Part one of a four-part series on children and gender identity
It’s important to know children and adolescents will explore their identity and it’s a normal part of growing up.
It’s not just about gender identity exploration but also what values are held dear, what kind of person they would like to be and it’s important to create a safe space for that exploration to occur.
A group of local healthcare providers and doctors, Physicians for Diversity & Inclusion, have come together to stand with families of gender diverse children and gender diverse members of the community.
Dr. Ingrid Cosio, whose practice includes time spent at the Northern Gender Clinic in Prince George each week, provides specialized care to transgender and gender diverse persons living in the Northern Health region.
Cosio offers some guidance during those first steps taken toward getting more information for a child talking about their gender identity.
“Any time is an OK time to bring it up,” Cosio said. “Going to talk to your doc doesn’t mean you’re expecting to have a treatment or some sort of solution. It’s a start of the discussion. Just like it would be for anything a patient is struggling with or has questions about. The ideal is that your primary care home – whether that’s a family physician or nurse practitioner – offers a safe place that you can go and talk about some feelings you’re having and have a chat about that. Even knowing that’s the starting point is so important and knowing you can come back if things are getting more difficult or you just want to follow up and talk some more.”
Knowing that identity exploration is normal and having a safe space to do that at the doctor’s office, at home and at school is the most important thing, Cosio said.
“Creation of the safe space at the doctor’s office where a patient can come and talk about things is super important,” Cosio said. “That they have a place to come – because some may not have that safe space – if they are coming with their parents, hopefully that means that there is some support to go get some questions answered and talk about it – so hopefully that’s already there. But the message for that first visit is that identity exploration in childhood and adolescents is totally normal, whether it’s gender, sexuality, just figuring out what your core values are, what’s important to you and what kind of person you want to be. And same goes for things like ‘the gender people assume I am doesn’t seem to fit.’ To think about that, to talk about that, so that’s where the whole exploration piece – and for the family and the child to know – that this is normal and we can just take their lead and support them.”
Having that safe space at home and at school is critically important, Cosio added.
“That’s where they can do that exploration,” Cosio said. “They can, so to speak, try on identities that they feel fit them better and to know that they are going to be accepted and loved no matter where they end up and would continue throughout that process.”
Feeling supported and safe while exploring their identity is essential for good mental health, Cosio added.
Gathering information from a patient is an important part of the job for a healthcare provider.
“Just letting them tell their story and talk about their experience and not necessarily guiding that but just seeing the important things they bring up, what are the questions, what are the fears and what their context is – who is in the home, things they like to do, what are the real successes that make them feel awesome, and what are some of the challenges they have. So the experience and the context are the two key pieces of understanding what’s really going on for the young patient.”
Cosio added it’s also important to ask about when they started thinking about this, how it has been making them feel, if it’s affecting their day-to-day life and has it affected their mood? Are there other more pressing concerns like depression, anxiety or thoughts of self-harm or suicide?
“We want to be screening for that because it can be super dangerous,” Cosio said. “And if we don’t ask the question, they might not bring it up. And we don’t want to miss the opportunity where we could put in a safety plan or be aware of how at risk they are. And also are there any hopes or expectations of how, as their primary care provider, we can help other than listening and providing support.”
Those are the issues a first visit to the family practitioner will address.
The Prince George Public Library, in partnership with the Northern Gender Clinic, provides excellent resources, including gender workbooks, and novels with gender diverse characters going through similar journeys.
For reliable and accurate information about gender identity, visit the BC Children's Hospital gender resource page.
Tomorrow: The second step is learning.