Working with trans youth and their families - Part 2: Working with Trans Youth

Estimated read time: 1:20

Summary

The second part of a three-part series focuses on working with trans youth, providing insights into their unique experiences and challenges. The webinar draws from ongoing research projects and offers a comprehensive understanding of the intersectional experiences of trans youth, including issues of oppression, mental health, and access to gender-affirming care. It emphasizes the importance of family acceptance, social support, and proper medical care in fostering resilience and well-being among trans youth.

Highlights

Research highlights the critical need for family and community support in fostering trans youth resilience. 🌟
Many trans youth face discrimination, but access to gender-affirming care can lessen this impact. ❤️
The importance of using correct names and pronouns in clinical settings is emphasized. 🏥
Delays and bureaucratic challenges are common obstacles for youth accessing gender-affirming care. ⏱️
Educational institutions must improve policies to support trans youth effectively. 🏫

Key Takeaways

Trans youth face numerous challenges but show remarkable resilience when supported by family and community. 💪
Understanding and respecting a trans youth's identity is crucial for their mental health and well-being. 🧠
Access to gender-affirming care is vital and shows positive outcomes for trans youth. 🚑
Education and awareness among caregivers and professionals can significantly improve the experiences of trans youth. 📘
Intersectionality is important in understanding the diverse experiences of trans youth. 🌈

Overview

The webinar delves into the complex experiences of trans youth, highlighting how both social support and systemic challenges shape their journey. It draws from real-life data to portray the nuanced struggles faced by these youth and the resilience that ensues when they are supported by their families and communities.

Access to gender-affirming medical care is a recurring theme throughout the discussion, showcasing its profound impact on improving the mental and physical well-being of trans youth. However, systemic barriers such as long waiting periods and lack of understanding from professionals often hinder this access.

The conversation extends to educational institutions, underlining the need for inclusive policies and practices that respect and affirm trans identities. The importance of creating a supportive environment in schools and healthcare facilities is seen as vital for the holistic development of trans youth.

Chapters

00:00 - 02:00: Introduction and Overview The chapter 'Introduction and Overview' is part two of a three-part webinar series focusing on working with transgender youth and their families by using evidence-based practices for intervention and social change. It aims to delve into the experiences of transgender youth. In the previous session, basic concepts about gender identity and understanding what it means to be a transgender youth were discussed. This chapter continues to build on those foundational ideas.
02:00 - 05:00: Projects on Trans Youth Experience The chapter begins by highlighting the foundational knowledge required to understand the topics discussed, such as the differences between sex and gender, sexual orientation, and gender expression. It suggests that new listeners should review previous chapters for better understanding of these concepts. The main focus of this chapter is on the experiences of transgender youth. It aims to explore transgender youth experiences by examining existing literature on the topic, while also implying a broader exploration beyond just academic sources.
05:00 - 09:00: Risks and Challenges for Trans Youth The chapter discusses the risks and challenges faced by transgender youth, drawing from two significant projects in Canada, including one in Quebec. The first project, titled 'Beneath the Surface: An Intersectional Investigation of Trans Youth Experience,' involves interviews with 70 young people between the ages of 15 and 25 to understand their experiences.
09:00 - 15:00: Access to Gender Affirming Care The chapter discusses a project focused on holistic approaches towards understanding oppression and resistance in the context of gender affirming care. It includes insights from young people regarding their experiences. The discussion also references another qualitative research project titled 'Stories of Gender Referral in Care,' which collects stories from children, youth, and their families to better understand their journeys in gender affirming care. Both projects aim to highlight the voices and experiences of young individuals in accessing gender affirming care.
15:00 - 18:30: School and Family Challenges The chapter discusses the challenges faced by children and their caregiver parents when accessing gender-affirming care.
18:30 - 23:00: Resilience and Support The chapter titled 'Resilience and Support' delves into the experiences of affirming gender through therapy and surgery. It highlights the need for gender-affirming care and the processes involved, especially as individuals grow older. In this context, the chapter refers to a specific project that explores these experiences, emphasizing the importance of resilience and external support systems in navigating gender identity and transition. Acknowledgment is given to the numerous teams and individuals involved in this comprehensive project, underscoring the collaborative effort required to address the needs of trans youth effectively. Additionally, an overview of the current understanding of trans youth issues is presented, setting the stage for more detailed insights.
23:00 - 29:00: Clinic Experiences and Medical Transitions The chapter titled 'Clinic Experiences and Medical Transitions' discusses the vulnerabilities and risks faced by transgender individuals, particularly focusing on a study from Ontario. This study revealed startling statistics about mental health challenges within the trans community, noting that 47% of young trans people aged 16 to 24 considered suicide, and 19% attempted it. The chapter emphasizes the critical nature of mental health support and monitoring in clinical settings for transgender individuals, to help mitigate these risks.
29:00 - 34:00: Intervention Strategies The chapter "Intervention Strategies" discusses the significant proportion of young people who are at risk of suicide, self-harm, and mental health issues. It highlights that nearly half of this demographic is also vulnerable to abuse and violence, often stemming from their own families. The text acknowledges a gap in the research specifically addressing why familial abuse and violence are prevalent, suggesting a need for further study in this area.
34:00 - 60:00: Q&A Session The chapter covers various challenges faced by young people regarding gender identity. It highlights parents' difficulties in accepting their children's gender identity and the related risks such as being more vulnerable to intimate partner violence, cyber intimidation, and bullying. One particular study mentioned involved a cohort of 24 young individuals undergoing Child Protection Services, underlining the seriousness of these risks.

