When should a parent mention to their trans child that hormones are an option?

Written by a trans friendly therapist in Long Beach.

Transitioning is a big step and a big commitment no matter how old you are. So when it comes to having a transgender child, it can seem intimidating. Hormones cause permanent changes; while one can go off of them or even start taking the opposing hormones should they desire, things may never go back to how they used to be. Taking hormones isn’t something to take lightly, so when it comes to having a transgender child, it can seem like an intimidating topic to broach.

First let me clarify that I am a mental health therapist in Long Beach, California.  I am not a medical doctor and cannot (and should not) give medical advice.  Please read the following information from a mental health perspective (one which I am very qualified to offer) and please consult your medical doctor before making any decisions.  It is very dangerous to get hormones from anywhere other than your medical doctor, so please make sure you are consulting with them as a part of this whole process.  To get referrals to trans friendly / trans positive medical doctors, call your local LGBTQ center.

The benefits of hormonal transition for a transgender person are clear. They can help a person to pass, or appear to the world as the gender they are; this can help with everything from dysphoria and depression to social acceptance. Transgender people who pass are even more likely to get a job and have other benefits due to social acceptance.

For a child or teen, it can seem like a drastic measure. Hormone treatments are permanent, both in the changes they cause and in the dedication they require. This could mean weekly injections for the rest of their lives or a regime of pills that they will, in most cases, be taking for life.

So, when is the right time to talk to a trans child about hormones?

Among the trans community, there are two common approaches.

First are child-led treatments. The fact of the matter is that no person can ever understand another’s body or mind the way that person does. When parents decide that their child is old enough, many parents of transgender kids sit the child down and discuss with them the options, and allow them to make their own decisions. Transitions and treatments are a big step, but as long as the issue is discussed thoroughly, and the child or teen understands the importance of their decision, then many parents feel it best to leave the final choice to them.  Another option is to have your child/teen meet with a trans friendly therapist who can help educate them on the mental health portion and give them tools to better make their decision.

But what if they regret their choice?

While this is a concern that pops up often in these discussions, it’s important to remember that the probability of a transgender teen or child later identifying as the gender they were assigned at birth is extremely low. Being transgender is an innate part of one’s identity, and it’s not something that is done on a whim or as part of a trend, as much as some media would like to make you believe it is.  By the time they are thinking about hormones or surgery, they have most likely thought this issue out for a while.

The second option is to wait until they’re legally an adult. While it’s uncommon for a transgender teen to later identify as cisgender, some parents believe that it’s best to wait until their brain is finished developing before any final decisions are made.

But waiting has consequences. Going through natural puberty makes passing harder, even after transitioning, and suffering through a puberty that opposes one’s gender can do serious damage to their psyche. Many transgender people report committing self-harm, while others admit to having starved themselves in an effort to force their body into submission. After all, without the necessary nutrients to support their body’s development, puberty is restricted and, for women and trans men, menstruation often stops or never occurs.

So how do you wait to make the big decisions without causing permanent harm in the process?

Many parents and transgender people support the use of hormone blockers for transgender teens and teens who are questioning their gender. These medications (prescribed by a medical doctor) would block their current development so that their body doesn’t continue forming into the wrong gender.  This gives them time to think about the decision a little longer.

When a transgender person transitions late in life, after having gone through puberty, they are often fighting against the changes their body already went through. Trans women have to shave or laser off the hair they grew as a teen. Trans men undergo surgery to remove their breasts. Trans men often experience a voice drop while using hormones, but unfortunately, there is often no effect on the voice for trans women (voice training with a speech therapist can help); once the voice drops, it does not revert, causing many trans women to have to take lessons or even try vocal surgeries which, at the time of writing, are still experimental. Using hormone blockers before puberty sets in negates this issue almost entirely. Without going through their natural puberty, a person remains generally androgynous and, should they decide to start hormones later in life to transition, they tend to have a much easier time of passing. And should they decide not to transition, and to live as the gender they were assigned at birth, all they have to do is stop the blockers, and allow their natural puberty to occur.

There are some downsides to this approach. A delayed puberty can have some social drawbacks, with other teens taking issue with the fact that they’re likely still small and androgynous for their age. And physically, a delayed puberty can sometimes affect how hard and how quickly puberty hits and how the effects can manifest; however, these differences are usually minimal, especially when one remembers that no two people experience puberty the same anyways. Most trans people agree that it would be a small price to pay for a lifetime of easier transitioning and lessened dysphoria.

Additionally, it’s important to note that there are some people, either transgender or nonbinary, who decide to remain on blockers for life, or never to hormonally transition at all. There is no right or wrong way to transition.

There are upsides and downsides to both options. With child-led transitioning, teens often report experiencing less depression and dysphoria, and are able to live an authentic life throughout their school years, but the possibility of making decisions prematurely and coming to regret them is, while unlikely, still a real risk. And with delayed transitions and the use of blockers, a person has plenty of time to make their decisions and decide what they want to do, but in the process they have the chance of falling behind their peers in physical development. There’s no easy answer as to which approach is best to take; all one can do is research, talk to each other, talk to the medical doctor and a therapist, and most importantly, make the decision together.

If you are looking for a bisexual, lesbian, gay or Transgender friendly therapist in Long Beach, please call to set up an appointment.  Please remember that if you are not in driving distance from my office, that I do provide Skype and facetime sessions.  It is sometimes difficult to find a gay friendly therapist, so I try to accommodate my clients by providing tele-therapy (meaning skype, facetime, etc). If it is important to find an LGBTQ therapist near you, check out my blog post to get tips on how to pick an LGBTQ therapist near you.