National Coming Out Day - October 11

National Coming Out Day (NCOD) 

https://en.wikipedia.org/wiki/National_Coming_Out_Day 

This is an annual awareness day that is observed on October 11 to support any LGBT+ member "coming out" of the closet, whether it be to their significant other, their family, their smaller circle of friends, colleagues, or the whole world.

The first NCOD in the United States was in 1988 (marking its 35th anniversary in 2022).  

NCOD Observance is also done in Ireland, Switzerland, the Netherlands, and United Kingdom. 

In the United States, NCOD is sponsored by the Human Rights Campaign with annual themes.

At the very beginning, it was grounded in the feminist and gay/ lesbian liberation spirit and the most basic form of activism being living life as an openly lesbian or gay person. The psychology behind this is that homophobia thrives in an atmosphere of silence and ignorance. People who know they are loved by their family, friends, and colleagues, even after coming out, are far less likely to maintain homophobic or oppressive views.

I do not personally care too much about that psychological explanation. I don't believe all gays and lesbians, and other LGBT+ members, suffer from homophobia. At least my simple child does not, other than some non-believing jokes about moving to Texas with me and being shot in the parking lot (however, for that valid phobia, I am willing to allow her to live with her father in California in her senior year of high school, so that she could have her peace of mind). I also don't believe by coming out, homophobia will go away overnight. It is more complicated than that.

But, as someone who is somewhat free spirited, someone who wants to treat others the way she wants to be treated, I want to be my truest self, I want to hold up my value system (which may overlap but not necessarily identical to other value systems such as the law, culture, or religions). I want the freedom to make my own conscious decisions and take full responsibilities for the consequences, while at the same time making sure I am a contributing member of the society and I am here to marginally make the world a better place.

One of the biggest social transitions we did early on after my kid came out to me was to take her to our local Pride Fest. I was up close and cheering and whistling and waving. I was wearing rainbow all over me. I was a strong ally, basically. But, I was not a member. I knew the euphoria I got was coming from being a good and supportive person, not from being accepted or belonging like the real LGBT+ members feel. My child, shy and worried, hid behind a tree peeking out most of the time, she did not want to be associated with a crazy and loud mom, but, I saw the beaming light in her eyes and the blush cheeks on her face. She was clearly excited, and I, in that moment, knew for sure I must accompany her on this long journey to happiness, and I will fight if I have to.

 

LGBT+ History Month - October

This is not to be confused with LGBT+ Pride Month, which is usually June.

https://en.wikipedia.org/wiki/LGBT_History_Month

In the United States, Canada, and Australia, it is celebrated in October. In Hungary and the United Kingdom it is observed during February (in the UK this coincides with a major celebration of the 2003 abolition of Section 28). In Berlin, the capital of Germany, it is in May (known as Queer History Month). 

In the United States, October was chosen as the month for the celebration because the first and second LGBT Marches on Washington, in 1979 and 1987, were in October; National Coming Out Day (NCOD) is on October 11 to mark the date of the Second March on Washington for Lesbian and Gay Rights in 1987, and October is within the academic calendar year.  

LGBT History Month is intended to encourage honesty and openness about being LGBT. While it was first known as Lesbian and Gay History Month, it has become known as LGBTQ+ History Month.

Medical Terms

I am just a mom that is doing her own homework and taking notes of things she learns along the way.

Some of the things I jot down might be common knowledge for some of you, but we are all different and I am sure there are also people like me who start from zero. 

As an educator, I now follow this approach in teaching - never assume students already knew something, always assume they knew nothing in the background.

* Specialists *

"It takes a whole village to raise a child." Similarly, transitioning is a team work.

Therapist

Psychologist

Psychotherapist

Psychiatrist

Social worker

* Medications *

It is critically important to know what we put into our (child's) body and the short-term and long-term side effects, many of which are yet known due to the first generations of teen trans have not reached their 50s-60s.

Oestradiol pill - a gender-affirming hormone in the form of pills

Sprionolactone - a testosterone suppression medication

Estriol - a sex steroids that would make the penis shrink

Lupron - NO!!!

Puberty blockers - controversial treatment from state to state

* Surgeries *

Except for the chest or breast removal (FtM without puberty blockers), most are *bottom* surgeries. Not all trans choose to have surgeries due to various reason, including affordability and internal desire.

