
happening to trans kids everywhere. But the problem is courts didn’t want
to you know be that first to sort of draw a line in the sand. But fortunately we had the right people,
we were there at the right time and they did the right thing,
so that set a precedent.>>Nicole,
I remember being at a hearing in Augusta, a sub-committee of the legislature,
a joint committee. That was taking up an issue that was
brought advice by one legislator. Trying to amend the then quite
liberal public accommodations rules in the state that would give
principals and restaurant owners the right to say to somebody,
you have to use, sounds familiar? The bathroom of your biological sex. Do you remember that? Because-
>>A little, it’s actually happening
again in Maine right now. They’re trying to get enough signatures.>>I just want the audience to
know that up to that point, as I recall,
you weren’t completely out to everybody. You were selective as
to who you would tell, and a whole bunch of us had gone up and
gotten our three minutes. The lead person, Jennifer Levi, got ten and the rest of us got like
three minutes and I remember, you said to your father that all these people are really trying
their best but they can’t do it, I can. And you made it your business to go and visit just about all the legislators
in Maine and this is what they saw. And suddenly, for
the first time, it hit them. It hit them. If I had a daughter, and they said I had to send her into
the men’s room, where is the risk here? They think that my daughter is
likely to prey on other women. This is a kind of reasoning you get from
someone like, I’m sorry I have to say his name, Dr. Paul McHugh,
who claims he’s never seen a transperson who convinced him that the
person had a different gender identity. He says all of the males
to females are really just gay men who found
a unique way to attract men.>>They’ve got me pegged, darn, my secrets!>>[LAUGH]
>>In doing so, however, she basically outed herself
because that testimony was so potent that it was written up and
her name was included. But she felt she had to do it. It was a pretty courageous thing to do.>>Thank you.>>How’s college, Jonas? How is it without her? How is it without her constant
chatter in the background?>>[LAUGH]
>>Careful>>[LAUGH]>>It’s peaceful, Norm.>>[LAUGH]>>It’s really interesting because we’ve been together for so long and college, like you said, it was really the first
time that Nicole and I were apart for more than a couple of days or so,
or when someone went on a trip. And it was a chance for me to have my own identity beyond being
Nicole’s brother which through high school had been
the title that developed with me. Both at school where we
shared the same friends and where everyone associated us together and
also on the state and national level, where all these
speaking events began to pop up. I was becoming identifiable
as Nicole’s twin brother and going to college alone was, I don’t wanna say an opportunity but
it was a moment where I was able just to be Jonas and
people picked that up. And that’s a phenomenon
that a lot of twins have, that ability to be becoming your own self. I think it was magnified for
me because on such a grand scale, I became associated to you and it was
really an interesting experience for me. With the book coming out,
we have one bookstore in my college town. It’s a very small town. We have one book store and Becoming Nicole
went up right in the front window.>>[LAUGH]
>>I’m always with you, Jonas.>>[LAUGH] Yeah, that idea of
individuality did not last for me.>>[LAUGH]
>>But no, it was very nice to be able to come into my own, and
college was also a chance for me to discover things about myself beyond advocating for
transgender rights and equality. It was a good chance for
me to come into my own, I guess.>>Since you also were both at state
schools within the same state of Maine, did you run into kids, Jonas,
who were aware of who you were?>>Yes, I was. Actually, funny story,
I have a friend, he and I hanging out one day and
there were bunch of us in the room. We’re in my dorm room and he decides to
play the game, let’s Google our names.>>[LAUGH]
>>He Googles himself, nothing comes up.>>[LAUGH]
>>He Googles my roommate, nothing comes up.>>[LAUGH]
>>He Googles my name. At this point, none of us are really
paying attention to what he’s saying, he’s just reading off random things and
he gets to me and he knows, shit! You’re famous!>>[LAUGH]
>>I’ve had a couple moments where, yeah, it comes up.>>[LAUGH]
>>But for the most part, I was surprised because it’s
not something that really, until the book, a lot of people
didn’t really pick up on it.>>But, she’s not in view.>>No.
