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What it takes to be supportive of a transgender child

Saturday is Transgender Day of Visibility, an international annual event observed since 2009.
Saturday is Transgender Day of Visibility, an international annual event observed since 2009. (PAUL J. RICHARDS / AFP/Getty Images)

I am a pediatrician and the parent of a transgender teenage girl. At the beginning, my husband and I thought that we had two sons. I was the queen of the house alongside my king and my two princes. But when my daughter was just a toddler, I learned I had been mistaken.

My daughter was never a boy. She was persistent, insistent and consistent in who she was. I can still remember her constant corrections — “I’m a girl, mommy.” But, early on, we weren’t ready to allow her to live her full life. We thought by letting her wear girls’ pajamas and play with girls’ toys at home — but restricting these in public — we were being supportive. We thought we were doing our best, and we thought that was enough. But we were wrong.

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Activists say that while gays and lesbians are enjoying greater acceptance in society, transgender people are facing more and more obstacles — legal battles, legislation and policies against their interests.

Nearly 10 years later, our child told us she wanted to harm herself, and we realized we were losing her to depression. My husband and I, after obtaining professional counseling, knew that our decision to support our child could be the difference between life and death. After debating the timing — largely due to concerns about her safety — she officially began to walk in her truth. But there were so many things that we didn’t know: how to navigate school, change her name, and, even though I’m a pediatrician, deal with the health insurance company or find a health care provider.

We were fortunate, though. With an ease not possible for many parents of transgender children, we were able to find health care providers who were — in a word — awesome. We had access to behavioral therapists and a fantastic pediatric endocrinologist. And even though our pediatrician was not well-versed on how to care for a transgender child, we were supported without question.

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This places them at higher risk for sexual exploitation, physical assault, substance abuse and death by suicide or homicide.

Even so, our experience was far from perfect. When I called to make a doctor’s appointment using her new name, I often had to listen to the pregnant pauses from the front desk staff. The first visits during which she was her true self had the occasional nursing staff member who wasn’t quite sure what to say.

These moments occur even when the provider is supportive and knowledgeable. As a parent, I was determined to navigate these waters while protecting my daughter. Other parents may not have the great fortune of knowing how to do this for their child, or even have providers near them who care for LGBTQ patients.

There are, however, resources for hospitals and health care facilities who want to get it right — as our pediatrician wanted to do. The Human Rights Campaign works with facilities to get them the training and policies they need — and they recently put out a report, the Healthcare Equality Index, that scores facilities across the country on their LGBTQ policies and practices.

As a physician, I am guided by the principles of medical ethics set forth by the American Medical Association, the first of which is to provide competent medical care, with compassion and respect for human dignity. The AMA is also fully supportive of ensuring transgender children and adults have affirming care. Yet we know that there are cases of pediatricians who use their personal beliefs as an excuse to refuse to treat children because they are LGBTQ, or because their parents are LGBTQ. I cannot imagine refusing to treat one of my patients because of who they are or who their parents are. As a parent, the thought that my child could be denied the medical care she needs because she is transgender saddens, angers and terrifies me. As a pediatrician, it is also categorically unethical.

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Following the loss of three Connecticut transgender teens to suicide in the last three months, True Colors executive director Robin McHaelen (at podium) joins U.S. Senator Richard Blumenthal (D-Conn.) and other advocates for children at the Legislative Office Building in Hartford on Monday in saying enough to the bullying, hostile, un-American rhetoric emanating from the current administration. McHaelen and Blumenthal denounced the deliberate efforts to rollback protections for LGBTQ youth. At left is Diana Lombardi, executive director, Connecticut TransAdvocacy Coalition, and at right is Steven Hernández, executive director, Connecticut Commission on Women, Children and Seniors. (Patrick Raycraft)

The efforts of HRC’s Healthcare Equality Index really do have meaning for every day folks like my family. It helps make hospitals and their staff better, more inclusive and more aware.

I believe that every parent of an LGBTQ child is looking for the same thing: equitable, caring and non-biased care. We can tell when a hospital isn’t on our side. So when we find a team that makes us feel at home, we stay. We commit. We are loyal.

In the spirit of making this a reality for families across this nation, from the bottom of my heart, I encourage every health care facility to put in that work to become inclusive for LGBTQ patients and their families. For my family, it helped my child blossom into the beautiful girl she is. Inclusive care allowed my child to live and thrive as her authentic self. Every child deserves that chance.

Dr. Keisha Michaels (ptec@hrc.org) is a Baltimore-based pediatrician and mother to two children. She is a member of the Human Rights Campaign Foundation's Parents for Transgender Equality National Council. Saturday is Transgender Day of Visibility, an international annual event observed since 2009.

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