For trans girls (MtF)

Penile inversion - note that only male-born that did not go through circumcision could do this

Testicles removal (disposal)

Erectile tissue removal (disposal)

Orchiectomy (same as vaginoplasty)

Phalloplasty (not functional)

Scrotectomy (scrotal tissue removal) 

Vulvoplasty (zero-depth vagina and vulva construction using the scrotal and penil tissue)

Vaginoplasty (vagina construction)

Medioplasty

Urethra cut short (and placed in female position)

Uterus (ovalry transplant) - this is the future of health care which may allow trans girls to be pregnant

For trans boys (FtM) - including top and bottom surgeries

Bilateral masectomy (chest reconstruction) - by far the most common

Hysterectomy (removing reproductive organs, required for some other surgeries)

Oophorectomy (same as hysterectomy)

Metoidioplasty (clitory release)

Scrotoplasty (crotum construction)

Uretheroplasty (urethral canal creation)

Vaginectomy (vaginal tissue removal to close the opening)

Phalloplasty (phallus/ penis-alike construction using a graft from another part of the body)

* Others *

Last but definitely not least, there are other things that are optional but could help significantly in emotional behavior.

Electrolysis (laser hair removal using electric needle) - for trans girls

Breast augmentation (silicone or silibreast implants) - for trans girls

Facial feminization (face bone contouring) - for trans girls

Fertility preservation (cryo preservation) - for both

(which could cost $1,000 in the first year and $150-300 for the subsequent years' preservation).

LGBT Rights in the United States

LGBT rights progress - in the United States

https://en.wikipedia.org/wiki/LGBT_rights_in_the_United_States

* Same-gender sex *

It is hard to believe that not too long ago, in 1962, all 50 states criminalized same-gender sexual activities!!!

By 2003 all remaining laws against same-sex sexual activity were invalidated with the last one in Lawrence v. Texas. 

* Marriage *

The movement to obtain civil marriage rights and benefits for same-sex couples in the United States began in the 1970s but remained unsuccessful for over forty years. 

On May 17, 2004, Massachusetts became the first U.S. state and the sixth jurisdiction in the world to legalize same-sex marriage following the Supreme Judicial Court's decision six months earlier.

Before nationwide legalization, same-sex marriage became legal in 36 states; twenty-four states by court order, nine by legislative action, and three by referendum. Some states had legalized same-sex marriage by more than one of the three actions.

On June 26, 2015, the Supreme Court ruled in Obergefell v. Hodges that states must license and recognize same-sex marriages. Consequently, same-sex marriage is legal in all 50 states, the District of Columbia, Puerto Rico, Guam, U.S. Virgin Islands, and Northern Mariana Islands.

Currently, same-sex marriages are neither licensed nor recognized in American Samoe, due to its unique constitutional status. 

The legal status of same-sex marriage also varies in Native American tribal nations, as their reservations are considered sovereign entities and were not affected by the Supreme Court's legalization in 2015.

* Anti-discrimination laws *

U.S. federal law does not explicitly include protections against discrimination on the basis of sexual orientation or gender identity. 

In June 2020, the U.S. Supreme Court ruled that sexual orientation and gender identity are included under "sex" as a prohibited ground of employment discrimination in the Civil Rights Act of 1964. The ruling may impact other federal civil rights barring sex discrimination in education, health care, housing, and financial credit.

Explicit and comprehensive anti-discrimination protections based on sexual orientation and gender identity are considered by the United States Congress under the Equality Act (May 17, 2019). As of July 27, 2020, the bill remains in the Senate.

* Employment *

There is no federal statute explicitly addressing employment discrimination based on sexual orientation or gender identity. 

However, in June 2020, the U.S. Supreme Court ruled that sexual orientation and gender identity are included under "sex" as a prohibited ground of employment discrimination in the Civil Rights Act of 1964. This effectively means that in the U.S., no employer can fire an employee on the basis of sexual orientation or gender identity.

Twenty-four states, the District of Columbia, Puerto Rico, Guam, and over 140 cities and counties have enacted bans on discrimination based on sexual orientation and/or sexual identity. 

Additionally, some states have laws or regulations that ban discrimination based on gender identity and/or sexual orientation in public employment only. 

At the start of 2010, the Obama Administration included gender identity among the classes protected against discrimination under the authority of the Equal Employment Opportunity Commission (EEOC). 

In 2012, the EEOC ruled that Title VII of the Civil Rights Act of 1964 does not allow gender identity-based employment discrimination because it is a form of sexual discrimination.

On July 21, 2014, President Obama signed Executive Order 13672, adding "gender identity" to the categories protected against discrimination in hiring in the federal civilian workforce, and both "sexual orientation" and "gender identity" to the categories protected against discrimination in hiring and employment on the part of federal government contractors and sub-contractors.

President Obama's related Executive Order 13673 required federal contractors to prove their compliance with labor laws, but President Trump revoked this requirement on March 27, 2017.

* Housing *

In 2012, the United States Department of Housing and Urban Development's Office of Fair Housing and Equal Opportunity issued a regulation called "Equal Access" to prohibit LGBT discrimination in federally-assisted housing programs.

It ensures that the Department's core housing programs are open to all eligible persons, regardless of sexual orientation or gender identity. In 2019, however, there was an attempt to weaken the regulation.

