Everyone knows the job of being a parent is one that can be unfathomably hard. A heartbreaking example was on a recent episode of Dateline about a six-year-old boy named Joey who, after years of acting out and being depressed, was determined by a doctor to likely be transgender. Despite facing a lot of criticism from their community, Joey’s parents decided to let Joey live as a girl and go by the name of Josie. Making that decision must have been hard, but it was nowhere near as hard as the decision they have ahead of them.
Josie, who has been better-adjusted since identifying as a girl, is approaching puberty and frightened she might change into a man with a deep voice, Adam’s apple, and large hands. Since Josie wants to remain as feminine as possible, her parents looked for a doctor who would be open to the possibility of giving Josie a treatment that would stop her from undergoing male puberty. They found one, but then something unexpected happened: Josie made a comment that she still might be a boy on the inside. Suddenly, Josie’s parents were no longer 100% convinced the treatment would be the right thing for her. But if Josie is to avoid going through male puberty, they are going to have to make an irreversible and staggeringly difficult decision very soon.
I was riveted by this episode and felt sick to my stomach watching these parents agonize over the decision ahead of them. They have two options:
OPTION 1: Have Josie undergo the treatment
PROS: Josie would be able to avoid male puberty and experience female puberty (including the development of breasts). For a transgender person, being able to reach adulthood looking as much like the gender they identify with is ideal.
CONS: The treatment would not only stop male development, but render Josie infertile through the injection of estrogen. If Josie later decides that she is indeed a boy on the inside and wants to live as one, she would be in a tough position to do so as she’d lack many masculine characteristics and be infertile.
OPTION 2: Do not give Josie the treatment
PROS: Josie would remain fertile and not have an irreversible treatment performed at a young age. Once she turns eighteen she could have gender reassignment surgery if she chooses.
CONS: Josie would go through male puberty and reach adulthood with overtly masculine characteristics. Even if she chooses to have gender reassignment surgery then, she would not look nearly as feminine as she could have if she’d undergone the treatment.
The experts on the show were split as to what should be done. One said true transgender persons know they are transgender at a very young age, and therefore should be allowed to decide to have this treatment before the onset of puberty (note: blockers can postpone puberty a couple years and give extra time to consider this large decision). Another said that transgender identifying children as young as Josie have been known to later revert to identifying with their original gender, so treatment at that young age is unwise.
The part that made me the most anxious is that regardless of which option Josie’s parents choose things could backfire horribly. I can see an adult Josie who underwent the treatment screaming, “I was just a little kid! How could you give me that treatment? I’ll never be the man I could have because of you! You’ve ruined my life!” I can also see an adult Josie who didn’t undergo the treatment screaming, “I told you since I was six-years-old I was a woman! How could you not give me that treatment? I’ll never be the woman I could have because of you! You’ve ruined my life!”
I am no expert on transgender issues, nor do I have any personal experience dealing with transgender children. All I know is that I hope Josie and her family are happy with what they decide, and that the thought of having to make such a difficult decision regarding Annabel’s future scares the crap out of me. Josie seems like a bright and loving child, and her parents seem like good people. I doubt they ever imagined being faced with such a difficult situation before becoming parents, and yet here they are. And here we all are.
Suzanne says:
Although there is nothing easy about this situation, how lucky is Josie to have such supportive parents?! It sounds like they truly have her best intrests at heart, rather then forcing her to be something she isn’t or acting like it isn’t an issue. I can’t imagine having to make such a tough decision for my child, but I would hope I would be just as supportive.
Tina says:
Athough I understand their dilemma, the truth is, we as parents are not given a handbook to take home with our baby. In fact something like 90% of us first time parents think (bewildered), “They are really letting me take this baby home? On my own?? Seriously?”
And we then have thoughts of accidentally killing our baby or at least accidentally harming it, because we have NO idea what to do with a baby, lol.
That said our entire lives are marked or changed or defined by how we were raised. If only my mother wasn’t not a neurotic psychopath, who kicked my dad out when I was 12 and then told me “I am all done with you kids, I’ve raised you, now I can live my life” leaving me alone with my brother (8 and 6 years old), who would I have turned out??
Did she ruin my life? Am I this idiotic doormat of a person because all my life she couldn’t stress enough how by being born, I ruined HER life? Would I have been a person that can actually say no and acutally NOT think that everything is her own fault and take responsibility and punishment even for this out of her control?
Possibly… did I scream at my mom “you’ve ruined my life”? No…
In the same way, am I ruining my kids by giving them everything?