Working with trans youth and their families - Part 2: Working with Trans Youth Transcription

00:00 - 00:30 so hello everyone um so this is the second part of the three-part series webinar on working with trans Youth and their family evidence-based practice for intervention and social change so today's webinar is going to be about focusing on trans youth experience for those who were with us last week you will remember that we talked about basic concepts to try to understand gender identity what it is to be a trans kid and all the information
00:30 - 01:00 that we needed to have as a base such as for example the difference between sex and gender and sexual orientation and gender expression so if you just join today I invite you to go back to the first one at some point and listen to it as well because it's really important I think to understand all these different components but today we're going to focus on Trends if experience and to do so we're going to look a little bit at literature on the topic but I didn't want to only draw from
01:00 - 01:30 literature so we're going to also um draw from two projects that are currently underways uh one in Quebec and one in Canada uh impi on principal investigator on those two projects so the first one is called begin beneath the surface an intersectional investigation of trans youth experience this is a project we have interviewed 70 young people aged between 15 and 25 to understand about the experience in a
01:30 - 02:00 more holistic way and focusing specifically on oppression and resistance so I'm going to talk a bit about that project not in terms of methodology but more in terms of what young people told us and we're also going to refer to another project which is called the stories of gender referral in care sorry there's little spelling here there's no T learning from children youth and their family and this project basically is also a qualitative project
02:00 - 02:30 that looked at children and their caregiver parents experience when they are accessing gender gender affirming care you'll remember last week we're talking about medical transition uh so some young people will decide they will need some some sort of medical care to deal with their experience so those can access to these gender affirming care where they can access puberty blockers for example hormones block almonds
02:30 - 03:00 um affirming gender sorry almond therapy and sometimes surgery when they they are a little bit older so we're going to look at their experience from that project as well um and at the end we should have a question and at the end you will see there is a couple of slides acknowledging all the teams that participate on those projects because to do a big projects like that would need to be many so an overview of trans youth this is
03:00 - 03:30 really a very short flight but we know that they are vulnerable and at risk of suicide attempt in fact a study conducted in Ontario by the transpose theme um found out that 47 of trans people age 16 to 24 in Ontario participated in their study attempted consider suicide and 19 attempted it this is a very high
03:30 - 04:00 proportion of young people we talk about nearly 47 nearly 50 so they are at risk of suicide self-harm and mental health issues and they are also as we see in the literature more at risk to abuse and violence and this can come from their family um we're not quite sure why there's not been research done specifically on that but we can hypothesize that some family
04:00 - 04:30 might find it difficult to accept the gender identity of their kids and actually in one of the research in the digging beneath the surface we we found without wanting to um for young people in our first cohort of 24 that went through Child Protection Services so that that gives you an idea how they can be at risk they're also at risk of intimate partner violence cyber intimidation in bullying and to several
04:30 - 05:00 structural challenges such as discrimination in employment social isolation poverty limited health care access um Adultism so not being considered you know old enough to make their own decision and gender policing we'll talk about those things a little bit more in detail in what is coming there are also at high risk of use and misuse of alcohol and other substances and they are more likely to engage in Risk sexual practice and rely on sex works as a source of income
05:00 - 05:30 [Music] um to have access to for example gender confirming surgery or medication can be very expensive and when you're already discriminated in employment it makes life very difficult for some and they are overrepresented in rates of homelessness the risk acquired in HIV detention incarceration and in particular we see that in trans youth of color and migrant last week we're
05:30 - 06:00 talking about the importance of not seeing trans youth experienced as a monolithic one as understanding that there's a lot of intersectionality to take into consideration so this is an example here um last week you will remember that we talked about the experience of gender dysphoria we said that gender dysphoria was a diagnosis from the DSM but that meant that it was an experience a feeling of incongruence between the youth gender identity and their body
06:00 - 06:30 um so experience of gender dysphoria if we look at at research and the experience of trans youth in Quebec we can see that it's one and probably one of the only kind of individual difficulty that they experience you will see throughout the presentation that a lot of issues and difficulties and challenge that these young people experience come from outside themselves but gender dysphoria is probably one of the only one that really kind of make them struggle a little bit more and I've put two citation here you know one 16 years old uh young young women who tell
06:30 - 07:00 us that basically you know this is you know the the important barrier that she she that's the first barrier she described to us saying that the fact that she cannot be the person that she would really like physically so it shows you that this can be kind of something difficult and the other one is telling us that gender dysphoria put me in a phase where um I'm very just like uncomfortable with my body so I think it describes you very well well as much as we can understand fossils people
07:00 - 07:30 um what gender dysphoria can feel and you know I feel a lot of Shame around who I am as a person I feel just like every kind of little aspect of my life is a struggle I don't know I don't feel well so I wanted to kind of share with you some some you know some experience of those young people who participated very generously in that research um so now and we'll talk about it a little bit later when we we explore gender affirming care but we know that uh you know access to General Social care and
07:30 - 08:00 Health Services are very very important for young people for Trans youth as well um but they experience some challenges in accessing them in fact uh veal genevil and Al collaborator as found in their study of Canadian transitive experience that's 61 of them between 14 and 18 years old did not receive any medical services mainly because they had fear of rejection by The Physician and 71
08:00 - 08:30 percent avoided accessing mental health for the same reason and here you see on the side on the right side an example of a young person who else explained that they would like to go to a clinic to have a complete STD test but they are worried about the Pap test which can be common for Trans masculine young people but the nevertheless still need to have those hair so it's important that young people can access those Medical Services easily and
08:30 - 09:00 obtaining General Health Care in the welcoming and respectful environment contribute to their well-being so we've seen that very clearly in our research what we see also is that accessing those those Mental Health Services when you've got a mental health challenge can make things even more complicated so it basically exacerbates the difficulty to Access healthcare and that came out quite clearly as well in our project
