I sprained my knee. That’s how I found out my 14-year-old daughter was struggling with her gender identity. I was combing the house for an ace wrap and found it in the dirty clothes basket in Karen’s room. It looked like it had been through a war. No elastic left. Karen had always been a tomboy. She wanted to mow the lawn, play with bugs, play sports…she was always moving and had zero interest in “girl stuff.” I took her to Claire’s in the mall a few times and she looked totally lost as I picked out headbands, earrings, and miscellaneous froufrou. I guess she was sending signals for years, but I wasn’t picking up the phone.

I don’t know how it dawned on me that she was binding her breasts. It just came to me and so I asked her, “Are you binding your breasts?” She started crying.

“I was born in the wrong body!” She said between racking sobs.

I’m ashamed to say it, but my first thought was, “Why me?” I took her to the pediatrician. She told me that this is just a phase. Karen is hanging out with the wrong people. Monitor her closely. Watch her friends. Ignore it and it will go away.

I was already pretty obsessive about who she hung out with. On play dates I would make sure I went in the house and met everyone involved. When I took her and her friends to the mall, I quizzed the friends about their home life and their grades. I thought I was doing everything right. Over the next year, our relationship deteriorated. I found marijuana, vape pens, bongs…she became a stranger to me. It was all yelling and grounding and taking the phone away. She didn’t do homework. She hated me. So much for the pediatrician’s advice.

I reached out to one of the pediatricians I had worked with and respected and asked him to recommend a doctor who worked with transgender teens. I made an appointment. Dr. Mitch spent an hour with Karen…without me in the room. When Karen came out of the appointment, a weight seemed to have lifted from her shoulders. Later, Karen told me the nurse had given her a shot to “make my period go away.”  I was beside myself. I called the office and demanded to speak with the doctor. My rights as a parent had been violated. How dare he give my child something without discussing it with me first. I wasn’t against the shot so much as being cut out of the decision.

Dr. Mitch called me back that afternoon and spent an hour on the phone with me. Can you imagine? An hour. He patiently discussed what Karen was going through and informed me that children over 12 can get birth control without parental consent. I had no idea. He explained that Karen had gender dysphoria: The constant feeling that her body was the wrong sex.  Karen had anxiety, anger, feelings of hopelessness, and diminished self-worth. My child was in pain. Thus, started my education in transgender children. I knew by now that it wasn’t a phase but, I have to admit, I was still hoping that it would go away.  My own feelings of self-worth had taken a hit, honestly. What kind of a parent was I? How could I let this happen?

WPATH (www.wpath.org) is the World Professional Association for Transgender Health and they write the standards of care for transgender health care. Dr. Mitch suggested I look over the information on the website and I did. It answered a lot of questions. Dr. Mitch assured me that there was nothing wrong with me and that Karen was always going to be my child. He suggested that if Karen wants to dress like a boy, it’s not permanent. He suggested I just back off and let her do what makes her comfortable. Of course, I was terrified that she would start taking hormones and have permanent changes that she would regret later. Dr. Mitch told me that Karen needs to live as a boy for a year and see a therapist every week to discuss her journey to make sure it’s the right thing. He wouldn’t prescribe hormones until Karen has been living as a boy for a year and his therapist signed off on the treatment.

Karen started seeing therapists who specialized in transgender teens. Insurance was a constant battle. The quality of the therapists was spotty. Karen, now Tony, was angry and impatient. He wanted testosterone now, now, now. He went to group meetings with other transgender teens and I think he saw how many of them struggled with no parental support. I remember seeing a young boy with long lanky hair and a defeated demeanor at a couple of his pizza party groups. I saw him, or her I should say, walking there and walking home. I really felt sad for this kid who wanted to be a girl so much. Tony told me the girl was grinding up DVDs and eating them because she heard the plastic works like estrogen. I really felt terrible for her. I determined that I was not going to be like her parents. However, I was not going to let Tony make any irrevocable decisions until we both were sure this was the way forward.

That year was a bit of a blur. Lots of appointments, Tony being angry. Kids and teachers at his school wouldn’t get with his name change and preferred pronoun. I blew it myself many times. I was so used to Karen, my daughter…not Tony my son. Problems at school came to a head and Tony pulled out of high school in favor of going to an alternative school. Things got better and worse, better and worse. I was at my wits’ end. All Tony wanted was to be seen by others as he saw himself, as a boy, not a girl. He bought some binders online and that worked, but they were uncomfortable and over time, left him bruised and misshapen. His girlish hips and curvy legs were problematic.

When he finally got the go ahead to start testosterone, he was so excited. Looking back, I think he thought that once he started hormone therapy, he would magically change into another person. It wasn’t like that. He still had problems with his old friends misgendering him. He still was behind in school. He still had all his old problems. That first year was the angry year. From my perspective, things got worse once he started testosterone. The doctor assured me that it wasn’t the hormones, it was just teenage angst. Tony went from twice a month dosing to once a week, halving the dose. I don’t know if that made things better or worse or didn’t do anything. I was scared, Tony was miserable.

Over that first year of testosterone, Tony gradually got more stable. I guess it was probably two years all in all before Tony got the body he wanted…or close enough that he can live with it. He’s 18 now and looks very boyish. He doesn’t bind his breasts anymore, but he does hunch his shoulders and tape his nipples flat when he goes out. We’ve discussed top surgery and I think the conclusion is that he can live with a small chest for now. There’s no talk of bottom surgery. I think Tony is finding a new middle ground between being a boy and being a girl. I tell him he doesn’t have to be binary, either/or. He can just be himself and I’m cool with whatever that self is. He is OK with being a boy with breasts. I know that given a choice he would choose not to have them. However, for now, the discomfort and risks of surgery are not worth the benefit.

Being a teenager is difficult in the best of circumstances. Tony is an adopted immigrant from Vietnam with a white single gay parent and born in the wrong body. Is it a surprise that his teen years were stormy? Not really. Tony worked all summer long at Chipotle and saved up his money. He bought his own car. He works two jobs. He’s smart and responsible. He’s good with money. He’s still afraid of school. He was tormented in high school and I think he has a lot of anxiety about going to college. I gently nudge him, but there is no hurry. He’s just about as perfect a person as I’ve ever seen. The trauma of those years of his transitioning is with us both, but gradually fading. I’d say he is a success story. He’s my son.

Spencer Miller, RN

Spencer Miller, RN, is an emergency room nurse who has worked at various hospitals in Florida, Georgia, and California as a traveler. He currently lives in Sunnyvale, California.

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