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My Transgender Daughter, Nicki: A Story of Suffering and Survival

Sharon has a teenage daughter who is transgender. She describes how Nicki was born in a male body but felt from a very young age that she should have been a girl.

“When my child Nick was about two, I realised that he wasn’t playing with toys that I expected a boy to play with. He was interested in dolls and girly dressing-up clothes. At that age, it doesn’t really matter. You just think they’re trying lots of different things, so I never made a fuss about it.

My-transgender-daughter“But when he was four years old, Nick told me that God had made a mistake, and he should have been a girl.

“I asked my GP what I should do. He told me to wait and see, and that it might just be a phase and go away. But it didn’t. It got stronger.

“One day when Nick was six, we were in the car, and he asked me when he could have the operation to cut off his ‘willy’ and give him a ‘fanny’ (*vagina). His older cousin had told him about these things.

“I spoke to a friend who’s a psychiatrist. He said I should contact the Tavistock Clinic [now The Tavistock and Portman service for children and young people with gender identity issues].

“He also told me that the medical term is ‘gender dysphoria’. When I looked it up online, I found Mermaids, a charity that helps children with gender identity issues and their families.

“I also spoke to my GP again, who referred us to the local mental health unit. The person at the unit had worked at the Tavistock and knew about gender identity issues.

“He was brilliant. It was such a relief to talk to somebody who understood what was going on. I’d blamed myself, but he reassured me that it wasn’t my fault. We were then referred to the Tavistock Clinic.

“The team from the Tavistock came to Nick’s school and talked to the teachers. They helped the teachers to understand that Nick wasn’t being difficult, and that this may or may not be a phase. When a child is this young, you just don’t know.”

From Nick to Nicki

“Nicki desperately wanted to be female all the time. When she was 10, we feminised her name from Nick to Nicki at home. The following year, Nicki started secondary school as a girl.

“The school was very supportive, but because she moved up to secondary school with her peer group, everybody knew.

“In the first week, she was called a ‘tranny’ and a ‘man-beast’. She was spat on and attacked in the corridors. Within her first six months of being at that school, she took four overdoses.

“We then pulled her out of school, but after a few months she decided to go back.

“Each year, the bullying and isolation got worse, and Nicki started harming herself. At the beginning of year nine, I transferred her to another secondary school, but unfortunately the kids there found out.

“At that point, I withdrew her from school completely, and the education welfare office found her a place at a Specialist Inclusive Learning Centre, which is a unit for children who can’t cope with mainstream schooling for various health reasons.”

Going Through Puberty

“When Nicki started puberty, I wanted her to get the type of treatment that’s offered in the Netherlands, where puberty is blocked before major physical changes take place.

“I felt that if she was going to change her mind about being a girl, she would have done so by now.

“The Tavistock Clinic wouldn’t give her hormone blockers. [The Tavistock and Portman follows British guidelines, which at the time suggested not introducing hormone blockers until the latter stages of puberty. Since January 2011, the age at which hormonal treatment may be offered has been lowered from 16 to 12, under a research study that is being carried out by the Tavistock and Portman into the effects of hormone blockers earlier in puberty.]

“In the end, we went to a doctor in the US. I found him through the WPATH network (The World Professional Association for Transgender Health). Nicki was 13 when she started taking hormone blockers. It’s put her male puberty on hold, and given her time to think.

“If she hadn’t been given blockers, she would have suffered the psychological agony of going through male puberty. She told me she would have killed herself. Nowadays, you’d never guess that she was born male.

“If at any point Nicki were to tell me that she wasn’t sure that this was the right thing for her, we’d simply stop the injections and male puberty would go ahead.

“For Nicki, the next step is starting hormones and surgery as soon as she can.

“During the first few years of secondary school, I was constantly in fear for Nicki’s life. It was so distressing to watch her go through all of this.

“Now it’s a million times better. She’s a typical teenage girl, and it’s a blessing. She leaves a mess, she borrows my clothes, my make-up and my perfume. I never thought she’d reach this stage. She still has to face many more hurdles but she’s looking forward to adulthood.”

*The names in this article have been changed.

Where to Get Help

Sharon, who tells her story above, says that the most helpful thing was speaking to other families who’ve been through the same thing. The charity Mermaids provides family support for children and teenagers with gender identity issues, and can put you in touch with other parents with similar experiences.

Further Information

The story above reflects one mother’s experience. Because gender identity issues are complex and each case is different, Sharon’s story shouldn’t be seen as typical.

For more information on gender identity issues in children and young people, see: Teenagers and gender identity, and Worried about a child with gender identity issues?