09:00 - 09:30 where you add some examples some young people who went to for example the emergency room for a crisis because they were suicidal for example and basically the person who treated them decided to take away their almonds because because they were saying that they were feeling suicidal because they're almonds so I mean we need to to understand that you know you you you you you've got a gender identity and then you can have mental
09:30 - 10:00 health problems you're not the same so you don't want to consider them as the same I've put you another citation here from a young person who explained that uh they they went to see their their psychiatrists and they were saying you know can you please uh call me by my name and call me by those pronouns and the psychiatrist just said no no no you know you're just having a gender crisis here because you've got a personality disorder so here again you see that someone with mental health difficulty were totally kind of erased in their
10:00 - 10:30 gender identity in trying to access care we we see that young people so we're looking at Health and Social care services there's also challenges in other spheres such as the school environment um a research from Chamberlain and call uh from 2011 in Quebec showed that they are experiencing still a lot of insecurity in school and that they are at high risk of dropping out of school
10:30 - 11:00 um School are places where transphobian violence are frequently experienced and you know my experience of working with schools and with different policies is that when there's no robust policy in the school board or when there's no you know at least a strong information from directory become very very difficult for the young person to navigate all of that there's two specific issues that seems to emerge from school experience um and and create difficulty for those young people the first one is not having
11:00 - 11:30 ID that is consistent with the gender identity we're talking last week about legal transition about the person asking for a change of sex mention of their birth certificate so then it becomes you know a change on other part of their life for example the the school number um in Quebec it's a permanent School number so you can't change that until until you get a formal legal change of
11:30 - 12:00 sex marker so this is making um life very difficult for young people to navigate because they they get to school for example and they will have their ID showing the wrong gender marker and you've got school that will even have the gender marker on the timetable so the kid is going to try to find their you know their room to go to their physics class or math class or whatever and then you know kids around them will be able to see
12:00 - 12:30 their name and their wrongs and enough so it's very difficult for those children to basically be stealth if you remember we're talking about being stealth or being out last week so some kids who don't want to affirm their gender identity publicly which is a total right that everyone has um they basically will be struggling a lot um I don't know what's the regulation in all provinces but I would say that in Quebec and in other provinces where gender identity is protected by the charter you know young people should not have to have a formal legal gender
12:30 - 13:00 change on their piece of ID to people to have their ID and their gender identity uh recognized in school but this is definitely a difficulty and we also have a lot of difficulty accessing toilets and changing room so young people sometimes are forced to use the bathroom that correspond to their legal assigned sex so that make a lot of difficulty and what happened is that you see some young people not being able to use any
13:00 - 13:30 bathroom for the whole day and it can lead to for example UTI which is impacting on the soul on health so these were examples of you know differential treatment that young people can experience in schools in our research we also found that there were like a discipline determination that was the other name the relationship for example between the teacher and the young person so here I just wanted to kind of highlight
13:30 - 14:00 um an example of how discrimination can impact the life of the young person and can and can basically you know be extremely problematic and this was in the case of a college student who was not sure about their their grade so they went back to see their teachers to consider the grading and the teacher said well if you want me to keep calling you by your name because I know what your legal name is and because because of the attendance sheet you will have to
14:00 - 14:30 accept my grade I didn't say anything because I didn't want to be outed I just wanted to graduate from the ninth grade and I lost all my friends so I didn't want to lose all my friend again so you see here that you know there's like an explicit power relationship between the the child between the young person and between the the teacher so I just wanted to highlight that sort of experience which is still happening this is a research from this is data from last year um there's other difficulties as well that young people experience in other
14:30 - 15:00 sphere a Family Circle um a lot of young people may lose all relationship with their families they work lose contact as I told you in the research on trans youth digging beneath the surface we found four young people out of 24 we've not finished to analyze the rest of the data because we've got 70 interviews so I can't tell you if we've got more but you know Child Protection trajectories were not something rare in that first sample and you can see here that that young person
15:00 - 15:30 say that my parents refused to see me honestly if it wasn't for my sister if it were if we weren't close I would never be in contact with my family so this is a 16 years old you know young person who has no contact with their parents at the moment and there's some others that so you know this is like worst case when the person don't have any contact with their family but what we found is that a lot of them have what we coined um we called it the negative neutrality
15:30 - 16:00 so basically they not rejected that right by their parents they they still have some sort of support for example it could be financial support or the child could be allowed to stay in the house but you know gender identity is not talked about there's no kind of strong affirming support in the house and here you've got an example of the impression talking about that 19 years old Valerie is saying that it's not bad in my family to the extent that I don't get death dress to get me out of the house they're not
16:00 - 16:30 openly against my identity but they don't deny it but it is a subject that is not addressed between us so that person and many other young person in this research was talking about experience where they are tolerating the house but there's no like explicit support and for them this is something that led to experience of deny and its experience of the opposite of well-being so distressed
16:30 - 17:00 but we've been talking about a lot of struggle that young people experience obviously there's a lot of resilience as well I think we want to acknowledge that trans youth are very very resilient um beyond the psychological resiliency which would be individual to every young person we work with um there's some aspect that seems to be making them more resilient for example the capacity to Define their own gender so we know that young people who are able to Define their gender be honored
17:00 - 17:30 for the name they choose the honor for the pronoun they choose the the gender they choose they they feel much better so so it really improved their well-being um also to be able to reframe them and their mental health challenges what does that mean is that young people who are able to to say you know I am like that this is my understanding of my mental health problem is very helpful for us for them as well so it's I think it's basically getting out of those boxes and
