How it Feels When Your Child Comes Out as Trans

 

Los Angeles Paediatrician, Dr Paria Hassouri, joins Dr Helen to discuss how it felt when her child came out as trans, and the journey she and her family have since been on to learn more about gender variance.

In this incredibly honest and open account, Dr Hassouri talks about how her daughter’s revelation led her to question her own identity as a mother and Paediatrician, and how the experience has helped her to grow.

 

Links
https://www.pariahassouri.com
Twitter: @PariaHassouri
Mermaids: https://www.mermaidsuk.org.uk
Gender Odyssey: http://www.genderodyssey.org
If you enjoyed this episode of our podcast please don't forget to rate and review via your favourite podcast app.

 
The GenderGP Podcast
How it feels when your child comes out as trans – The GenderGP Podcast S3 E1
 

Hello, this is Dr Helen Webberley. Welcome to our Gender GP Podcast, where we will be discussing some of the issues affecting the trans and non-binary community in the world today, together with my co-host Marianne Oakes, a trans woman herself, and our head of therapy.

 

Dr. Helen Webberley:

So I'm on my own today. I haven't got Marianne with me, but I'm really excited about welcoming Dr Hassouri who is a paediatrician from Los Angeles. Dr Hassouri, if you wouldn't mind introducing yourself and telling us a little bit about yourself and why we might be interested in some of the things you have to say.

Dr Paria Hassouri:

Sure. My name is Paria Hassouri. I'm a paediatrician in Los Angeles. I've been practising for about 17 years now. I have three children, and my middle child, who is almost 16 now, came out to us as transgender at the age of 13. And we were completely blindsided. I would say that I didn't think she had any signs of being trans before she came out to us. And so that started a journey of me learning more about transgender kids and teens and young adults, and starting to write about it a little bit. And so here I am.

Dr. Helen Webberley:

Brilliant. So if you don't mind telling us a little bit about your daughter. So you say that it was completely unknown to you, didn't you? You didn't see it coming, which is obviously something that we have a lot of parents talking about. What was that like for you?

Dr Paria Hassouri:

Yeah, I mean we really—I never saw any signs in her that I would consider consistent with gender dysphoria before she came out to us at 13. When she was 12, she told us that she thought she was bisexual and that wasn't really a surprise to us. We were supportive of that and said, “OK, maybe you're just gay, not bisexual.” But you know, we were very supportive. But when at 13 she told us she's actually trans, we were just completely surprised. I guess prior to that—I mean, I thought that signs of being transgender would be her wanting to do more traditionally opposite sex, opposite gender things. when she was younger, she had never had any history of let's say wanting to play with traditionally girl toys or grow out her hair or wear dresses, or skirts or anything like that in my mind that I considered signs of being transgender. And I really wracked my brain to try to think if there was there any time where she may have shown any sort of interest in what you would consider traditionally female gender things. And there really was not. She'd always play with cars and trains, and she liked video games. She wasn't sporty, but plenty of boys aren't sporty necessarily. We really couldn't think of anything. In our house, I have an older son and then a younger daughter. So our home had both boy and girl traditional toys, costumes, all of that. And there really—she never tried to play with her sister's toys in a way that was unusual other than them just sometimes playing together, or wanting to try on her sister's costumes. I mean, she always was much closer to her older brother and really seemed to follow the same interests t...

 

Los Angeles Paediatrician, Dr Paria Hassouri, joins Dr Helen to discuss how it felt when her child came out as trans, and the journey she and her family have since been on to learn more about gender variance.

In this incredibly honest and open account, Dr Hassouri talks about how her daughter’s revelation led her to question her own identity as a mother and Paediatrician, and how the experience has helped her to grow.

 

Links

https://www.pariahassouri.com

Twitter: @PariaHassouri

Mermaids: https://www.mermaidsuk.org.uk

Gender Odyssey: http://www.genderodyssey.org

If you enjoyed this episode of our podcast please don’t forget to rate and review via your favourite podcast app.

