What do you do when your teenage daughter comes home from school one day and, says, “Don’t call me Janet. I’m a boy and my name is Jack”?

This week, we're answering a question from Dr. Lorie who writes:

I’m a psychiatrist and have a situation that has come up a couple of times recently and would like your opinion about it. What does a parent do for a teenage child who comes out as transgender when the parent's opinion is that it is more a product of social pressure and functioning than actual gender dysphoria? There was no pushing the limits of gender conformity as the child was growing up, and then the child hits jr high/high school and literally one day to the next the child announces this. The parent, of course, seeks therapy for the teen and quickly learns that gender therapists shuttle these teens in one direction only, and do no questioning of the teen's decision. How is a parent to handle this complex situation? Could some of this be part of a power struggle on the part of the teen? i.e. call me by this name, rather than the name you gave me, call me a boy, etc.

Thanks for your question, Dr. Lorie. Let’s see what we can figure out here and see if we can offer parents in this awkward and shocking situation some guidance.

A Realization, Not A Choice

First of all, yes there are transgendered youth and adults. It’s a real thing. These are individuals who know that their biological self is simply not their correct gender. They feel and know that they are of the other gender. This is, of course, not an easy realization to come to.

They’ll often have felt for a long time that something was wrong with them, that they aren’t like others and they’ll often have a hard time with peers and family. Some in the transgender community undergo hormone treatments to biologically support their other gender identity and sometimes they’ll have surgeries to support their change. Sometimes they’ll do neither and simply wear the clothing and identify as being of the other gender.

It’s important for folks to know that this isn’t so much a choice as it is a realization. Once the realization is made, and transgendered individuals get support for their new identity, they can also move from insecurity, feelings of unworthiness and depression, to happiness and fulfillment.

But as a parent, what do you do if your teenager says to you one day, “Mom, don’t call me Janet anymore. Call me Jack; I’m a boy now.” That would be pretty weird right?

In the cases that Dr. Lorie has been dealing with, parents believe that their teenager’s idea is simply one of social pressure from other kids who have this identity.

Exploring The Why

So let’s think about this. If a teenager suddenly comes out as transgendered, that’s pretty extreme and we have to wonder what’s driving it. Simply to say it’s peer pressure would be missing something. For instance, let’s say peer pressure is a major reason for Janet suddenly wanting to be called Jack; but why? Why was Janet so vulnerable to peer pressure that she’d accept something so extreme. Could it be that her transgendered friends were the only group she could connect to? If so, what is going on with her or what’s going on in the school, that she only feels safe or connected with the trans students? What’s going on with her that her sense of identity is so underdeveloped?

Another consideration could be that she has some other kind of psychiatric issues, such as schizophrenia or bipolar disorder. Either one of those conditions could be coming on in adolescence, and that could be effecting a sudden change in identity. There could have been some kind of trauma, perhaps even sexual trauma recently or at an earlier age that is effecting how this teenager is feeling about their sexual identity.

And of course, what if they’ve been struggling with the feelings and perhaps knowing that they are in fact transsexual, and they’ve been resisting acknowledging it to themselves and, once they did, when they come out to parents, it comes out as if it is coming out of the blue.

What Is A Parent To Do?

Here’s what I recommend. If you’re shocked, don’t react at all. We simply can’t react well when we’re shocked. When you get up off the floor, be cool, and ask questions.

“Tell me more about this. Obviously this is something you’ve been struggling with. Tell me more about how you arrived at this.”

Of course, if whom you’ve always called Janet now wants to be called Jack, that’s going to be a tough one, but my recommendation is something like: “Jack, I might not always get it right since you’ve always been Janet to me, but I’ll try.”

The important thing is not to get into an argument about the legitimacy of your teenager’s declaration or even what name you will call them, or what gender pronoun you will use for them. Go with whatever they request the best you can, and ask their indulgence for the fact that it will take you a while to adjust.

Simply do not over-react and don’t react negatively. Finding a therapist could be appropriate and they should be vetted and briefed so that you know they will take a slow measured approach. They should work with the teenager with respect to their overall functioning, how they manage feelings, relationships within the family and with peers, responsibilities, substance use or abuse, overall mental health - everything, not just issues around gender identity, which of course would be addressed as well.

It should be a positive, supportive, and non-judgmental experience for the youth. It should not be treated as a crisis, and nothing is urgent. It should not be treated as we now have an identified transgendered youth who needs full support for the reality of their transgendered identity. Things should move more slowly and as the therapist discovers who this young person is and what they need, a psychiatric evaluation, or psychological testing, could be in order. Family therapy would be important to support the youth and parents staying in a quality relationship. We don’t want a Control Battle to develop around this. If there was one previously, this would be a great time to kill it, to Starve the Beast, as I like to call ending a Control Battle.

I should mention that there are some cases where young adults discovered that their adolescent trans identity was part of an identity crisis and they were not in fact transgendered. That’s why going full speed ahead with certainty towards medical intervention and trans community support is not the way to go.

So, parents, therapists, and anyone working with teens and parents: anything a teenager says about who they are or who they want to be, or what they think, should be accepted as what they think right now, and not what they will think later. Their thoughts may endure. They may shift and they may turn 180%, but let them be and feel heard and validated and keep things moving forward with the focus on healthy development in all areas.

Thanks for tuning in today and special thanks to you Dr. Lorie for your important question.

A COVID-19 Message

I’d like to offer a little coping with COVID-19 advice. I’ll even call it a challenge. A lot of things are different right now and in fact, almost everything is different. Where we go, what we do, how we shop, eat, socialize, go to school, work: everything is different and often, very stressful and anxiety-provoking. One way to cope and reduce our anxiety with everything changing is to embrace change and do something different as individuals and as a family that’s fun and calming.

Here’s my idea: SING. Yes, most of us either don’t sing or rarely sing, we’re too shy or embarrassed, it simply isn’t done. But singing is a simple way to feel better. Singing activates the parasympathetic nervous system, much like slow deep breathing. So if we sing more, we’ll all feel better. Learn a new song to sing every couple of weeks or so. Then have a singing night with the family, where everyone sings their songs. Then sing them together, teach each other the songs. I’m guessing that there aren’t too many families out there that are doing that, although there are some lucky families that make music with singing and instruments.

Check out the podcast episode to hear me sing a song that my friend Terry taught me, Our Love Is Here To Stay. Terry is a beautiful singer with a trained singing voice. I’m not a good singer, but that doesn’t matter, it’s still healthy and fun.

During this very challenging time for our respective countries, and in our communities and families, many folks will experience feelings and situations that are overwhelming and I want to encourage you all to reach out to your mental health community. Many individual therapists and community mental health centers are providing services by phone and video platforms. If you’d like a consultation with me, give me a call or email and we can set up a meeting in a Zoom meeting room.

If you're looking for a resource to help keep you productive at home while also helping you become a better parent, I've prepared a free gift just for you. It’s called Parenting Through Your Child's Second 12 Years. I know you’re thinking, "What the heck, 12 more years of parenting?" Adolescence neurologically, socially and emotionally, and often financially goes to around age 24. Yes, parenting your 20-year-olds is different than the teens. Download my gift and read and learn about the different stages of adolescence and critical strategies parents can use to avoid control battles and best support their adolescents’ quest for happy successful independence.

If you are a therapist who works in a behavioral health treatment program and would like to talk with me about improving outcomes in your program, come on over to my website neildbrown.com and shoot me an email or give me a call. I’ll be happy to talk with you.

Please, take care of yourselves; you need it, you deserve it, you’re worth it. Bye for now.