17:30 - 18:00 those labels to find access to supporting services and trans affirming communities it's important as well as family acceptance and social support and when we talk about family acceptance we're talking about like strong support in fact it is key to Optimal development of trans youth when they supported their depression and anxiety is no higher than cisgender children so what there would make love in and Olson did is that they look at you know um Stress and Anxiety scales and they
18:00 - 18:30 did like a survey of trans youth were affirmed by their parents and supported strongly and cisgender children um you know were also affirmed by their parents and basically when you compare their rate of anxiety and depression it's no higher so there's just like a marginal like slight little kind of difference in term of of of stress but you know it's it's nearly the same so it shows us basically that you know when a child is a firm in support by their
18:30 - 19:00 family it's really very very doing well uh suicide self-harm and depression rates along with other indicator of mental health issue or lower for Trans people receive support from their parents than those who don't and you know that transpose study that come from Ontario um show that basically suicide rates you know that uh 14 above 43 47 depending on the statistic you look at will drop consideringly about 93 percent
19:00 - 19:30 drop for young people while supported we've got strong support by their parents so it's a real strong supportive resilience Factor um it is also uh I'm really sorry I've repeated that that point by der Woody and Cole but it's also Family Support is really important to counter isolation um so here you've got like a young person saying my family is always helping me they will always be important
19:30 - 20:00 to me I'm someone who has a hard time staying in touch with people but my family is always there of course thing would not be going so well for me if they had not accepted me so you see someone who's like having a little bit of difficulty making friend to go back to their family is a real source of support and what we've seen is that a family can also be a really great source for advocacy so you've got young people telling us that their parents have not put any citation here but parents you know went with them and advocate for them in schools and it's really helpful
20:00 - 20:30 and it helped them to cope with the discrimination and negative effect on mental health so we're talking about gender reforming care last week as I said the transition whether it be social or legal can alleviate gender dysphoria but when you have access to gender affirming care model in terms of medical it also help we need to remember that this should be the decision of the young person so you know not every young person will decide to have access to uh
20:30 - 21:00 medication to you know to medical support but those who want to have it they should have access to it widely um in fact a research I wanted to uh to cite here I mean it's a collection of research but it's all from the same team um talking about in the United States and the Netherlands they demonstrated that access to almond blockers almond replacement therapy and surgery as needed improve medium and long-term care outcome for transgender youth in
21:00 - 21:30 adulthood so this is data we've got so we know that this gender affirming care is very very important um in our research in clinics so we're looking at the experience of children or access Clinic to have access to those almond blockers and almonds and eventually surgery this is a project that look at Tree Clinic just to put you into contact one in Montreal one in Ottawa and one in Winnipeg and um so we looked at their experience and and
21:30 - 22:00 basically um we know that we're starting to understand that seeking gender affirming here to start with was often raised by a parent or professional so when we see in the media oh young people they just see things online and they want to go to access almonds well the research say that actually it was more of a reference that they got from other people and here you've got a young person explaining us to be honest I forgot how but I remember my mom and I talking about the next step at this point it was so very unsure and so my mom had the
22:00 - 22:30 idea that we could talk to someone I talked to many different people who had more knowledge than me maybe they could help me guide me and in track and I'm trying to get and so she found the place here and so I came here and I met with the doctor the intake nurse that was awesome so that's a 14 years old trans male trans masculine boy who's explaining how you know just to be able to access that clinic was you know important for them
22:30 - 23:00 um we found some participants that first brought their idea to their parents so out of 35 youth it was six of them they were all trans male but we need to also remember that between the time that the person is talking to their parents and doing a coming out and the person that realized about their gender identity there's often a big gap there's a big gap of time because it takes time for the young person to do their coming out it took several months to Year from
23:00 - 23:30 the first moment that they first told their parent about their gender identity until their first appointment with the physician at the clinic and by them many had a clear idea of what intervention they wanted so when they get to the clinic they say okay I really need to have access to blockers now I need access to blockers well often we need to understand that the process getting to the clinic has been a long one and you know the first order is to top your parent about that and the second is to kind of make sense of your own gender identity so we need to understand that it's a really long kind of wanted
23:30 - 24:00 process for those who had access to medication we can see that there's really positive outcome feelings of Happiness about physical effect from the medical intervention was noted in in all young people they alleviate anxiety and made the feel the youth feel like they were moving forward in their transitions I've put three citation I think we we can never have better than the the voice of young people themselves but here you know we don't have them so
24:00 - 24:30 um so ever since we got the referral we came to the gender identity clinic and things have been really going great I'm really happy with my skin so that's a young person who's been able to access to uh to treatment I realized that I accepted myself much more and that it feel much less bad looking at myself in the mirror I've take after taking blockers remember that blockers don't really do anything they will just put a a stop on pubert scenes so it's not going to undo things that you know already happened with the body but just
24:30 - 25:00 to be able to have access to something like blockers really seems to be taking a lot of anxiety away from those young people to know that things are not going to carry on to develop um and then you've got like a 16 years old who say since I was around seven I would did my arm again wall and stuff because I was just really unhappy and it's better now I am on testosterone because I'm kind of feeling content like things are going to get better so it hasn't been banned for quite a while so
25:00 - 25:30 you can see that having access to um having access to gender affirming Omens there has really made an improvement again to the life of that young person um their experience at the gender um affirming Clinic I've been positive um overall I would say um and what came to young person who are asking them why is it positive is that the staff always use the correct pronoun and this is something specific about
25:30 - 26:00 gender affirming care is that they are Clinic that are working with trans youth so they used to work with trans youth so obviously using the right pronoun using the right name is something that is more common than when you go to General General Health Care or social care but you can see here that this is something that was raised as very important for those young people uh they say that many staff were helpful giving them access to Medical intervention understanding their gender they felt heard welcome validated cared for you see here a young person 16 years
