Parenting a Trans-Identifying Child
By Anonymous
A parent’s response to the Cass Review’s Final Report
Dear Reader,
You may be questioning why the Cass Review is important when it affects so few people or why so many of us are relieved to see our concerns validated in black and white. Or why so many people seem to want to stop ‘trans kids’ from getting the care and acceptance they need.
If you have a few minutes I’d like to share my experience of navigating the NHS and CAMHS with a gender-distressed child.
Nearly 19 years ago I had my first child. She was a cute and tiny bundle with big, inquisitive blue eyes. She started crying on day three and pretty much didn’t stop for the first year due to colic (lactose intolerance). She crawled at 4 months and walked at 8 months. Something we were secretly chuffed about, but now (after 19 years of parenting and a degree in psychology) realise may have been a signal that certain developmental windows were being bypassed.
She was strongly and securely attached, but shy. Obsessed with first Thomas the Tank Engine and then dinosaurs. She held lovely little tea parties with Emily and Thomas on an elaborate, extensive wooden train set that covered the entire room’s floor, using a pretty miniature porcelain tea set where Emily would cry and ask Thomas for a kiss better—my daughter’s linear version of a dollhouse. Mermaids et al. have since convinced her this was the first sign of being born in the wrong body. Because boys conduct tea parties with their trains, and STEM interests are just not for uterus-havers, amirite?
She struggled with friendships and school—vomiting from the stress of the impending school day every morning, slipping into a depression after tea on a Sunday so that by the age of 7 she was withdrawn and homeschooled for a bit. The Head Teacher, a very close friend and advisor for Mr Gove (Education Secretary at the time), asked whether I disliked school and was she picking up on this… I grew up in a toxic, domestic violence-filled home, so school was my refuge; teachers were my saviours and role models and often invited me home to study and eat tea in their kitchens (they could do that in the 80’s). I have several degrees and am doing a PhD as I write. So, no, school was not an issue for me. Even though I also struggled to make friends with kids my own age and experienced the same isolation my child would.
It was another 5 years when, as the result of the degree in psychology, I realised my beautiful, quirky, extraordinarily bright and artistically gifted 12-year-old was on the autism spectrum (and a further 6 years before ADHD was ascertained, having been told by CAMHS that she had no indicators). None of the professionals who worked with her spotted it. All queried home life—we gave up and both her ASD and ADHD assessments were done privately. We’re deeply privileged to be able to go the private route. Many vulnerable children and young adults are not. But that’s a rant for another day.
At age 12, it was the summer of the Trump Tapes, the Weinstein scandal, and the giddy heights of the #metoo movement which, rather than embodying female empowerment, promoted a narrative of female victimhood, of passivity in the face of men with wandering hands, of powerlessness if they wanted career advancement. My beautiful little girl, with her Katniss Everdeen side plait, and her love of film, art and books (dinosaurs and trains long since forgotten), had her first period. And her world imploded.
She really didn’t want to be a girl—periods were painful and messy and boys didn’t have to go through it so why the hell should she? OCD is common in autistics, by the way, as is a higher sensitivity to discomfort. There were few to no female film directors in Hollywood so how would she ever have a career in the industry she aspired to; and, thanks to the likes of Trump, she was just plain, fucking scared because girls/women just didn’t stand a chance against powerful white men who run the world and can ‘grab ‘em by the pussy’ whenever the mood takes them—oh, and brag about it to their sycophantic hangers-on without repercussions.
The answer? To opt out of womanhood. Become a man. As a child, an autistic child, a lonely child who already finds the world scary she was very ill-equipped to cope when people started dying all over the world from Covid and enforced isolations/lockdowns came into play, so choosing to be a boy was a logical course of action, no? Especially when you are being told by SM, the rainbow-waving senior/pastoral staff at your progressive and inclusive school that [gasps] you can actually be born in the wrong body—it’s just a matter of taking tablets to change sex; that they will be able to 3D print you a functioning phallus (yep, that’s out there) and rebuild your body; that your mother ‘grew you wrong’. So not only is she a trans-hating TERF bigot, but it’s also all her fault. Lovely.
Especially when identifying as trans means you are no longer the weird (autistic) kid in the class, but suddenly the new equivalent of the gay best friend (and, yes, teens expressly talk about wanting one of those, thank you GLEE etc.), so there is social cachet in befriending you. You go from being shunned to being celebrated; from being unseen to being centred—but you know, even as an autistic person, that this is transactional. That your acceptance is conditional. And when, within a year or two, 50% of your year group (I kid you not) identify as trans, gay, lesbian, bi, demi, ace, pan and every other sub-category of the new trans fam, you see your social desirability ebb away.
