Many people struggle with basic questions about gender and labels, including the concept of a transgender identity. While debate around recent legislation has brought the issue into the spotlight, social media and the internet have played a key role in shifting the culture's perspective on gender for several years.
On this edition of The Exchange, we'll look at the terms, the biology, and the emotional aspects of gender identity.
GUESTS:
- Rachel Allen - Nurse Practitioner at Equality Health Center, where she provides transgender health services.
- Gerri Cannon - Transgender representative for PFLAG New Hampshire. Cannon was assigned male at birth, and now identifies as female.
- Dr. Paul Cody - License psychologist and gender specialist at Equality Health Center, with more than 30 years of experience with the LGBTQ community.
- Linds Jakows - Campaign manager for Freedom New Hampshire, a nonpartisan organization that educates and advocates for transgender people. Jakows is a non-binary transgender person.
- Dr. Nancy Charest - Pediatric endocrinologist with Dartmouth-Hitchcock.
What is your definition of transgender?
Gerri Cannon: Essentially, it's people who are born physically one gender, but identify as the other gender, or another gender, let's put it that way. So part of the challenge that we have is that especially when someone is born, a doctor makes a decision at birth as to who this person is based on what they physically see, and most of the time it's correct, but once in a while, it's not.
Rachel Allen: When we think about terms like gender identity, or transgender, or gender nonconformity, these are big terms that are umbrellas of a lot of individual people's varied experiences.
What is the difference between sex and gender?
Dr. Paul Cody: Sex is our physical morphology...based on external genitalia, [a doctor] says, "Oh this is the sex." And gender is our identity that we come to understand ourselves by age two to four...There is an interaction between our biology and our socialization, including hormones...Other societies have two genders, and in living Native American Languages, more than 250, 168 of them have terms for third or even fourth gender statuses. So this is not something that is just happening now. Our society is beginning to be more inclusive, where other societies have been so for longer.
Producer's note: Check out this documentary about "two-spirits" from PBS, and the third gender associated with some Native American tribes.
What does it mean to be gender non-binary?
Linds Jakows: I'm someone who doesn't neatly fit into the category either male or female. I was assigned female at birth, but growing up, especially when I hit puberty, I felt really uncomfortable with the language [associated with] becoming a woman, and my body changing. So I identify as either non-binary or genderqueer, which means I don't fit into either male or female. I don't feel comfortable with that. I am a gender neutral person, which can mean a lot of different things for a lot of different people, but for me, that means I would like you to use gender neutral language, so "person," instead of "woman," "lady," "girl," et cetera.
How should someone with questions or who is uncertain how to address a person who is transgender handle that situation?
Linds Jakows: I would encourage people who are new to this issue to not get hung up on "I need to learn this exact vocabulary," and [instead] really listen to individuals and the words that they feel comfortable with, and to ask questions about what is going to be the best way to respect you as a person.
Gerri Cannon: If someone doesn't know how to address someone, it's okay to ask. It's the polite thing to do. "How would you like to be addressed?" And we will volunteer that information, because that's good for conversation, so people know how to communicate with us. And sometimes, it's very awkward, and someone refers to us in a different way or the wrong way, and we will correct them. And we understand that people don't fully grasp it, and that's okay.
What about young children who express different gender identities?
Dr. Nancy Charest: The parents bring the child in and say, "I don't know what this is, how much should I be doing?" and, "Should I do a social transition for my child who is identifying in a different gender than they were assigned?" I do just a little bit of education: most of the data says that in a prepubertal child, this could definitely be a stage and not permanent, and most children will not persist in identifying in a different gender. And I try to get the parents hooked up with a therapist who specializes in gender issues in children.
What about a young teenager who is about to start puberty?
Dr. Nancy Charest: I can provide what's called a "puberty blocker"... you can see this medication in the early pubertal stage, possibly transgender child to prevent them from going through the puberty that is causing them such distress, because their body changes are not matching who they feel they are.
Listener Heather from Amherst asked the following question about puberty blockers: Aren't puberty and hormones important to a child developing their gender identity? I'm concerned that if a child is given puberty blockers, they might not be able to develop their final identities.
Rachel Allen: Most of the rationale behind using a puberty blocker would be to actually give someone some time to really consider their identity. It is not irreversible, so if that blocker is removed, then your body would go through the puberty that would have started without the blocker. The benefit of it is if we can give someone some time to an age where they feel more comfortable about their decisions, and then they decide to use gender-affirming hormones to move towards the other gender, than that gives them the freedom to use them if they choose.
Dr. Paul Cody: [These patients] have already been brought into medical and psychological care. This is not a snap decision. These are children who have been expressing fairly strong identification with another gender, so the decision is made to block puberty from starting, because once it starts, changes happen that make it much harder for the person to reverse them.
Rachel Allen: I've heard from a lot of clients that puberty was a really really difficult time for them, and it can be traumatic to develop secondary sex characteristics if that is not congruent with your identity. So I think there is a lot of risks for not treating with hormone blockers where [they] are appropriate.
Additional Resources and Reading:
Educational Resources:
Click here to read GLAAD's comprehensive list of transgender terms, as well as a chart that breaks down problematic and preferred terminology.
GLAAD also provides a list of common questions and answers for those curious about gender identity.
The American Psychological Association published a list of common questions about transgender, with answers and links to additional resources.
The Trans Student Educational Resources website (which provided the above info graphic) has many resources for students and educators.
Support and Local Services:
Transgender New Hampshire provides information on support groups and healthcare in the Granite State.
PFLAG, formerly known as Parents, Families and Friends of Lesbians and Gays, is an organization for families, friends, and allies of the LGBTQ community.
Trans NH Magazine is an online publication for the transgender community and their allies in New Hampshire.
NH Commission for Human Rights accepts gender identity discrimination claims related to employment, housing, or public accommodations.
Statistics:
The U.S. Transgender Survey from 2015 provides socioeconomic and health statistics for transgender people both nationally and in New Hampshire.
