Going through puberty is traumatic on almost any teenager. But for transgendered teenagers, it can be a nightmare. When a person is transgendered, their brain gender and their biological gender are at odds. For a girl who was born a boy, growing facial hair and hearing her voice deepen can be traumatic. For a boy born a girl, menstruation and breast growth may seem like betrayal by his own body. Delaying puberty by means of administering hormones may help save the mental health of these teens.
Gender Identity Disorder
According to AtHealth.com, a diagnosis of gender identity disorder is merited when a person identifies with the opposite sex to the point of believing he or she was born in the wrong body. This belief often manifests in early childhood, when a boy prefers to wear girls' clothing, and vice versa. A child with gender identity disorder may believe she will eventually grow a penis or that he will someday grow breasts or have a baby. Most transgendered people know they have the disorder by the time they reach adolescence.
Suppresion of Puberty
By treating a teenager with a gonadotropin-releasing hormone analogue, or GnRH analogue, puberty can be suppressed until the age of 16, when endocrinologists recommend starting testosterone therapy in biological females or estrogen and progesterone therapy in biological males. Teens who undergo GnRH analogue therapy are approved to do so only after a psychotherapist trained in childhood pathology determines that gender identity disorder has not remitted by the age at which pubic hair begins to grow.
Psychotherapy
For teens who are conflicted about their gender identity, psychotherapy may help them sort it out. Before referring a child for GnRH therapy, the therapist will make an attempt to reconcile him to his biological gender. However, if the conviction that he has been born in the wrong body persists into early adolescence, hormone therapy is recommended. An ethical therapist will counsel the teen about the possible risks of hormone therapy, including infertility and loss of bone density. The teen's willingness to risk these side effects in order to live as her true gender is an indication that she is can see no other option for sustaining her mental health.
Surgery
Estrogen or testosterone therapy is initiated at age 16. The Endocrine Society recommends waiting until age 18 to undergo sex reassignment surgery. Surgical options for transgendered individuals include hysterectomy, castration, breast implants or mastectomy, and ultimately, genital reassignment. Only a few surgeons worldwide are qualified to perform genital reassignment. Among the most prominent and pioneering in the field are Dr. Marci Bowers of Trinidad, Colorado and Dr. Pierre Brassard of Montreal, Quebec.
How to Help a Transgender Teen
Transgender teens whose families are not understanding or supportive often run away from home or turn to illegal employment in order to transition. Gender identity disorder is real, painful and confusing. The best thing you can do if your child, or a child you care about, expresses dissatisfaction with biological gender is listen to him and take him seriously. Educate yourself about the lives of transgender people, and help the child find transgender role models. Your understanding can literally mean the difference between life and death.
