Who I Want To Be

Gender Affirming Healthcare for Teens

Pine+Osborne+%28left%29+and+Jessica+Slavick+stand+donning+the+flags+of+their+respective+gender+identities.+Osborne+is+pictured+with+the+non-binary+flag%2C+and+Slavick+with+the+transgender+flag.

Pine Osborne (left) and Jessica Slavick stand donning the flags of their respective gender identities. Osborne is pictured with the non-binary flag, and Slavick with the transgender flag.

RJ Stevenson, Editorial Board

 

Important terminology for understanding this article:

 

Cisgender – an identity that correlates to one’s assigned gender at birth

Gender-queer – an identity that isn’t cisgender, or an identity that is neither male or female 

Transgender – any identity that it is not inline with that of ones assigned gender at birth and thus involves some element of physical and or social transition to present as desired

Passing – to present like the desired gender in a manner without question to others

Dysphoria – discomfort in regards to one’s body presenting as a gender that is not aligned with one’s gender identity

Trans Man – someone who was assigned female at birth and has transitioned to a male

Trans Woman – someone who was assigned male at birth and has transitioned to a female

Medical Transition – to changes one’s gender presentation through the use of medical procedures to align more physically with one’s gender identity

Social Transition – to change one’s gender presentation by changing one’s name, pronouns, way of dressing or other gendered aspects of one’s life

Binder – an undergarment worn to compress the chest to appear more masculine for those who are biologically female

Agender – the lack of correlation of one’s gender identity to any binary or established gender identity

 

Being gender-queer is hard. Not just emotionally, but physically, social, and economically. It has varying impacts on every aspect of your life. It’s a multi-year process of confusion and self doubt. Many trans people start questioning their gender before they even reach double digits in age, and from then on, an internal conflict of who they are versus who they want to be, is present and unyielding in their day to day lives. 

 

According to an article published on Cedars Sinai, a Los Angles academic healthcare organization, data from 2016 indicates that 0.6% to 0.7%, or 1.4 million to 1.65 million adults in the US identify as transgender. The article also notes that over 70% of people, both trans women, and trans men, first experienced gender dysphoria by the age of 7. Tegan Coughlin, a freshman at Arlington High school, realized that he was gender queer at 12 years old, when the world first shut down due to Covid-19. Due to the surplus of time he had, he was given an extended period of time available for self reflection. “I did a lot of research, and then a lot of the things that trans people online were saying, like, matched up with me, and I talked to a couple trans friends, and what they were saying also matched up with me. So I kinda figured ‘okay, I’ll try this out’ and it ended up being the right label for me.” said Coughlin. 

 

As of writing, Coughlin, a trans man, has transitioned socially, and he is in the starting stages of a medical transition. For him, transitioning currently entails a change in first name, and a change in pronouns to he/him. Additionally, he makes use of a binder and vocal exercises to deepen his voice, in order to present more masculine. Most excitingly, he was able to access medical support in the form of hormone treatments. “So I’m actually currently… 7 weeks on T [testosterone],” said Coughlin. “ I plan to continue doing that, and when I’m 18, I’m probably going to get gender reassignment surgery, just to feel more comfortable.”

 

Unfortunately, physical presentation is often the most upfront cause of distress for gender-queer people, and the restriction to how they can present themselves. The average person does have daily conflicts with themselves over how they look, but they’re in the sense that their hair doesn’t look right, or their clothes don’t fit them how they want. They are not the mental anguish a trans person experiences living each day in a body that is not theirs. Unlike being misgendered, or being called slurs and harassed, a person’s body is always present, and for a trans person, this is a constant reminder of what they are not. It is there at school. When you are working. When you’re sleeping. Every time you have to change your clothes. It is draining. It drags down your mood. It makes you uncomfortable when you’re doing simple things like sitting and walking. You are always picking apart yourself, and wondering if you look close enough to your gender identity, or if people see you for only your biological sex.

 

 In response, the trans community has developed ways to help decrease the impact of these feelings. Such things as simple as special underclothing, to things as extreme as hormone supplements and gender reassignment surgery have been developed by each generation of the community to allow gender-queer people to get at least a little closer to the person they need to be. Jessica Slavick, a trans woman, and a senior at Arlington High School has been planning for several years to seek medical support in her transition. “I actually plan on, around the time that I turn 18, setting up an appointment with a specialist to see what the next step will be. I’ve been talking to my doctor about it for about three years.” said Slavick. 

 

Such aspirations are far from uncommon among trans teens. As previously stated, both Slavick and Coughlin have described a strong interest in medical transitions. Unfortunately, such needs are often difficult to attend to at best, and impossible to address at worst. Beyond the medical roadblocks, the social interference of appropriate treatment are often much more evident, and possibly more damaging. Rejection, ostracization and harassment by those opposed to the mere existence of trans people are terribly damaging to the mental and social health of gender-queer people. Even more unfortunately, it often manifests in the most extreme and uncomfortably intimate ways. During our interview, Pine Osborne, a senior at Arlington High School, reflected on their experience with their family’s acceptance, or lack thereof, in response to their identity as agender. They specifically mentioned their mother, the guardian they currently live with and thus are closest with. “Shes not very accepting or savvy with the way that I am, or other people like me, who are non-binary, are.” said Osborne. 

