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“What the hell are you doing?” my patient Dan screamed at his 4-year-old son, who was dressed in his wife’s floral apron and twirling a whisk.
“I’m cooking, Daddy,” Bobby responded as he started to cry.
“I felt like such a jerk,” Dan told me. “I know I’m not the poster child for gentle parenting, and I know I shouldn’t have yelled, but I can’t stand it when he wears his sister’s pink dresses and plays with her dolls. I dreamed of having a child who played football, the way I did, and my father did.” He paused. “He’ll grow out of this, won’t he?” Dan asked in a voice that was almost pleading.
For the past 30 years, I’ve worked with parents who have struggled with the gender choices that their children are making. Sometimes they berate themselves, other times they take out their rage on their children. Often, family members compound the guilt and shame. Years ago, it was often unusual for children to want to transition in middle school or high school, but we are now seeing this conversation arise as early as elementary school.
I’ve seen this anguish from many perspectives. I trained at a college counseling center in the mid-1980s when gender questioning was uncharted territory, and there was little support for teenagers to come to terms with the complexities of sexual desire that challenged the traditional norms. And the issue of sexuality emerges full force in college when students are away from home and family.
But change is not easy for anyone. Eileen, a very polished executive, entered my office and began to sob. She had never lost her composure in our three years of therapy, which focused on her early trauma. “I feel torn between my head and heart, and there is no one to talk to about this.” She explained that Sara, now 14, wanted to be male, and was asking their classmates and teachers to use the name “Sam.” The teachers and other kids were accommodating. However, in Scouts, there was teasing and bullying from other girls. Sara developed an eating disorder. It was hard to get support from family. The grandfather, from a very different generation, could not understand what was happening. “I miss my sweet little girl,” he lamented, causing everyone to cringe. Sara ran to the bathroom to cry and wouldn’t speak to him for months.
“I know I’m not supposed to say this, but I had dreams of doing conventional girly things with Sara, like clothes shopping, or going to rom-com movies. Nope. That is not going to happen.”
After watching the heartache of parents for decades, I have come up with suggestions that have been helpful for many.
Don’t Do This Alone.
Many parents feel that they have lost a child in this process. They are aware that this isn’t the death of their child, but the child they are now parenting is not who they imagined. Finding others who are struggling in the same way can be comforting, whether it’s an online group or chat, or locating support at the local hospital, church, or other place of worship. It is OK to allow yourself to grieve. Give yourself the space to have ambivalent feelings.
Learn to Love the Child Who Is Present.
Mindfulness has been a major support for the parents (and children) I work with, as change is one of the basic maxims of mindfulness. Can you bring compassion for everyone in the family? Change is a constant, in everything. Watching your child change is part of nature. This change was not anticipated, but then nothing is. And we can’t control our lives, or the lives of our children. This perspective added some comfort as Sara transitioned to Sam, complete with surgery and hormones.
What was especially helpful for Eileen was that Sam didn’t seem so “tortured” as she put it. They are finding increased comfort in being in their body. “Mom,” Sam commented, “this is who I am supposed to be. I like who I am.”
They had always been interested in music, studying piano, singing, and guitar when young. But now, as Sam, they could find a new sound.
“I’m finding I like this new voice,” Eileen commented. The lyrics are edgy, the beat is strong, and the music is fresh and new. Sam and his band have developed a following, and a recording label is talking about a deal. It has been a huge change for all of us, but we have worked together to find our way. It is not what I wanted, but I find that we all have become more resilient.