Did I make a mistake when my premature son’s front teeth rotted because of enamel dysplasia (due to prematurity) and we had them removed, then discovered that they won’t come in for a few more years as his development is super slow and now speaks with a lisp?
How would my marriage be if my husband had a milder temperament? Had he been raised with a mother who was calm, educated and loving and actually around?
SOOOO many factors that determine who we are, who we become and where we end up… How do you decide? And once you decide how can you control the ripple effects your actions will have down the line?
Truth is.. you can’t. You can only do what you think is best at the time. Weigh the pros and cons, pray even and go for it…
Truth is we make decisions that will affect our children and our children’s children and those around our children (see: school bully for instance or school stuck up diva), every singly minute of the day.
Even if we don’t know it, EVERYTHING we do will affect our children for the rest of their lives, maybe in not such a proufound way all at once as in Josie’s case, but little by little.
When it comes to parenting I think in reality we are all clueless
Some go with instict, some go with experience, some go by what “experts” say… in the end, all we do in reality is take a chance, pray and hope for the best
Meyli says:
What about the hormone blockers? They delay puberty and if you stop taking them, you start puberty. That seems like a good decision for any transgender child – then they can make the irreversible decisions as a teenager or young adult, instead of such a young kid.
Annalisa says:
That sounds like the best option, actually. It would hopefully give Josie/Joey time to figure what s/he wants to do. Throughout my read of your post I thought that very thing: How young is Josie? Is there any way this can wait until s/he figured it out for her/himself?
My other thought is, gender and sex are two separate issues. If I am to take friends who are way more experienced on the issue than I’ll ever be, it’s not as simple as “if you want to be a female, you need to be a girl”. You can identify as female and still want to be a boy on the outside. Ditto with being a male and being a girl on the outside.
There is no imperative that who you are gender-wise should match your genetic sex markers, and viceversa. It’s important for Josie and her parents to consider that, as well. Then again, I say that as someone who knows a parent whose doubleX chromosome college kid all of a sudden decided “she” was “neither a he or a she, but both”, and would therefore only respond to “they” from then on (Kids these days! :P).
Meyli says:
Exactly, sex and gender are different things!
I hope Josie just tries to be true to her/his self, and not try to fit in as a ‘girl’ or ‘boy’. Those are two very strict boxes to fit into, and why should you have to?
Josie is Josie, and Josie is exactly the way Josie should be.
Zelda says:
Yeah, hormone blockers are probably the best bet for Josie’s situation. That way she can buy more time to figure herself out.
Quart says:
What Suzanne said!
Evelyn says:
How lucky this little girl was born into a family who accepted her struggle and are open minded to enough to consider the various courses of action. (note – I believe as parents we should all accept our children, however I know that’s not the reality) I have to imagine, when their son was younger, after consultation with his doctors and just knowing their child, were able in the end to trust their gut and give her the opportunity to live as a girl. I hope they’re able to reach this next hurdle in a similar matter. Also kudos to you, mike for presenting a hot button topic in such a diplomatic way.
Emily says:
George Jessie Love is a great blog about this very subject. Check it out if you’re interested in learning more about these challenges.
http://georgejessielove.wordpress.com/
I enjoy reading it even though I have no children and am not acquainted with anyone who identifies as transgender.
Kim says:
My heart goes out to Josie and her parents in making such a difficult decision.
Melli says:
I saw the episode too. I was all for blockers and estrogen for this kid’s sanity (since he mentioned suicide) but once he appeared to possible having a change of heart, I wasn’t so sure…even though he seemed to change it back quickly. The momentary doubt was so troublesome. I don’t know what I think anymore, such a complex problem. Poor kid.
lilcg says:
those poor parents. I just hope that regardless of what they decide to do that josie will always understand that she is very loved and that might just make the next few years a little easier.
Lanie says:
Parenting is not for wimps.
meg....ct says:
so true
Amy Marshall says:
I appreciate the way you’ve approached this, with sensitivity and openness… yes, really really hard decisions…
Trisha says:
Thank goodness she has such loving and understanding parents who are even willing to research options for her. I didn’t catch this episode but I wish the family the best in coming to a decdion that works out for all.
Thanks for sharing Mike!
kellye says:
I thought the majority of your post was well-writen, presenting the facts as the facts without adding in opinion, and being sensitive to the situation.
However, I was turned off by the second line in your post when you say Josie was “diagnosed as transgender” – I do not believe transgender is a diagnosis; the use of the word “diagnosis” also implies that it is a medical disease/illness/etc.