Editor’s Note: *clarification provided for our US readers.





Video: How to Introduce Your Child to Sleeping in a Bed

In this brief video, NHS Health Visitor, Sara, discusses how to approach moving your young child from a cot (*crib) to a bed and gives some tips for success.

Editor’s Note: Video Highlights

  • child-moving-to-a-bedThere are no hard-and-fast rules for when to move your baby from a cot (*crib) to a bed – do it when it feels comfortable for your child and for you
  • From 18 months, you might find that your child is too big for a cot or is trying to climb out – that’s the time to move them into a bed
  • For some children, moving from a cot to a bed is really exciting and they accept it really well
  • For other children, they might feel a bit stressed about the change – so you might need to choose a calm time in their life
    • Challenging times for moving from a cot to a bed can be if you’re moving house, if you’ve gone back to work or if your child is not feeling well
  • You may need to move your child to a bed if you have another baby on the way – if so, do it about six to eight weeks before your new baby is born, to help keep your child from being unsettled with too much change
  • Once sleeping in a bed, your child might get up in the night and wander around, so be sure to childproof their room
    • Put a stair gate across the door
    • Check their room for any electrical appliances or wires they could trip over, any small toys or objects they can get hold of or any cord blinds that they could get tangled in
    • You might also want to put barrier next to the bed or put cushions on the floor in case they fall out
  • If your child doesn’t like the bed initially and they want to protest, just stay calm, reassure them, give them a cuddle, but put them back in the bed
    • You might find that you have to do it a few times, but if you’re consistent, they’ll soon get used to being in the bed
  • When your child has slept in the bed, or had some naps in the bed, praise them because it can make a big difference to their confidence and they’ll feel much more willing to sleep in the bed if you praise them for what they’ve done

Editor’s Note: *clarification provided for our US readers.

 





Condoms: Knowing these Facts Could Keep Your Teen Safe

There are a lot of myths about condoms, so make sure that you are aware of the facts before you have sex.

MYTH: It’s safer if you use two condoms.
TRUTH: No it isn’t. Using two condoms at once is a really bad idea, whether it’s two male condoms or a male and female condom. It increases the chances of them ripping. Only use one at a time.

condom factsMYTH: Condoms break easily.
TRUTH: No they don’t. To avoid a condom breaking, you need to put it on carefully, ensuring there’s no airbubble at the end. Be careful of sharp nails, jewelry or teeth. If the condom won’t roll down, it’s the wrong way round. Throw this condom away and start again with a new one as there could be semen on the tip of the previous condom.

If a condom breaks and you’re not using any other contraception, go to a clinic, pharmacist or doctor as soon as possible and ask about emergency contraception. You’ll also need to get tested for sexually transmitted infections (STIs).

MYTH: Condoms are the only type of contraception I need to think about.
TRUTH: No they’re not. Condoms can provide protection from STIs and unintended pregnancy. But to ensure the best protection, it is recommended that you and your partner use a condom and another form of contraception. There are many different types of contraception that can be used, including the implant, injection, coil or the pill. It’s worth exploring all options.

MYTH: You need extra lube. Vaseline is good.
TRUTH: No it’s not. A bit of extra lubrication is good but don’t use anything with oil in it as it can dissolve the condom – that includes baby oil, Vaseline and hand cream. Lipstick has oil in it too. Use a water-based lubricant, such as KY jelly or Durex Play from a pharmacy.

MYTH: Condoms make him less sensitive.
TRUTH: Using a condom doesn’t have to spoil the moment. They can make some men last longer before they come, which is good news for both of you. There are many different sizes, shapes, colours, textures and flavours of condoms, so enjoy finding the one that suits you both best.

MYTH: Condoms cut off his circulation.
TRUTH: No they don’t. A condom can stretch to 18 inches round. He’ll be fine. There are many different shapes and sizes available to try.

MYTH: I’m on the pill, so we don’t need condoms.
TRUTH: Yes you do. The pill does not protect you or your partner from STIs. Also, if you’ve forgotten to take a pill, been sick or you’ve been using antibiotics, the effectiveness of the pill is reduced and you could still get pregnant.

MYTH: If I ask to use a condom, my partner will think less of me.
TRUTH: Insisting that you use a condom suggests that you know how to take care of yourself and shows that you know what you want, which can be very sexy.

MYTH: You don’t need a condom if you’re having oral sex.
TRUTH: Yes you do. You should use a condom for oral sex because gonorrhoea, chlamydia and herpes can be passed to each other this way.