Transgender Athletes

https://www.hrc.org/resources/get-the-facts-about-transgender-non-binary-athletes

Article by the Human Rights Campaign (HRC).

*** Twenty states, the IOC, and the NCAA have allowed trans athletes to play sports for decades, with no problems ***

The alternative way to look at the flip-side of the coin is, nearly thirty states and many sports associations have some form of restrictions towards trans athletes, and it is very discouraging.

My child does not play super manly/ boyish team sports like the typical American kids (football, baseball, soccer, basketball...) or other individual competitive varsity sports (swimming, wrestling, tennis, you name it!). My child does/ did get exposed to some uncommon individual activities (table tennis, fencing, curling, sailing, soon, rowing) and the thing she expresses an interest to continue to pursue at college level is fencing. 

However, due to the way sports are always organized by gender (practice, competitions, rankings, coaching, or the locker room per se), the severe gender dysphoria (with the aid of COVID) made her gradually withdraw from fencing completely. Currently a junior, I do hope she will pick up fencing again, that is, if her future college has it. One of the fair concerns as we assume she would have her name and pronouns legally changed by then, but not her gender, and we do not know how it will affect her access to sport teams. (Note: it should be a topic of another post but, she must change her gender in the state where she was born, unfortunately, it was Texas, and Texas would not allow gender change until bottom surgeries are done, which might never happen to some trans due to the high costs and high risks).

To sum up the situation: (mostly directly targeting transgender girls and women in sports)

2015 used to be the worst year for LGBTQA+ community.

2021 surpassed it as the new worst year, with 250+ anti-LGBTQA+ bills enacted, 35+ towards trans girl athletes.

2022 continued the trend, with at least 55 new anti-LGBTQA+ bills under consideration across states.

What could you do? What could we do? What could I do?

Fact #1: some particular trans girls might have physical advantages that help them in sports of their choices (height in volleyball, for example).

Fact #2: natural variation of such physical attributes is a part of sports, any sport, especially at younger age and they are not always advantages.

Fact #3: not all trans girls have the so-called physical advantages, just like any youth, they have varying physical attributes and interests in sports.    

Fact #4: kids should be allowed to play sports that they enjoy, because playing sports has known benefits emotionally, socially, and mentally.

In conclusion, this is not just adding more discrimination to a minority group that is already marginalized in many social contexts, particularly school, but also a poor practice of inclusion.

My girl, for example, is currently about 5' 5" or 5' 6" and maybe 120 lbs which is considered on the smaller size even for biologically born girls. She also prays every day that she stops growing taller or bolder because she really wants to have the feminine look. Physically, she is not that much stronger than me, who is a 42-year-young female after two pregnancies.

My Amber Girl

Today, I found out about my kid's chosen name. As you can see, the "my daughter/ my girl/ she/ her" pronoun has not come naturally to me when I talk about my child and there are various reasons for that.

- My child is not ready to come out publicly (not even to their siblings) and I am unsure what I should do but I think my child should be the lead

- In most social contexts, except for being in a private closed-door room with their physician, I have to refer to them as "he/ him/ his" to avoid unnecessary attention 

- Between going half-way to "they/ them/ their" and all the way to "she/ her/ her", I am not convinced one is better than the other or two-step is needed

- My child has a very masculine first name, and not making it better, a very masculine nickname, which they have learned how to ignore/ to cope with

Anyway, we have made little progress. The first appointment with the specialists at the Gender Health Services won't happen until mid-October. And I suspect hormone therapy won't start before 2023. 

We have bought girl clothing for their first job at the pizzeria. It is barely noticeable due to the fact these are tan uniform shorts and pants and look almost unisex to me. They excitedly whispered into my ears "the girls' pockets are so shallow".

We have shaved the whole body down - armpit, legs, private. It feels good for a short while but we now have to explore waxing or laser treatment for long-lasting effects. The joy on the face, the beaming light in the eyes, somebody really hated the hair.

We have bought a few small girl accessories - some pink stuff for the room, a tiara, I am not ready to paint the wall but definitely want to go with bedding and unisex clothing (it is not easy to do things in a subtle way so that my other kid would not notice yet). 

We have thought of changing preferred name as well as changing legal name on the documents, preferably matching in time to avoid issues during high school graduation, college application, and similar matters. They never told me what name they would like.

Today, we have received a shirt in the mail. This was bought by my kid using some gift card money from their best friend as a birthday gift not long ago when they turned sixteen. 

The label was addressed to "Amber..." My heart just melted. I will save the envelope in my keepsakes, it marks a significant step for us. One is lucky to pick their own names? :)

AMBER

Amber is of French, Latin, Celtic origin, meaning “amber-colored”. This gemstone name is derived from the Arabic Ambar, meaning “jewel”. In Hindi, Amber has roots in Sanskrit, meansing“the sky”. This precious moniker is related to Opal, Sapphire, Ruby, and Pearl. 

