E and D

Parents of a trans son and a trans daughter. Ethnicity: White British.

Their trans son came out to them as a young adult. Sometime later their younger child, also an adult, came out as a trans woman.

Their trans son came out as a young adult in his first year of university: “He just suddenly, out of the blue announced it. But there’ve been some signs during the gap year.” After their son left school, he started wearing jeans and T-shirts all the time rather than the skirts and dresses he had worn as a younger teenager. He told his university friends his male name, but his parents didn’t start using it for about a year. During this time their son started binding. Their son had previously had mental health issues for which he’d had counselling, but during his university year he became quite depressed and anxious and was prescribed antidepressants. His mother asked what they could do to help and he asked them to use his male name, which they did, but they found using male pronouns difficult to adjust to.

During his third year at university their son was experiencing bad anxiety and went to see a psychiatrist. The psychiatrist said they thought his gender identity issues were a real problem.

Their son had been referred through his GP at university to gender identity services, but where he was in that part of the country the waiting list was about 4 years. So his parents decided that they would pay for him to see a gender specialist privately.

They recommended that he start hormone therapy, and after a referral to an endocrinologist he was prescribed hormone therapy which was then prescribed by the local GP. Before starting hormone therapy he legally changed his name, driving licence and passport. After starting the hormone therapy they saw physical changes in their son such as facial hair and a deeper voice, but he was still unhappy with having breasts. After being on the waiting list for about 4 years he was referred to a clinic to have top surgery. Their son is pleased with the outcome and does not feel the need for any further surgery at the moment.

Their son continued to have some mental health issues during this time and his parents paid for him to see a psychiatrist privately. In these sessions it was uncovered that he had major sleep problems and the psychiatrist suggested he might also have ASD (autistic spectrum disorder). He had a formal assessment done, which confirmed a diagnosis of ASD. His parents believe there is an overlap between ASD and gender dysphoria and feel “that’s been really helpful to know. It makes sense for a lot of behaviour.” Although they do wonder if they had known about their son’s ASD whether they would have “chosen a different route”.

When their younger child was in their twenties, “out of the blue he suddenly said ‘I think I’m trans’.” This was a bigger surprise, “And we just kind of… Knocked us for six and thought, ‘What?!? Again? A second one. Cannot believe this!'” They have found accepting their youngest child as trans more difficult as “it’s not the same. He flips between the two. He’ll dress up to go out in the full-on gear, you know, with loads of makeup and hair, looks really glamorous. But then, in the day, he’s back in jeans and the T-shirt, just looking like any other… Kind of quite slight, but he looks like any other boy.”

Their younger child has chosen a typically female name, which they used on their degree certificate, but they haven’t changed their name by Deed Poll and still use their birth name, apart from when they go out in typically female clothes. Their younger child has said that they do not want any surgery but would like to start hormone therapy. They are on the waiting list to gender identity services.

As parents they are still probing their younger child’s gender issues as they “still sense the ambivalence and question it” but also stress that “they are adults. They make their own decisions. They both came out with this when they are over 18. So, in one sense, we are around as parents and we want to be supportive. But at the same time, we don’t have any control. They are independent, autonomous adults. So, they kind of, you know, they will do what they want to do.”

As parents of trans children they are worried about the long-term effects of hormone therapy on their children: “I worry hugely. There is no long-term data on giving people hormones for life, essentially, in large doses. We worry about the effects of giving menopausal women a tiny dose of hormones for 5 years and get excited about that. We’re talking about giving young people big doses of hormones for 50 years. That, to me, is a huge worry.”

They also feel more support is needed while people are on waiting lists: “Psychological support is woefully lacking in the NHS, at the moment.” Their message to other parents is to “talk to other parents. Find out where your local support groups are. Get your child really good psychological support. You know, get any independent psychologists or psychotherapist to assess them.”

E talked about how GPs should treat the young person holistically.

You know, I think I would be encouraged to treat them holistically and sort of ex, you know, explore their issues of gender. Other, you know, lots of ways that they could help themselves. And you know, being a good GP is all about the assessing in a similar situation. I think I would encourage people not to just to say, okay, you say you’ve gotta gender issue. Let’s send you off to the gender clinic, but look at them in a, in a more rounded way and say, what’s distressing you? What’s making you unhappy? What is going on in your life? And trying to find out, you know, what will be a most appropriate help for them.

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E and D say people on the waiting lists are left high and dry.

Father: I mean, you could say that we the people aren’t rushed. But they are not getting any support in that time.

Mother: But they’re not getting the support, necessarily. I mean, we gave our kids the support. We are giving them the support. Someone who can’t afford the private.

Father: High and dry for two years.

Mother: High and dry, you know, and all they, yeah, that’s right.

