Our Visit to the Lurie Children's Hospital Gender Clinic

At TransHealth in June, I had the opportunity to hear Dr. Jo Olson speak. She is director of the Transgender Youth program at Children's Hospital Los Angeles, which until very recently was one of only two programs in the US dedicated to treatings trans youth; the other is in Boston. Recently, the Lurie Children's Hospital in Chicago has begun to work on creating a gender clinic as well; not officially open yet, the clinic already has around 75 patients, from age 4 to early 20s. Chicago is only four hours from us, so I was excited to learn about the Lurie clinic, and assumed the Tiny Tornado would be a patient there someday.

But when? I went to Dr. Olson's presentation with a burning question: at what point should we make contact with a gender clinic? The Tiny Tornado is years away from puberty, and has no behavioral or psychological problems. Should we get started early, or wait until it's time to consider puberty blockers?

Dr. Olson talked about many other topics of interest to me, and I learned a great deal. In fact, I have another blog post to write about all the notes I took in her presentation. But as I listened and took notes and found little nooks and crannies in my brain to store all the new information, I was still thinking: When do we take the Tiny Tornado to a gender clinic?

Dr. Olson's presentation ran over, and she had said nothing about this. I raised my hand, but others with questions were called on first. The answers to their questions were long and complicated. I raised my hand more forcefully, but I was in the very back of a large and crowded room and went unnoticed. Dr. Olson began to mention more often how much the session was running over. The people leading the next session in the room began to mill about near the door, looking cranky. Dr. Olson was about to wrap things up, and she hadn't answered my question. "I am not letting her out of here without answering me," I said to myself. "I will tackle her in the hallway outside if I have to."

I didn't have to. In the middle of the very last question she took, she digressed to say that she often doesn't see kids until they're in crisis in one way or another. "If I had my way," she said, "I'd have these kids in my clinic at 4, 5, 6, 7, get to know them, have a baseline, have the chance to avert some of the crises."

I had my answer. And as soon as we got home to Michigan, I called Lurie and made an appointment to visit the children's gender clinic.

Raider, the Tiny Tornado, and I drove to Chicago yesterday for our appointment. The clinic has two pediatricians and a psychologist on staff, and will be adding another doctor in the fall. We talked mostly with Dr. Gales, but we also met the clinic director, Dr. Garofalo; the staff psychologist, Dr. Chen;and the friendly, efficient, and quick-witted administrative person who helped me set up the appointment, Jen Leininger.

Everyone was very welcoming, and they seemed delighted to meet the Tiny Tornado. We ran through a short version of the Tiny Tornado's gender history with Dr. Gales, and it was such a relief and pleasure to be with someone to whom nothing had to be explained. I realized partway into my recitation that I am always, when talking to people about this, braced for conflict, or for the rude question I've answered a hundred times before, or prepared with an overabundance of evidence to make my case. With Dr. Gales, we just had to hit the highlights, and he listened openly and nodded in a "Yep, that's about what we'd expect," kind of way.

We had one fun moment when we were talking about TT's first haircut--the mohawk he got just before he turned three--and I delivered my usual rant about "But I learned how to do the hair! The oiling, the combing, the parting, the braiding--all for nought." Dr. Gales, who is black, said, "Well, if my partner and I end up with a girl, I'll call you. I've been terrified about the hair thing. I know nothing!" I was like, "Oh, heck yeah, I can hook you up. I have resources."

Dr. Gales talked to TT for quite awhile. He reassured TT, who worries about his body betraying him and growing breasts when he gets older, that he has nothing to worry about, that his body is not going to change for a long time, and there are things the doctors can do to make sure it changes in the ways he wants. He told TT, "It's your job right now to enjoy turning six, have fun in kindergarten, keep growing. I don't want you to worry about this at all."

We've been telling TT for some time that there are doctors who can help him grow up as a boy, if that's what he continues to want. Now those doctors have names and faces. TT hasn't wanted to talk about the appointment with us, but he smiled broadly and nodded when asked during the appointment if he was glad to be meeting them. Though Dr. Garofalo commented that he doesn't think they'll necessarily be TT's doctors long-term--this is an "exploding field," he said. By the time TT is 11 and likely to be encountering puberty, there may well be someone closer than Chicago working with transgendered kids ("though doing it well," Dr Garofalo said, and shook his head).

