>> 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.