Father: And maybe, I mean, I don’t know what the answer is. Maybe we haven’t got the answers to provide some provide the support, if you like for people on waiting lists, separately. Maybe that would be a better system.

Mother: That would be a benefit. Maybe then you, you’re doing some sort of more rational exploration and other than—

Father: And maybe you provide it through CAMHS or you provide it through other you know, psychological services in the community. Maybe that would be a different model for doing it. But I, but I think, yeah, definitely that, that needs to happen.

Mother: That’s definitely needed.

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D talked about making sure the young person has someone to talk to besides the parents, about the things that worry them.

I think the advice that parents would be to try and open up the conversation with your children to find out what’s really worrying them. What’s upsetting them. How they feel about people at school. There’s often, there’s often something going on as they’re younger. Even at university, and it’s very difficult because as the parents, you know, especially when you’ve got teenagers and older adults, they, they naturally want to keep things to themselves. They may not want to talk to you. So, it might be that you get someone else like a trusted friend or someone who acts like an aunt or a godparent, someone else in your connection maybe able to talk to them more easily than you can.

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E and D thought the debate around trans issues was very polarised, in particular on social media. They felt this was shutting down important discussions.

Mother: Very polarising, isn’t it.

Father: It is.

Mother: it’s kind of, you said that this is—

Father: I call it trench warfare.

Mother: It makes it difficult to have an unemotional, rational conversation with our children because they immediately say, oh, you are being anti trans. You are being transphobic’ and they don’t like that. I think it makes it very hard to be questioning or exploratory. And I think the trouble with the way social media and Twitter and things work is that, you know, you get furious exchanges and people getting labelled, which isn’t helpful.

Father: Which is not helpful, no. Well, that’s the trouble with social media is that people follow, you get into camps, don’t you and then camps sort of hurl abuse at each other and that, that’s doesn’t help at all.

Mother: I think it’s really unhelpful the way that that’s happening. And it feels like debate is being shut down instead of actually opening it up. it’s not healthy at all or, you know, there’s only, there’s only one politically correct way to be. And I think that that’s difficult isn’t it.

Father: I think so.

Mother: If you’re not, if you’re not sort of automatically assuming that everyone should take hormones and have surgery then you are somehow, you’re therefore very anti.

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D experienced feelings of loss when looking at old photos of his child.

I suppose it happened because it happened sort of gradually over a few years, I got used to that in a sense. The feeling of loss happens when I look at old photographs of when she was young. I just think, oh my God, what happened, you know? So it’s that feeling of loss, yes is that there was this gorgeous daughter, you could say. And now I have a wonderful son. I mean, he’s fantastic. I mean, I love him. But it’s like, there was that person there and now I have this one instead, it’s kind, you know, you know it’s the same of course. But it’s different. it’s yeah, it’s difficult to explain that. I think, yes, there is a sense of bereavement there over a period of time. But it’s when it’s, when you look back at old photos.

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E and D found the pronoun change to be more difficult than the change of name.

Father: Well it was, like I say, I think that was the thing that was most difficult was name not his first name change, I think was change of pronouns.

Mother: We didn’t do it. Not for a while.

Father: No, some of our friends who, who we obviously we told our close friends about this and they probably adapted quicker than we did [laughs], I think, some of them

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E and D talked about their son having top surgery, how it went and how they felt about it as parents.

Father: He wasn’t totally happy because he still had the problem with binding breasts and that was the issue for him.

Mother: They put a referral through to the [name] clinic. Eventually, he got seen in the NHS that was probably three or four years further on. He obviously, eventually, did all, got the assessment and they, they transferred him over and so now he’s totally under the NHS, under that clinic. And he saw them there and eventually he went onto the surgical pathway and had the mastectomy last April. So, it took quite a long time on the waiting list and everything. So, that’s eventually what he went and did.

Father: As far as we know. That’s only, that’s as far as he wants to go, really.

How did the surgery go?

Mother: I mean, technically, it went fine. He was very lucky. They had money for a waiting list initiative, so he ended up in a private hospital with a single room and the care was, the kind of technical care was excellent. I think he had a good surgeon who did the operation, you know, very well. He didn’t have any post op complications and recovered quite fast.

Father: He was very pleased with that. I mean, he’s been pleased with the outcome of that.

Mother: Yeah, I think he’s very pleased with the outcome. It all went according to—yeah, as I say, we can’t fault the care that he had in the hospital and technical care. You know, it’s just, it’s just a horrible thing to see happening to your children, an unnecessary operation. But, you know, on a perfectly healthy person. But, you know, what can you do? I had so many conversations with him to say, are you sure about this and are you sure about this. Do you really want to do it? And you did the same and he was absolutely adamant he wanted to go through with it.

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E and D talk about getting private care and initial prescription from a private endocrinologist, with the local GP continuing the hormone care for their son on the NHS.