Dr Gales also told TT that he's a "trailblazer." TT is part of a cohort of young children--there are several others, as young as four, who are patients at Lurie as well, and others elsewhere in the country--who are the first ever to have access to quality care for gender dysphoria at such a young age. Dr. Gales told TT that, as they help him, they will also be learning from him, and what they learn will help them do even better with the kids who come along later. This kind of went over TT's head but it meant a lot to me. The Tiny Tornado has been a lot of people's "first," including the staff at his school, and most of our friends and family. Although people have been overwhelmingly supportive and positive, he will continue to be in the position of educating people by his very presence, and by the conversations that we need to have in order to make sure he's treated appropriately and has the support he needs. This isn't always easy and, although we've encountered very little, there is always the possibility of judgment or hostility.

In addition, I've struggled with my conscience over my decision to share TT's story on my blog, on Facebook, and, soon, in Friends Journal. But you know, writing about my life is what I do. It's my talent, my gift, my ministry, and, about some things, my obligation (it's also my pleasure). If TT really is among the first kids to have care from a young age, then he might not have the luxury of perfect privacy. Partly just because I'm his mom, and this is what I do. If he wanted a more private type of mom he should have arranged with God to be adopted by a different family. But partly because he is a very resiliant, self-assured, powerful child and, it seems to me that we might have a job to do, one that would be impossible for a different kind of kid and a different kind of mom. Certainly Raider has commented that one thing we bring to, say, the parent support groups at TransHealth is our totally calm assumption that the Tiny Tornado is OK as he is, and that things are likely to work out fine.

This was one of the interesting things about our talk with Dr. Gales: we did not require the usual degree of parent education or reassurance. "I do affirm everything you're doing," he said, and that was nice. The next time anybody gives me trouble about it, I have a board-certified pediatrician with expertise in this area to back me up.

I mentioned seeing Dr. Olson at TransHealth, and Dr. Gales said that not only do they know her well, but there are so few doctors doing full-time work with trans youth that they have a conference call every week. The group of them are seeking NIH funding to do some research into treatments and best practices, and it's possible that TT will be part of a research study at some point. Like Dr. Garofalo, Dr. Gales commented on how fast the field is growing, suggesting that, by the time TT reaches puberty, there may be more treatment options than just hormone blockers. That will be interesting to see.

As well as being a trailblazer, we get to be followers as well. Dr. Gales mentioned that they have a female-to-male teenager in the clinic who is dealing with his school around participation sports--the hormones he is taking are technically banned substances. This has been something I've thought about many times, with TT being as athletic as he is. What if he wants to participate in team sports when he's older? It's good to know we're not going to be the first family facing that issue, and I am holding the young man we heard about in the Light.

In some ways, not much happened in the meeting. We chatted, we smiled, the Tiny Tornado fist-bumped everybody on the way out. But we accomplished our goal: we made the connection. We made the possibilty of medical assistance more concrete for TT. We established a relationship so that, if problems come up, we're not scrambling to find help. I feel surprisingly buoyed up, and less alone, although I would not have said before yesterday that I felt alone on this journey.

We'll go back next summer. At some point, we'll start going every six months. Eventually, there will be decisions to be made. It's good to know that there are people out there dedicating their careers to figuring out how to help us, and other families like us, make them.

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My letter to Philadelphia Yearly Meeting's Education Committee

A lot of my friends and loved ones are part of Philadelphia Yearly Meeting, and many of them are struggling with PYM's recently formulated policy requiring that attenders at PYM youth events be housed and use the bathroom with their "biological gender." PYM's policy can be read here. The policy about activities with "intimate aspects, such as sleeping room assignments, using bathrooms and changing clothes" is not in keeping with the spirit of inclusiveness the Education Standing Committee is explicitly striving for. A number of my friends are also considering responding in writing to the policy, and many will also be part of the conversation about this policy at PYM's upcoming annual sessions. Some of my friends are finding this policy very painful, and some are quite angry about it. It has been helpful to us to share our thoughts and what we've written, so I am posting the letter I sent to the committee earlier this evening. I did not feel angered or hurt by the policy, perhaps because I am confident that as trans Friends and their loved ones and allies share their Light, the policy will not stand as it is written for long.