Amber is actually fossilized resin from evergreen trees. It looks and feels similar and is often treated as gemstone, having been a popular element in decoration and adornment for many years. Many believe amber stone has a number of mystical/ metaphysical properties.

Amber is a feminine given name taken from amber, the fossilized tree resin. The word can also refer to a yellowish-orange or golden brown color and very rarely, blue amber. Amber is used to make jewelry, which has helped inspire that name and brought it to popularity. 

 

Popularity-wise, since its onset in the 1800s Amber remained uncommon until the 1950s, likely due to Kathleen Winsor's 1944 novel "Forever Amber". The name Amber really took off in the 1960s and '70s and was in the top 20 names for girls in the U.S. from 1981 to 1993.

 

1974 marks the year that Amber finally achieved a top 100 spot, a position Amber would hold for the next 30 years. Amber reached peak popularity in the late 1980s and early 1990s. The name Amber got as high as the 13th most popular girl's name in the United States in 1986.

 

Amber is a name that indicates a gift of gab. Amber is expressive, optimistic, outgoing, and inspiring, charming and cheerful. Amber fascinates others with creativity, especially in writing. In 2018, Amber declined in usage to 471th most popular girl's names.

 

Note: I just purchased "Forever Amber" by Kathleen Winsor from eBay, an amber ring and an amber necklace from Amazon. They are to be shipped to "Amber .... " at our address :)

UCSF Gender-Affirming Guidelines

https://transcare.ucsf.edu/guidelines/

Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People

By the University of California in San Francisco (UCSF) as the standard.  

Table of Contents - so that we have an idea of the broad topics.

• Introduction to the guidelines
• Contributors
• Grading of evidence
• Terminology and definitions
• Creating a safe and welcoming clinic environment
• Transgender patients and the physical examination
• Overview of gender affirming treatments and procedures
• Initiating hormone therapy
• Overview of feminizing hormone therapy
• Overview of masculinizing hormone therapy
• Pelvic pain and persistent menses in transgender men
• Approach to genderqueer, gender non-conforming, and gender nonbinary people
• Cardiovascular disease
• Diabetes mellitus
• Bone health and osteoporosis
• Transgender health and HIV
• Transgender health and hepatitis C
• Transgender people and sexually transmitted infections (STIs)
• Testicular and scrotal pain and related complaints
• Free silicone and other filler use
• Fertility options for transgender persons
• General approach to cancer screening in transgender people
• Screening for breast cancer in transgender women
• Prostate and testicular cancer considerations in transgender women
• Breast cancer screening in transgender men
• Screening for cervical cancer in transgender men
• Ovarian and endometrial cancer considerations in transgender men
• Mental health considerations with transgender and gender nonconforming clients
• Postoperative care and common issues after masculinizing chest surgery
• Perioperative and postoperative care for feminizing augmentation mammaplasty
• Vaginoplasty procedures, complications, and aftercare
• Phalloplasty and metoidioplasty - overview and postoperative considerations
• Hysterectomy
• Binding, packing, and tucking
• Hair removal
• Transgender voice and communication - vocal health and considerations
• Health insurance coverage issues for transgender people in the United States
• Legal and identity documents
• Sex-segregated systems
• Homeless transgender individuals
• Health considerations for gender non-conforming children and transgender adolescents

Dictionary

Body dysmorphia

Bottom surgery

Conversion therapy (-)

Cross-dressing

Desister/ desistance

Gender (identity) dysphoria (GID)

Gender chromosome 

Gender euphoria

Gender expression

Gender identity

Gender reassignment surgery

Hormone (replacement) therapy (HRT)

Intersex

Mental disorder

Non-binary - bigendered, agendered, gender-nonconforming, gender queer

Oxydative stress

Partial transition

Persister/ persistence

Puberty blockers

Rapid onset gender dysphoria (ROGD) - coined by Lisa Littman (Institution for Comprehensive Gender Dysphoria Research)

Reparative therapy (-)

Sex hormone

Sterility/ fertility

Transgender

Transition

Transphobic/ transphobe

Transsexual 

Transvestism

Non-Medication Social Intervention

Gender-affirming could start with social intervention before hormone therapy and wayyy before surgeries.