>>You’re not at the same school. It would be quite different. [CROSSTALK]
>>Yeah, yeah. Absolutely.
I think it’d be something way bigger. Especially, I go to such a small school, I think it’d be something that’s way
more in the forefront of my daily life. But no, I think it’s a nice balance. I think it’s something that
people recognize about me but it doesn’t dominate who I am.>>Nicole, one of the things that
my colleagues and I talk about when we now have a special interest
group of Pediatric Endocrine Society. We were talking about has anyone
really studied what it’s like for these kids to be forcibly delayed,
puberty.>>Mm-hm.>>You know the reasons why,
you know all that but what was it like to be in never,
never land for a few years?>>I think being a twin,
it was nice, especially for my parents, not having two kids go through
puberty together at the same time.>>[LAUGH] [LAUGH]
>>No. And I think having, I think it was
just on a psychological level. It was very nice not dealing with
all those shifting hormones, at that particular moment in time for
me, personally. Just because so much was going on. I was already in a really weird place. Because after the move I had to hide my
transgender status from my new school, after being out for five years, and so
that was really rough for me already. So, I think timing wise,
it was definitely convenient. But the actual process itself,
I didn’t have any problem with it at all. It didn’t feel strange to me,
I just think, I felt very normal.>>The other side of it is that when you
start from such a low hormonal level, from being blocked, that giving you any hormones and in this case, the estrogens.>>Mm-hm
>>And some people say, it hits like a ton of rocks.>>When I started estrogen,
I definitely got moody. [LAUGH]
>>You were moody before that.>>Well. [LAUGH]
>>I just wanna get that straight.>>Well.
[LAUGH]>>What can I say? I mean you saw the video. I was already a diva. [LAUGH]
>>But no, I don’t know. I think when I started estrogen, I don’t know if I particularly
noticed it hit me very hard. And I think that’s because we
sort of started gradually, and sort of slowly went up in dosage. But I don’t really recall or
remembering any sudden changes for me, personally.>>The other thing is many of
the kids talk about in retrospect.>>Mm-hm
>>That until things are all done. It’s very hard to be
as involved in dating.>>Mm-hm.>>In any romantic relationships until in that study from Holland. Yes they came out fine psychosocially but
they all admitted that it took until they had finished with the surgery for
them not to be gender dysphoric anymore.>>Absolutely.>>So going after colleges for
many, for some, the beginning of dating and for some a continuation of something that they
have started a couple of years before.>>for me acceptance for myself, when I talked about it in my TEDx talk. It came a little bit before surgery, and I think that was personally,
what made that decision to do it harder. Because I think acceptance comes from being in an environment that
allows you to accept yourself. Because I think self acceptance
is really hard to do, when you aren’t accepted
from an outside perspective. Jones and I went to a private school
that was incredibly accepting. And yes, like acceptance at home is
like where it starts, you need it. But, if you’re just accepted at home,
it’s not enough cause if you’re going to school all the time and
you’re not accepted there then. Okay.