 

The GenderGP Podcast
How it feels when your child comes out as trans – The GenderGP Podcast S3 E1

 

Hello, this is Dr Helen Webberley. Welcome to our Gender GP Podcast, where we will be discussing some of the issues affecting the trans and non-binary community in the world today, together with my co-host Marianne Oakes, a trans woman herself, and our head of therapy.

 

Dr. Helen Webberley:

So I’m on my own today. I haven’t got Marianne with me, but I’m really excited about welcoming Dr Hassouri who is a paediatrician from Los Angeles. Dr Hassouri, if you wouldn’t mind introducing yourself and telling us a little bit about yourself and why we might be interested in some of the things you have to say.

Dr Paria Hassouri:

Sure. My name is Paria Hassouri. I’m a paediatrician in Los Angeles. I’ve been practising for about 17 years now. I have three children, and my middle child, who is almost 16 now, came out to us as transgender at the age of 13. And we were completely blindsided. I would say that I didn’t think she had any signs of being trans before she came out to us. And so that started a journey of me learning more about transgender kids and teens and young adults, and starting to write about it a little bit. And so here I am.

Dr. Helen Webberley:

Brilliant. So if you don’t mind telling us a little bit about your daughter. So you say that it was completely unknown to you, didn’t you? You didn’t see it coming, which is obviously something that we have a lot of parents talking about. What was that like for you?

Dr Paria Hassouri:

Yeah, I mean we really—I never saw any signs in her that I would consider consistent with gender dysphoria before she came out to us at 13. When she was 12, she told us that she thought she was bisexual and that wasn’t really a surprise to us. We were supportive of that and said, “OK, maybe you’re just gay, not bisexual.” But you know, we were very supportive. But when at 13 she told us she’s actually trans, we were just completely surprised. I guess prior to that—I mean, I thought that signs of being transgender would be her wanting to do more traditionally opposite sex, opposite gender things. when she was younger, she had never had any history of let’s say wanting to play with traditionally girl toys or grow out her hair or wear dresses, or skirts or anything like that in my mind that I considered signs of being transgender. And I really wracked my brain to try to think if there was there any time where she may have shown any sort of interest in what you would consider traditionally female gender things. And there really was not. She’d always play with cars and trains, and she liked video games. She wasn’t sporty, but plenty of boys aren’t sporty necessarily. We really couldn’t think of anything. In our house, I have an older son and then a younger daughter. So our home had both boy and girl traditional toys, costumes, all of that. And there really—she never tried to play with her sister’s toys in a way that was unusual other than them just sometimes playing together, or wanting to try on her sister’s costumes. I mean, she always was much closer to her older brother and really seemed to follow the same interests that he had. So to us, when she told us she was trans at 13, we just thought this can’t be right. And she must be confused. And the only thing she did have before she was 13, she was often depressed, lonely, she had difficulty making friends. We had taken her to therapists before; there was a lot of depression, social difficulty, hard time connecting with people. But there was never anything to us to indicate that maybe gender might be the underlying cause of those issues. And so later, I came to see those as the signs of it. And the interesting thing, the other thing that when she first came out to me, it was frustrating for me, is that I expected her to say then, “Actually, I’ve known about this all along, but I just didn’t tell you.” But when I would ask her, she would continue to maintain, and she still does, that really before 13, she didn’t know. She was lonely. She did have a hard time making friends. But she didn’t know why that was, and she never considered that maybe it was a gender issue herself until 13. And then she had, around twelve, she had started to question her sexuality. and then she started going online, and watching YouTube videos, and then started putting it together that maybe this is what it is. Maybe it’s that I’m trans. And took about six months for her to do her own research and then come to a conclusion where she felt she definitely was trans. And so when she told us, I mean she basically out of the blue sat down and told us she was trans, and then gave us an entire dissertation on why she is trans. The research she had done.

Dr. Helen Webberley:

So that’s an amazing story, isn’t it? It’s an amazing story. It’s one that we often hear but in a different way. And there are so many things now that I want to talk to you about. how there are many parents who would say, “Well if there was no sign of it at all, how can it possibly be true?” I was just listening to a podcast on the way up today about this rapid-onset gender dysphoria, which is causing so much heartache and discomfort and consternation amongst parents. But it sounds like your daughter didn’t have the language or understanding of what her feelings were all about until she did her own research. Like you say in that six months.

