Welcome to Trans Tuesday! We conclude our talk on trans kids by learning what most go through just to access that care, and what their parents will do to protect them, in THE INTAKE EXAM AND TRANS FLIGHT.
Be sure you’ve read TRANS KIDS 1: FACTS AND DANGERS, so you know what is actually involved in transition care for youth, and the dangers of withholding it from them.
And here’s where we get into the intake exam, which most cis folks have literally no idea about. Now there are places in this country that have informed consent for trans people… you go in, certify that you consent to the treatment, and you get treated. These places are vanishing quickly with the legislative assault on trans care, however.
In the rare places that might have informed consent for trans kids, what does that look like? It’s something the entire medical establishment has rules for, to deal with everything related to kids and their medical care, gender-affirming care or not. Doctors know how to handle all these medical issues with kids! Trans care is no different!
What if a medical provider does not have informed consent for gender-affirming healthcare? Well let me tell you about what it was like, and how difficult it was for me, as an adult. I could have found an informed consent provider, there are several here in Los Angeles.
But they would not have been covered by my insurance. Gender affirming care paid for out of pocket is just not feasible for many trans folks, who are often financially unstable due to the employment and housing discrimination we face. One in five trans people has been discriminated against when seeking housing, one in ten has been evicted due to anti-trans discrimination.
Thirty percent have experienced homelessness, more than one-third have experienced poverty, and the unemployment rate is at 18%.
For a whole lot of us paying out of pocket for transition care just is not feasible. So for those of us lucky enough to even have insurance, we have little choice other than to do what our healthcare insurance and provider require.
The first thing that happened when I told my doctor I was trans and wanted to transition was her referring me to a psychologist. Not because she thought being transgender is a mental illness, but because it’s their policy.
Some of the reason is that mental illness can often be worsened by (and even caused by) gender dysphoria, so of course they want to check for that and be sure you get whatever help you may need on that front. Which is good and I absolutely understand and appreciate that.
But… they also want to “make sure” you’re trans, again showing they’re more concerned about not letting a cis person make a mistake than they are about helping actual trans people get the care we need.
They wouldn’t even consider referring me to an endocrinologist to begin HRT until I had my intake exam with the psychologist.
This psychologist was a specialist in gender and transitioning. She’s my go-to for any other referrals I need for other services related to transitioning. Voice therapy, laser/electrolysis hair removal, gender confirmation surgeries, etc.
So how did this lady determine I was trans? We had a very long talk, and she had a billion questions to ask me.
And.
I.
Had.
To.
Justify.
My.
Existence.
As.
A.
Woman.
Please sit with that for a minute.
Have you ever had to convince someone you’re a man or a woman? How would you do that? Especially when you can’t reduce it to your secondary sexual characteristics.
I mean even outside of being trans, the entire point of feminism is that women (or anyone) cannot be reduced to nothing but their reproductive organs. All of us are more than the sex junk we were born with, despite what right wing bigots want us to think, because they see cis women as nothing more than babymaking machines.
I had to dig up every memory I could find, in the course of my years of self-examination, where looking back I could see signs of my dysphoria, of my longing to be the girl I knew I was. I had to prove to a total stranger that I am who I say I am.
And if I failed?
Too bad, Tilly.
You don’t get the medical care you need to make your life worth living.
Does that scare you? It should. It fucking scared me.
Because what if I didn’t say the right thing? What if because my dysphoria revolved mostly around my face, chest, and my body hair, and not my crotch, she decided I wasn’t “trans enough” to transition? By the way, YES YOU ARE TRANS ENOUGH no matter how much or how little medical or social transition you do or want.
It’s just terrifying and awful. It’s a nightmare. I don’t know how to tell you what it’s like.
I’m a writer, and I can’t find the words for it.
And what you have to understand is the trans kids who want puberty blockers, all of those kids who are already on puberty blockers… the vast majority don’t have informed consent. They go through varying versions of this.
And a doctor, a psychologist trained in gender and transitioning, has listened to them and made the medical determination that it’s in the patient’s best interest to be on those puberty blockers. Especially given, again, they make no permanent changes to the body!
So what right does any government have to interfere in a matter between patients and their doctors? If you’re seeing stark parallels between trans folks and their transition care, and cis women and trans men and nonbinary people with uteruses and their right to choice… yeah, weird huh? Maybe think about why that is.
It’s all connected. See BODILY AUTONOMY (and my tattoo) and TRANS RAGE (stop forgetting about us) to learn how it’s all the same fight and cis people, as a whole, need to wake the hell up to that already.
Every trans kid has already done more self-examination than a whole lot of cis adults ever do in their entire lives. And I’m so thankful some of them have safe home environments in which to do that, but I know also that many do not. I certainly didn’t.