Well, I guess you can be accepted
in the evening, but in the morning, you’re gonna be
a freaky guy and just so you know. So being accepted on both places gave me
sort of fun ability to become comfortable with myself and that’s, and so
that came probably around my senior year. I mean that’s when I started trying to
get into the dating pool, but it was so really weird. But I mean,
I guess dating’s weird for anybody.>>[LAUGH]
>>And I think after deciding to have surgery was hard because I was afraid
that gender dysphoria would come back, after just having gotten to a place
where I had sort of accepted myself. But it was definitely the right decision,
because those feelings of any gender dysphoria completely gone. I feel, it’s, I’m coming up on
a year now actually in August since surgery and it kind of feels like,
it’s been a lot longer than a year. It’s really weird. But I’m in a really good
place with everything. So dating is that much easier. I don’t know, if that’s what
you were looking for [LAUGH]. I realized half way through that I
was ranting and I was like well, I’m here [LAUGH]
>>Are you maintaining friendships from high school as in from home or, Maine is pretty big state,
but not that big.>>Well, most of it is occupied by trees. [LAUGH] So.>>Yes, yes. Actually, being home after college
finished up has given us a chance to reconnect with a lot of friends from high
school and it’s been really interesting. I think part of the reason they stayed so
close was because they were, no. I think they were just so
understanding of who Nicole was.>>Mm-hm.>>And our personal struggles, I think
that didn’t mean anything to them, really, in the sense that didn’t
define who we are to them. That they looked beyond that and
they saw us for just being other kids in the school, and I think that says a lot about not only
them and the school environment, but also a standard which I think we
should all strive to meet. Looking beyond that,
to seeing who transgender students and their families are beyond
being transgender.>>You know also my friends,
our friends, we had the same group. Our friends were so fundamental in me
getting to that place of self acceptance. So I think not staying in touch
with them at this point would be->>Which should be impossible.>>Almost impossible. My two closest friends were actually
mentioned in the book, Austin and Lexie. And they’ve been incredible actually. Austin is coming to my college next year. He’s transferring. So we’re gonna sort of resume our
whirlwind that we had in high school. So they’ve been really great. And I think having that close circle
of friends is just so important, when you’re going through something,
as complicated as hormone therapy and this gender this for you and general
having people that you can talk to. And understand you regardless
of whether ro not their trans. Because, my friends, it was very yes and coming out to them they were,
it wasn’t that big of a deal and we also got to that place Where me being
trans a wasn’t my defining factor, but it was definitely something
we could all joke about. Especially for instance,
we went to the mall one time and Austin had a new boyfriend we
were all getting to know him. And he said something and
I saw this opportunity and they all knew it was coming cuz
they saw this look in my eye.>>[LAUGH]
>>And I looked right at him and I said, are you saying that cuz I’m trans?>>[LAUGH]
>>And he just went white as a sheet.>>[LAUGH]
>>And then, they all like broke up in laughter so having good friends is
amazing, they’re all incredible.>>Except for your public notice, you really would have the opportunity of never telling anybody except some very special close people about you.>>Mm-hm.
>>I see kids, for example, who happen to be trans, who become very active about
GLBT issues when they get to college. But actually I would have
to say that’s the minority because if the kids are very much
completed in terms of treatment, whatever, many of them
just want to blend in. So to what extent is your career so far a potential impediment to whether people will know you as Nicole Maines who happens to be trans, which at least is nicer than no Nicole Maines, the trans.>>Yeah, exactly.>>But in any case, at least for people
to associate you with this part of you.>>Well, I think at this point, having
done as many things as we’ve all done.>>I think we’ve all been given
a certain platform and for me personally I do intend to continue to
use that platform to keep speaking out and to keep making a difference. Because until we’re at that point
where we’ll tell our kids that there was a time when they didn’t
want me to use the women’s bathroom. Until we get to that point I was like,
wait, what?>>[LAUGH]
>>Then the work isn’t, we’re not done, we’re not. We have so much more work to do. And so, I think so
long as I have this platform, and as long as I have the opportunity to keep
working, that’s what I’m going to do. And as far as you know my
identity being define as trans. I’m definitely doing other
things besides being the trans person because everybody
is not just their gender. No one’s just something as humans we all have billion other things that defines us. And so, I think I’m also working on making
sure other people know I do other stuff. So?
>>[APPLAUSE]>>So that means that the two of you are gonna run for
President and Vice-President.>>[LAUGH]
>>You know, I think that would just be too complicated.>>I’d go to Canada.>>[LAUGH]
>>What would you be? The President or the Vice-President?>>I’d be in Canada.