Dr Paria Hassouri:

She definitely maintains that before, you know, 12, questioning sexuality, and then 13, starting to question gender, that before that in all the years of going to therapy or trying to figure out why she was often depressed when there was really no definite reason for depression. I mean, she was in a stable, happy, loving family. You know, it never really crossed her mind that maybe there was a gender issue or why she had a difficult time making friends, or the other interesting thing about her, was that she didn’t like physical affection. She wouldn’t want to be hugged or held. So we would question whether she might be like kind of on the Asperger’s spectrum because she was, she is also just a brilliant person. But after she came out and once she transitioned and she got I mean now she’s incredibly social and incredibly touchy-feely hugs all the time. So it would just all really vanish. I mean, it was just outstanding to watch the transformation in her.

Dr. Helen Webberley:

I mean you mentioned the Asperger’s spectrum. And we as doctors are confused about the overlap between gender and the autistic disorder spectrum, but a lot of those things that you talk about are features of both, aren’t they. This unexplained depression and loneliness and social difficulty and a hard time making friends. That physical contact. So it is really difficult sometimes to unpick the two. And like you obviously have done, listening to your child, there’s got to be someone who hasn’t met to want to try and understand it without adult eyes.

Dr Paria Hassouri:

And I mean I just want to be clear that for about six months I was and I did all the wrong things. I was in complete denial. I mean, I did get her a therapist right away. But my thought process was like, “OK, the therapy is going to be, ‘No, you’re not trans. Let’s move on.’” I was in denial, shock, anger, grief. I mean I went through all of that. And then after about six months, it just became clear that this whole denial grief thing was not really an option. I needed to start opening my eyes and my mind. And being open to the possibility that maybe she really is trans. And then once I decided just to open my mind and really listen to her, then it took a few months after that. So I would say from when she came out to when I finally really accepted, it was probably about nine months or so. So it wasn’t like I instantly did all the right things or listen to her. I made some terrible mistakes there in that first six months. I would say.

Dr. Helen Webberley:

I guess parenting is hard, isn’t it? Getting it right is hard. Something is so big as that it is really hard. And the guilt of parenthood is huge, isn’t it? Whatever the issue is, the self-reflective parent is always thinking, “Oh my goodness, did I do that well? Could I have done that better?” But it’s hard I mean especially when it’s so out of the blue like this. It’s really hard. And again we hear so often, don’t we, that we have trans children who do that research. And Jo and Aydin Olson-Kennedy, they talk really clear about that coming in time, and I love that concept of the research, the YouTube videos, the Internet, because it’s got so much language and diversity and opinion, and people on there, that you can find a voice and that coming in of six months, before you come out to your mom and dad and say, “Look, mom, dad, I got something to tell you. You might not be expecting this.” But I love that concept of coming in and then as parents we’ve to do our own coming in, I guess, definitely. Which is what you were just talking about, getting used to the idea. It’s interesting as well, isn’t it? Because the criteria for diagnosing somebody with gender dysphoria or gender incongruence, they don’t include that list that your daughter had. So depression and loneliness and social difficulty, her time making friends not wanting being held or hugged, that’s not on the criteria, is it? All the things that are on the criteria list are the other ones that you mentioned that she doesn’t have. The toys and clothes and costumes and trains. So it’s really hard, isn’t it? That list of criteria has been criticized often, and this is a very good example of how it just doesn’t work for everybody.

Dr Paria Hassouri:

It’s hard to really listen to your kid and really hear what they’re telling you when you think that as a parent for me, a lot of it was I felt as a mother and as a paediatrician, for goodness sake, I should know my kid. I was questioning my own identity. Well, what kind of paediatrician am I? What kind of mother am I if this is true? like there was a certain amount of ego and refusal to believe that I could be so ignorant about this. And just questioning then who I was as well. But then I had to come to the point where I accepted that we don’t train paediatricians, therapists, counsellors, teachers. We don’t train anybody working with kids on what could actually be potential signs of gender dysphoria, other than just the more so-called traditional signs of it.