Mother: And, I mean, in fact, he said to me, I am not going to be blunt, but he said to me, if you don’t sort the gender stuff out, you’re looking at suicide which terrified me. Absolutely, sort of threw me into a spin as you would expect. So, on the back of that, we decided. Cos he had self-referred himself through his GP at university to Gender Identity Services, but where he was in that part of the country, the waiting list was about four years. It was crazy. So, I decided that I would pay to see a gender specialist privately in [name of a city] at least for an initial consultation.

Father: That’s right, yes.

Mother: So, he went off to see him in [name of a city] and sort of saw him once, I think or and did an assessment and I thought, yes, yeah, he thought he—

Father: This was the main issue.

Mother: This was, this was an issue he would qualify as suffering from gender dysphoria. And then, recommended that he sort of start a hormone therapy. And so then did a referral to an endocrinologist again, privately who started, who did the initial prescription for hormone therapy, because it was then carried out by the local GP. So, sort of started him on that track.

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E and D talk about their trans son’s autism and how getting the diagnosis helped them make sense of things.

Mother: We took him on the recommendation of some colleagues to see a psychiatrist at our local [name of a hospital] who was very good. It was very good. And changed his antidepressants. Realised that he had a major problem with sleep and had for years and gave him some sleep medication, but also recognised that there was a lot of initially thought he had an emotionally unstable personality disorder and recommended dialectical behaviour therapy, which was a course, sort of three months on management. It was a really good course for managing emotions and learning how to kind of manage your time and manage stress and your interactions, which I think he benefitted hugely from and he did over that summer. But, at the same time, the psychiatrist was very astute and said, I just wonder if actually one of his problems is that he could be on the spectrum, could be autistic. So, we thought about that. And, and it was very interesting because various people in our family and my cousin who is a—we discovered that they had thought so too. So, we thought, this could explain a lot of the anxiety and issues. So, we eventually, he had, he stayed under the [name of a hospital] and had his therapy continued and was doing well. But we did get the formal assessment done, which confirmed that a diagnosis of ASD [Autism Spectrum Disorder] and I think that’s been really helpful to know. It makes sense for a lot of behaviour.

Father: It did. We’ve since learned that there is an association between ASD and gender dysphoria.

Mother: Certainly, that’s what the psychiatrist said. And I then read a lot more about it since then. There’s a huge, there’s I think one of the psychologists who did the assessment also works at [name of a place] and she said, The number of people at [name of a place] who are on the that I see in my clinic there you know, have ASD and have gender dysphoria, the overlap is huge. So, it made a lot of sense to us. Yeah, it really did.

Father: That’s true.

Mother: So, it was kind of like the last piece of the jigsaw.

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E and D talk about their son’s social transition over time.

Father: He just suddenly, out of the blue announced it. But there’ve been some signs during the gap year. That’s what I remember, because do you remember, he suddenly once he’d left school, suddenly started wearing kind of
Mother: Very grungy clothes.

Father: Jeans and T-Shirts and—

Mother: Whereas before as a younger teenager, he was quite short skirts and dresses.

Father: He could be quite dressy, yes.

Mother: Quite dressy, yes.

Father: But it was like suddenly over the summer things changed like that and he just suddenly got out and he was all jeans and T-Shirts, no dresses and yeah. I think we noticed that before he went travelling. And then, I think we had a wedding in June when he got back. We had to go to a wedding in [name of a country] and he was wearing a suit instead of a dress.

Mother: That’s right, yes. That’s right.

Father: That is I think where we got our first inkling. So, he’d have been 19 at the time.

Mother: That’s right.

Father: Yeah.

Mother: Yes.

Father: That’s right. And then I think later when he came, after his first term at university, he came back. Did he start talking about wanting to be called [male name].

Mother: That’s right he told his university friends that, you know, his male name. And that’s what he wanted to be called there.

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E and D talked about their son seeing a gender identity specialist and an endocrinologist privately but ongoing treatment was carried out in primary care under the NHS.

Father: He had self-referred himself through his GP at university to Gender Identity Services, but where he was in that part of the country, the waiting list was about four years. It was crazy. So, I decided that I would pay to see a gender specialist privatelyat least for an initial consultation.

Mother: That’s right, yes.

Father: So, he went off to see himand sort of saw him once, I think or and did an assessment and I thought, yes, yeah, he thought he—

Mother: This was the main issue.

Father: This was an issue, he would qualify as suffering from gender dysphoria. And then, recommended that he sort of start a hormone therapy. And so then did a referral to an endocrinologist again, privately who started, who did the initial prescription for hormone therapy, because it was then carried out by the local GP. So, sort of started him on that track. Which he was, obviously, when he was, he was very happy there. We were very relieved about that. That did seem to help a lot, didn’t it? The anxiety and depression didn’t go away. But it made him, he was certainly very happy about that.

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