Gender Dysphoria in Children with Dr. Chelsea Gordner | Connecting Point | Feb. 6, 2019


>>2017 REPORT FROM THE WILLIAMS
INSTITUTE FOUND ONE IN EVERY 130 TEENAGERS WOULD IDENTIFY AS
TRANSGENDER IF THEY WERE ASKED AND RECOGNIZES WHAT COULD START
IN THE MEDICAL COMMUNITY AND AGENDA DYSPHORIA. WHEN I SPOKE WITH DR. CHELSEA
GORDENER, I ASKED HER TO BEGIN WITH A DEFINITION OF THAT.>>IT’S REALLY WHEN A PERSON IS
UNCOMFORTABLE WITH THEIR BIRTH GENDER AND IF THEY’RE BORN MALE,
THEY’RE UNCOMFORTABLE BEING MALE AND POTENTIALLY WOULD IDENTIFY
AS FEMALE.>>IS THERE SOMETHING A
PARTICULAR AGE WHERE WE SEE THIS MORE COMMONLY DISCUSSED OR
BROUGHT OUT TO LIGHT?>>THAT’S A GOOD QUESTION. YOU KNOW, I SEE KIDS AS YOUNG AS
FOUR OR FIVE AND I HEAR FROM PARENTS AND FAMILIES THAT KIDS
HAVE FEELS OF GENDER DYSPHORIA AS YOUNG AS TWO OR THREE AND IT
CAN START VERY YOUNG. I WOULD SAY IN MY CLINIC, THE
PATIENTS THAT ARE COMING IN FOR EVALUATION ARE MORE IN THEIR
TEENAGE YEARS BUT WE SEE ALL AGES.>>AND WHEN THIS CONVERSATION IS
COMING COMING UP FOR PARENTS,
ESPECIALLY ON THE YOUNGER SPECTRUM, WHAT DO YOU DO AS A
PARENT? WHAT DO YOU ENCOURAGE THE PARENE
THE PARENT TO APPROACH THAT CONVERSATION?>>IT’S TOUGH FOR SOME FAMILIES. AS YOU CAN IMAGINE, IT CAN BE A
BIG SURPRISE FOR SOME FAMILIES. I WOULD ENCOURAGE OPENNESS,
TALKING WITH THEIR CHILD ABOUT THEIR FEELINGS AND JUST TRYING
TO LEAVE THE METHOD OF COMMUNICATION OPEN SO THAT YOU
CAN SEE HOW THEY’RE FEELING BECAUSE SOMETIMES WHEN THE
GENDER DYSPHORIA PRESENTS VERY YOUNG, SOMETIMES IT GOES AWAY AS
THE CHILD ENTERS PUBERTY AND MAY SHIFT.>>WHETHER OR NOT OR SHIFTS,
PARENTS SHOULD BE OPEN TO JUST WHATEVER IT IS THEIR KID ARE
FEELING, VALIDATING THEIR FEELINGS AS IF ANYTHING THEY
WERE EXPERIENCING.>>ABSOLUTELY.>>FOR PARENTS WHO FIND THIS IS
SOMETHING THEIR CHILDREN DO CONTINUE WITH, HOW IS THAT,
THEN, HANDLED OR OR DISCUSSED?>>THE SUBSET OF CHILDREN WHO,
LEAD SAY THEY ARE GENDER DYSPHORIA VERY YOUNG, AS THEY
START PUBERTY AND GREW PUBERTY, SOME OF IT THE AGENDA DYSPHORIA
WILL GO AWAY AND SOME IT GETS WORSE AND THAT’S WHEN YOU NEED
TREATMENT.>>DO YOU MEAN PSYCHOLOGICAL
TREATMENT, PHYSICAL TREATMENT IN HORMONE THERAPY?>>I THINK IT’S GOOD AT ANY
POINT TO CONSIDER THERAPY. WE HAVE A LOT OF THERAPISTS IN
THE AREA THAT SPECIALIZE IF GENDER DYSPHORIA, SPECIAL WITH
CHILDREN, TALENTS ADOLESCEND YOUNG ADULTS SO IT’S GOOD TO
START WITH THERAPY.>>TALK THERAPY, YOU MEAN?>>TALK THERAPY, YEAH.>>THROUGH THAT PROCESS, WHAT
WOULD BE OPTIONS THAT WOULD BE DISCUSSED IN TANDEM WITH SOMEONE
MAYBE FROM YOUR OFFICE?>>SO SOME PATIENTS MAY WANT TWO
GO ON TO PURSUE MEDICATION, HORMONE THERAPY, AS YOU
MENTIONED. I WOULD IMAGINE THAT’S SOMETHING
THAT’S PRETTY CONTROVERSIAL POTENTIALLY, WHETHER OR NOT
THAT’S SOMETHING A CHILD WANTS TO PURSUE.>>WE DON’T JUMP TO TREATMENT AS
OUR FIRST THERAPY, I GUESS TREATMENT OPTION. COUNSELING IS THE MAINSTAY IN
THE BEGINNING BUT IF THE GENDER DYSPHORIA IS PERSISTING THROUGH
PUBERTY AND WORSENING, UNTREATED DYSPHORIA LEADS TO DEPRESSION,
SUICIDE, SO WE WANT TO SUPPORT THE CHILD AS BEST WE CAN AND
SOMETIMES THAT INVOLVES MEDICATION.>>I WAS LOOKING AT STATISTICS
AND THE WILLIAMS INSTITUTE AT UCLA SCHOOL OF LAW, IN 2017,
THEY REPORTED THAT ABOUT 150,000 TEENAGERS IN THE UNITED STATES,
