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.

Gender Dysphoria - How It Started

"Gender Dysphoria"!

That was my child's conversation starter one day, alongside with, "We need to talk".

It was not really a bomb to me, an immigrant with English as a second language. 

Just like every time I cannot understand the vocabulary my children use, and just like the million times we discuss intellectual matters or scientific terms, I asked, "What is a dysphoria?"

To me my child replied, "It is a disorder, a fear of something".

Still clueless, I pondered, "So, gender dysphoria means the fear of (the other) gender?"

A short moment of silence, and then, "No, it is when someone has a fear of their own gender."

Very confused, and curious, I genuinely continued, "What are the symptoms?"

"A lot, but to name a few, anxiety, stress, depression, eating disorder, lack of energy..."

I quietly murmured, "Do you have those symptoms?"

"Yes, all of them..."