MYTH: You have to be 18 to buy condoms.
TRUTH: No you don’t, you can buy condoms at any age. You can also get them free at any age, as well as confidential advice, from community contraception clinics (formerly family planning clinics), Brook centres, sexual health (GUM) clinics, Further Education colleges and young people’s clinics.

MYTH: I don’t need a condom – I only sleep with nice people.
TRUTH: STIs don’t know or care if you’re nice or not. The way someone looks is no indicator of whether they have an STI. Many STIs don’t show any symptoms, so you could infect each other without even knowing it.

MYTH: If it’s a condom, it’s safe.
TRUTH: Not necessarily – novelty condoms aren’t safe. Always choose condoms that carry the European CE or Kite mark, which is a recognised safety standard. Also check the date on the packet as condoms don’t last forever.

 





Study: ADHD Meds Given More Often to Youngest Kids in Class

“Youngest children in class more likely to get ADHD medication, study says,” The Guardian reports.

The results of an Australian study have caused concerns that, in some cases, immature behaviour may be misinterpreted as evidence of a behavioural disorder.

In a brief report, researchers found nearly 2% of 6-15-year-olds in Western Australia received a prescription for attention deficit hyperactivity disorder (ADHD) medication in 2013. Those born in the last months of the school year intake were more likely to have had a prescription than the oldest children in the year.

The gap between the oldest and youngest children in the class had a small, but significant, association with the increased use of ADHD medications. The researchers say their findings compare with those of other international studies.

It’s possible the youngest children in a school year may find it harder to keep up in lessons than children almost a year older than them, and may be more likely to have problems with concentration.

But it would be a big assumption to say ADHD is being overdiagnosed and overtreated on the grounds of this study alone.

The use of ADHD medication for under-16s in the UK is far lower than in many other developed nations – 0.4%, compared with Australia’s 1.9% or the US’ 4.4% – so the potential problem of inappropriate treatment may not be as much of an issue in this country.

Where did the story come from?

The report was authored by four researchers from Curtin University, Murdoch University and the University of Western Australia, all in Australia.

The study was published in the peer-reviewed Medical Journal of Australia, and the researchers declared no conflict of interest or study funding.

It’s available to read online on an open access basis, so you can download the study for free.

The UK media coverage was accurate, but does not point out the limitations of this brief report.

What kind of research was this?

In this brief one-page report, the researchers say four international studies found the youngest children in a school year are more likely to be receiving ADHD medication.

They aimed to see how Western Australia compares by analysing data from the Pharmaceutical Benefits Scheme – a scheme similar to the NHS, where the cost of medicine is subsidised by the Australian government – to see how many children were receiving ADHD medication.

This brief report provides very limited information about the authors’ methods, making it difficult to critique.

And we don’t know how the authors identified the four international studies they reported, so we don’t know whether this is a fully comprehensive look at the subject.

This means the report must largely be considered to be the opinion of its authors.

What did the researchers do?

The researchers compared the proportion of children born in the first and last months of a “recommended school year intake” who were recorded in the Pharmaceutical Benefits Scheme as receiving at least one prescription for ADHD medication in 2013.

The study included a total of 311,384 children, covering two age bands: those aged 6-10 (born July 2003 to June 2008) and those aged 11-15 (born July 1998 to June 2003).

The researchers looked at the number of children receiving medication and the patterns by time of birth.

What did they find?

The researchers found 1.9% of the full study sample (5,937 children) had received at least one prescription of ADHD medication, with more boys than girls being prescribed for (2.9% versus 0.8%).

In the 6-10-year-olds, they found those born in the last month of the school year intake (June) were nearly twice as likely to have been prescribed medication as those born in the first month (the previous July): relative risk (RR) 1.93 for boys (95% confidence interval [CI] 1.53 to 2.38) and RR 2.11 for girls (95% CI 1.57 to 2.53)

The same pattern was seen for 11-15-year-olds, but the risk increase was less, though still significant (RR 1.26, 95% CI 1.03 to 1.52 for boys; RR 1.43, 95% CI 1.15 to 1.76 for girls).

The authors say similar effects were also seen when comparing those in the first three to six months of intake with the last three to six months.

What did the researchers conclude?

The researchers say at 1.9%, their observed prescription rate is comparable to a recent Taiwanese study, and both this study and three North American studies observed the effects of birth month on prescription rates.

They describe a professional from the American Psychiatric Association who feels ADHD is overdiagnosed and overmedicated, saying that, “Developmental immaturity is mislabelled as a mental disorder and unnecessarily treated with stimulant medication.”

