Teen gets help, gives help at Children’s Medical Center Dallas’ new Genecis program for trans children
Editor’s Note: The last names of the transgender teen and her mother profiled in this story and the name of the school the teenager attends are being omitted to protect the teen from possible harassment because of her gender identity.
If you ask her, Christina will tell you that her daughter Kammie, 15, didn’t transition — it was the whole family that transitioned. Christina used to think she had a son, but she has transitioned into understanding that she has a daughter.
Kammie participates in the new Genecis gender program at Children’s Medical Center Dallas, the first program of its kind for trans youth in the southwest. Born in Germany, Kammie began presenting as a girl at age 9 when the family lived in rural Alabama.
She and her family live in North Texas now, but before moving here, Kammie had her birth certificate changed with a letter from an attending endocrinologist. She got her name changed legally to match her birth certificate after moving to Texas.
Christina said doctors in Alabama didn’t know what to do with Kammie. So she put them in touch with doctors elsewhere who had experience dealing with gender dysphoria. When Kammie began attending counseling, she and her mom traveled 250 miles each way to Atlanta to see a counselor there.
At the end of the first session, the counselor asked, “If you had one wish, what would it be?”
“To be a girl,” Kammie answered. That’s what it took for the counselor to declare, “Then we can do this.”
At the end of 4th grade, Kammie began presenting as a girl. When she returned to school in the fall, she was placed in a different class to avoid any possible harassment.
Christina, who describes herself as a devout Christian, doesn’t understand why more parents don’t accept their transgender children. Her religion teaches her that it is “bizarre … that parents don’t embrace their families,” she said.
Christina said she knows that many parents have rejected their trans children, throwing them out of the house and cutting off contact with them.
But for her, the focus has always instead been on how to protect her daughter.
Christina acknowledges that she could have been a stronger advocate for Kammie when her daughter was younger. She has seen the difference that having the support of her family has made for Kammie, noting, “The more I championed her, the stronger she was.”
Christina said she has also seen the kind of anxiety and depression transgender children struggle with when they are not embraced by their family, and she is glad that hasn’t been the case with her daughter.
An exceptional case
Kammie is an exceptional case, says Dr. Ximena Lopez, medical director of Genecis. But while Kammie is “well adjusted and has friends,” not all children who have come through the clinic are at the same point on the spectrum, nor are they as easy to diagnose, the doctor said.
Children diagnosed with gender dysphoria are often prescribed puberty suppression medications to help “buy time,” Lopez says. She adds, “If you avoid the effects of puberty, the outcome might be better” for a child in transition.
Lopez stresses that no puberty suppressors are ever administered without support from both of a child’s parents. Many times, she says, one parent — usually the mother — is supportive while the other — usually the father — insists the child is just going through a phase.
And Lopez acknowledges that gender dysphoria is not necessarily an easy diagnosis to make. She says that counselors look for the kind of consistency in self identification that Kammie’s counselor saw in her before they begin treatment.
Kammie says that she can remember as early as kindergarten thinking to herself that “my body was not the way it was supposed to be.” But Christina says Kammie showed signs even earlier.
Christina says that even as a toddler, Kammie would cover her genitals with a washcloth when bathing. At the age of 7, Kammie told her mother “it wasn’t supposed to be there.”
“What do you want me to do? Snip it off?” Christina recalls asking. Now, she says, she wishes she had been more understanding way back then.
Soon after that, both mother and daughter recall, something happened that was a turning point in their lives: They were in the car and Kammie began crying, telling her mother that she didn’t “feel like a boy.” Her mother responded then by telling her “it was OK to be who she was,” Christina recalls.
And to back up that message of love and support, Christina says, Kammie’s stepfather went out to a thrift store and bought her girl clothes.
“The transition was in us,” Christina explains now. “These children were born who they are. The real transition comes in the people around them.”
“Every child is different,” Lopez says. “We’re seeing younger and younger children who meet certain criteria for gender dysphoria. The younger they express themselves, the more likely they’ll persist.”
Lopez says the Genecis program — which stands for GENder Education and Care, Interdisciplinary Support — sees children of a variety of ages.
If gender behavior is not consistent in younger children, counselors and doctors are likely to wait until the child reaches puberty before beginning any treatment, she says.
Lopez says that many of the children referred for treatment in the program have attempted suicide, adding that the attempted suicide rate for gender dysphoric children is as high as 80 percent for those with unsupportive parents and as low as 4 percent when parents are supportive.
Programs like Genecis “prepare people for a better life,” Lopez says, noting that such programs are still very new. Europe led the way, and the first North American clinic opened in 2007 at Harvard Medical School’s Boston Children’s Hospital. That program has seen 500 patients and currently gets 10 referrals a month.
Since that time, 23 other programs have opened — most of them in the last year and most located in the northeast and California. Lopez says that over the last three years as Children’s Medical Center Dallas was assembling its staff and putting the Genecis program together, the hospital has already seen about 40 gender dysphoric children.
Hospital spokesman Scott Summerall says the program officially opens sometime in the next two months. Lopez says this is a new generation of trans youth that are getting the parental support they need.
Feleshia Porter, a licensed professional counselor in Dallas who specializes in working with transgender clients, says she is “so excited about this program I can’t stand it.”
Porter says there are a number of advantages to transitioning at a young age.
“There’s not as much erasing you have to do,” she says. “They don’t have to play the game. And they’re socialized in the appropriate gender role.”
Porter says when older people transition, they have to dismantle their old life to live a new life that’s authentic. Transitioning younger allows the person to live a more authentic life from the beginning and have more authentic relationships.
Living with confidence
While delighted with the Genecis program, Christina says she’s learned over the years that confidence is Kammie’s best protection in a world that is so often cruel to those who don’t “fit in.”
“A mean dog will bite you if you show you’re afraid of them,” she says. “But people are comfortable with people who are confident.”
After Kammie began presenting as a girl in her rural Alabama school, Christina says, another student’s parent found out about her transition and sent an email to about 150 parents, including Christina, demanding a “boycott of Kammie’s right to gender expression in school.”
Christina says she decided to send her own email to the list. She included a link to a blog she’d been keeping documenting her family’s experiences. She also included her phone number and invited any parents with questions to call her.
Christina says she didn’t receive a single phone call, while the number of people reading the blog soared.
Then she got calls from media. But Christina says didn’t think a story on the television news about her 9-year-old transgender daughter was either necessary or appropriate. So she told reporters, “If something happens to my child because of what you put in the media, I hope you can sleep, because I’ll be looking for you.”
They never published a word, Christina says.
Now, six years later, Kammie says she is ready to tell her story, and she is ready to help the Genecis program however she can.
Lopez says Kammie may be a good role model to participate in group sessions with other youths as those sessions begin. She has already addressed a group of 50 pediatric residents who work at the hospital.
Lopez says that considering doctors don’t have any free time, she is even more impressed than Kammie was that they took time out to write her letters of thanks.
While she continues to participate in Genecis as a patient to monitor her progress, Lopez and other Genecis staff view Kammie as a role model and a success story.
This article appeared in the Dallas Voice print edition January 30, 2015.