Dr. Helen Webberley:

Yeah, I mean that is such a huge problem. I mean I don’t know what your medical education system is like, but certainly over in the UK through medical school, there is nothing. And then after medical school, you do a couple of years of foundation training where you do a little bit of everything, and there’s nothing there. And then when you specialize like you say in paediatrics, or pediatric endocrinology, or general practice, or adult endocrinology, adult psychiatry, child psychiatry, in the UK in the curriculae there is no training at all. It is not a core competence in any of the specialities or in general practice. So wow. I mean, how are our patients supposed to trust us?

Dr Paria Hassouri:

Yeah, I mean there definitely wasn’t. I went to medical school from 1995 to 99, and then residency I guess through 2002. Definitely, there was zero training then. I never heard the word transgender. I think just in the last 2-3 years, in some programs, there is a little bit of training, but not across the US and in every residency or medical school for sure.

Dr. Helen Webberley:

I’m interested as well that you mentioned the therapists because we work with a lot of therapists in our company and they’re trained to deal with everything. So someone can go to them and say, “Look, I’m divorced and I’m upset. I’m having difficulty with my family. I’m upset. I’ve been sexually abused. I’m upset. I’ve lost my job. I’m upset.” but then someone will come to them saying “My gender feels different and I’m upset.” And they’re like, “Whoa, I can’t deal with that. I have no training in that.” There’s such a divide isn’t there? About this hugely scary thing of gender incongruence.

Dr Paria Hassouri:

There’s such a worry for the general therapist who hasn’t specialized in this. There’s such a fear of what if I get this wrong, I can’t do this, I can’t listen to you. You need to see somebody else. And there is such a fear surrounding treating kids with gender dysphoria. People just need to get comfortable with it.

Dr. Helen Webberley:

How is your daughter’s father? Were you cohesive on—

Dr Paria Hassouri:

He was very supportive. So interestingly, he handled it better than I did. He’s actually a plastic surgeon, and he had been doing some transgender top surgery a few years before our daughter came out to us. So he did not dismiss her right away. He said to me this was possible. I had you, and he recalled one patient specifically whose parents said, “We never knew, we had no idea, we never knew.” And so because he knew that, he was not dismissive of her right away. And he kept trying to tell me that that I should prepare myself, that there is a possibility that it’s real. So he was definitely better than I was because he had some more experience there. Still, a lot of denial was the same. A lot of the grief was obviously still there, and the same. But yeah, he definitely handled it better than I did. And we’ve been very fortunate in terms of all our family and friends were very supportive. I mean, we never had to question whether our family and friends were going to be supportive. So our worry was really just about her, whether this is true or not, safety, those kinds of issues. But we were never worried about how our friends and family would handle it. And her siblings were incredible as well. I mean, she didn’t come out to her siblings until maybe around nine months after she told us. So around the same time where I finally started to accept it, I was like, “OK, so now we need to tell your siblings.” Although I mean, they sort of knew. Her older brother definitely had just kind of figured it out himself because in that nine-month period she did start wearing more traditional girl clothes and using a little makeup and being this weird, odd kid at school who likes to crossdress for fun without actually being out. And so he had figured out that. My younger daughter just thought that she was just trying to be a cool unicorn and hadn’t really put it all together as what it meant, but they handled it very well. I would say that in our family I had the hardest time, and everybody else handled that very well.

Dr. Helen Webberley:

Well, it sounds like she’s a very lucky girl actually. To have that support from family is such a huge step and there are so many children who don’t have that. Which is very, very sad. And I love the way that siblings and young people are so accepting. It’s us, adults, isn’t it, that find thing’s really tricky? but today’s youth are so accepting of the unicorns as you say, and that diversity and colour and sexuality and gender and everything. So that is so expressive about humans. Youngsters get it right, and I love them for that, I really do. You talked about the safety thing. What kind of things were you worried about on the safety in your journey of acceptance for your daughter? What things were you worried about?