The authors say the findings indicate that, “Even at relatively low rates of prescribing, there are significant concerns about the validity of ADHD as a diagnosis.”

Conclusion

Overall, this study suggests that in Western Australia – and reportedly in other countries, too – the youngest children in a given school year are more likely to be diagnosed with and treated for ADHD than the eldest in the year.

However, it’s important not to draw too many conclusions from this brief report. The authors provide very limited information about their methods, so it’s not possible to critique how they conducted their study.

We don’t know why they selected the 2013 school year, for example. It was said to be recommended, but we don’t know why. It could be it was known there were an unusually high number of prescriptions noted in the Pharmaceutical Benefits Scheme that year, which means it might not be representative.

Also, this database can only tell us the number of children that filled out at least one prescription for ADHD medication. We don’t know how the children were diagnosed, how long they had been diagnosed or treated for, or whether they actually took the medication.

The authors also point out the possible limitation that they didn’t know how many children may have entered school outside of their recommended starting year – although this was thought to be few.

We also don’t know how the researchers identified the international studies, and we don’t know that these reported findings give a comprehensive look at ADHD diagnosis and treatment worldwide.

It would be a big assumption to say ADHD is being overdiagnosed and overtreated on the grounds of this study alone. And, as no UK studies were reported, we don’t know what the true situation is like in this country.

It’s possible the youngest children in a school year may find it harder to keep up with lessons than children almost a year older than them, and so could be more likely to be distracted – though this is clearly a big generalisation and is not always going to be the case.

However, it does perhaps highlight there is a need for children who are struggling or finding it difficult to concentrate at school to be recognised, and get the additional attention and support they need – something both teachers and parents of the youngest children in a school year may need to be aware of.

Analysis by Bazian. Edited by NHS Choices

Links to the Headlines

Links to the Science





Do You Know Your Family’s Asthma Triggers?

Some people are much more likely than others to develop allergies, such as asthma, hay fever and eczema. Certain ‘triggers’, such as pollens, household cleaners or pets, can cause an allergic response.

What can trigger asthma?

Many things can make asthma worse. Keep a list of your triggers when you discover them, and discuss them with your GP or asthma nurse.

Environmental triggers include:

  • Animal proteins, such as house dust mites, animal hair and cat saliva. Read more about pet hygiene if you have asthma.
  • Household cleaners and sprays can have an irritant effect, which can trigger asthma. Strong perfume can do the same.
  • Mould spores, which are released from trees at the end of the year, or in damp housing.
  • Pollens, including trees and grass.
  • Traffic fumes.
  • Weather and changes in temperature.

Other triggers include:

  • Some people with asthma find that exercise triggers their asthma symptoms. However, exercise is good for most people, including people with asthma.
  • Emotions. Negative emotions can act as a trigger, possibly for the same reason that exercise is a trigger. Your respiratory rate (the rate of breathing) increases, which means that you take in more air.
  • Hormones. A small number of women with asthma find that changes in their hormone levels can be a trigger. This may be worse before menstruation.
  • Medicines. In a few people, asthma is triggered by medicines containing salicylates, such as ibuprofen and some other anti-inflammatory drugs. It may also be triggered by beta-blockers, a type of drug prescribed for some people with cardiac disease, anxiety, hypertension, angina and glaucoma. If you have asthma, be cautious of taking ibuprofen (which may be sold by the brand name, Nurofen) or beta-blockers. Your GP, asthma nurse or pharmacist may be able to suggest an alternative.
  • Smoking.
  • Viral infections. A cold, the flu or other respiratory infections can make asthma worse.

Visit the Asthma UK website to find out more about asthma triggers.

Find out more about living with asthma.





How to Cope with Teen Arguments, Aggression and Violence

Many parents find that when their child becomes a teenager, their behaviour becomes more challenging. But how do you cope if they become aggressive or even violent towards you?

If you’re experiencing aggression or violence from your teen, you’re not alone. A recent Parentline Plus survey found that 60% of calls (between October 2007 and June 2008) included verbal aggression from a teenager, and 30% involved physical aggression, much of it aimed at the parent themselves.

teen aggression and violenceIt is common to keep this kind of abuse behind closed doors and not confide in anyone. Many parents feel  that they have failed to control their child, or that they are responsible for the behaviour in some way – or they may not know where to turn.

However, any kind of aggression can be stressful, and can cause an atmosphere of tension and fear for the entire family, not to mention the possibility of physical harm if their teen becomes violent.

No parent should feel obliged to put up with an unruly teen, and as with any type of domestic abuse, help and support is available. You can find appropriate organisations and helpline numbers (*for the UK)  in “Help and Support” further below. There are also a number of techniques and tips that you might find helpful.

