News stories focusing on transgender children and adults have emerged as prominent topics in the media in recent months. Actor/activist Laverne Cox has been celebrated for her role as Sophia Burset, transgender inmate in the popular television series “Orange is the New Black”. Transgender teen icon Jazz Jennings has been tapped to appear in a national ad campaign for Clean and Clear skin care. Jennings has also written a children’s book “I am Jazz” in which she talks about “what it is like to have “a girl brain but a boy body” and how it was for her family to understand it all”.
Tragically, the nation, and the world, shared a common heartbreak when Ohio transgender teen Leelah Alcorn committed suicide three days after Christmas. Leaving an online suicide note, Leelah stated that she took her own life because she felt unsupported by her parents.
While considerable attention has been paid to the need for counseling, advocacy and medical care for transgender children and youth, much less attention has been given to the need to provide similar services to their parents. National studies conducted by the Family Acceptance Project (http://familyproject.sfsu.edu) have consistently shown that GLBT (Gay, lesbian, bisexual and transgender) children and youth who have secure, accepting, familial bonds experience remarkably better outcomes in school and in adulthood and have fewer mental health issues including fewer suicides.
Providing supportive services to mothers and fathers of transitioning children is a worthy goal on its own merits. However, rendering these services also has the added benefit of helping to strengthen family stability during a turbulent time, thus helping to ensure more successful outcomes for the young transgender member of the family.
What is transgender?
Transgender is an umbrella term for people whose gender identity differs from what is typically associated with the sex they were assigned at birth.
What is a gender transition? The following definition is offered by the National Center for Transgender Equality:
Transition is the time when a person begins to living as the gender with which they identify rather than the gender they were assigned at birth, which often includes changing one’s first name and dressing and grooming differently. Transitioning may or may not also include medical and legal aspects, including taking hormones, having surgery, or changing identity documents (e.g. driver’s license, Social Security record) to reflect one’s gender identity. Medical and legal steps are often difficult for people to afford.
How can we, as social workers, provide parents with the services they need and do so from an ethical perspective? Here are some suggestions for getting started. Suggestions listed below are linked to the relevant tenant(s) of the NASW Code of Ethics.
1. For social workers that may be unfamiliar with the transgender community, numerous books and professional development opportunities are available to learn more. It is inappropriate and disrespectful to use your session with the transgender child or parent to educate yourself about issues relevant to the transgender community. Do your homework in advance so you are prepared to be helpful from the first session.
Ethical Values – Competence, Integrity
2. Be an advocate within your agency or organization. Participate in events such as The Transgender Day of Visibility, Transgender Day of Empowerment and the Transgender Day of Remembrance. Consider becoming a financial sponsor for these events by helping to underwrite some of the costs. Encourage your agency or organization to advertise in GLBT publications.
Show that your office is a safe place by using inclusive language in your literature and forms and by posting welcoming images throughout your office, brochures and your website.
Ethical Values – Cultural Competence and Social Diversity, Social Justice
3. Parents of transgender youth often focus on feelings of loss after a son or daughter initiates a gender transition. Transgender children often change their first names as part of the gender transition. For some parents the loss of a name they lovingly bestowed on a child is especially difficult.
Parents who experience feelings of grief need to know they are not alone and that their feelings are normal. Counseling strategies that address issues of grief and loss may be adapted for individual, family and support group sessions. The social worker can help the parent find effective ways to understand and process their feelings and facilitate parents in finding ways to establish and maintain a continuing relationship with the transitioning child.
Ethical Value – Importance of Human Relationships, Client Self-Determination
4. Parents may feel confused and overwhelmed as they attempt to sort through the many aspects of their child’s gender transition. Medical and legal expenses often place a financial strain on parents.
Again, do your homework. Be familiar with local programs and services so you can offer appropriate referrals and guidance. Advocacy is especially important with regard to dealing with health insurance companies and schools.