 

Such rejection of their identity has impacted Osborne’s mental health, and unfortunately, may not be a solvable conflict for them. Sadly, such experiences are far from uncommon. Both Slavick and Coughlin have also described situations where people both close and distant from them have questioned or rejected their identity. “My parents don’t see it as necessary. So they’re not totally on board with me getting HRT and surgeries,” said Slavick.  

 

Her parents are not the only members of her family that do not fully accept her. “[I’m] really anxious to put in the effort to try and start a full medical transition, just out of fear of what my family might think,” said Slavick. “Not just my parents, but my extended family as well.” 

 

She also described fear and discomfort that arises from interaction with those in her community. “I don’t know if it’s internalized fear, or if it’s real fear, but yeah. It’s a fear that I have whenever I try and present how I’d like to, that something might happen, “ said Slavick. “Something might go wrong.”

 

Coughlin’s description of transphobia came from a different setting, but was just as harmful. He recalled rhetoric that “there’s also like the whole thing about being on testosterone, like, under 16 or under 18 being child abuse,” said Coughlin. “And any time I like, look it up, it’s like ‘Yeah, you’re being abused by your parents. Hate to break it to you’, and I was the one who pushed for it?”

 

It is far from uncommon for those outside the trans community to believe that teens and young adults are too young and inexperienced to know that they are trans. There are even those that say that trans people are delusional or severely mentally-ill and their trans-ness is merely a symptom, and not a foundational part of their identity. This causes fear and self doubt in many trans people as they are led to question the legitimacy of their identity. “I do question myself sometimes, because almost everywhere I turn, that’s not like a trans specialist, or a trans person, is saying that I’m making the wrong choice,” said Coughlin. “Some of them think that I’m delusional, you know what I mean, because I want to do this at a young age.” 

 

He expanded on this by describing the initial reaction of his parents. “I was really pressured by my family to not, because they felt like I was too young to make that decision,” said Coughlin. “For my family, like pressuring me not to do it [testosterone], I felt like I was causing them stress, and I don’t want to do that to my family, but my dad specifically was really worried about it, and just like ‘oh, this is permanent change’. I considered not going on testosterone because it was stressing them out so much.”

 

He went on to acknowledge the opposing argument to his choice, but made it clear that transitioning, both socially and medically is the individual’s choice, and their choice only. “I think it’s interesting that obviously this kinda makes sense. Fourteen year olds don’t have the best advice, but if I’m in my body, you shouldn’t like, talk over me when I try to tell you how it feels to be in my body,” said Coughlin.

 

This hostility commonly has a detrimental effect on the mental health of trans individuals. According to the American Academy of Pediatrics, 25% to 30% of trans teens reported attempting suicide at least once in their lifetime. This percentage increases to 45% percent of trans individuals reporting at least one suicide attempt within the 18 to 24 age group. The report goes on to say that other studies indicated that a range of 28% to 52% of trans individuals across all age groups, have reported attempting suicide on at least one occasion.  This is an horrifying number of people suffering from sever mental health issues within one demographic, mainly stemming from fact that they are transgender. 

 

All three of the people I interviewed intimately understood the correlations between medical support, and most importantly, social acceptance, and mental health. “I had some mental health issues that I was struggling with that just never really got addressed, and then when we went into quarantine, I had a lot more time to think about, like actually try and address those things, like ‘Why is this happening? Why do I hate myself so much?’ ,” said Coughlin.

 

Osborne and Slavick also described their battles with mental health, with Slavick describing her experience as “mentally, it’s definitely taking a toll. It’s hard to like, wake up sometimes. It seems a little heavy, but it’s the truth. It’s hard to kinda, get out of a depression when all of these roadblocks are there, because I don’t feel like I can be me, and so if I don’t feel like I can be me, I can’t really function.”

 

The wants and needs of trans kids are being restricted and rejected, and this is having a detrimental effect on trans youth, and because of this, trans kids are being ostracized by their community, and grow to hate and harm themselves. The causes and effects of these situations are accepted, and often encouraged by our society, and that is terrible, and inhuman. It is caused by our politicians, our media, our CEO’s, our corporations, our schools, our churches, our hospitals, our law enforcement, and the individuals in our communities. These destructive norms are everywhere, and they are killing people. Just a little tolerance, a little willingness to listen. That could change our communities, and that could make the world a safer and more nurturing place for the trans community. 

 

In the end, it really doesn’t take much effort to support those in the trans community. Whether you’re voting for bills that give more treatment access to trans individuals, or merely respecting someone’s preferred pronouns, just a little support could make a world of difference in the lives of a trans person. Helping trans people access gender affirming healthcare, or supporting them though their transition is super important, and impactful for the quality of life of trans individuals. “Not just for me, but 90% of trans people who are seeking medical assistance in their transitions will definitely benefit both mentally and physically, from alleviating that stress, and alleviating their anxiety and dysphoria, and finally getting to be who they are, “ said Slavick. “Parents of trans folks need to realize that medical and non-medical transitions both will help their kids feel more comfortable in their own skin, help alleviate anxiety and depression, and instead of, you know, parents trying to stop their kids from transitioning, or punishing them for trying to be who they are, they should just accept their kids, and you know, support them in their social and medical transitions.”