26:00 - 26:30 old say it was helpful because talking to someone who knew about a lot of stuff more than Google could give you is helpful because what we see is that young person when they start feeling something often they will go on Google my thought here is like who doesn't go on Google to check things out yeah so young people do exactly the same so they go on Google and they try to find things but what they realize is that when they get in clinics you know there's so much more knowledge and they can really make sense of what's Happening so they really make you feel good about
26:30 - 27:00 your decision and help you realize what you really want so it's nice there's been frustration however um long waiting time um sometimes it's waiting time because of waiting list we're talking about very specialized Clinic here so there's not a lot of them around so sometimes there's a lot of people waiting and sometimes there's protocol restriction I have not put any citations there but there's some young people who wanted to access blocker for example but the clinic wouldn't provide blockers before certain
27:00 - 27:30 age or certain stage of development it's time for almonds so protocol restriction was frustrating for them because sometimes they felt they needed but they couldn't have it because doctors were following protocols um there's been some time discomfort about some question I've put that because I think it's important that we remember that as social workers that when we are with young people you know young people may feel uncomfortable with the question we ask so if you have to ask questions I mean always ask yourself
27:30 - 28:00 do you need to ask a question but if you have to ask a question always try to put it into context um so that the young person can understand why you're asking that question sometimes they felt that they had to convince the staff that they are trans so that is less that is less good um as we're saying you know we need to uh we should be uh you know we shouldn't be arguing with someone's identity there's only the person I don't think that these young people at the experience of being argued with but by the sort of question they were asked they felt like they have to prove before
28:00 - 28:30 being able to access and some staff has limited understanding of non-binary Youth we've not talked so much about those non-binary youth there were lots of questions about them last week but um you know some some staff have limited understand ending and actually there's a really interesting project being done in Quebec on decision making process of doctors who are prescribing almonds to non-binary use so we'll be able to know more about that very soon when that data is analyzed
28:30 - 29:00 um has there been any second thoughts or regrets in taking those almonds so uh no even those youth who had more serious side effect uh from taking those medication where empathic that medical transition where the right right choice for them uh though they add question their decision in the past so this is really good because you know another preconceived idea some people have is like oh yeah those young people like says those almond quickly and they don't reflect about it and you know what we see is basically from the research is
29:00 - 29:30 that those young people they are in reflection they they think about it you know they there's a long process going on and even when you've got like you know side effects on desired second secondary effect it's still the right thing for them um and uh I don't know if it's something that interests you but some of them add some some effect I mean the yeah I mean hot flash uh it could be like uh yeah that was one of the main one
29:30 - 30:00 um you know mood swing um that's a sort of effect that they could get but uh basically you know this young person is telling us that the time of my suicide attempt was one of my most strong part where I was like okay what if I'm a lesbian you know and what if if all of this is a mistake but then eventually everything stabilized and I was like but I'm so much happier come on I would that wouldn't make sense I feel like it would be difficult if I change my mind because I've gone so far but honestly I personally don't think it
30:00 - 30:30 will happen so so basically you see that the person was really kind of questioning their own identity and is that the right thing and yes it is the right thing for them and they even say at the end you know it's okay I've read about people who the transition and it's perfectly fine so that person is really conscious about that but still is the right course of action for them and a majority I'd never questioned their decision and those who said that they had doubt about it has been fleeting so add little moments where like what am I doing is that something
30:30 - 31:00 serious but then I look at the mirror and listen to my deeper voice and I'm like this is what I want to do so the preliminary conclusion of that research because we're still analyzing data and next week I'm going to talk about parents experience I'm going to draw from the same research because we talked to parents and caregiver in that research but for the young person I would say that the vast majority of Youth described their experience of accessing medical intervention and gender affirming Care at the clinics in
31:00 - 31:30 positive term they improve the describe improve well-being the frustration more more frequently concerned with delays in accessing current intervention uh that non-expressed regret and that you know the result are coherent with data from limited existing literature with one Mark exception is that all you've said that gender affirming Care staff always use their prefer pronoun and noun because in literature we see that often young people who access care they feel
31:30 - 32:00 frustrated because people don't use those so in our research everyone was using the right name and pronoun so that was really positive for those young people if we turn into intervention and then I'm going to open the flow for question but if we look at intervention I think regardless of the setting um affirming The Young Person's identity listening to them asserting their identity is what's considered as best practice remember that treatment that attempt to change gender identity or gender
32:00 - 32:30 expression is basically unethical this is a strong statement from the world Professional Association of transgender health and from the American Academy of Pediatrics says that recent and rigorous research suggests that instead of focusing on the question of what will happen to a child accepting them for who they are even at young age help them to develop a secure bound of attachment and resilience not only for the child but also for the family and you can see here that basically this is a really important thing I'm
32:30 - 33:00 just going to plug my computer it can go without any age so last week it was a dog there you go and then don't forget to respect the name and pronoun affirmed by the young person supporting the different form of transition in social work this could be through writing letters some provinces will ask for auditor of support to be able to do a gender a legal change of
33:00 - 33:30 gender marker so it could be writing letter of support to Vital Statistics or birth registration office you know writing reference to Specialized Service or for school when necessary so this can be things that we can do as social workers and also know the available resources and refer when needed for organization an institution might be in contact with transu for working with them it's about remembering that only the person can Define and affirm their identity and putting in place structure
33:30 - 34:00 that can accommodate that and honor the person's identity so often we get I didn't give an example of that today but sometimes we get a young person going to an organization and say you know this you know I'm Annie I want to be called ER and the organization will say well you know unless you do the legal change we can't do anything for you well we should be doing something we should try to you know change system and make sure that we can have you know usual name and you know a note on pronoun that a person