Here is a link for Child Gender Dysphoria Quiz. It is a very short one with just eight questions.

https://www.psycom.net/quizzes/child-gender-dysphoria-test

Here are a few things we could try as soon as possible:

  -  Consistent, insistent, and persistent communication about gender dysphoria

  -  Use the name and pronoun they prefer, that align with their (internal) gender identity

  -  Check with school and teachers to see what they could do to support

  -  Encourage them to stand up for themselves (trans are among the bravest people)

  -  Assure unconditional love and support by listening and being there

  -  Do everyday little things to reduce the impacts of gender dysphoria / body dysmorphia

       +  Steam up to cover the bathroom mirror

       +  Use big sponges for bathing

       +  Cuddle a pillow while sleeping

       +  Point out positive things about the body

       +  Express feelings (notes, diary, blog, art)

       +  Talk to someone (best friend, family, therapist)

       +  Watch Vloggers with relatable issues (transgender, body dysmorphia)

       +  Wear clothing and accessories for gender-affirming purpose 

       +  Make personal plans (both short-term and long-term)

       +  Exercise and do physical activities (including chores) to improve moods

       +  Stimulate all senses from everyday items (smell, vision, hearing...)

       +  Avoid places and people that are depressing

       +  Escape once in a while (a game, a show, a long bubble bath, a walk...)

       +  Connect with nature (hiking, running, gardening, walking the dog...)

       +  Stay busy (SAT, personal or family projects, teen jobs, tests...)

       +  Go to bed early (no devices, no social media...)

       +  Keep a well-balanced diet with a lot of vegetables, fruits, supplemental vitamins

Pride Fest

https://en.wikipedia.org/wiki/Pride_parade

Pride Parade and Pride Festival debuted in 1970 in memorial of a 1969 event in Manhattan (NYC) with the original focus of gay rights. At its 52th year, Pride Festival now not only celebrate LGBT+ community (lesbians, gays, bisexuals, transgenders, queers, asexuals, plus...) but also encourages social and self acceptance, achievements, legal rights, human rights, and *pride*. Pride Fest is usually in late June, but where we live, the city chose to celebrate July as the Pride Month.

I have always known from groups I am a member of, that being an ally is, in some way, still being an outsider. Here are some examples.

I am on/ in several committees to promote equity, inclusion and diversity, and typically, we immediately think of racial equality for the minorities (which is a narrow definition). I have seen white allies being accused for making insensitive statements or misunderstanding the non-whites. I have also felt most efforts are spent on African-Americans and not on other minorities such as Indigenous or even Asians.

I listened to a podcast interviewing Danielle Ponder, a rising song writer-singer from Rochester, New York, and even though she became a full-time singer at the age of 39, she used to be a public defender and the reason was, when she was very young, her brother violated the "three-strike law" in New York and had to go to prison for 20 years for three misdemeanors he committed. She saw it from inside out.

I took my child to Pride Fest this year as the first major activity towards gender-affirming. We were in Manhattan, NYC right by Pride Fest in June 2021, and I did not really know what it was or did I care too much. Ally to me means supporting the community to have their freedom while I mind my own business. This year, though, I moved from the front-row audience to being on the stage. My shy child hid away behind a tree, but peeking with curiosity and excitement beaming in their eyes.

B.UR.SLF Resources

https://www.burslfllc.com/faq/

Be Ur Self was started with trans men Elliott and Mom Gayle where they offer solutions for the overlapping between transgender, non-binary, gender non-conforming community, and the cosplay community. 

They offer two things:

- Some accessories for the specific cosplay needs of trans

- A blog with opinions and resources for trans and their families

Specifically, they have amazing lists of state-by-state health care resources and HRT clinics.

States covered so far: Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, West Virginia, and Utah.

Trans Medical Care across States

https://www.washingtonpost.com/politics/2022/03/10/texas-trans-kids-abortion-lgbtq-gender-ideology/

List of states denying essential medical care to trans youths.

~ conservatives are increasingly imposing government control over sexuality and gender ~  

What happened in Texas?

Feb 2022 - Governor Greg Abbott (R) issued a letter to Texas state health agencies announcing that delivering gender-affirming medical treatment to transgender youths "constitutes child abuse" under state law.

It stipulates that doctors, nurses, and teachers are legally now required to report parents who aid their child in receiving such care to the Texas Department of Family and Protective Services (DFPS) and its investigative arm, Child Protective Services.

The directive followed a non-binding opinion by a Texas Attorney General, Ken Paxton (R), that some "sex-change" procedures and the prescribing of puberty-blockers to certain children is "child abuse" under Texas law.

The American Civil Liberties Union (ACLU) has sued Texas to prevent implementation.

A Texas judge has partially blocked enforcement. The ruling was done by District Judge Amy Clark Meachum in Travis County (larger Austin). Paxton later appealed to a state appellate court but the effort was rejected and he said he would take his battle to the Texas Supreme Court.

The U.S. Department of Health and Human Services issued a statement indicating that denying trans youths health care is discriminatory and illegal under federal law.

What is happening across United States?

More than a dozen state legislatures are considering legislation that could ban access to medical treatment for trans youths. 

It has been a decade of politically motivated anti-trans lawmaking in the US. 