>>[LAUGH]>>So we do the, my advice?>>Cool, do you know who skip.>>Come on up.>>My mom.>>[APPLAUSE]>>Kelly is a self-effacing person. I remember I need it someone to speak
with me whoever live near for London. It was send in Medical school and she said I don’t do this speaking
in the and family weaned us. Well, she took questions and she stood up from that side and she just knocked the house down. I mean it was like where have you been? [LAUGH] So, anyhow
>>I hope I don’t disappoint today.>>[LAUGH]
>>You want to expand on any of the things
that we discussed here?>>Well,
I think we’re just a normal family.>>[LAUGH]
>>And I think we just got really lucky that
things happened the way that they did. And I have two really awesome kids,
and there’s a Dr. Spack in this world because I
couldn’t have made it without you.>>[APPLAUSE]
>>I haven’t actually read the book. I read the book when we were
working on the book, but I find-
>>We were there! We were there for all of it.>>For me it’s really hard to read
the book because it cannot explain how hard how much pain I was in
going through that whole thing. And not knowing I’d be
sitting here today and everything is great everything is fine. But I can’t tell you how many
times I didn’t think we’d ever come anywhere near this. I couldn’t have even dreamed of this,
but to think that they would be okay. Both of them would be okay. I had no idea. I mean there was a whole section of
time when Wayne was not even on board. So I didn’t know, and Dr. Spack wouldn’t
even see us if Wayne wouldn’t have. It was very very hard, but. [NOISE] [LAUGH]>>[APPLAUSE]>>Prepare to take questions from the audience? I know there are people with mics. And, would you direct the question
at a particular individual?>>Yes, actually I’d love Jonas and mom.>>Kelly.>>I’m also known as Kelly. [LAUGH] Could you talk some about the
support you needed going through this and also any advice you have, having support
Nicole, for those of us who in the future or right now, in a position where we
will have people somewhere in our lives. Who need the kind of support she does,
what advise you would give whether it’s in school or teachers or
just friends, about how to support. And make it as safe as you can, but also
I assume you all needed some support to because it’s not just Nicole, but
it’s a whole family thing as she said. Is that articulate enough a question?>>Absolutely, yeah, thank you.>>I hope, I like to think that I was
always watching for both of them. But, I do think it was hard to
make sure that Jonas didn’t get lost in that whole shuffle. And I think anyone who has a child
that has any kind of special needs, the other kids do kind of
get shuffled in the back. And I hope he doesn’t feel that way,
but it probably did happen sometimes. [LAUGH]
>>So I can’t make up for it though,
I just can’t make it up.>>Can I have 20 bucks?>>[LAUGH]
>>Jonas Maines.>>Yes, great question. I think that’s absolutely true. Anytime there are multiple children and one child needs special care as
important and as vital as that is. There is this other aspect to
it where it’s very easy for a young child to kind of have
that what about me feeling. And I don’t think, it’s, because I don’t want to say it’s like a jealous or
selfish thing. I think it’s natural for
a child to wanna feel the same amount of value as their sibling. Growing up especially in middle school and high school is where I
think felt it the most. I understood, there was never a time where
I was like, she doesn’t deserve this. It was always, no,
I understood this is what Nicole needed. And under no circumstances
did I want that to go away. I think there were times,
especially with my dad, where it felt like I wasn’t
good enough for him. And I think that’s my advise to parents
with siblings in any situation like this. Whether it be with the trench
in the child or not would be, of course always give your child
whatever they need, always. That is not negotiable. Also it’s hard but I think just giving that
extra support it’s not.>>I think to add to what you asked
earlier and I’m speaking for you now.>>That’s fine.>>I don’t think Nicole would have
done quite as well without Jonas.>>No.
>>Because was a constant support to her, constant. Always watching her and
always had her back, I wouldn’t say I hope I didn’t
put that pressure on him. To make him think he had to go
to school and protect Nicole. But we’re a family, so
we kind of do that for each other and maybe it’s because they’re twins. Or just sibling or whatever it is,
he’s always been there for her. He’s been a great support system. For me, as far as counseling, when
Nicole used to get her counseling, and this may be in the books. So stop me if you’ve
heard it before [LAUGH].>>[LAUGH].