34:00 - 34:30 wants to ask because there's nothing more um intimidating for a young person than having to go to a medical clinic and waiting in the waiting room and getting a doctor calling you by the wrong name and the wrong pronoun in front of everyone so we need to really think about that as organizations um and attending training on the reality of trans people that's really important to be able to understand knowledge and updated evidence for communities I think
34:30 - 35:00 it's about offering space for solidarities and sharing both online and offline we didn't talk a lot about it but young people really benefit from accessing other young people and being able to talk ensuring that trained resources if it's available in certain space in order to facilitate the sharing and discussion and organize activities that allow various transitive Community to share their needs and concern with each other so this is the acknowledgment for the story of gender affirming care it's a project I will just name it funded by
35:00 - 35:30 the cihr and this is the team of this digging beneath the surface project which is funded by the social science and Humanity research Council so I don't know if you've got any questions um so thank you so much any of this presentation and we are it's time from the Q a period I'm your moderator today I'm Sally guy I'm the director of policy at the Canadian Association of Social Workers and I'm looking at the stats and most of
35:30 - 36:00 you in the audience are back from the first event but for anyone who's new in the audience the information you need like how to access this slide deck download that um where to get your your certificate of attendance those kinds of details are in the welcome widget when you logged on but you can access it by clicking on the loudspeaker icon at the bottom of your screen um also if you are new you can read Annie's full bio on the right side of your screen it's posted I also just quickly want to know before
36:00 - 36:30 we take questions and we have a bunch coming in right now which is awesome at the end of the presentation a survey is going to pop up right away and once that happens you're not going to be able to go back in to access your certificate or download the slides if you hadn't already but never fear within 24 hours of the presentation concluding you're going to be sent a link to your email to um get into the recorded version and you can pop back in and download the slides or access any other resources so that's to say if you forget to do it before the
36:30 - 37:00 presentation Ends don't worry you will get a link to login so with that said I have questions coming in and let's get to some so Annie lots of people are asking about terminology um so friend I think some of this is because of just translation and thank you for doing this presentation in your second language and uh translating a lot of it yourself from French but if people are asking they've seen the word uh trans mascara cons masculine response on the slides as well as transgender male
37:00 - 37:30 um does that mean the same thing which one is correct and then another person is asking I was recently informed that it's not okay to say transgendered but the word is transgender so basically can you just talk to us about what the what the correct terms are um and and how to know what to use okay um so on the slides um there's two sets of way of talking about young person when it refers to the um digging beneath the surface or the first
37:30 - 38:00 few slides we decided as a team to honor the way that the person we're describing themselves so basically if you see um I can't remember the name of the Jeanette 16 years old girl is because when we say agent you know can you tell us about your gender identities say I'm a girl and a UC problem so so this is you know how we work for the um story of uh gender affirming care we just put
38:00 - 38:30 towards transmasculine or trans feminine it's another way of categorizing them because we had a different uh social demographic uh questionnaire but basically I think the bottom line is to use the term that the person prefer um your writing transgendered is not uh it's not it's not right transgender is not a noun it's an adjective so it
38:30 - 39:00 shouldn't be used as a noun because um some trans people will say that it it has an effect of uh dehumanizing them so so we should use transgender or trans just trans as as an adjective so a trans person a trans youth so that's a really really good question um for the rest as I said you know if we roll transmasculine or trans feminine is because we wanted to uh you know
39:00 - 39:30 mention that they are trans Youth and they identify more towards the feminine Spectrum or the masculine Spectrum although we had some non-binary young person in that sample as well but I didn't cite any of them and otherwise you know the other citation not just how people describe themselves and actually we had in that project digging beneath the surface we had probably as many ways of describing yourself as participants we asked them you know how do you
39:30 - 40:00 describe yourself in terms of gender identity and we had such a wide range of way of describing yourself so you know when we ask we are so rich answer yeah thank you for that I mean there was lots of questions about that also last week so I'm glad that you were able to touch on that on one of your slides uh you said that you recommend getting training on the realities of trans of trans Youth and just wondering was there any specific organizations or like websites or
40:00 - 40:30 resources that you would want to direct people to for that oh that's a good question um in term of canada-wise um in term of I mean you can always contact UM and I'm going to declare conflict of interest here because I was co-founder of that organization but if you are really lost you can always contact gender Creative Kids Canada they can probably help you to kind of identify the you know a resource but apart from that there's quite a lot of
40:30 - 41:00 resources I'm thinking about um but I don't know who's offering training across Canada actually um I would be careful I would I would inquire if I was you you know before booking a training you know what your perspective what's your perspective on on Trends you know on Trends uh you know on Trends training are you abiding by the world Professional Association of transgender health for example so I would be curious before booking something since I can't recommend something just make sure that the training you're getting is one that fits
41:00 - 41:30 within the standard of care because as we're saying last week there's still people who could uh not um am I still there I've lost my complete okay sorry oh yeah okay my screen skipper I don't know why but my screen keeper flipping so I can't see you anymore but if you hear me that's great uh I hear you loud and clear okay um so so yes I would just make sure that basically you know the person giving the
41:30 - 42:00 training are themselves trained by recognized organizations such as the Canadian Association of transgender health or the world Professional Association of transgender health so I'm sorry not being so specific today but I don't know the resources in Canada no I I think that's a a great advice for people going out and seeking their own training further themselves or their organizations like like being attentive to the perspective that's being brought um this one might be a bit too early
42:00 - 42:30 childhood development or a bit to psychology for you to answer and just say so if but we had a couple questions like this um what age do you think a child's brain development is at the level where they are able to make you know informed decisions about their life or about their gender and then they add many children with whom I have contact and my work would love to change the circumstances of who they are or where they live um and then the caveat being like you don't come into contact with a social
