Treatment and Support for Transgender Children

Treatment and Support for Transgender Children Jill Seale Transgender children and adolescents face many obstacles in todays society that others do not; however, these obstacles are socially constructed and can be mitigated, and in some cases even negated, when the child or teen is afforded an affirming environment and the appropriate social and medical interventions. These factors are crucial to the welfare of transgender children and ideally would be available to them as early in their lives as possible. Kohlbergs Theory of Gender Constancy (as cited in Bernal Coolhart, 2012) states that children begin developing their gender identity in their preschool years. It is therefore unsurprising that the World Professional Association for Transgender Health (WPATH), the organization that is responsible for drafting the standards of care by which all trans people are treated by medical and psychiatric professionals, has found that signs pointing to Gender Dysphoria have been observed in children as young as two years old (2012). Gender Dysphoria, previously known as Gender Identity Disorder, is the state of feeling dissonance between ones gender assigned at birth and ones self-perceived or experienced gender. The number of children and youth who are being diagnosed and treated for this condition is growing, and according to Bernal Coolhart (2012), research and treatment protocols are showing that early intervention is effective in improving the lives of these children. In early childhood, one of the biggest decisions families will have to face is whether or not to allow their gender non-conforming child to begin socially transitioning into their preferred gender. In Kuvalanka, Weiner, and Mahans (2014) study, in which five mothers of transgender girls between the ages of eight and eleven years old were interviewed, it was shown that all five of the children were happier, more outgoing, and had a more confident demeanor after being allowed to express their self-perceived gender. At the point in her social transition in which she was allowed to express herself as a girl at home but had to pretend to be a boy in public, Lilly, a nine year old at the time, was described by her teacher as being â€Å"very quiet and shy (p.363).† Her mother, however, reported that at home she was happy and vibrant (Kuvalanka et al., 2014). Ehrensaft (2012) explains Lillys behavior at school as being what she calls the â€Å"false gender self,† that is, â₠¬Å"the face a child puts on for the world [either consciously or subconsciously] based on the expectations of the external environment and the childs interpretations and internalizations of either appropriate or adaptive gender behaviors (p.342).† When the girls in the study were allowed to express their â€Å"true gender self,† the positive effects went even further than just changes in attitude; their mothers reported that the childrens friendships and participation in school also improved (Kuvalanka et al., 2014). With the support of their families, these girls were able to go on to lead relatively normal childhoods. However, many children maintain this false gender self for years, sometimes into adulthood, with no parental support and no outlet to express their true self. Parental support has been shown to be extremely important in the quality of life of transgender children and teens. Simons, Schrager, Clark, Belzer, and Olsons (2013) study on the effects of parental support on the mental health of transgender adolescents shows that parental support correlates positively with higher life satisfaction, lower perceived burden of being trans, and fewer depressive symptoms. The study surveyed transgender youth between the ages of 12 and 24, excluding those who had not yet decided to pursue hormone replacement therapy, on their quality of life and the level of parental support they were receiving (Simons et al., 2013). Their quality of life was measured as their life satisfaction and their perceived burden of being trans, and their level of parental support was determined using the family subscale o f the Multidimensional Scale of Perceived Social Support (Simons et al., 2013). This includes questions such as, â€Å"I get the emotional help and support I need from my [parents]† and â€Å"I can talk about my problems with my [parents] (Zimet, Dahlem, Zimet, and Farley, 1988, p. 35).† It was also shown that greater depressive symptoms were associated with a greater perceived burden and that life satisfaction negatively correlated with perceived burden (Simons et al, 2013). What this study shows is that without parental support, transgender youth face a litany of hardships because of their gender identity that most children do not. Parental support is even more important when we consider the fact that many of the necessary medical and therapeutic interventions transgender children and adolescents need become much more difficult, if not impossible, for them to attain without the resources and support of their parents. Arguably the most important of these, and undoubtedly the most difficult to obtain without parental support, is the medicine used to delay the effects of puberty, known as puberty blockers. According to Bernal Coolhart (2012), many transgender people describe puberty as â€Å"extremely distressing, as changes in their bodies feel like betrayals to their sense of self (p. 292). † Puberty blockers allow the child to stall their natal puberty so that they can further explore their gender identity without fear of experiencing this potentially traumatic and permanently life-altering event. Even after being allowed to socially transition, one girl in the Kuvalanka et al. (2014) study, Nicole, experienced suicidal urges and was diagnosed with bipolar disorder when her natal puberty began; however, the diagnosis was removed after she began taking puberty blockers. According to her mother, Nicole is now â€Å"doing very well and her issues are only those of a normal middle school girl (Kuvalanka et al., 2014, p. 364).† A study by Cohen-Kettenis, Schagen, Steensma, de Vries, and Delemarre-van de Waal (2011) that followed a transgender man from age 13 to age 35, who at the age of 13 had received puberty blockers, showed that puberty suppression can be a safe and effective treatment for transgender adolescents. They found that puberty blockers make certain gender affirming surgeries unnecessary, because many of them involve correcting the effects of natal puberty; they also made other surgeries less invasive, should the person decide they are necessary for them in the future (Cohen-Kettenis et al., 2011). According to Cohen-Kettenis et al. (2011), â€Å"unfavorable post operative outcomes seem to be associated with a late rather than an early start of gender reassignment (p.844).† One possible side effect, as noted by Bernal Coolhart (2012) is that cognitive development may be delayed as long as puberty is being delayed, however Cohen-Kettenis et al. (2011) found that the puberty blockers can be stopped at any time and the adolescents natal puberty, including their cognitive development, will commence. The research presented shows that with family support and positive, early intervention, transgender children and adolescents lives can be improved; however, there is a dearth of research on transgender people in general, and on children and adolescents in particular. That is why this paper will propose a study to be performed to learn more about this under served population. Cohen Kettenis et al. (2011) showed that puberty blockers can be an effective intervention for transgender adolescents, but because their study was longitudinal and limited to one transgender man it was unable to make conclusions that could be generalized to the larger transgender population; also, it was unable to measure the effects of puberty blockers against a control group of transgender adolescents who are not receiving puberty blockers. Therefore, the question this research will be attempting to answer is this: How do puberty blockers affect the quality of life of transgender adolescents? The study will measure quality of life by the subjects reported life satisfaction (to include their satisfaction with their social lives) as well as their academic and/or professional achievement. The hypothesis of this study is that taking puberty blockers will positively correlate with higher quality of life. References Bernal, A. T., Coolhart, D. (2012). Treatment and Ethical Considerations with Transgender Children and Youth in Family Therapy.Journal of Family Psychotherapy,23(4), 287-303. Cohen-Kettenis, P. T., Schagen, S. E., Steensma, T. D., de Vries, A. L., Delemarre-van de Waal, H. A. (2011). Puberty Suppression in a Gender-Dysphoric Adolescent: A 22-year Follow-Up.Archives of sexual behavior,40(4), 843-847. Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., Zucker, K. (2012). Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. International Journal of Transgenderism,13(4), 165-232. Ehrensaft, D. (2012). From Gender Identity Disorder to Gender Identity Creativity: True Gender Self Child Therapy.Journal of Homosexuality,59(3), 337-356. Kuvalanka, K. A., Weiner, J. L., Mahan, D. (2014). Child, Family, and Community Transformations: Findings from Interviews with Mothers of Transgender Girls.Journal of GLBT Family Studies,10(4), 354-379. Simons, L., Schrager, S. M., Clark, L. F., Belzer, M., Olson, J. (2013). Parental Support and Mental Health among Transgender Adolescents.Journal of Adolescent Health,53(6), 791-793. Zimet, G. D., Dahlem, N. W., Zimet, S. G., Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support.Journal of personality assessment,52(1), 30-41.