>>But she had a counselor around the same time we’re seeing you. And we go in and
the first half hour is my time [LAUGH]. I did not know what I was doing. I didn’t know cuz
the counselor kept telling me, I know he’s just gay, he’s just
going through to a phase right now. I’ve had several clients like this and
they all grew up. And I said, but wait a minute won’t
you rather be gay than transgender at least people kinda get that one. If they don’t get this at all, so
for me it worked out really well. Because I was able to go in and say,
my god my life’s falling apart. And then also say here’s whats going on,
what do you think? And we could bounce these ideas off
each other, and, without her, and without you [LAUGH]. I can’t express enough,
I couldn’t do it alone, there was no way. I had to have a support system of
people with reasonable minds that could help me through all of this. And that was certainly how I, but
I don’t think I slept for about 18 years. I don’t think I slept cuz I
know what was gonna happen. I know is another shoe
going to drop tomorrow. Is someone going to be dead? I thought that so many times, it was-
>>I think that goes into the second part of the question, advice wise,
is definitely I think with family members. It is absolutely vital to take it
upon yourselves to educate yourselves regarding the issue. Because your family member is going to be
scared and they’re going to be confused. And they’re going to be angry,
and they’re gonna be sad, and they’re going to immediately
look to the family for support. It is the responsibility and the obligation of the family
to be there for that person.>>I don’t know if you’ve felt this but I’ve always felt like I
was doing this a lot. What did you say about my kid? What did you say about my kid?>>[LAUGH].>>Back off,
I always felt like I had to protect her. Because I always was getting
questions thrown at me. Why is your daughter named Wyatt? It’s a family name, it’s a family name.>>[LAUGH].>>So you must have seen a lot of
that yourself at the school because.>>Yeah, especially at school. There was a lot of times
where students would be, too afraid to ask the trans kid
what being transgendered was. So I would often get approached by
other students they’d be like so.>>What’s up.>>[LAUGH].>>Is your sister a boy or a girl?>>Or like, what’s going on?>>[LAUGH].
>>Yeah, and I->>I’ve got 5 minutes, explain the whole thing [LAUGH].>>It would often be like I
would be going to class or I would be in the bathroom and-
>>I need to go!>>And I was like probably nine or
ten myself, and I had no idea what it meant either. So, I was like,
we’ll get through it together man. I’ll give you my best shot, and
then we’ll sort of piece it together. I don’t know.>>I’ll call you when I find out.>>Yeah, it was really confusing for
me, I didn’t have all of the answers. And then, I was being approached by
a lot of kids who expected me to.>>I know it was confusing for all of us
because again, now it looks so simple. But back then, I would go online and
there was no information. And what you did find,
you didn’t wanna find. Cuz that wasn’t what you were hoping that
your baby was going to grow up to do. You know and that’s not what transgender
people go out to do, but online it is.>>Well, I just want the audience to
understand that, forget about the fact that they’re identical twins,
that makes them unique in and of itself. But we’re not seeing a lot
of people coming in with because their child is at age one, two or three is literally behaving in
a totally questioned way and is being consistent about that And who actually go on to continue
to express that gender as puberty hits. So it’s more common for us to see kids
a bit older and we don’t actually even consider kids definitely trans
until the time of potential treatment. And that because that’s based on data that
prior to puberty, a lot of kids vacillate with respect to experimenting
with gender roles. But kids who say they’re
in which puberty and insist that this is there Gender identity. There I’m most certainly transgender and I most certainly will never
go back the other way. That which is why the Dutchshund,
we do not have kids who desist.>>I was gonna add to that. At that time too when the kids were in
first grade is that people are starting to ask why your son’s wearing pink. And dressing like a girl and
carrying the Kimpossible lunch box. So but you don’t wanna pigeon hole them
and okay if you’re gonna dress that way you’re gonna be transgender
that’s the end of it we’re done. You can’t do it that way you’ve gotta
give them that space And that I think for Jonas and
I was probably that the hardest part. When parents would come to me and
say, what’s up with Wyatt? I’d say, Wyatt likes girl stuff. I don’t know why and we are friends
with everybody in town for awhile there. He starts explaining it to everybody but you wanna make that’s all I care about,
I gotta make allies. I got to make sure they’re safe,
wherever they go and that’s exhausting, it’s really exhausting.>>Well, you know,
I just want to say, I just want to take like a moment and
like appreciate those two. Because I don’t think there’s
a thing that they could’ve done better [APPLAUSE] [APPLAUSE]
Stay humble.>>Jonas wants us to move on
to another question [LAUGH].>>I just wanted to, something you
were saying earlier about how it’s really the family’s obligation
to support each other. I want to add that it’s hard to do when
there’s when there wasn’t when we were starting. It was like you were saying,
there was no information. And that’s why the education is so
important and fundamental for people to have, before a transgendered
person comes into their life and that’s what the whole, if you’re on Earth, you’re
part on the trans story thing is about. Because you don’t know when a transperson
is going to come into your life. I bet you a million dollars,
if you told my father like a year before I was born that he was
gonna have a transgender daughter. He would have laughed in your face. And then, guess what, Dad? Sorry.