42:30 - 43:00 worker that often if your life is great um so I think the question is sort of how do you know at what age um when a kid is saying they're trans how do you know if that's authentic okay um well I would go back to a little bit what we said I mean for all question of identities the only person that you can trust is the person with affirming their own identity so there's no you know there's there's no test there's no there's nothing we can use and but I
43:00 - 43:30 think the question is not that the question is that we shouldn't be testing someone identity because it's only the person who can affirm it so I think that that's the bottom line so even if you've got like a two three four five six years old to say you know why I am a girl or I'm a boy or I'm both or you know I think what you need to do is ready to follow the child's lead and and stop focusing on what they will become but more what they are at the moment and what they're telling you that they are at the moment
43:30 - 44:00 um you know it's it's just going to make them feel validated for who they are to be able to affirm them like that and you know if it's a phase it's going to go away if it's not a faith you will have started to kind of put some really kind of strong uh seed of resilience in that kid because Society you know if we are worried about like influencing a kid to think in a way I would say that Society in general influence everyone to think in some ways in terms of gender so
44:00 - 44:30 um well now the question of informed consent is always like a difficult one um I think when you talk about um you know supporting a kid to affirmative identity and social life you know you can do that at any age when you talk about medical transition protocol anyway will will not you know I mean that's not happening before teenager that doesn't happen there's nothing happening before tender stage
44:30 - 45:00 two of puberty so you're not going to have a anyone offering any medical kind of formal like on unchangeable form of transition to a child that is not in an age to make some sort of decision some sort of informed decision and then I think it depends of the maturity I don't think that it's uh I think we need to be careful you know because you know 12 years old can be super mature a 14 years old can be immature so it's very difficult so I
45:00 - 45:30 think we need to move towards an informed consent model and and remember that when they start with some sort of like gender affirming care such as puberty blockers these are not uh irreversible um you know they're not irreversible so the child the young person can start using almond blockers if they feel like really important gender dysphoria and then you know if after two months they feel that it's not for them they can stop and there's like no there's no
45:30 - 46:00 effect it's it's totally reversible it just put a pause on on the development of puberty um then the more semi you know semi-permanent change you will get with medical transition will be when you start taking almonds such as estrogen and testosterone but that again is not going to happen before a certain age you know normally those young people are not going to access it before 14 15 sometimes 16 years old depending on the
46:00 - 46:30 protocol of the clinic so again you know the young person through an informed consent model will be able to really make an informed decision about how they feel and how you know they how they feel their body needs to align to their gender identity so it's not a very straightforward answer but I think there's you know I don't think that there is one here I think we just need to kind of follow the child's lead whatever that age is and make sure that we have explored with them not trying to convince them that they're not you know of their gender
46:30 - 47:00 identity but just follow them through these kind of Pathways that are really complicated and one last thing I would say is that in that research on clinics and we're not very far in data analysis uh when we compare the kids narrative to the parents narrative so these are very very preliminary stuff I'm telling you there yeah but we realized that the parents became aware of the gender identity of the kid much later so when we look at the kids narrative they talk about it you know as being there for a while and then the parents
47:00 - 47:30 when you look at their and everything they say oh it just happened last year so so what what people from the outside see of a kid is often you know the end of an internal process that the kid went through and is ready to kind of so we need to kind of and you know the we'll see next week that maybe the coming out to a parent is the beginning of a journey for parents but sometimes it's like a stepping stone for the kid who's been like through that for such a long time
47:30 - 48:00 all right anyway no no um uh actually this goes well with um somebody was asking too about you know you talked about how important it is to foster a gender affirming environment especially I think in places where you have to use ID cards um and you have to you know do traditional forms of identification like that that may not align with the kids experience um and then some and then I'm asking you to elaborate on that but then someone
48:00 - 48:30 just put this is a really neat concept and I would wonder your thoughts on it they say I wondered if there's any groundwork being done um at National or provincial levels across the care pathway where Information Technology can be used to create a seamless pathway for the introduction of trans clients to new care providers so that they're not always having to explain who they are and their identity to new people along the care pathway um just wondering if you know anything like that or what your thoughts on a program like that would be well I think
48:30 - 49:00 we don't want to add labels where we don't need to add labels but at the same time it can be a really helpful things not to have to repeat everything all the time so you know I think this is the first thing I would say I think what may be helpful is if there was like some sort of universal medical record yeah that and and where on that record where there's a place where you can put usual name prefer name and prefer pronoun so I think if you could have a system
49:00 - 49:30 where you add these two little spots prefer name prefer pronoun I think that would that would help a lot then you need to have the training because it's not because it's written preferred name and prefer pronoun that you will have every helpful social professional who will understand what that means you know so so we need to kind of continue to make people aware of gender identity and we need to make people aware that you know it can be if I'm very young
49:30 - 50:00 but you know I I you know we we don't want we don't want to have a register we don't want that but because you know obviously it could be used for any any sort of reason but I think through uh you know anybody's kind of medical record if we could just be more flexible in time we identify ourselves that could be really helpful for everyone yeah flexibility individuality social workers
50:00 - 50:30 are already you know totally on board with this idea of honoring lived experience it's super consistent with I think how folks like to practice already would be great if our systems can follow through um we had a couple questions actually about you mentioned just quickly about the rates of intimate partner violence and I think this just this just was interesting for people um some people are just asking like I've heard this before and I've never really understood it um are you able to speak to this more well not a lot because remember that I
50:30 - 51:00 do research more on very youth on youth than adults and I think those research animal kind of geared towards adult uh I don't think that they are excluding young people but there's no intimate partner violence on research on young people so you know it's going to be more I think hypothesis what I'm going to say than anything I've read but um we know that there's a lot of well Society is so full of transphobia yeah