Ethical Values – Service, Self Determination
5. Help parents cope with transition related fears. (a, b, c, d, & e - below):
a. Fear is a driving factor for many parents. Parents embarking with their children on a gender transition may be fearful of the unknown. Social workers can help parents sort through all of the relevant information and can facilitate informed decision-making.
Some parents choose to attend local support groups and transgender related conferences to personally connect with experts and with peers.
There are also numerous Facebook groups dedicated to parents of transgender youth and teens. Many of these groups are private and they do an excellent job of providing a safe space for parents to share concerns, successes, and resources. Even more important is the opportunity to connect with others to avoid the sense of being isolated.
Well-informed parents are also more likely to experience an increased sense of confidence about their decision-making with regard to the child’s gender transition.
b. Fear of judgment or rejection is very common. Parents struggle with how “open” to be within their extended family units, in their communities and in their schools. Sometimes the child is not ready to go public with their gender transition, which limits the parent’s options. Sharing information about a child’s gender transition can feel frightening and overwhelming and working through the process is a valid and appropriate counseling goal for parents. Remember, in some communities it may be unsafe for parents or for the youth, to be “out” publicly.
c. Studies have revealed that as many as fifty percent of transgender youth and teens attempt suicide. Parents who worry about the increased suicide risk for transgender teens and children can be reassured when they learn that the risk of suicide decreases as family acceptance and support increases.
d. Transgender youth are also at a high risk of violence and bullying within the community. The simple act of using a public restroom that matches ones affirmed gender could set transgender persons up for ridicule and even assault. Many parents are interested in learning about their child’s rights so they can advocate on behalf of their child. Many parents of transgender children have gone on to serve as vocal advocates for transgender rights.
e. Some parents are fearful of losing custody of a minor child if they permit that minor child to proceed with a gender transition. Parents who are divorced are vulnerable to custody battles. Some parents who have allowed a minor child to transition have been investigated by Child Protective Services for possible removal of the child.
Parents should be instructed to establish and maintain a “safe folder”. According to Trans Youth Family Advocates, A “safe folder” is a collection of documents that are assembled in a binder or folder that will be useful in protecting your family and educating others. This is something that should not put off until you “know for sure.” As soon as a parent suspects their child might be transgender they should begin assembling the “safe folder”. Visit imatyfa.org for more information.
Ethical Values – Competence (individual/family counseling), Dignity and Worth of the Person, Self Determination
As social workers, we are uniquely equipped to educate, advocate and support parents throughout the various stages of their child’s gender transition.
Eventually, many parents who initially struggled are able to celebrate their child’s gender transition as well as their child’s courage (and their own!). Parents often feel great relief when their child, now living an authentic life, is able to thrive after the gender transition is underway.
- NASW’s LGBT resources (http://goo.gl/rVuI0K)
- The National Association of Social Workers is a partner on two reports that show transgender people are still more likely to experience violence, poverty, and poor health and limited job opportunities. The reports are co-authored by the Movement Advancement Project (MAP), the Center for American Progress, the National Center for Transgender Equality (NCTE), and the Transgender Law Center(http://goo.gl/7bafVQ)
- Gender Spectrum Education and Training: Education, resources and training to create a more gender sensitive and supportive environment for all children. (www.genderspectrum.org)
- Moving the Margins: Curriculum for child Welfare Services with Lesbian, Gay, Bisexual, Transgender, and Question Youth in Out of Home Care (www.socialworkers.org/diversity/outofhome/)
- Family Acceptance Project: Research on LGBT adolescents and young adults and their families. Developing family education materials, and assessment and intervention materials for providers. (http://familyproject.sfsu.edu/)
- Clinical and Ethical Considerations for Social Workers Serving LGBT Youth (www.nasw-michigan.org/?page=Ethics)
- Transgender Michigan (www.transgendermichigan.org)
- Affirmations: Two-day intensive clinical issues and gender identity training (sponsored by NASW-Michigan) (www.goaffirmations.org)