Since 2020, those policies have overwhelmingly targeting trans youths.

Since 2021, nearly 20 states passed bans on trans youths competing in school-sponsored athletics (see map).

In Oct 2021, Texas House Bill 25 was passed which requires public school students competing in interscholastic athlete competitions based solely on their assigned sex at birth.

In Jan-Feb 2022, dozens of proposals were introduced to further restrict access to sports teams, health care, and teachers discussing LGBT+ issues. 

Mar 2022, Iowa House File 2416 passed a law banning trans girls from girls' interscholastic sports teams. Similarly, Indiana House Bill 1041 was also passed. 

https://www.lgbtmap.org/equality-maps/sports_participation_bans

 

"Child Abuse" in Texas

https://www.npr.org/2022/02/28/1083235665/transgender-kids-in-texas-face-challenges-accessing-gender-affirming-health-care

February 2022.

Texas Governor Greg Abbott directed the Department of Family and Protective Services (DFPS) to investigate parents who allow gender-affirming health care.

They say it falls under a new interpretation of child abuse.

Many transgender kids and their families in Texas may become targets.

The Texas Legislature already tried to ban transgender kids from accessing puberty blockers, hormone therapy, and gender-affirming surgeries with two failed bills in 2021.

Those bills sought to charge parents with child abuse for letting their kids access treatments that the medical community largely agrees can be lifesaving.

Trans kids face higher rates of suicide, anxiety, gender dysphoria, and mental health issues, that could get better after starting hormone therapy.

Now, instead of passing a new bill, they are trying to interpret existing laws in a new way - considering these treatments child abuse, as gender-affirming surgery constitutes (genital) mutilation.

District attorneys in some blue counties will likely refuse to prosecute parents or clinics. While there are yet no real, live people involved, this may force trans kids, already an invisible minority, to hide even further to protect their families from legal actions and allegations of child abuse. 

A study from the Stanford University School of Medicine found that transgender people who began hormone treatment in adolescence had fewer thoughts of suicide, were less likely to experience major mental health disorders and had fewer problems with substance abuse than those who started hormone later in life.

FYI - back in April 2021

https://www.texastribune.org/2021/04/20/texas-transgender-health-care-restrictions/

- House Bill 1399, advanced by the House Public Health Committee, would prohibit health care providers and physicians from performing gender confirmation surgery or prescribing, administering, or supplying puberty blockers or hormone treatment to anyone under the age of 18.  

https://openstates.org/tx/bills/87/HB1399/

- Senate Bill 1311, by Sen. Bob Hall, R-Edgewood, advanced by the Senate State Affairs Committee, passed with 18-13 vote and then failed in the House - would revoke the medical license of health care providers and physicians who perform such procedures or prescribe such drugs or hormones to people younger than 18.

https://openstates.org/tx/bills/87/SB1311/ 

Gender-Care Clinic Locator for Adolescences

The Human Rights Campaign (HRC) has a great locator for Clinical Care Programs for Gender-Expansive Children and Adolescences here (and they are willing to update/ add new or missing locations if you report to them).

https://www.hrc.org/resources/interactive-map-clinical-care-programs-for-gender-nonconforming-children-and-adolescences

The states without one are Texas, Georgia, Louisiana, Mississippi, Nevada, New Mexico, Kansas, Nebraska, South Dakota, North Dakota, Wyoming, Idaho, Montana, Delaware, and New Hampshire.

The states with most are California (9), New York (5), Pennsylvania (5), Ohio (5), Massachusetts (4), Maryland (3).

The cities with most are San Francisco (5), Los Angeles-Irvine (3), New York City (3), Boston (3), Cleveland (2), Philly (2), Amherst (2). 

Transgender Day of Visibility

https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/31/fact-sheet-biden-harris-administration-advances-equality-and-visibility-for-transgender-americans/

On March 31, 2022, the administration recognized Transgender Day of Visibility, an annual celebration of the resilience, achievements, and joy of transgender people in the United States and around the world.

Every American deserves the freedom to be themselves. But far too many transgender Americans still face systemic barriers, discrimination, and acts of violence.

Transgender people are some of the bravest people in the nation. But nobody should have to be brave just to be themselves. On this day, the administration announced new actions to support the mental health of transgender children, remove barriers that transgender people face, and improve the visibility of transgender people in the nation's data.

#1. Reinforcing federal protections for transgender kids.

#2. Advancing dignity, respect, and self-determination for transgender people by improving the traveler experience.

#3. Providing resources for transgender kids and their families.

#4. Improving access to federal services and benefits for transgender Americans.

#5. Advancing inclusion and visibility in federal data.

Historical work to advance equality for transgender Americans include:

- Combating legislative attacks on transgender kids at the state level.

- Advancing civil rights protections for transgender Americans.