And don’t give me bullshit about supportive environments, or being exposed to the very idea of trans people, as being “brainwashing” or whatever the fuck you want to call it. Hey cis folks, how much trans acceptance would make you suddenly not feel like a man or woman?
Is it zero? Of course it’s fucking zero. No amount of exposure to trans people is going to make cis people suddenly trans, just as no amount of exposure to cis people is going to suddenly make trans people cisgender.
Where the fear comes in is that learning about trans people, seeing us, may make you think you might be trans too. Might make your kids wonder. And some of you might discover that you are. And that scares the shit out of them.
Because it means everyone you know, and all of society, has been lying to you. It means the very foundation of our society’s patriarchal white supremacy, that men are manly men fighters who feel only lust and anger, that women are demure subservient babymakers, is a fucking lie. And then you see all the other lies our society is founded on in terms of racism, ableism, xenophobia, fatphobia, ageism, and on and on.
It means admitting you got conned about who you are, and choosing to make it right because you know yourself better than anyone else, and you don’t have to be who anyone else tells you to be.
Even if you’re not trans, just thinking about whether or not you are (which may just reconfirm your cisness!) means waking up to the lies you’ve been force fed for your entire life.
And sadly, when people learn they’ve been scammed, most can’t admit to themselves that they got took, so they double-down on the scam… rather than change and chase actual, real happiness. It’s the sunk cost fallacy. They’ve invested so much in believing the lie, they can’t risk it all now, especially when society rewards you for conforming.
See my trans allegory deep-dives on The Matrix, BARBIE, I SAW THE TV GLOW, STAR TREK: STRANGE NEW WORLDS’ “AD ASTRA PER ASPERA”, SILO s1, REAL GENIUS, and THE TWILIGHT ZONE’S “NERVOUS MAN IN A FOUR DOLLAR ROOM” for more, because all of them deal with that!)
Let’s end on an up note. Please read these, from the parents of a trans child, about what it’s like for them… and what a difference acceptance makes.
What I Wish I Knew Before My Child Came Out As Transgender
What I Wish People Knew About Raising A Trans Child
I’m raising a transgender son. My child is not a threat
Gender affirming care for trans kids is so important, many parents will uproot their entire lives to move to states who still have it and better protect it, because it’s what their kids need to survive. This has been going on for years.
There are tons more stories like these that you can find if you do ten seconds of looking. Some families are even leaving the country.
There are even guides on how to do it, and organizations whose sole purpose is to help families move to where their trans kids will be safer!
After all you’ve seen over these two essays, you’re going to tell me these kids are faking it? Their parents don’t know how vital that care is for them? That you think those kids should be forced through unimaginable suffering that many won’t survive?
If so, please fling yourself into the sun immediately.
Cis friends, this fight is yours too. It has to be, or these kids are going to suffer and many will never make it to adulthood. There aren’t enough trans people to change things on our own. See TRANS POLITICS 1: STOP TOLERATING TRANSPHOBIA and TRANS POLITICS 2: YOU MUST VOTE TO PROTECT US for a whoooole lot more on that.
See PERFORMATIVE ALLYSHIP and FALSE ALLYSHIP, and don’t let that be you. And PROACTIVE ALLYSHIP and NO ESCAPE 2: SOME ESCAPE (due to cis allyship) for what it looks like when you get it right.
And if you still, still, still can’t believe this is true, look…
Lawmakers in Utah, commissioned a study on gender affirming care for trans kids, thinking it would justify the ways they were already banning that care. Guess what? THE STUDY FOUND THAT THE CARE WORKS AND IS GOOD and the lawmakers just decided to throw it out and ignore it.
Why would they do that?
Excellent question!
It’s so hard for trans people right now, even more so for trans kids. I need you to let them know you support them. You’re there for them. You’re going to fight for them and defend them with everything you’ve got.
I don’t remember who started it or why it disappeared, but let’s bring it back… #Letters4TransKids was a hashtag going around from adults writing letters of support to trans kids. And they need to see them now more than ever. Write it, photograph it, post it to your social media accounts. Here’s mine:
Your support of trans kids is literally life-saving. If I’d had that, it would have changed my entire life.
SUPPORT AND FIGHT FOR TRANS KIDS.
They need us.
They need you.
Tilly Bridges, end transmission.
tillysbridges@gmail.com
PS – Here’s a list of BOOKS FOR TRANS KIDS! Thanks to Karla, mom of a trans kid and the guest on the podcast version of these episodes, for providing this!
It Feels Good to be Yourself
My Shadow is Pink
Call Me Max
Me and My Dysphoria Monster
Pink , Blue or Rainbow… It’s Okay to Be you!
Being You
Pink, Blue and You! Questions for Kids About Gender Stereotypes
Fred Gets Dressed
Who Are You? The Kid’s Guide to Gender Identity