That’s why it’s so fundamental for you to be prepared, because it’s not fair to the
child to have somebody to have to wait. The world shouldn’t have to catch up. They should already be there. When we started the GeMS Clinic in 07,
we were the first in North America to have the program
that the Dutch had started through, as I explained,unique personal connection. But right now, it’s only ten years and
there were 60 programs. Unfortunately, they are on
a solid blue states, which shouldn’t surprise you. So there are very large
segments of the country, where a kid remember this
is a random phenomenon. I’m convinced it’s in the brain and
I’m convinced that it not influenced by external factors. So it just as likely when
I see people from Kansas, I’ve seen people from the Mormon faith,
who’ve been kicked out. I’ve seen Orthodox Jews and on and on. But this means, that this has to go. we used to say how many
people are trans in America? And I remember this distinctly from
med school that someone came back with a figure of 1 in 10,000. And then, I looked up and I saw that there were 10,000 operations. 10,000 people
have had surgery and that’s how they got to
such a ridiculous number. Well, if there are one in 10,000,
I don’t know why Brookline high school, a school of 2400
kids has four or five trans kids in it. Okay, and so in other words the more
you have an environment where people can thrive, obviously, the more people are going to come
forward and the numbers will shift. The other interesting thing is when
you look at people under age 21, over age 21,
the numbers always seem to accentuate 3 times as many people going from male
to female as from female to male. But I think that statistic
is ridiculous and probably, just reflects biases in terms
of when people can do things. And do we really know, whether
the person who is female to male is actually whether we’re getting gay people, gay females, as supposed to people
who affirm a male identity. So I think,
it’s It’s at least one in a thousand and it’s probably closer to one in 500.>>Yes.
And I guess this is to Nicole and Dr. Spack. So I feel like a lot of the discussion has
been framed in terms of the sort of gender binary that you’re either
aiming at an ideal male or an ideal female sort of archetype and
for my kids and the transgender community that they have got me in
contact with, I have a perception that there’s a sense of a broad spectrum
>>Mm-hm.>>that a lot of people have this. Some people really are not necessarily
aiming for one of those two end points. I’m just kinda curious to
hear about it that you said something about the spectrum.>>Yeah.
