Decisions, decisions

If you watched the footage from the Dr. Oz show in the previous post there is a theme you will notice. It is a theme I notice in my life when I tell people about Anneke's journey, blockers and the many other choices we make on behalf of our kids. "Are you sure you are doing the right thing?" or "Don't you think giving your child a drug to stop puberty is extreme?"

There are two things I know for sure.
1. As a parent, you never know with certainty you are making the right choice for your child. You have to trust your instincts and listen to your child.

2. Doing nothing, when it comes to big decisions like blockers and surgery is making a decision for your child.

Since the age of 6 Anneke had suffered from migraines and extreme stomach pains. S/he has had head CT's, ultrasounds, X-rays and countless days of missed school. When signs of female development began, all of these things got worse and a deepening depression ensued.

The universe takes care of us, I beleive. When I confided in my student at the time she had told me she had just recently attended a trans-health conference and heard a talk by Dr. Metzger, a pediatric endocrinologist who helped gender-variant kids stop puberty. When I told Anneke about this s/he jumped at the chance without hesitation. Dr. Metzger has been a gift to us. Since starting blockers Anneke has not had any more migraines, stomach pains or missed school.

I hesitated to get in touch with him at first. When I reached out to medical professionals, when Anneke was about 4 or 5 we met Dr. Zucker. He is a world renowned specialist in 'Gender Identity Disorder', especially with respect to children and adolescence. When he realized Anneke indeed fit the diagnostic criteria for GID, he wanted to enrol her in a study

The following is a summary I found on line
Dr. Kenneth Zucker, a psychologist and head of the gender-identity service at the Center for Addiction and Mental Health in Toronto, disagrees with the “free to be” approach with young children and cross-dressing in public. Over the past 30 years, Dr. Zucker has treated about 500 preadolescent gender-variant children. In his studies, 80 percent grow out of the behavior, but 15 percent to 20 percent continue to be distressed about their gender and may ultimately change their sex.
Dr. Zucker tries to “help these kids be more content in their biological gender” until they are older and can determine their sexual identity — accomplished, he said, by encouraging same-sex friendships and activities like board games that move beyond
Zucker thinks that an important goal of treatment is to help the children accept their birth sex and to avoid becoming transsexual. His experience has convinced him that if a boy with GID becomes an adolescent with GID, the chances that he will become an adult with GID and seek a sex change are much higher. And he thinks that the kind of therapy he practices helps reduce this risk. Zucker emphasizes a three-pronged treatment approach for boys with GID. First, he thinks that family dynamics play a large role in childhood GID—not necessarily in the origins of cross-gendered behavior, but in their persistence. It is the disordered and chaotic family, according to Zucker, that can’t get its act together to present a consistent and sensible reaction to the child, which would be something like the following: “We love you, but you are a boy, not a girl. Wishing to be a girl will only make you unhappy in the long run, and pretending to be a girl will only make your life around others harder.” So the first prong of Zucker’s approach is family therapy. Whatever conflicts or issues that parents have that prevent them from uniting to help their child must be addressed.

Once we realized this was Dr. Zuckers' approach we ran for the hills. He basically wanted to enrol Anneke (and our whole family) in behavioural modifcation therapy. When I confided in my friend Christine that I didn't know what to do about Anneke's kindergarden depression, and the interaction with Dr. Zucker, she asked simply "What do you want to do?"
"I want to take her out of this school that she hates, and surround her with people that love and support her, no matter what - not people that want to change her."
"Then that is what we will do." she said with a certainty that I yearned for. As we walked up to the school Anneke attended at the time.
I took Anneke out of that school that week. I begged the YMCA where s/he went to preschool to accept her in their kindergarden program, which they did. And I never returned Dr. Zucker's phone calls. As you can imagine, these were obviously big decisions. I had no idea if they were the right ones.

I now know they were some of the best decisions I have ever made.

Dr. Metzger and blockers

A couple years ago. Anneke became very depressed. S/he had chronic headaches, stomach aches, and missed a lot of school. Many doctor visits later we realized s/he was very depressed and anxious. Much of it had to do with the subtle changes her body was going through that indicated the onset of puberty. To her, her body was betraying her.

"I don't want boobs mom. I just don't." S/her would fervently state.

As if by miracle of fate, my student that year told me about an endocrinologist at BC Children's Hospital who helped 'gender variant' children block the hormones of puberty until they felt ready to adopt the gender that fit them best. For some that meant starting testosterone, and never developing into a female body.

When I told Anneke about his doctor and this possible therapy, s/he immediately said "When can we see him?" About a month later we were in Dr. Metzger's office. He began our visit by asking which pronoun Anneke preferred to use - he or she. S/he said she. He asks this question at every visit. He also asks if Anneke is still the name s/he prefers to be called. He really understands our child. He asked Anneke at that visit what she wanted, as he said most kids who came to him had a clear idea of what they wanted from him. In her own words she said s/he had heard he could prescribe a medication that could prevent her from 'growing boobs' and developing other female characteristics. By the end of the appointment Anneke had her first injection of Lupron a hormone 'blocker' that is now largely considered a community standard in treating trans-gendered children/adolescents.

Anneke has been taking blockers for the past 9 months and has never been happier. No more headaches, no more missed school. As a parent it is a huge decision to make on behalf of your child. While there of no dangerous long term side effects, it feels like a huge step to block puberty in your 12 year old child. Now that we see how happy s/he is, however, it feel like a no brainer. I give Anneke her monthly injection. It cost over $500 per month. A small price to pay for your child's happiness.

At New Year's our family goes around and states what the best thing about the past year has been. For Anneke it was meeting Dr. Metzger - go figure.