An Ideal Student Essay

An Ideal Student Children are the wealth of a nation. A Nation that produces a generation of talented and hardworking youth marches ahead on the path of progress. However creating quality citizens is no easy task and cannot be achieved overnight. The first step for that is to produce ideal students in our schools. These ideal students would go on to become ideal citizens. Who is an ideal student? There isn’t one definite answer to that because there are many qualities that together define an ideal student. The most important quality of an ideal student is that for him. The foremost duty of his school life is to study. He studies regularly and works hard to improve his performance in each exam. But his objective of studying is not to only score good marks or secure a high rank. Beyond that he has a thirst for knowledge, an interest to learn more about everything he observes. Apart from studies, an ideal student actively gets involves in other activities. He is good in arts and sports and regularly participates in intra and inter school events. He is an active member of various clubs in the school and helps in organizing events. But participating in competitions and winning events is not the only big thing in life, and an ideal student knows that very well. Virtues like kindness, compassion, respect, sincerity, honesty, politeness are equally important in today’s world, and these qualities are found in abundance in an ideal student. He treats his parents, teachers and elders with respect, and speaks politely to everybody. In times of crisis for his friends, he is the first person to stand by them. He never boasts of his achievements and never gets depressed by his failures. He is always cheerful and maintains a positive approach to life. He spreads hope and happiness wherever he goes. In short his conduct is admired by everyone. An ideal student is a voracious reader. He reads the newspaper regularly and is well aware about the events and happenings in various parts of the world. He also reads magazines, novels and short stories. He has an excellent grasp of the language and is very good at communicating things to others. Last but not the least, an ideal student loves his parents and family members very much and does as much as he can to help them and to keep them happy. He never wastes his parents’ hard-earned money and believes that knowledge is the biggest wealth he can acquire. An ideal students grows up to be an asset to his family, his society and the country. If only all our schools could produce more and more ideal students, our country could achieve tremendous progress and become the envy of the whole world.

