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A List of Questions from Pandora's Box

(The letter that follows was shared by a mother concerned about her daughter. You can hear the letter read aloud on this episode of The Witness: True Stories of Children and Gender Identity.)

This letter was sent to my ex-husband after he filed with the court to remove my medical decision-making for our 13 year old daughter.

If you wish to make all medical and therapeutic decisions regarding our child, then I request that you consider how you would answer some questions that other parents of daughters have been faced with as their adolescent girls quite suddenly become enamored with living as boys thus attempting to escape the physically and mentally painful period of puberty in a society that values girls differently than boys. I have thought deeply about my answers to all of the questions that I am posing to you, since as part of my parent support group for transgender teens, I have talked to many, many parents who have had to make these difficult decisions.

Before I begin, I want to review some of the physical and mental health information for the past years of our daughter, our daughter. (Since this new identity is a recent creation and I’m speaking historically of the experiences of our daughter as a female girl in this letter, I have chosen to use the most logical nomenclature, which is supported and encouraged by other parents in my support groups.)

Do you feel that our daughter is physically and mentally healthy? What indicators of her health are notable to you currently and over the past year(s)?

  • Do you remember where you were when our daughter’s therapist called you to inform you that our daughter had expressed thoughts of suicide at age 8?

  • Do you remember how scared you were?

  • Do you remember when our daughter's therapist suggested that we consider antidepressants/antianxiety medication for our daughter when she was 9?

  • Do you want to reconsider our decision to not explore that therapeutic intervention that was recommended?

  • Do you feel that her anxiety has increased or decreased since age 8? Do you feel that her anxiety impacts her life in significant ways and does not allow her to maintain healthy relationships or participate in every day activities with expressing thoughts of overwhelming worry or panic?

  • What have you observed over the past year?

  • Have you joined any parent support groups to discuss your observations?

  • Are you meeting with your own individual therapist and/or parent support group to identify whether your observations are part of a period of normal “teenage angst” or are indicative of more significant mental health challenges?

  • What supports have you provided for our daughter’s physical and mental health?

  • Do you feel that additional resources are needed to evaluate and address her anxiety and depression?

  • What do you suggest?

The onset of puberty and the beginning of the menstrual cycle and its accompanying symptoms and impacts on a girl’s daily life are something that you have never experienced. It is a significant, though universal, experience, and many, many research studies have been done regarding its impact on the lives of girls.

  • Have you read about this physical and emotional experience in order to be able to parent our daughter, given that you don’t have your own personal experience to reference?

  • What have your discussions centered on regarding puberty and her experiences with her body?

  • Have you spoken with our daughter about her periods and how they impact her life?

  • Do you know that our daughter has had significant cramps that accompany her period, causing her debilitating pain to the point of vomiting?

  • Do you know what the cause of that is?

  • Have you spoken with her doctor about that?

  • Has she expressed that she doesn’t want to feel those awful cramps?

  • Are you aware that cramping and abdominal pain of that type could be a sign of a more serious, though possibly treatable, reproductive issue?

  • Has the cramping increased or decreased as she’s gotten older?

  • Are you aware that a doctor discussing monthly menstrual cycles are a way to catch significant physical development issues early in puberty?

  • Has our daughter expressed hatred for her period and a desire for it to end?

  • Are you aware that most if not all adolescent girls express a dislike of their menstrual periods?

  • What treatments have you explored with our daughter to address the significant painful cramping (physical) and monthly annoyance (mental) with the universal female experience of puberty and periods?

  • Have you spoken with her doctor (or will you) about the possibility of using hormonal birth control to alleviate some of the symptoms of painful cramping that accompany her period?

  • Have you asked whether an ultrasound might yield more information about why she has such painful cramping?

  • If you are not addressing these concerns, who is?

  • Who is speaking with our daughter and her doctors about these issues?

  • Have you started taking her to a gynecologist to address these common issues so that problems can be addressed early and that it doesn’t contribute to her body hatred?

  • Are you aware that this could be contributing to her desire to “not be a girl”?

  • Do you observe that she is attempting to disassociate from her identity as a girl in order to find a way out of the physical discomfort that accompanies this period of physical development?

Regarding our daughter’s recent demand for affirmation as a boy, I’d like to start with the most basic question that needs to be answered before any discussion can begin regarding medical decisions.