Gloria Bachmann, a researcher in transgender health at The Gender Center of New Jersey at Rutgers Robert Wood Johnson Medical School, is available to discuss the decisions transgender people face when starting the transition process and considerations they frequently overlook:
How does the age of people who transition affect their decisions?
Bachmann: About 1.4 million U.S. adults and nearly 2 percent of high school students identify as transgender — and that number is growing. Research has shown that strong social support and family affection, no matter the age of the transgender person, is important to their mental health. A major barrier for young transgender people is parental acceptance. They learn whether they can reveal that they are transgender through the subtle hints: Do their parents talk negatively about LGBT issues or does their religion discourage them? Young adults also face the possibility that siblings will ostracize them or pressure them to remain silent, so as not to affect their own reputation in school. For these reasons, some of the young people we see wait to transition until they move from the family home.
Deciding to transition is more complex for people who have built a career and family as a cisgender individual. Coming out as transgender can jeopardize their employment, marriage and their relationship with their children. They have spent a lifetime establishing an identity that they now have to end. Older transgender people compare it to dying: They have to cope with the death of the person they were.
What important considerations are often missed by people who are transitioning?
Bachmann: Since the focus tends to be on the person who is transitioning, support for the family often is forgotten. The family and the person are on different clocks: While the transgender person has contemplated the decision and is comfortable, the decision is new to the family and they need time to adjust to the changes. They feel helpless and have questions about how they can support their child, spouse or parent. They are confronted by grief and loss and face social isolation as well. Although they feel like they are pioneers, they are not alone. It’s critical that families find a professional who is trained in counseling transgender persons and their families and join support groups.
Transgender people also need to weigh the long-term impact of any surgery they are considering. Although top surgery is safe, bottom surgery is still being perfected, and older people can have increased risk of bladder and bowel issues.
Young people, especially teens, do not often think about how medical treatments will affect their ability to build a family later. It’s best to not make irreversible decisions, like having a uterus removed, too early. They may want to consider saving their sperm or eggs. We also do not have the long-term data on how starting hormones before puberty will affect a person later in life since this type of treatment is relatively new.
Bachmann can be reached at email@example.com.
Reporters who wish to speak transgender people at different life stages about the transition process can contact:
Rowen Kanj, 22, at firstname.lastname@example.org
Nicole Brownstein, early 70s, at email@example.com. Brownstein is the group leader of the Proud Transitions Family Support Group at Robert Wood Johnson University Hospital–Somerset in New Jersey and can speak on family support.
Jackie Baras, LGBT Health Navigator at Robert Wood Johnson University Hospital, is available to speak on family support during transition: 908-442-5609 or firstname.lastname@example.org