- Supporting transgender service members and veterans.

- Responding to the crisis of anti-transgender violence and advancing safety.

- Advancing health equity and expanding access to gender-affirming health care to transgender patients.

- Supporting transgender students and their families.

- Promoting fair housing and ending homelessness for transgender Americans.

- Advancing economic opportunity and protections for transgender Americans.

- Advancing gender equity and transgender equality at home and around the world.

- Supporting transgender leaders and public servants.

- Advancing visibility for transgender Americans.

Gender-Affirming Care Facts

https://www.hrc.org/resources/get-the-facts-on-gender-affirming-care

Everyone deserves to be treated with dignity and respect. But bills in statehouses across the country aim to take away access to gender-affirming care while this medically necessary, safe, life-saving healthcare has been backed by decades of research and supported by every major medical association representing totally over 1.3 million American doctors.

- Parents, kids, and doctors make decisions together, and no medical interventions with permanent consequences happen until a transgender person is old enough to give truly informed consent.

-  Every credible medical organization - representing over 1.3 million American doctors in the United States - calls for age-appropriate gender-affirming care for transgender and non-binary people.

- Gender transition is a personal process that can include changing clothes, names, and hairstyles to fit a person's gender identity.

- In most young children, this can be entirely social, such as new name, new hairstyle, new clothing, and none of these cares are irreversible.

- Being transgender is now new - transgender people have always existed and will continue to exist regardless of the bills.

- All gender-affirming care is age-appropriate, medically necessary, supported by all major medical organizations, and made in consultation with medical and mental health professionals, and parents.

- In many cases, this care is lifesaving! A recent study from the Trevor Project provides the data - transgender youth with access to gender-affirming hormone therapy have lower rates of depression or suicide.

Medical-Legal Partnerships

Clinics should have collaborations with local legal practices to support the overwhelmingly increasing number of patients who have to deal with legal issues that negatively impact their health.

Some examples of legal services may be an attorney working on-site at the clinic, providing legal assistance and representation for patients on a variety of issues, including public benefits (Social Security and disability, Medicare/ Medicaid, TANF, SNAP, etc.); housing (Section 8, subsidized housing, habitability, etc.); advanced directives (powers of attorney, wills, and living wills); guardianship and kinship care; and immigration.

Examples of such doctor-lawyer partnership: 

- People's Community Clinic (PCC) in Central Texas and Texas Legal Services Center (TLSC).

To be finished.

Gender Infographics

https://genspect.org/infographics/

Not applicable to my teens anymore, but might be interesting to parents with younger children.

Growing up, I remember following other kids to a neighborhood where they could see and make fun of some skinny males wearing female clothing and high heels, as well as makeups. I never found them funny, disgusting, or little like most people did, but I always wonder "why"... Back then, why did they do that, and now, why did they do that despite being ridiculed...

It does not hit me until I have one in my circle. Knowing the internal struggles, even suicidal thoughts that my little child have, hurts me. And I know gender dysphoria is not only real, it is detrimental and hurtful. And for those who choose to come out and live with their identified gender, they are the braver of the humankind.

I can't help but blame myself sometimes for giving my child a very boyish/ manly name, and then, a very boyish/ manly nickname as well. Seeing these infographics, I am wondering if they are appropriate to just young trans who knew from early ages, or if they are appropriate to all young humans? I do not have an answer, because I am neither a medical doctor nor a psychologist/ psychiatrist.

However, there are some heated conversations on social media sometimes, and I saw someone arguing that we should raise our kids in a gender-neutral way, and let them explore and identify the gender themselves. On one hand, I personally think that is pushing things too far left too fast, and I don't know if it is necessary for the whole society to adopt it, but it is an interesting thought, and today all of a sudden I do wish my child was not assumed as a boy their whole life thus far.

Basics of Transgenderism

https://www.hrc.org/resources/reporting-about-transgender-people-read-this

Number one. Understand what "transgender" means.

A transgender, a trans person, or a trans, is someone knowing their inner gender feeling is different from the gender they were assigned at birth.

It includes not only those who have completed the medical transition to align their internal knowledge of their gender with their physical presentation, but also those who have not or will not medically transition, as well as those who prefer to be identified as "non-binary" or "gender-nonconforming" or "gender-expansive" people.

Number two. Know the difference between "gender identity", "gender expression", and "sexual orientation".

"Gender identity" is the internal concept of one's gender. It could be male, female, or neither. It can be the same or different from their sex assigned at birth. For many trans, they do not match.

"Gender expression" is the external appearance of one's gender identity. It is usually expressed through behavior, clothing, haircut, voice, which may or may not conform to social norms.

"Sexual orientation" is the emotional, romantic, sexual, and relational attraction to others' gender. It could be gay, lesbian, bisexual, straight, or another.   