 

To the Philadelphia Yearly Meeting Education Standing Committee:

Dear Friends,

I recently read your policy on welcoming trans youth. I was struck by the clear desire to welcome and support trans youth, and by the committee's humility in recognizing that they are in need of further Light. In that spirit, I am responding to your invitation to write although I am not a part of PYM; I am a Quaker who lives in Michigan. However, I am also the parent of a 6-year-old who was assigned female at birth but socially transitioned to living full-time as a boy at age 4, and I wanted to introduce you to him as an example of the kind of trans youth you might someday find joining you at PYM youth events.

Our son has been at every FGC Summer Gathering since he was born, for the last two years attending as a boy. Although there are people who remember him from before his transition, most people who encounter him at FGC are not aware that he was assigned female. My oldest son, who is 12, has friends at the Gathering whom he has known since toddlerhood. When our six-year-old reaches that age, so will he, and most of his friends will know him only as a boy. Imagine the confusion and discomfort that would be caused if, in that setting, he were expected to room with girls and use the bathroom with them. It would be painful for him, and disorienting to adults and children alike who know him as a boy. It would be little different than asking my oldest son, assigned male at birth and affirmed male in his gender identification, to room with a girl when he reaches high school age, and use the girls' bathroom.

The thing that trans youth of all ages need most from us is affirmation of their chosen gender, and any act that undermines their sense of themselves can be painful and damaging. Many people without experience of trans youth have concerns about bathroom use, but I have had the opportunity to meet a number of other parents of trans kids of all ages, and have heard of very few problems when schools and camps have allowed young people to make their own decisions about which bathrooms they are most comfortable using. For instance, I know a ten-year-old girl, assigned male at birth, who changes in the girls' locker room of her public school, and has done so over a long period of time without incident. This kind of support is tremendously important to trans and gender-nonconforming kids, and it carries very little risk.

I'd like to offer you three resources as well. TransHealth is a free conference that takes place every May or June at the Pennsylvania Convention Center. The conference has been invaluable for our family; it is where I have had opportunities to meet other families, as well as to hear from doctors and therapists who work extensively with trans youth. You mentioned that some adults would be educating themselves about trans issues; I encourage Friends to review next year's conference program when it becomes available and attend any sessions that seem useful (and perhaps one or two that seem challenging).

It might also be useful for you to know that the right to use facilities consistent with a person's affirmed gender is afforded civil rights protection in some places. You can find a comprehensive list here. Colorado's Division of Civil Rights recently ruled that the state's anti-discrimination laws, which prohibit discrimination against transgendered people, apply to a first-grader whose school had not been allowing her to use the girls' bathroom. The decision included the opinion that asking the girl to "disregard her identity while performing one of the most essential human functions constitutes severe and pervasive treatment, and creates an environment that is objectively and subjectively hostile, intimidating or offensive" (quoted in a New York Times article about the case.).

Finally, an article about my son's gender development will appear in the August issue of Friends Journal. Trans and gender nonconforming kids follow all kinds of paths; this is just the story of his so far, but you may find it interesting.

I will be holding you in the Light as you continue your work.

Su Penn

 

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Sex, Birth, and Singing Alto in the Sacred Harp

My partner Raider is an extraordinary lover. When we were first together, he would take me to bed with no thought but my pleasure. He spent weeks and months exploring my body and listening to what it told him. In quiet persuasive whispers he got me to give up all the secret wishes I'd been harboring, and then he made them come true. He was like a guide leading me into my dark secret places, and sex with him was like psychoanalysis, spiritual revelation, deep epiphany. Every time. I could tell you about the orgasms I had with him, and how they started deep in my body, centered in my womb, and spread out from there, pulling all my muscles into one great clenched fist, and then letting go. I've always thought I was so good at giving birth because he helped me find the muscles in my deep core, got me acquainted with the iron earth. But after awhile, I didn't always want to have sex with Raider. Nobody wants to have a life-changing experience every time they go to bed; who can stand to be that in touch with her deepest parts, bodily and spiritually, day after day? Sometimes you need a break. So we had to learn to have sex that was merely very good, that was satisfying but didn't leave me drenched and mind-blown, that didn't have me staggering through the next few days, dazed and happy but unable to balance my checkbook or safely drive a car.

This is exactly why, although singing alto in the Sacred Harp is one of the things I love best, I don't do it at every opportunity. There's a local singing twice a month, but I only go occasionally. There's a larger one two hours away; I make it once or twice a year. I love the Sacred Harp, but I don't trust it. It's too powerful. Singing the Sacred Harp reminds me of the time I was bodysurfing in big waves in Hawaii and got tumbled about when I missed my timing; I made it to the beach safe and sound, but when I stood up in the shallows, the water had taken my swimsuit off.

