When Is It Too Early to Decide to Change Genders?

by Joseph Erbentraut

EDGE Media Network Contributor

Monday July 19, 2010

The decision to transition from one gender to another should be among the most private matters. But when you're the offspring of Hollywood power couple Annette Bening and Warren Beatty, it becomes a matter of public debate -- especially when you are 18 years old. Kathlyn Beatty, eldest child of the acting duo, had privately confided that she planned to transition and become a man. Once the tabloids got a hold of the news, the conflagration quickly ignited the Blogosphere.

Some asked whether a reportedly "heartbroken" Warren would be able to accept his son. The U.K. Daily Mail has reported that Kathlyn plans to go by the name Stephen and reportedly has been living as a man for two years.

Some question whether an 18-year-old, though a legal adult, is old enough to make the drastic decision to transition.

Perhaps not surprisingly, the answer to the question of what age is appropriate or advantageous for transgender youth to transition is neither easy nor universally applicable. A number of factors -- such as the youth's family, school and social environments -- are at work in influencing such decisions. Many transgender advocates argue the issue is often sensationalized in mainstream media and largely misunderstood by the general public.

Dignity & Respect

EDGE spoke with a number of national leaders on the topic. Delving deeper into concerns and issues facing transgender youth reveals profound questions about their abilities to feel safe, secure and happy in their own skin.

According to several sources, the question of when a youth may transition and what that process might entail is a deeply personal one for both the youth and his or her family. A transgendered person feels, often from a very young age, that the gender they were assigned at birth is incorrect, not indicative of the gender they personally identify with. In order to align their at-odds internal and external expressions, many transgender people choose to undergo hormone treatments or reconstructive surgeries.

Many also do not, however, and the options available depend greatly on a number of factors. Michael Silverman, executive director of the Transgender Legal Defense & Education Fund, hopes the Beattys are given some room by the media to sort out what is best for Stephen. While tabloids jumped on other recent celebrity transitions, most especially Chaz Bono's, advocates feel Beatty's age is particularly deserving of privacy.

"We need to insure the media covers stories like this with respect and a sense of dignity for the children and families involved," Silverman told EDGE. "Transitioning is a personal and private process for someone that ends up happening in the public eye. It's difficult enough for someone to deal with without it becoming sensationalized."

Further, Silverman emphasized the importance of a space for all youth to openly come to terms with their gender and whether what they've been given makes sense for them. It's often a thought process more challenging than what many cisgender (non-transgender) people might think.

"At all ages, children and young adults should be free to explore their gender identities," Silverman added. "I think it's important that we not punish children because they identify their gender in a way that's different than what society expects of them."

Media-Made Misconceptions

For the most part the media have offered problematic commentary on transgender youth. Unfortunately, they all-too often employ rhetoric that even sometimes goes as far as to seem condoning of anti-transgender violence. On Sacramento's KRXQ-FM last year, radio host Arnie States argued trans youth are "freaks" and "weird people," further stating if his son ever wore female clothing, he would "hit him with one of my shoes." Opponents to efforts to help trans youth transition, such as physician Paul McHugh, often describe hormone treatments and surgeries as a "form of child abuse."

Anti-transgender language in the media has only increased as legislation like a transgender-inclusive national Employment Non-Discrimination Act has entered the political fore this year. Fox News talking head Bill O'Reilly compared transgender people to Ewoks and described a transgender student's concern over which bathroom to use as "bogus" and "ridiculous."

Negative media coverage feeding into stereotypes about the transgender community may very likely contribute to the many concerns to which trans youth are prone. According to findings from a 2009 GLSEN survey of transgender students, nearly nine out of 10 respondents had experienced verbal harassment in the last year; a quarter had experienced physical assault. They were also markedly likely to miss class and receive lower grades. Research also indicates transgender youth are at a heightened risk of depression, substance abuse and suicidal behavior.

The Clock Is Ticking

When compared with gay, bisexual and lesbian youth, transgender youth also feel their difference at a younger age. That only means that more damage is often done more quickly, but it also heightens the need for open-minded medical care and a supportive family unit in considering the possibility of intervening with treatment.