Comparison Of Virgil s The Aeneid, The Iliad And Homer s...

The idea of destiny or fate is at the heart of most Greek and Roman myths, poems, and stories. It is the ultimate driving force in every person’s life. It is not focused only in a hero or god’s life. Every man, woman, child, and god is effected by destiny. This is an idea that Ancient Greeks and Romans clung to. The idea that no matter what an individual does there is no escaping their true destiny. Every twist and turn taken in life is predestined and the outcome will remain the same. The idea of being able to control one’s own fate is laughed at. This idea of a definite destiny is found in both Virgil’s â€Å"The Aeneid† and Homer’s â€Å"The Odyssey.† Both hero’s lives are shaped by their destiny and it forces them to make difficult decisions. In â€Å"The Odyssey† Homer presents us with an epic hero, Odysseus. A man who fought in the Trojan War and won. All he wants is to return home and be with his family. He was giv en a prophecy by the seer Tiresias, that determined his destiny, and it read: â€Å"’A sweet smooth journey home, renowned Odysseus, that is what you seek but a god will make it hard for you- I know- you will escape the one who shakes the earth, quaking with anger still, still enraged because you blinded the Cyclops, his dear son. Even so, you and your crew may still reach home suffering all the way†¦Ã¢â‚¬â„¢ (Book 11 lines 111-118).† Odysseus’ goal was to reach home and return to his family, but fate had other plans. He would be derailed and prohibited from returning homeShow MoreRelatedAeneid Analysis789 Words   |  4 PagesAeneid By Virgil Written 19 B.C.E Translated by John Dryden Analysis Jazymn Talley SNHU Analysis The intention of Virgil s poem, Aeneid, is to romanticize the origins of the Roman Empire. Aeneid shares many characteristic to Grecian writer Homer s Epic poems the Iliad and the Odyssey. Much of Roman culture is modeled after or inspired by the Greeks, especially the arts. Roman art, writings, religion, and celebrations were on the rise as they experienced a time of rest, enabling themRead MoreThe Aeneid By Publius Virgilius Maro1712 Words   |  7 PagesThe Aeneid was written by Publius Virgilius Maro, also referred to as Virgil. He was a Roman man born in northern Italy, in around 70 B.C.E. Virgil, who known for his poetry, especially his earliest work, wrote The Aeneid which was known as his greatest work. His gained his knowledge from studying Greek and Roman authors. Although Virgil studied both cultures his work was more so influenced by the Greek culture, his work was written with the use of common themes that Greek writers used for so manyRead MoreComparison of Homer an d Virgil’s Tragic Hero1908 Words   |  8 PagesComparison of Homer and Virgil’s Tragic Hero Homer, an ancient Greek epic poet, influenced many writers in the ancient Greek and Roman culture, particularly Virgil. Virgil, most famous for his epic poem The Aeneid demonstrates Homer’s influence through similar characters, mythology, and ideals. Homer in both his most famous works the Iliad and The Odyssey weaves poetry based on centuries worth of oral stories handed down and uses a sophisticated style of writing that is still recognized todayRead MoreEssay about Epic Conventions Applied in The Faerie Queene1711 Words   |  7 Pagesexistence of the national epic works, English writers feel the lack of epic writer figure such as Homer of Greeks, or Virgil of Latins in their literature and this obligates them to focus on writing in epic genre and this need causes them to complain about this absence more frequently. For instance, Edmund Spenser claims in one of his pastoral, The Shepheardes Calender, as if a poet wants to be master in poetry, s/he has to abandon writing the basic forms of poetry such as pastoral and has to write an epic

