Gender Identity
In today’s world there is a lot of discussion about teen gender identity and expression. For parents from my generation, this can be quite confusing. We didn’t grow up with words to identify feeling something different than the sex we were assigned at birth. Although some people may have experienced a sense of gender incongruence, there wasn’t any discussion about this. If someone did seek help, they were likely seen as having a psychiatric disorder.
Today we know so much more about gender identity. Many teens are struggling with their gender identity and are feeling confused and unsure about their emotions. They may feel a strong sense that their body doesn’t align with the sex they were assigned at birth, leading to feelings of confusion, anxiety, and distress. Their overall mental wellness is often completely dependent on their environmental circumstances, emotional support, and acceptance from the most important human relationships in their life. If they feel safe to express themselves without judgment, they will have a much more positive outcome during their journey to discovering their gender identity. Yet what happens when their social, cultural, or spiritual community doesn’t allow for safe expression of their felt gender and or feelings related to their gender identity?
Challenges in Gender Identity
Teens who are questioning their gender identity may face a range of challenges, including discrimination, harassment, and social isolation. They may also experience anxiety and depression, especially when they feel unsupported or misunderstood by their family or community. When family members don’t understand and or choose not to become curious or educate themselves about their child’s experience, they can contribute to the anxiety the teen is already feeling.
While it is essential for parents and caregivers to create a safe and supportive environment for teens who are questioning their gender identity, it is imperative that parents recognize their own feelings, and seek knowledge, support, and even personal therapy so they can be more emotionally available to their teens. Parents who allow teens access to mental health services and give them the opportunity to connect with support groups and resources for LGBTQ+ youth, demonstrate their willingness to show up and help their teen seek wisdom and counseling from trained professionals.
My Clinical Experience
As a clinician who has worked with transgender and gender non-conforming teens and adults, I have witnessed a strong connection between anxiety and gender identity. Many of my clients report feeling anxious about how they will be perceived and treated by others, including family, friends, and healthcare providers. There is additional stress for those in Christian based schools, and/or very conservative communities that ban access to safe gender confirming restrooms, as they refuse to acknowledge the risk to trans and non-binary students.
Teens may also experience anxiety related to the physical changes that come with puberty, particularly if these changes do not align with their gender identity. These teens feel body dysmorphia that can be very severe. Looking at themselves in the mirror with sex organs that don’t align with how they feel inside is a big issue for their mental health. For instance, trans male or trans-masculine clients might have a strong hatred for their breasts and long for Top Surgery (removal of breast through mastectomy). This type of dysmorphia is very different from your typical teen who may struggle with body image and self esteem. Yet conservative religious groups and media attack body dysmorphia as if it’s not real, and as if individuals, parents, and or medical professionals are physically mutilating bodies, when instead they are trying to help teens feel safe inside their body, and prevent further depression and or risk of suicide.
Treatment Barriers
Discussion with other clinicians has helped confirm that teen anxiety can be a barrier to accessing necessary healthcare services for transgender and gender non-conforming youth. Teens may experience anxiety about coming out to healthcare providers or fear discrimination or lack of understanding from medical professionals. If they live in states that are working to ban access to gender confirming care, they are even more at risk of opening up about their needs and emotional feelings. Some are forced to even seek “religious counseling” that doesn’t affirm their identity, and or participate in groups that seek to help them suppress their feelings and try to accept their assigned sex at birth.
Treating Teens
As a gender-affirming therapist, my role is to help meet teens where they are and learn about their struggle and potential traumatic experiences. I use Cognitive Behavioral Therapy, Exposure Response Prevention, and IFS Informed EMDR therapy in order to address negative beliefs that teens have about themselves. Once we identify these negative feelings, images or the worst part of the memories attached to their thoughts, we can work to change their perception through desensitization of their memories. They get to choose what they would rather believe when they think about these situations and or experiences, and then we work to install these adaptive beliefs.
Family therapy and or consultation with the teen may be imperative in order to assist with facilitation of communication. Most teens find it hard to communicate their feelings verbally from a safe place with their parents. If they feel threatened or as if their parent is not going to understand or accept them, then with their permission, I may ask for a parent to join us in a session and help facilitate communication between the teen and their parent.
Parents of Gender Non-Conforming Teens
As a mother of a 23-year-old Trans son, I have first-hand experience of all the thoughts, feelings and emotional turmoil you are experiencing. For 20 years I thought I had a daughter, only to learn that he was always my son. The past three years have been an incredible journey that started out with Fear and Anxiety until I chose to lean into the emotions and feelings and become educated. So much of our fear stems from what we don’t know (uncertainty) and what we are afraid other people will think (perfectionism). We have to do our own work in order to be the parent our child needs us to be. That requires admitting what you don’t know and seeking information to learn. It may involve deconstructing some of your own beliefs, and or letting go of friends, groups, and organizations that don’t accept or allow you to support your child’s life experience.
For more information and support please head to my website Authentic Gains.