Dr Paria Hassouri:

I mean I’m obviously worried, always worried about her getting bullied or beat up or a hate crime sort of issue. I mean I’m very—like my older son will take a Lyft on his own. With my daughter, we don’t let her take a Lyft unless you’re taking a Lyft with friends. So we will pick her up and drop her off places or if we can’t, make her come home early. I have these little things where I want not to treat her differently, but I’m scared about these things, obviously. And we live in Los Angeles, so we’re in the city with a lot of diversity and just a big LGBTQ population. I think about her going to college. I mean we’re going to keep in mind what schools she’s applying to, and making sure she’s in cities with a big LGBTQ population, where the school is going to be accepting. So these are things I worry about. I worry anytime she’s walking home, and it gets a little dark, and she’s by herself. I think she is now at the point where she is passing a lot more easily. so as that happens and I’m less scared because it’s not so obvious anymore. And so hopefully there will come a time when I’m not worried, or nearly as worried. But yeah that’s made my big main leftover worries just about her safety. I mean she, fortunately, she never really got bullied. She never really got bullied in school. There were a few people who made some comments to her, but then those comments got shut down pretty quickly. and a lot of her friends did change, but she has so many more friends now, so the other kids at school were not an issue. Some of the parents were an issue. We had an instance where like one of the things that upset me was last year or the beginning of this school year, they had issues in the school choir, and they were having an away trip for the weekend. And the school without really getting back to me decided to put her in a cabin by herself. So all the girls were in one cabin, all the boys were in one cabin, and she was in the cabin by herself. And this was done without really contacting me first. And by the time I found out that that was going to happen, it was only a few days before the field trip, and I asked my daughter, and she didn’t want to draw attention and have me complain to the school. And so we decided for that time to let it go, but that for any subsequent trip I would make sure ahead of time that that didn’t happen to her again. That was really very sad and heartbreaking, that even though it seemed like the school was being so supportive that they would just say, “OK, well you don’t belong in either group so we’ll put you by yourself.”

Dr. Helen Webberley:

What does that say to trans people? That message gives trans people. You’re not a valid boy, you’re not on the boy team, you’re not on the girl team, you don’t fit in a team, you don’t fit in our society. So that’s the message it gives, and it’s such a sad message to be on the end of. And actually it just comes down to education and policy-making, doesn’t it? There will be schools that suddenly come across the first time they have a trans person and then there will be the first time that they take a trans person on a field trip. and it’s like we just need these questions answered beforehand: which toilet shall all these kids use? which bedroom should they be allowed in on the field trip? Which companies should they be allowed? And it’s all about education and policy-making in advance, isn’t it? And we have some great charities in the UK, Mermaids, who do some really good work with schools to help them make their policies in advance of the tricky situations like which changing room should the child get ready for swimming in? And what are they allowed to wear to go swimming? It’s all these things that need to be thought of in advance, don’t they?

Dr Paria Hassouri:

Yes, absolutely. And for her, she was the first out trans person in her school. They did have one bathroom that they had marked as an all-gender bathroom before she started at school because I believe there was maybe one other trans person in her school before her. Not so sure about that, but for example, for her P.E. she in the first two weeks of school she walked into that and this is how brave and—incredible she was because this is while I was in my denial—but she, within the first two weeks of school, walked into this school counselling office and said this is what’s going on and I need a private area to change. And they arranged for a private area for her to change. I mean she had to do all this advocacy for herself because I was in denial and the school didn’t already have a system in place, you know. And so then they arranged for a private area for her to change. And they also arranged for a school counsellor that she could talk to anytime she needed to do that.

Dr. Helen Webberley:

And it sounds like she’s paved the way for future trans kids to have an easier time, which is lovely. I’m wondering, just to change the subject slightly—so as a doctor yourself, you must have thought, “Okay, I’m going to do some research now and find out what medical help is available for my daughter and what this is all about.” And I’m interested in what you might have read because I don’t know about you in your country, but certainly over here people often use it as an excuse to deny people health care by saying there just isn’t enough research to say that that is a safe treatment. And so, therefore, we are going to deny you of that treatment until we have more research. So I’m interested in your reading of the literature and whether you found that there was enough robust evidence for treating or giving children and young people medication.