So then comes the depression; the overdoses of paracetamol; the severe self-harming that spans wrist to shoulder and when that’s too sore, ankle to thigh; the standing on the roof threatening to jump or to come back inside and drink bleach; the 48hr stays in the local hospital where you are discharged with yet another ‘pls follow up’ note to CAMHS, who still haven’t actually had a first triage appointment with you after THREE years of being referred.
You see, as Dr David Bell mentioned in an interview last week, the moment you mention the word ‘trans’ to a GP or CAMHS, you (and sadly not the can) are kicked down the road and every single thing you think or feel or do or can’t do is now seen through the lens of being trans—something that only GIDS at the Tavistock can treat. You ask all the questions as a parent and get no answers.
What about the fact that the sudden onset of gender dysphoria, coming as it did with a child’s first menarche, could be to do with their autism? ‘Well, that’s not CAMHS’ area, we don’t deal with autism, there’s a different pathway for that.’
What about the OCD, social anxiety, depression, and possible ADHD? ‘Well, that’s the autism, isn’t it? So it won’t go away. HE’ll need to learn to cope.’
But she isn’t coping, she is suicidally ideating and self-harming—what about that? ‘Has HE tried holding an ice cube really, really tightly until it hurts? That can be a great way to displace the urge to cut HIS arms to bits.
Then there are the referrals to Social Services every time we’ve had an A&E visit over deep cuts, overdoses, or the counsellor at the 6th Form takes offence that I refer to my child using sex-based pronouns and believe—due to my degree in psychology and several decades of working with kids—that the ‘affirmative approach’ is not appropriate. There’s the in-depth, invasive community-wide investigation into your parenting, that seems to get repeated every 12-18 months as the old Social Services team leaves and a new one takes over your case, or your child ups the ante.
Meanwhile, your child has STILL not seen anyone or begun therapy. No private psychiatrist will take you on as seeing a CAMHS-referred child means a conflict of care, so you can’t even opt out. So, in fact, it is not until nearly 6 years—and only due to your child ageing out of the CAMHS system and needing to ‘graduate’ into the adult service—that they finally get an online, 6-week, group course in Dialectical behaviour therapy (DBT), where helpful nuggets of wisdom, such as ‘there is hope in hope itself’ are imparted. Child-centred care?
You, as that child, finally get a letter (after 5 years) from the Tavistock asking if you still wish to remain on the waitlist; and another before your 18th birthday explaining you will move to the adult waitlist. Plus a billion forms and questionnaires that, in your ASD/ADHD/distressed mindset are completely unable to face anyway.
Despite getting 10 GCSEs—mainly grades 8-9—you cannot cope with 6th Form. You try but drop out twice so that, at nearly 19, you are now trying and failing to do A Levels at home. Isolated, enveloped in feelings of failure as your cheerleading trans ally mates have lost interest, buggered off to uni, and are now busy partying and becoming enmeshed in the next cause celebre—JustStopOil, anyone? Queers for Palestine? After all, as they are only allies, they have no skin in the game. Not even an epidermal cell.
They aren’t the ones who potentially would have risked their fertility or cognitive development by taking puberty blockers or cross-sex hormones. They aren’t the ones desperate to take testosterone oblivious to the fact that this will cause premature menopause, which in turn will lead to early onset osteoporosis as well as, ironically, an increase in female cancers. They aren’t the ones wanting healthy breast tissue removed in unnecessary surgery.
They aren’t the ones who’ve already had to have a breast cyst drained/excised on their 13th birthday due to wearing the chest binder a friend procured behind the parents’ backs; they weren’t the ones sleeping on a camp-bed for 3 days while your child was on IV antibiotics and traumatised at having to have two male clinicians look at, palpate and aspirate her breast.
So easy to be an ally when you lose nothing at all yourself and can waltz off to university, or go home from school/CAMHS and leave the child you’ve helped damage languishing in their grief and loss.
So, dear Reader, please take a moment to listen to real parents and to detransitioners, to those pointing out that these individuals—whatever their age—are deeply vulnerable and in need of holistic, science-based care; entitled to impartial exploratory therapy; deserving of better ASD/ADHD/ND support in the community and schools; to unbiased, non-political, and ideology-free clinicians who affirm their distress but nothing else.
First, do no harm.
This should be at the centre of all treatment protocols. But so should:
Second, ensure timely, holistic and evidence-based therapy is offered.
I hope the Cass Report will facilitate a wholesale revision in mental health services for children and young people—gender-questioning or otherwise—on both a global as well as a national level, but it can only happen if we park the ideological bullshit.
Photo by Priscilla Du Preez 🇨🇦 on Unsplash