Mary Rose O'Reilley says in The Barn at the End of the World that the six elements of a Sacred Harp alto are rage, darkness, motherhood, earth, malice, and sex. The trebles, by contrast, "sing a descant line composed of ecstasy, light, purity, jet contrails, and self-surrender." O'Reilley isn't wrong, except about the malice, perhaps--she seems to have encountered a meaner and more self-interested brand of alto than I have. The altos tend to take the grounding line, the steady drone that keeps a song on the earth. We tend to sing the notes that give the harmonies their rough edge, and we do it sometimes by staying still while the other three parts move around us. Sometimes the altos are holding a steady, solid note and the music shifts around us and I hear a buzzsaw digging into lumber, I see the invisible whirling blade that, one time, took off the end of my father's thumb, I taste the sudden spurt of blood.

Singing alto in the sacred harp isn't for the dainty or squeamish. It's loud and raw. It helps to have had some really good sex, or to have given birth a time or two without anesthesia, to know where the womb is with its hidden muscles, the strongest in the body, some say, but locked away and not for you to command. Singing Sacred Harp has something in common with sex and birthing: all three are done better if you can set aside self-consciousness, modesty, and concerns for propriety, if you're willing to lay it all out there.

It helps, too, to have grieved a time or two. You can see that right in the music, that it was created and sung by people for whom death was always present. The Sacred Harp birthday song goes like this:

Youth, like the spring, will soon be gone, by fleeting time or conquering death.
Your morning sun may set at noon, and leave you ever in the dark.
Your sparkling eyes and blooming cheeks must wither like the blasted rose.
The coffin, earth, and winding sheet will soon your active limbs enclose,
Will soon your active limbs enclose. (Morning Sun, 436)

We sing it as a joke, but the people who originated this music weren't making fun of death. They were living side-by-side with it.

That's one of the dangerous things about the Sacred Harp, to my mind: the way you take on someone else's religion for a few hours or a couple of days at a time, belting it full-out like you're a believer, too. I always feel, when I sing, like I'm pushing at an invisible membrane between me and some woman not that different from me, who sang this music a hundred and fifty years ago, who struggled with her husband to make a go of a farm with poor soil, who had buried a baby, say, as well as two kids at once the year cholera came through. A woman who carried all of the hard work of her days, all of her losses and disappointments, to church with her, whose church was her only consolation.

Sacred Harp was a teaching tradition, originally, and we still call a short sing a lesson, an all-day sing a school, and a group of singers a class. It's not just the music we're being schooled in, though; it's the lives and faith of the original singers, the times they lived in, the God they worshipped.

Mary Rose O'Reilley writes, "The trebles have by now burst the bounds of earth. They will all call in sick on Monday." She writes, "The singing over, we drop like birds who have been buffeted to the edge of the oxygen zone. We have barely escaped with our lives." And that's the thing, that's the answer to why I don't show up twice a month at my local singing and drive two hours every month to the singing in Kalamazoo, why I go to only some of the conventions, and often for only one day. It's not just to save my voice, though that gets raw enough after awhile. It's to save my life, the life I'm living now and love, the one I could lose if that membrane ever ruptures and I'm not just getting a view of another life, another faith, but dropped into the middle of it. I don't want to find myself face-to-face with the God of that gray woman; I like the God I have, so much friendlier, more loving, less capricious. The God I have lets me keep the things I love best.

I walk away from a Sacred Harp singing sweaty, hoarse, wrung-out, and with a sense of having narrowly escaped being turned into something else, someone else. It's a good thing there's not an altar call in the afternoon, in place of the Memorial Lesson, or after four hours of singing to God with my whole heart, I'd be on my knees in the center of the square, accepting Jesus as my personal savior.

Convicted as a sinner, to Jesus I come,
Informed by the gospel for such there is room.
O'erwhelmed with sorrows for sin I will cry,
Lead me to the rock that is higher than I. (The Rock That is Higher Than I, 496)

It's like a kind of Russian roulette, every time I sing. I never know when the hammer will come down and boom! I'l be on the other side of a change I can't easily come back from. I carry my songbook into the square and settle myself in the second row of altos. Today, I have decided, I'll take my chances.

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