Dr Paria Hassouri:

Well, these are not medications that are new or that we haven’t used before. Puberty blockers, hormone therapy—I mean none of this is new medications, and they have been used in children before for reasons other than being trans. Then the other issue is this is it’s a life and death—I mean, what are the options? I mean, especially once you’re getting to the teens. I mean, these kids are at a higher risk for suicide and self-harming. I mean, my daughter had engaged in some self-harming before telling us because she didn’t know how to tell us. And even later in the year, and like six months after she told us, she was again, I was still in denial, she was again having some suicidal thoughts and ideations, you know. So what if we’re going to talk about what’s safe and not and I mean you really have to do what’s best for the child. And Dr Jo Olson-Kennedy from Children’s says we will put our children on antidepressants and anti-anxiety medications and ADHD medications and all these other medications which have maybe bigger and different side effects than puberty blockers and hormones—all in an attempt to avoid treating their gender dysphoria. And now obviously there’s plenty of kids who both need hormones and antidepressants. But there are some kids who actually don’t need, they really just need gender-affirming care. My daughter would have been an example of somebody who would have eventually had to end up on antidepressants or anti-anxiety medications when really, she didn’t need that. She just needed gender-affirming care.

Dr. Helen Webberley:

I mean, some of the cocktails of drugs that I’ve seen children on young people on since I started this work are just phenomenal. And I just look at the list, and I’m thinking, how ever did anyone sign off that prescription for those medications when actually this young person is just needing gender-affirming medication? And I just I shake my head at it, and just think how has this happened? And yeah, the self-harm and suicide. It’s so heartbreaking, isn’t it? To see the scars on these young bodies is heartbreaking. And they’re screaming to be listened to. And sometimes they don’t have anyone to listen to them. And it’s really heartbreaking. So as a woman, as a mother, as a doctor, it’s heartbreaking.

Dr Paria Hassouri:

Absolutely. And just for my daughter seeing that change in her from before to now, where she’s out with friends. I mean, before she was in her bedroom all the time. We were concerned. we would argue about like, why don’t you call people? Why don’t you try harder? And now we’re begging her to sometimes stay home with us but she is out with friends. I was so worried that if she came out as trans that she would be lonelier, and the exact opposite of what I was worried about happened. She came out as trans, and she’s happy, and she’s made friends who understand her. And you know, she has more friends than she’s ever had before. And one of my big worries was that, “Oh, if she’s trans, she’ll never find a partner or be with somebody.” And now, I mean I have zero concern about that now. I mean she’s still young, and obviously, I’m not worried about a permanent partner for her now, but I now have zero concern that she will not have friends, not have a partner in the future. And really the only remaining worry I have is just still some safety issues, but all my other concerns are gone and if she had stayed on the track that she was on, she would have been lonely she wouldn’t have had a partner she would have been depressed, she would have potentially not made it to be an adult.

Dr. Helen Webberley:

What are your feelings about, not necessarily your daughter, but disclosure to a new partner. It is a difficult thing, isn’t it? And again Jo Olson-Kennedy talks about this with sadness about some groups of trans people who on that disclosure is such a shock to their partner and that hurting happens. Did you talk to your daughter about that? I mean, what kind of advice would you think people listening might glean from you on this one?

Dr Paria Hassouri:

She’ll be 16 in a couple of months yet. So right now she’s in a school where everyone knew her like her old self and now. so unless she’s meeting new people outside of school, everybody sort of already knows. Again it would be like safety, I do worry about that. I do think maybe early disclosed is better. But if she’s starting to date somebody new, or when those things come up—it hasn’t really come up for her yet, although she’s definitely interested in dating. She has a really good therapist. And these are things that I know she and her therapist talk about, just how to handle these situations as they come up in the future. But I think, I guess, I would maybe—I just think may be (unclear 28:53) on the side of earlier disclosure. It’s interesting, we had a conversation in the car yesterday where she told me that before she was thinking that, when she goes to college, she doesn’t necessarily want to tell everybody that she’s trans by that point. If she’s based, if she’s passing, because right now we’re doing some electrolysis for hair removal and these kinds of things. So she was saying that by that time if she passes, she’s not. Before, she thought was that she would like to just go to college and not tell anyone about her history. And then yesterday in the car she was telling me, “You know, I’ve been thinking that I’m not going to hide. I don’t want to hide that part of me. I mean that’s such a big part of who I am. So I’m not going to tell people that the first time I meet them. But I’m also not going to avoid talking about it or hide it. I’m going to bring it up when it’s appropriate because it’s a big part of who I am.” So I see her thinking about these things and coming to. Initially, her goal was like passing, passing, passing; trying to look as feminine as she can. and now finding herself wearing definitely less makeup than she actually was initially, just being more comfortable, which makes me really happy to see her saying, “I’m gonna embrace myself as a woman however way I am, and I don’t need to put on more makeup to prove that I’m a woman. I don’t need to pass 100 per cent of the time to prove I’m a woman.” I mean, it’s really interesting to see somebody so young so maturely start to have these thoughts and own who she is. and it makes me think a lot about myself. I mean I know in my core that I’m a woman, and you could take my breasts off, you could shave my hair, you know. I could have had to have chemo and have my breasts removed, and it wouldn’t make me any less of a woman than that. like you, who you are, you feel it in your corner. And I see her realizing that she knows who she is at such a young age, and realizing that she doesn’t have to conform to what everybody else thinks a woman should look like.

Dr. Helen Webberley:

She sounds amazing to me because she really sounds amazing. It’s interesting that although she doesn’t want to wear “I am trans” all over her head but she’s not going to hide that big part of her. And I sometimes think the children and young people that worry me most all those ones that just keep it that huge secret. No one must ever find out. the world will fall apart if anybody finds out. And I worry for those, because that’s such a big secret to hold for the whole of your life, isn’t it? And such a big place to fall down from if someone does find out. Although I respect people who have that desire, it does worry me. That some really strong desire to hide it.

Dr Paria Hassouri:

Right now she’s definitely very out she’s very out in the open. She wears her jacket with all these she pins and pride and all that, but I think she had thought that maybe in college she would like back down a little and now she’s, “No, I’m just going to continue being who I am,” which is great.

Dr. Helen Webberley:

So has it affected your medical practice at all? Have you had any trans patients come under you or come to you?

Dr Paria Hassouri:

Yeah. So it’s interesting because one, I’ve started to just read a lot more about trans care and entered and I went to the transgender health care summit and read the WPath guidelines and I’m going to actually this Gender Odyssey conference this weekend. And so basically teaching myself as much about trans care as possible, and thinking about maybe in a couple of years starting to do some trans care myself, although we’ll see how that goes. So certainly, I’m sure that if this hadn’t happened in our family, it’s unlikely that I would have gone the route of developing an interest in trans care. Now, I do. When I see teens who are depressed or kids who are depressed, I keep in the back of my mind that that gender could be possible. Obviously, I’m not that I’m like every kid, “Oh, maybe it’s just your gender,” but when for most people ninety-eight present probably it’s not. I know to look at people who look a little differently. I had one of my patients who’re pretty young who is showing some signs of gender dysphoria. And the parents told me about it, and they’re being very open and supportive and just going with what the child wants to do, and I was able to provide them with a lot of resources which I wouldn’t have known about before. I’ve also just become someone who—I’m in a group of eight paediatricians, so my colleagues when they have someone they right away come and ask me what should I do, where should I send this person? And so it becomes, and then I’m also with eight paediatricians, but also part of a group of about 115 physicians of various specialities who take care of adults. But they also then if it comes up for them or someone they know, will go to me as a point person resource who can say, “Oh well, for therapy go here, for this go here.” So it’s definitely changed a lot. Well I mean I think in terms of—I definitely have an interest in doing trans care myself as well, providing trans care. It’s a little hard because we have obviously Children’s hospital here and it’s so incredible. And so it would be something that I wouldn’t do, unless I felt like I also—I would have to have the resources they have: a social worker, caseworker, all the things that make it really comprehensive good care. So unless I got to that point where I could surround myself with all of that and feel that I could provide it, if not as well close to as well as they do at Children’s Hospital, then I probably wouldn’t do it. We’ll have to see how things evolve over the next couple of years, although I do believe that there is going to be so much more need for it that we are going to have to do it. They’re not going to be able to take care of all the children.