Defusing Heated Arguments

It’s useful to remember that your own behaviour can improve or worsen an aggressive situation, so it’s important to be a good role model for your teen.

Linda Blair, clinical psychologist working with families, advises: “Bear in mind that you are their principal role model. If you act aggressively but tell them not to, they won’t listen. It’s also helpful to remember that their anger is often based on fear – fear that they’re losing control.”

With that in mind, it is worth trying to maintain a calm and peaceful presence. You need to be strong without being threatening. Remember that your body language, as well as what you say and how you say it, should also reflect this.

Avoid staring them in the eye, and give them personal space. Allow them the opportunity to express their point of view, then respond in a reasoned way.

Breathing Exercises to Control Anger

If an argument becomes very heated, Linda suggests that you “stop for a moment”. Take a deep breath, hold it for a few seconds and then exhale. Repeat five times. This technique is very useful in intense situations.

If your teen is becoming aggressive during arguments, suggest this technique to them when they’re calm, so they too have a way of controlling their anger.

If an argument feels out of control, you can also try explaining to them that you are going to walk away, and that you’ll come back again in half an hour. Given the chance to reflect and calm down, you and your teen will both be more reasonable when you resume your discussion.

As with toddlers, if you give in to teenagers because their shouting and screaming intimidates or baffles you, you are in effect encouraging them to repeat the unreasonable behaviour as a way of getting what they want.

Counselling for Teenagers

Family Lives is a charity dedicated to helping families. They suggest that if very heated arguments happen frequently, it may be worth suggesting counselling to your teen. They’ll benefit from talking to someone new and unbiased, someone who isn’t in their family and who won’t judge them.

Read more about the benefits of talking treatments.

Remember they may not know how to handle their anger, and this can leave them frustrated and even frightened. Some guidance from an outsider can be very helpful.

Dealing with Violent Behaviour

Sometimes, teen aggression can turn into violence. If they lash out at you, or someone or something else, put safety first.

Let your teenager know that violence is unacceptable and you will walk away from them until they’ve calmed down. If leaving the room or house isn’t helping, call the police – after all, if you feel threatened or scared, then you have the right to protect yourself.

Family Lives offer this advice for coping with, and helping, a violent teen:

  • Give them space – once they have calmed down, you may want to talk to them about what has happened and suggest that they let you find them some help.
  • Be clear – teenagers need to know that you will stand by the boundaries you set. They need to know that any kind of violence is unacceptable.
  • Talk to their school and find out if their aggressive behaviour is happening there as well. Some schools offer counselling.
  • Arrange counselling – if your teen admits they have a problem and is willing to get help, book an appointment with a counsellor or psychologist as soon as possible. Speak to your GP (*pediatrician  or family doctor) or their school about what help is available.

Help and Support (*in the UK – see end for resources in other locations)

There are many organisations that offer emotional support and practical advice. Getting some support can help you and your child. At such an important development stage, it’s important that they learn how to communicate well and express anger in a healthy way.

  • You can call Family Lives’ Parentline on 0800 800 2222 any time, or email parentsupport@parentlineplus.org.uk for a personalised reply within three days. They also offer i-parent modules to help you learn more about communicating better with your teen.
  • You can call the Samaritans on 08457 909090 any time to talk about any type of distress and to get confidential support and advice.
  • Youth Access has details about youth organisations and services offering teens counselling, advice and support.
  • Young Minds is a charitable organisation supporting children and young people with mental health issues, and their parents. They provide information to help young people with anger issues. If you discuss your child’s behaviour with them and they are open to getting help, you might like to direct them to the information on the Young Minds website.

Concerned about Mental Health Issues?

If you’re worried that your teen has a mental health problem such as depression, talk to your GP (*pediatrician  or family doctor). In the UK, he or she can refer them to the Child and Adolescent Mental Health Services, who in turn can refer all or some of you for Family Therapy. Or contact the Young Minds Parents’ Helpline on 0808 802 5544 for advice and support concerning mental health issues in young people.

If you are having trouble coping with your teenager, and you suspect you may have symptoms of depression or other mental health problems, discuss this with your GP (*pediatrician  or family doctor). He or she can then suggest suitable treatment. You may, for example, be referred for counselling, or directed to support groups or other services in your area.

Editor’s Note: *clarification provided for our US readers.

US Resources for Family and Teen Challenges:

Canadian Resources for Family and Teen Challenges:

Australian Resources for Teen Aggression:

 





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