51:00 - 51:30 there's there's a lot of people who are transphobic who are scared they don't understand so you could imagine uh you know a situation in which you know a trans person is being abused and violated because of their gender identity with someone who either can't cope with their own idea of gender or I don't know do you know what I mean so I can't explain it but I'm sure it's pretty sure it's related to transphobia in society
51:30 - 52:00 there's a lot of murder of of especially women of color in the United States uh we we add you know in Quebec last year as well someone was coming out of um someone's apartment and they were murdered um you know there's a lot of there's a lot of of violence of trans people and I think you know whether they are intimate partner violence or you know General violence the the all related to transphobia probably
52:00 - 52:30 um this is after you answered the question about um making sure that you uh ensure that whatever training you're seeking or whoever you're seeking for advice knowing what perspective they're coming from after that a bunch of people asked if you could recommend some titles like a for further reading um that they could inform themselves about what they actually should be seeking yeah so I've I've added another slide there
52:30 - 53:00 so I don't know if you see it there's resources so there's a few books here that you could access well first of all there's like the site the gendercreativekids.ca uh gen Trans youth is like a bilingual site that I'm I'm maintaining we're trying to put the policy documents and uh there's some fact sheet on that so you can have a browse it's not very completed yet because I've started writing that not long time ago but it it will become populated soon but you've got also a brand new book by uh Colt
53:00 - 53:30 Mayer and Diana renzov which I've cited a lot last week when we're talking about basic concept which is called the gender affirming model so that could be a really good book to start I've not read the book but knowing the author I can you know I can vouch on on what's in there I'm I'm sure it's it's absolutely fine but I've not reviewed it personally but those two authors are really kind of trans affirming and then you've got um another book from some person in British
53:30 - 54:00 Columbia the transgeneration this is a book from Ann Travers with the professors of Sociology who's done a quite an extensive uh piece of research on trans youth so that could be another book um and then does the gender Creative Child another book from Diana renzov that will go back into basic concept about gender identity and there's a book that we call edited myself and Elizabeth Meyer in Colorado on transgender children and youth supporting them
54:00 - 54:30 through family schools and communities so these are four books that you know people could probably kind of learn from awesome I hope that's really helpful for people um uh I think that this is uh knowing that social workers often have like an activist hat on and that we like to make change when we can this person is asking I feel like it's probably coming from personal experience what would you recommend we do when we work on a team on an interdisciplinary team with
54:30 - 55:00 someone another professional who is not being gender affirmative would you have any recommendations for going about addressing that well my personal experience is that I like to pull as much evidence and as much policy documents supporting that as possible I think in Social Work we've got like wherever you are if you're a member of casually you know there is a Palestinian document about trans youth uh which says that you know we should affirm them so I
55:00 - 55:30 think you know as a social worker and you know I would say well look you know ethically you know I need to support the trans youth you know so now you're asking me to practice here and you don't support so what do I do yeah so I would I would probably start from my my my professional my professional uh posture my professional um deontology and ethics and then I would draw from other professional association you know like in Pediatrics you know they they've got like a really strong
55:30 - 56:00 policy statement in sexology they've got like a really strong policy statement in Psychology the American Psychological Association has got one so I think in the end you know most Professional Association whether they are in Canada or in the United States came out with some really strong policy saying that it's not okay to try to change someone's gender identity and that the affirming model of care is the model that we should be doing because it's what evidence tell us that is the best outcome for young people
56:00 - 56:30 so I think that I would try to kind of creep in with those things and and and make sure that people are aware of that and um yeah I think that's what I would do because you know I mean evidence is there now you know I mean 10 years ago we didn't have evidence that much we started adding evidence but now you know I think we've got lots of strong policy statements so I think we just need to make them known right right just be just be knowledge brokers in that way um uh this will be I think this is our
56:30 - 57:00 last question um I'm getting the sense that this is from uh maybe a school social worker or people are just trying to contextualize what they already know about um certain communities and they're asking how do trans youth fit in with uh the gay straight Alliance um what could I say on that I think there's a piece of research and I can't I can't fight it because I can't remember where I read that but I think
57:00 - 57:30 that to have those spaces where young people can find themselves and discuss is very very helpful in terms of res you know resilience um in our digging beneath the surface project young people told us that to have link and to be related to a community of trans people was very helpful for them so I assume that a gay straight Alliance would be very helpful as well even if it's not just kind of trans people there
57:30 - 58:00 you know but often engage straight Alliance young people don't even you know affirm their Identity or sexuality so I think it's just to have a place where people feel safe and they can you know make links with other people um so I would say you know I mean it's about doing it with a young person I mean you know I'm a I'm a CIS person you know I think it's we need to be careful and you know not do for people and just kind of facilitate process but I think you know to develop something with if
58:00 - 58:30 you've got like a trans person a trans kid in a school and they talk about it maybe to try to help them to set it up or or you know if they don't feel confident doing it doing it with them but I think you know evidence say that having access to communities is very helpful so I I see you know I think that the engagement Alliance would be extremely helpful for those young people that's great yeah I know it comes back to you know being a good Ally is walking with not leading
58:30 - 59:00 um I think that's really helpful for people to contextualize where trans youth fit and structures that they're maybe already more familiar with um so I'm looking at the time it is uh it's two o'clock so we are out of time um I have to say another huge thank you to you Annie um or you know Dr Annie Poland's office now as you're probably known to your students at the University of Montreal no never just Daniel no no we don't use that title here we just no madam
59:00 - 59:30 enter the audience thank you for your thoughtful questions and comments I'm sorry I couldn't get to them all like and thank you everyone that's been typing in your things for Annie I will make sure I share all of your comments uh and your recommendations for books and some of those other resources that people have been sharing with me I'll share them with her um and I hope that we're going to see all of you for part three which is of course next week and um until then take care thank you
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