London as setting for Mrs. Dalloway - 1470 Words

When a man is tired of London, he is tired of life; for there is in London all that life can afford. --Samuel Johnson In Mrs. Dalloway, Virginia Woolf uses the setting of the city of London to effectively show the vastly different emotional responses of the characters. The city of London, in June, is the primary location in which three of the novels characters are placed; although they inhabit the same period of time, they display completely different responses. The protagonist, Clarissa Dalloway, enjoys the experience from her position of privilege and comfort. Septimus Warren Smith, by contrast, is being swallowed up by the city since he is in the depths of shell-shocked depression; he contemplates suicide because he cannot cope†¦show more content†¦Clarissa seems unaffected by the serenity of the park, except for a cursory acknowledgement of the silence; the mist; the hum; the slow-swimming happy ducks; the pouched birds waddling (5). She is more interested in the social encounter with her old friend, Hugh Whitbread, and what he may think of her and the hat she is wearing. Hughs presence in the park reminds her of happier times at Bourton where they spent considerable time together on the lawns and gardens. Conversely, Septimus finds himself in this same peaceful setting, yet he is tormented by his interpretation of the ordinary activities of the people in the park. As the injured, shell-shocked war veteran, he contemplates suicide while drifting in and out of lucidity as he is caught in a downward spiral of depression. The normal, everyday life in Regents Park feeds his psychosis to the point where he sees everything as a threat to him. Septimus experiences hallucinations of trees being alive and connected to him by millions of fibres (24); birds singing to him in Greek; a dog turning into a man; promises of beauty from the smoke of the sky-writing plan, and ultimately, Peter Walsh seeming to take the form of Septimus friend, Evans, who was killed in the war. Despite the intervention of his wife and doctors, Septimus is unable to bear life as he perceives it; he is swallowed up by London, and eventually commitsShow MoreRelatedLondon of Mrs Dalloway1184 Words   |  5 PagesMrs. Dallow ay’s London When a man is tired of London, he is tired of life; for there is in London all that life can afford. --Samuel Johnson The early part of the Twentieth Century saw England as the major super power in the world. During this time, England ascended to the height of its imperial powers, with its grasp and influence worldwide. A phrase was even coined in recognition of this fact: â€Å"The Empire on which the sun never sets†. 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Social oppression was shown in two ways: the oppression of women as English society returned to its traditional norms and customs after the war, and the oppression of the hard realities of life, concealing these realities with the elegance of English society. This paper discusses the purpose of the city in mirroring the theme of social oppression, focusing on issuesRead MoreIntertextuality in the Hours4441 Words   |  18 PagesVirginia Woolf wrote â€Å"Mrs. Dalloway,† a novel about a woman’s ordinary day, from which the reader can extract essential elements of life of her and human as well. Michael Cunningham, years later, reads that book, and writes another one about three seemingly normal days of three women. And then David Hare and Stephen Daldry write and direct a movie based on Cunningham’s book that adds eve n more layers to the whole story. The Hours was Woolfs working title for Mrs Dalloway. 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Raised by a privileged English household in 1882, writer Virginia Woolf had freethinking parents (Adeline). Born Kensington, London, England, United Kingdom, January 25, 1882 as AdelineRead MoreCultural Disenchantment in a Postwar Climate Illustrated in Virginia Woolf’s Novel Mrs. Dalloway2198 Words   |  9 PagesOne of the principal themes in Virginia Woolf’s novel Mrs. Dalloway is the English people’s collective loss of confidence in the state of the British Empire after the First World War. Set in London in the June of 1923, the novel opens at the close of a global war that lasted only four years but cost the United Kingdom more than 100,000 lives and permanently shifted the political boundaries and social world order of its people. Each of the novel’s many characters represent a different aspect ofRead MoreThe Between Septimus And Dr. Holmes1602 Words   |  7 PagesFrom pages 90 - 100 of Mrs. Dalloway, we see the interaction between Septimus, Dr . Holmes, and Dr. Bradshaw. Dr. Holmes tries to force Septimus to see that he is not crazy, that there is absolutely nothing wrong with him, which doesn’t help either Rezia or Septimus. Then there is Dr. Bradshaw who sees that there is something wrong with Septimus, but his only method of helping him is to put him in a home to rest, away from the rest of society. Both men should be trying to help him, but they are alienatingRead MoreVirginia Woolfs Mrs. Dalloway and Samuel Becketts Waiting for Godot2438 Words   |  10 Pages Virginia Woolf’s Mrs. Dalloway and Samuel Beckett’s Waiting for Godot are representative works of two separate movements in literature: Modernism and Post-Modernism. 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