Grace Stowell, executive director of BAGLY, the Boston Alliance of Gay, Lesbian, Bisexual & Transgender Youth, has been working in the community for over 30 years and noticed transgender youth are also coming out earlier in recent years, sometimes catching parents and schools alike unprepared.

At all ages, children and young adults should be free to explore their gender identities

"The advocacy is being pushed younger," Stowell said. "For non-transgender GLB people, they're identifying as that post-puberty, but the transgender conversation is shifting into grade and preschool in some case. It brings the issue front and center where parents and school systems would not have expected that before."

And it's also pushing the need, in many cases, for earlier intervention. While that might just mean changes in dress or hairstyle at younger ages, once youth reach puberty in middle school, there are options available that can put a "pause" button on puberty, allowing for decisions about taking cross-gender hormones or undergoing sex-reassignment surgery to be made sometimes years later. Such options are essential, Stowell said.

"It's not enough to say they're too young to know because a lot of damage can be done by forcing a child to live a gender that they are not," Stowell added. "Waiting 15 years can mean the damage has been done. A lot of issues can stem from forcing someone to live a life in a way that is fundamentally not who they are."

Kim Pearson, executive director of the TransYouth Family Allies, is active in helping families find the resources they need to make the choices that are best suited for their child. At times it can be an especially difficult task to find a sympathetic health care professional willing to work with a family on transitioning options.

"Finding a willing care provider who will educate themselves and work with you is essential," Pearson told EDGE. "Many still don't want to approach the issue until the youth is 18, which is much too late for a lot of these kids. There needs to be intervention at puberty, at which point they are very high risk. For a lot of these kids, intervention is literally life-saving."

One of those interventions is puberty suppressants, which hold off the onset of secondary sex characteristics. Once the suppressants are no longer taken, the youth resumes where they left off within a matter of months, allowing transgender youth some time to make their decision.

But the suppressants are not cheap: They run roughly $1200 per month. And families may need to travel to find a willing care provider who's educated, or willing to learn about transgender issues. Families also often need a mental health professional on board in order to go ahead with treatment, which can also be an added expense.

That said, there are roughly 500 specialists nationwide who have followed the example of names like the trailblazing Dr. Norman Spack of Children's Hospital Boston and Dr. Johanna Olson at Children's Hospital Los Angeles, and more are becoming open to the idea. That support can make the difference between life and death, particularly if the youth doesn't have a supportive environment at home, an important first step to the process that is sometimes missing.

School Finally Helping

Schools are also increasingly stepping up to the plate on trans issues, even though most still have a far way to go. Emily Greytak, author of the Gay & Lesbian Straight Education Network's report on transgender youth, noted many schools were warming up to educating their staff about transgender issues and advocating for bullied trans youth, though progress has been "slow but steady."

This year, the National School Board Association hosted a transgender panel at its conference, and many schools have felt support by statewide anti-bullying legislation pending in California and recently passed in Illinois and Massachusetts. Fifteen states have passed such legislation, mandating that gender expression and gender identity are included as protected identities for students.

"But this is still an issue that probably most schools really don't think about at all or address," Greytak said. "Most transgender youth are likely experiencing a hostile school climate and experiencing harassment on a regular basis."

Support Is Crucial

Ultimately, transgender youth, just like any other young people, depend on support from their family during what is an undeniably challenging time. Advocates say that even if that unconditional love isn't coming from home, it is essential that it comes from somewhere during their transitioning process, whatever form it takes.

"Parental support or having even one adult in your life that 'gets it' and is supportive can make the difference if a youth can survive or not," Pearson added. "This is a matter of desperation for that child wanting to express themselves and the more we talk about these misconceptions and educate ourselves, the better our society will do."

"The most important part is letting [the youth] know they are loved, valued and good people with nothing wrong with them," Stowell said. "They need to have trusted and supportive adults and peers who value who they are and will give them a safe space to make healthy choices, whatever they might be, as they go along."

Joseph covers news, arts and entertainment and lives in Chicago. He is the assistant Chicago editor for The Huffington Post. Log on to www.joe-erbentraut.com to read more of his work.