Dr. Helen Webberley:

One of my big campaigns in the UK is really just to try and normalize this, that providing general trans care to routine cases to easy cases with where the situation is not complex can really be done by any well-informed doctor and team. And I’m trying to really push to bring a lot of the care into general practice, then run it down back into family medicine. Because you’re quite right, these big specialist teams are just bursting at the seams. Our children service over here, there’s a two-year waiting list just to be seen. So from the point of referral to your first appointment is two years. And that’s a lot of puberty that happens in those two years. A lot of puberty, a lot of self-harm. It’s frightening. Ahere actually, a puberty blocker is such a safe medication. It is reversible. It causes such a lot of relief in someone who’s got real bad gender dysphoria going through puberty. So I’m really trying to push over here to try and normalize this care back into family medicine. I don’t think we need to have these massively specialized centres for all the cases. Let’s leave them for the trickier cases where there are more difficulties. So I think you’re right. We’re seeing so many more youngsters coming forward for care that as doctors, we need to step up and say, hold our hands up if we’re prepared to listen to these families and children and youngsters, and give them the care that they’re asking for. Because a bit like your daughter, they seem to know much more than we do sometimes, don’t they? They’ve done their research they know exactly what it is that they need and then they’re knocking on our door going, “Why don’t you all know? you’re supposed to be the specialist here.” So it’s interesting.

Dr Paria Hassouri:

I think so in terms of us as physicians just learning to not be scared of listening to these kids and treating them. Here, I think it was a three to four-month wait for us to get in with my daughter at Children’s Hospital. But so three to four months wait isn’t too bad. I mean two years is just that. Yeah. You can’t block puberty for two years.

Dr. Helen Webberley:

Unfortunately, it’s worse because it’s two years to wait to be seen. And then you have your six months to a year of assessments, and then you’re referred from the psychology department to the endocrine department, which takes another X months. So we have a big problem here for young people screaming for just a puberty blocker and not having access to it during their teenage years. It’s really sad.

Dr Paria Hassouri:

The reason really I’ve been writing a little bit about our journey, my daughter’s journey and mine, is really to bring awareness and change the trans narrative that people have out there in their mind. I think a lot of people have a negative vision of trans people. And so I’ve sort of gone on this journey of writing about it because I just want people to see how beautiful and brilliant and incredibly special these kids and adults are, and to really use my voice in any way I can to change what people think of as trans and in their head. and hopefully that’s happening over the next few years with the changes and the media coverage on more trans people being portrayed whether on TV or in writing or books or in different venues.

Dr. Helen Webberley:

I agree. And the people that come forward to tell their stories. It helps so much, and it helps people to see that this is just ordinary folk wanting to go about their ordinary day, go on field trips, go to school, go to college, have a partner, things that everybody wants to do. and people coming forward for these are sharing their stories: you as a mom and as a doctor sharing your daughter’s story it just helps so much for people to see that trans people need to be included in the same dormitory as anybody else on the field trip. And I love the way that you say that your daughter, you described her as a brilliant person. And so many of the trans people that I have met have been truly brilliant in many ways. And I don’t know why they’re such a high percentage of brilliant people in this community, but it’s such a treasure to work, and a pleasure to work with. And I think when I think of them doing their own research and having to share that with the parents with families with school, leading the way, they’re truly remarkable. And we have a lot to learn from them. So thank you so much for sharing your story. I’ve really enjoyed listening about your daughter, and I wish you both extremely well.

Dr Paria Hassouri:

Thank you so much for having me on your program. It was a pleasure.

Dr. Helen Webberley:

Thank you. And thanks very much.

 

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