I am so pleased you asked that. Because it right now, represents one
of the biggest challenges that we have. And of course,
I tend to talk about what I know or what I can do and yet
it’s probably because the difference is that when
we see kids like Nicole, they’re very often dragging
their parents into the clinic. When we’re now seeing people,
who I call the term gender fluid. I just can’t say gender queer. It’s just cultural. Know that a person that has not
truly defined their gender. Now, I know that I’ve
seen people like that. Some of them ultimately do find
a place for themselves, but they don’t necessarily have to. But this I know, [LAUGH] is that this is
a situation where the parents come and dragging someone and says why
are you bringing me into a doctor? And the parents are saying essentially,
just make him trans.>>[LAUGH]
>>I just wanna know what pronouns to use.>>[LAUGH]
>>And so, since all I do when I see people like that is say, we’re here
for you if there’s anything we can do. There may come a time when there are
people who go through a gender fluidity until they find a place where they fit. And if not, be happy.>>I think for me, and
I’m not a doctor, so I don’t know anything of the medical things regarding
gender fluidity or gender neutrality. All I can do is provide a commentary,
the cultural and familial aspects of it and I think when
you have a child who’s expressing that they don’t fall on this line or
this end of the spectrum and that they’re somewhere in the middle,
I say cool. I mean, we don’t give kids enough credit. They’re smarter than we think they are. They’re not going to
steer themselves wrong, when it comes to their own identity. We just have to trust that
they know who they are. Cuz we know ourselves best. Something that I say is that it’s okay
if you don’t understand something. Like that’s fine,
it’s human nature not to understand everything because we’re not all knowing. That’s okay but what’s important
is you can educate yourself or you can be educated on your own time. Just the most important thing is to
respect it on everybody else’s time. And especially in this case,
on your child’s time, And so I think just trust that
they know who they are.>>All right, so
we have our last question here.>>Thank you, I have a question for
Kelly, the mom, and I hope I am not minimizing this at all. Having a trans-kid,
whether having a trans kid or having a kid with ADD is incredibly
difficult for the parents. And if the couple cannot agree on, nevermind the treatment, but
even on the diagnosis, that’s so hard. I was wondering,
if that was your experience? And then my second part is, for
those parents out there who may not, who have that problem,
what advice would you give them?>>Well, we did have that problem
because Wayne wasn’t on board. But I think I’m pretty bossy.>>[LAUGH]
>>So I ended up getting my way. But I also did my research,
I didn’t just go well, Wayne, she’s transgender and that’s that. I really did a lot of work, I mean, Dr.
Spack and the counselors and other people that I met along the way,
pediatricians. I did my research so it was really
hard for him to argue with me about it because I knew what I was talking about,
as much as I could at that time. I think you’ve got to put
your own feelings aside and you’ve got to think about what’s
going to be best for the kid. And even though you might have a cultural
bias about something no matter what it is, you’ve still got to surround yourself with
some professionals that can help you do what’s right for the kid. You can’t let your feelings
get involved in it. And it is hard to go, like I said, I would
have people come to me on the playground. Why is your daughter named Wyatt, you know there’s scary things you
have to do and talk about, but you got to do them because in the long
run, you can’t abandon the kid. You can’t make them suffer because
the two of you can’t get along, and I think that in the end that’s where
Wayne and I ended up coming together. He finally realized that he
may not understand this but that’s his problem and
he needed to work it out and he did. And the book actually,
after it was written and I fought it all the way cuz
I’m a private person but when it’s done I realized it was really
a book of transition for both Nicole and for Wayne because he really changed so
much through that book and I think we did too Jonas but
we just kind of always got it in a way. I mean I didn’t get it I didn’t go yes
that’s transgender it wasn’t that but we just accepted that there
were gonna be some things that we didn’t expect in this world. And for Wayne that was very difficult
he I got two boys who we’re gonna do our hunting thing we’re gonna.>>Play baseball.>>And to be fair,
I don’t go hunting with him anymore.>>[LAUGH]
>>And to be fair, we did play catch with him, and
I did hit a home run better than Jonas.>>And she was in heels.>>And I was in heels so.>>One time I look outside and
there’s Nicole in a skirt and heels and
she’s helping Wayne clean the turkey. So you don’t know. No kid should have to
go through this at all. But if you have to, you’ve got to at
least have your parents that love you. And to me,
that was the bottom line right there. There is no way these kids were ever
gonna leave that house thinking that they didn’t have somebody
that loved them cuz I do. Sometimes, I’m all they got,
you know it as yourselves. Sometimes your mom is the only thing you
got, and you gotta be able to have that. So, I think that’s kinda where
he got on board, actually.>>[APPLAUSE]
>>What an amazing and important conversation. Thank you Dr. Spack, Nicole, Jonas, and Kelly for
sharing your story for with us tonight. Thank all of you for joining us,
the evening is not over quite yet. We invite all of you to join us for
a reception one floor down, where you will be able to pick up your
own copy of the book Becoming Nicole, and have it signed by Nicole and
Jonas as well. We are also so fortunate to have several
local LGBTQ organizations present as well. They all have informational tables
down there and representatives, so please engage them, learn about their work
and continue this important conversation, thank you.>>[APPLAUSE]

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