Mike says:
Hi Kellye,
I didn’t mean to imply that transgender is a disease or illness. I used the world diagnosed because the parents took Josie to a doctor who was the first one to suggest Josie might be transgender. Since it was a doctor who determined why Josie was acting out/depressed I used the word “diagnosed,” but you’re right, it doesn’t quite fit here. I changed it in the post.
kellye says:
no harm no foul
giselle says:
Sucks for the parents. Josie is so lucky to have such awesome parents. I hope that they make a decision they are all happy with forever and I hope that Josie realizes that she is extremely lucky.
twingles says:
Wow. I really don’t think Josie will grow up and scream at his/her parents if they choose not to delay puberty, since they have been behind him/her all the way. It sounds like Josie is being raised in as healthy a way as possible. The momentary lapse makes me wonder if a child this age should be allowed to make such a monumental decision. I would sway toward no and let the chips fall where they may, even if it means surgery later on. Again it’s all in how the parents are approaching it.
Leah says:
I think they should leave well enough alone, let him decide when he is an adult, in the meantime get him some good counseling. Praying for the family.
C says:
I can’t imagine how hard it is for both the child and the parents. I’m so glad Josie’s parents are supportive.
Annalisa says:
Okay, so I tried to reply to Meiji, but am having no luck getting it to stick. I would think postponing puberty for the time being would be the way to go. It would hopefully give Josie/Joey time to figure what s/he wants to do. Throughout my read of your post I thought that very thing: How young is Josie? Is there any way this can wait until s/he figured it out for her/himself?
My other thought is, gender and sex are two separate issues. If I am to take friends who are way more experienced on the issue than I’ll ever be, it’s not as simple as “if you want to be a female, you need to be a girl”. You can identify as female and still want to be a boy on the outside. Ditto with being a male and being a girl on the outside. There is no imperative that who you are gender-wise should match your genetic sex markers, and viceversa. It’s important for Josie and her parents to consider that, as well.
Mommy says:
My only experience in this area was a few years ago. I had a student who labeled herself as a tomboy, but looking back maybe she did identify more as a boy than a girl. Anyway, the end of the year swim party was fast approaching and she and her mom were arguing over what she could wear, so they scheduled a conference with me. She wanted to wear board shorts and nothing else, and her mom wanted her to wear a one piece made for a girl. This student was adamant that she would only go if she could wear just the shorts. But at 11 years old, and developing breasts already, her mom and I were both concerned with what the other students would say and do if she were to go topless. I really had NO clue what the right answer was. I didn’t want her to feel ashamed or ostracized by not being allowed to wear what she wanted, but I also didn’t want her to be made fun of or laughed at while at the party. We tried compromising and asking her if she would wear the shorts and a rash guard or shirt, but she insisted it wasn’t fair because at home she could wear just shorts, and the boys didn’t have to wear shirts, so why did she? She was in tears, and so was mom, and to be honest, I was too, because I just didn’t kn
Mommy says:
Oops, hit send too soon. Anyway, I was so upset too because I just didn’t know what to do. I knew that if I let her wear what she wanted, I would be setting her up to be tormented. Yet I knew that telling her no was causing her such hurt as well. After much discussion, she said she would consider wearing a wetsuit. But on the day of the party, she decided to skip it all together. I have always wondered what I could have done differently that day to help her or make her feel more comfortable.
My point is, even as a teacher I found myself in a difficult spot trying to do the right thing for a sweet kid who was upset. I can’t even fathom what the parents go through on a daily basis with kids who are transgender. If only life was simple for all of us….
mercadeo says:
Transgender youths potentially face many hardships in obtaining medical treatment for their condition. Psychiatrists and endocrinologists are generally reluctant to provide hormone therapy to youths under 16, and obtaining sex reassignment surgery prior to the age of 18 is almost impossible in most countries. However, the latest revision of the Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People has addressed the needs of transgender children. Currently, the SOC allows for medications for prevention of puberty to be prescribed to these children as soon as the first signs of puberty become apparent.
lacey says:
Twingles and Leah and Annalisa and maybe other people whose comments I didn’t see / haven’t seen:
Respectful and correct pronouns (when discussing trasngender OR cisgender individuals!) are the ones that the person in question has identified. Thus Josie’s pronouns are “she” and “her.” (From watching the episode it sounds like Josie is firmly identified with she/her pronouns, although I can see where her recent statements about being a boy on the inside would create confusion for the commenter!) Mike set a great example here!
lacey says:
Mike,
I am very impressed by your respect and correctness writing about a topic that you say you have no expertness/experience with. Correct pronouns, “transgender” instead of “transgendered,” supportive and compassionate dialogue all around. It is so so so important for LGBTQ individuals to have kind and thoughtful and smart allies in the community! You are the best ever. Thanks.