Number three. Understand what "transition" means.

"Transition" is a process that some trans undergo when they decide to live with their gender identity rather than the one assigned at birth, they are not becoming different, just starting to live openly and have their "gender expression" as their true gender.

Transition can include medical components such as hormone therapy and surgery, but not necessarily. Some trans are happy with non-medical intervention transitions while some others cannot pursue medical interventions due to expenses or health.

Number four. Know that the "transitioning process" isn't just about the surgery

It starts with non-medical gender-affirming process of about six month that has a lot of questionnaires and affirming actions through social means - changing pronouns, changing name and gender on legal documents.

Number five. Respect transgender people by using the name and pronoun they use

Number six. Be aware of the reality of many transgender people in the US

Transgender people in the United States are extraordinary diverse, coming from every type of community and representing every race and ethnicity, pursuing a wide range of professions and participating in various religious traditions. 

Number seven. Refrain from contrasting trans with "real" or "biological" people

Transgender people's gender identities are real, and using false frame of comparison can contribute to the inaccurate perception that trans are being deceptive or less than equal, when in fact, they are being authentic and courageous.

Number eight. Focus on the whole person

It is inhuman to focus solely on the transition. Put the person at the center of the story, in the context of family, friends, and daily life.   

Gender Euphoria

As you see the term "gender dysphoria", you might wonder if there is a term for the opposite side of the spectrum like I did. 

"Gender euphoria" is the term, and it is dominantly used to refer to the joys of trans who finally feel like they are in their true identity. 

Gender euphoria could be achieved emotionally, socially, physically, or, cognitively.

So, let's start your teen with small, non-medical things that they could apply on a daily basis. Good chance it will help reduce gender dysphoria.

To deal with body dysmorphia, if any

-  Steam up to cover the bathroom mirrors during showers

-  Use big sponge while bathing

-  Cuddle a pillow while sleeping

-  Point out the positive things about their body

To deal with emotions

-  Express feelings through notes, diaries, blogs, or art

-  Talk to someone trustworthy (friends, family, therapists)

-  Watch vloggers with relatable issues

To deal with gender-affirming journey

-  Use accessories for gender-affirming

-  Make plans (short-term and long-term)

-  Exercise to improve moods

-  Stimulate senses (smell, vision, hearing...)

To deal with gender dysphoria and its effects

-  Avoid places and people that are depressing

-  Escape with favorite games/ shows or a bath/ a walk

-  Connect with nature (hike, jog, bike, yardwork)

-  Stay busy (create projects to improve some skills)

-  Go to bed early (cut off social media and devices)

-  Keep a balanced and healthy diet

https://www.emilyperlkingsley.com/welcome-to-holland

©1987 by Emily Perl Kingsley. All rights reserved.  Reprinted by permission of the author.

Welcome To Holland

By Emily Perl Kingsley

I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this......

When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The flight attendant comes in and says, "Welcome to Holland."

"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."

But there's been a change in the flight plan. They've landed in Holland and there you must stay.

The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.

So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.

It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."

And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.

But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.

What is a Transgender?

I'll come back to "gender dysphoria" on another day, because it is more complicated than one or two days of research. However, understanding the implication that my boy-born child wants to live their life as a girl, I later looked up "transgender". 

The biggest reason was because there is a strong *causal* connection between "transgender" and "gender dysphoria". I have learned that gender dysphoria must happen to transgenders (trans) and not to cisgenders (people feeling they were assigned the correct gender at birth), but, not all trans have gender dysphoria. Sometimes, gender dysphoria goes away on its own, sometimes, after hormone therapy (for gender-affirming) and/or full transition (I'll come back to this), and sometimes, it never truly goes away.

So, for both the root and the solution of the problem, I started with basic conceptions.

- Transgender refers to one who feel like they were assigned the wrong gender at birth, for example, born and raised as a boy but feeling like a girl inside, or, hating female genital and wanting to have male body instead.

- Transgenders are not cisgenders, but it does not mean they have to be romantically interested in the same gender as they were assigned to, trans could be straight man, gay man, straight woman, lesbian woman, non-conforming, or agender...

- Cisgenders might also have body dysmorphia (hating their body image), which is one of the major symptoms of gender dysphoria, but they do not have an issue with their assigned gender, meaning the root of body dysmorphia is not the genetic gender.

- Transgender cannot be cured, and it is quite unhealthy to suppress or ignore or accept to just live by with it. There are about 0.3% of US populations that are trans, out of which, some choose to do continue living with their assigned gender, some choose to live with their genetic gender but without medical intervention, and some choose to transition to have their genetic gender, both psychologically, emotionally, and physically. 

For most of us, seeing a trans just means "another one" on earth and at best, we accept their freedom. Only until you are trans or have someone really close to you coming out as trans, you start to do more research and get better understanding.