IF THEY WERE ASKED WOULD IDENTIFY AS TRANSGENDER. 40 HOW DOES THAT CONCEPT OF
GENDER DYSPHORIA LINK TO SOMEONE TRANSGENDERED? MANY PEOPLE WILL GO ON TO
TRANSITION AND IDENTIFY AS TRANSGENDER.>>IN TERMS OF THIS IDEA OF A
TOMBOY OR TOMGIRL, I THINK THAT’S A CONCEPT PEOPLE HAVE
LONG TALKED ABOUT AND KNOW ABOUT, BUT HOW DO YOU AS A
PARENT DISTINGUISH BETWEEN, MAYBE, A CHILD STRUGGLING WITH
GENDER DYSPHORIA AND SOMEONE WHO HAS AN AFFINITY THAT MAYBE
DOESN’T LINK UP WITH THE SEX THEY’RE ASSIGNED AT BIRTH SOME.>>ABSOLUTELY. SO A LOT COMES DOWN TO HOW
UNCOMFORTABLE THEY ARE WITH THEIR BODY. YOU CAN BE A TOMBOY AS THEY SAY
AND LIKE TO PLAY MASCULINE SPORTS OR PLAY BUT IT COMES DOWN
TO HOW UNCOMFORTABLE THEIR BODY PARTS AND DO THEY WANT TO CHANGE
THOSE BODY PARTS.>>IT’S NOT A PHYSICAL
DISCOMFORT OR IS IT A MENTAL DISCOMFORT? HOW ARE WE DEFINING THAT
DISCOMFORT?>>MORE OF A MENTAL DISCOMFORT
IN THAT THEY DON’T LIKE THEIR BODY PARTS, THEY’RE NOT
COMFORTABLE WITH THEM AND NOT COMFORTABLE IN THEIR OWN SKIN. DIDN’T I WAS DOING SOME READING
ONLINE, ALSO THAT WAS PROFILING A YOUNG GIRL AND HER FAMILY AND
SHE TRANSITIONED FROM MALE TO FEMALE AT A YOUNG AGE, TEENAGE
YEARS. AND ONE OF THE WAYS THAT SHE
DISCOVERED THAT SHE FELT SHE WAS TRANSGENDER WAS BY CONNECTING
WITH THE COMMUNITY ONLINE, WATCHING YOUTUBE VIDEOS AND
VISITING BLOGS AND CHATS AND THINGS LIKE THAT, WITH THE
ADVENT OF THE INFORMATION THAT’S AVAILABLE TO YOUNG PEOPLE NOW
WHAT HAS THAT DONE FOR THIS LINE OF THERAPY AND MEDICAL APPROACH?>>I THINK JUST LIKE ANYTHING
ELSE, PATIENTS, CHILDREN, AND DAD LESS
ADOLESCENTS ARE TURNING TO THE INTERNET FOR INFORMATION AND
DYSPHORIA IS NO DIFFERENT AND A LOT OF THESE PATIENTSES SUFFER
FROM DEPRESSION AND MAY NOT KNOW ANY OTHER TRANSGENDER
INDIVIDUALS AND SO THEY FIND THAT SUPPORT ONLINE. THEY DO FIND INFORMATION ONLINE.>>AND SO IF A CHILD OR A
TEENAGER, YOUNG ADULT IS EXPERIENCING THESE THOUGHTS OR
FEELINGS, WHAT WOULD YOU SAY TO THEM AS THEIR FIRST COMING TO
LOOK AT THESE, EXAMINE THESE THOUGHTS AND FEELINGS?>>I WOULD SAY ABSOLUTELY, THEY
SHOULD BE EXPLORED FURTHER AND DISCUSSED FURTHER AND THERE ARE
A LOT OF SPECIALISTS IN THE AREA THAT CAN HELP WITH THAT, A LOT
OF THERAPISTS THAT CAN SUPPORT BOOTH THE
BOTH THE CHILD AND PARENT, WHICH IS IMPORTANT AS WELL. AND THAT WOULD BE A GOOD FIRST
STARTING POINT.>>AND THEN WHAT ABOUT FOR THE
PARENT? I KNOW WE TALKED ABOUT BEING
OPEN TO THE CONVERSATION, BUT OTHER RECOMMENDATIONS THAT YOU
WOULD GIVE TO A PARENT?>>THERE ARE SOME SUPPORT GROUPS
IN THE AREA FOR PARENTS OF CHILDREN WHO ARE TRANSGENDER OR
GENDER NONCONFORMING AND THAT’S A GOOD RESEARCH FOR PARENT.>>IT SOUNDS LIKE YOU’RE SAYING
IT’S NOT A HARD AND FAST DETERMINATION THAT’S MADE, THAT
THERE’S A RANGE OF THOUGHT, FEELINGS THAT CAN AND MAYBE
SHOULD BE EXPLORED AROUND THIS ISSUE?>>YOU’RE RIGHT. I THINK IT’S IMPORTANT TO KNOW
THAT WHEN THIS STARTS VERY YOUNG IN LIFE, THE FEELINGS OF GENDER
DYSPHORIA ARE UNCOMFORTABLE WITH YOUR BODY PARTS, THOSE FEELINGS
MAY GO AWAY AND SO NOT ALL CHILDREN WILL HAVE PERSISTENT
FEELINGS, I GUESS IS WHAT I WANT TO SAY. BUT IF THOSE FEELINGS OF GENDER
DYSPHORIA OCCUR AFTER PUBERTY AND PERSISTING BEYOND PUBERTY
AND LASTING MORE THAN SIX MONTHS, WE THINK THE FEELINGS
ARE HERE TO STAY.

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