We had to fight to get top surgery. Now our future here is unclear.
AS TOLD TO
EVAN URQUHART
This is an as-told-to essay based on a conversation with the mother of a 16-year-old trans boy in Texas, where a ban on gender-affirming care for minors recently passed the Legislature and seems close to becoming law. (A grandfather clause that would have allowed minors already receiving this care to continue was recently removed.
) This essay has been transcribed, condensed, and lightly edited for clarity. Because of the highly sensitive nature of the medical matters discussed in this piece, the mother and her child are remaining anonymous (we are referring to the child with a pseudonym), and we allowed them both to review the piece prior to publication.
When Reese was 8, he came to me. I was in the bathroom, putting some laundry away. He came in: “Mom, I need to tell you something.” I could tell it was a big deal. I thought he was about to say, “I broke my iPad.”
He was like, “I’m a boy.” I took a beat to process—I was kind of relieved it wasn’t the iPad! I was like, “Well, thank you so much for sharing that with me, and I love you.”
I didn’t know in the moment that what Reese told me would demand something of me as a parent, in terms of advocating for him or helping him get what he needed—I didn’t know any of that. For example, he didn’t bring up anything about pronouns, and we didn’t ask, so we did nothing. I think at some point he must have said, “Will you use
he/
him for me?” We were uneven at best. Not, like, misgendering him on purpose, but just a failure to understand the importance of it.
I regret my ignorance more than anything else. There were times where Reese did try to talk to me. He said, “I want to get on testosterone.” And I’m like, “What the fuck? You’re 9.”
He’s like, “I want to get top surgery.” And I’m like, “Top? You don’t even have a bra, sir.” I knew that those were things that he was thinking about and believing that he needed, but again, I didn’t understand that this was something we should go see a doctor about. We were accepting, and we thought that was enough.
He got his first period, bless him, literally the second day of school. Ten years old. Fifth grade. And I was like, “Honey, don’t even worry about it. You probably won’t even get another one for a while.”
He got it again the very next month. I could tell that he was upset by it, but I had a hard time understanding that it was related to being trans at all.
One Monday morning a few months later, we were getting ready for school. I was trying to rush out the door, and I went in to check on him. I was like, “What are you doing?” And he goes, “I just took a bunch of pills.” And I was like, “What? What do you mean?” And he was like, “I just took a”—I think he said “a fistful”—of ibuprofen.
From the time he told me that to the time we were getting in the car and driving to the hospital, it couldn’t have been three minutes. I knew it was serious. I wasn’t going to wait around to find out what any of that meant or why.
On the way to the hospital, I said, “What … caused you to do this?” And he goes, “Because I know I’ll never really be a boy.” And let me tell you, I look at that moment and I hate that it took
that, but we got real fucking consistent with pronouns after that. I understood, in that moment, all the compounding hurt that had been happening because we weren’t taking it seriously enough.
I reached out to a couple of people I knew to get recommendations and I found a therapist. And bless her: First of all, not only was she good for him, she was probably even more good for me.
She was like, “Look, basically this is so easy to address. We just get him into counseling. We start him on hormones. You get your mind around the fact that you’ve always had a boy; you just didn’t know that you had a boy.” She helped us see that this, actually, even though we were
in crisis, it wasn’t a crisis.
He went to therapy every day for a week after the hospital. Not just him going to therapy, also me, my husband, us as a family. Reese was in a much better place after a week, so then he went to therapy twice a week for several months, then it went down to once a week, and then it was once every other week.
The very first thing that we tried medically was to stop the period.
Reese tried birth control, which, God bless him, it somehow made his period even worse. He didn’t stop having a period, he stopped
not having a period. Three or four months after that, it was like, “OK, we tried switching medicines a couple of times. Nothing doing. Nothing helped.” And the doctor was like, “OK, well, we could try an IUD.”
Getting that done was such a relief, for him and for us. I didn’t begin to unwind emotionally from the suicide attempt until we had gotten to that point, since having a period precipitated it. That was the first time I remember feeling like I could sleep at night.
He finally began T when he was around 12½. But the [chest] binders that worked when he was 9 are not working anymore when he’s 12. He got some kind of a skin infection. It was really becoming apparent to me that it wasn’t just like he’s having a tough time: He can’t shower anymore.
I was sitting on my patio. I remember he was wearing multiple binders, multiple shirts, a hoodie on top, and he was at a point where he was not coming out of his room.
I remember sitting on the patio, shopping for another binder, and I was like, “You know what? Maybe he doesn’t need some special binder; maybe he needs top surgery.” So I asked him. And he was like, “Oh, you mean like I’ve been saying for three years?”
I love how people think kids are just getting mastectomies left and right. His pediatrician was like, here are the 20 to 30 people in America we think
might be willing to hear you out. I called a couple. I called someone in Austin. I called someone, I think, in California. The people that I called in Austin, they must have thought I was Project Veritas. They basically hung up on me. They were like, “How old is the patient? Are you saying this is a 13-year-old that you want to see about having gender-affirming top surgery?” And I was like, “Yes.” And they were like, “Yeah, no. Bye.”
Eventually, we found a surgeon—world-class, low-key but also very brusque, the way surgeons are. All his providers were on board with top surgery, his pediatrician, two psychologists, endocrinologist, and the surgeon himself. We had counseling with multiple providers along the way. We knew what we were getting into. So, yeah. I know 13 is young, but I didn’t feel like it was early. He was young, but it wasn’t too early for him.
Reese’s surgeon put together an argument for the medical ethics board at the children’s hospital: “I’m going to make it so watertight that if they say no, it won’t be because of science or medical ethics. There is no reason that they can point to to say, ‘We don’t know if, in this situation, this is the right clinical approach.’ They will have to say no for other reasons, and then I’m going to push them on that. What are those reasons?”
And then … the hospital ethics board just approved it. So basically, the surgeon prepared this whole thing, but when the people in charge looked at Reese’s case and looked at the situation, everybody approved it.
Now we don’t see the hoodies anymore. He’ll never wear a hoodie ever again. He hates hoodies. Not only does he wear normal clothes now, it helped his social anxiety quite a bit. Like I said, he still has some, but he’s not afraid to be around people looking at him. He has grown his hair out to shoulder-length. He wouldn’t have ever felt comfortable doing that. Now he’s not worried that it’s going to make him look too feminine.
Basically, everything we did allowed him to enter in ninth grade completely socially transitioned, completely medically transitioned, as far as he wants. He’s completely legally transitioned, too. There’s nothing more for him to do. So that’s allowed him to have a high school experience where being trans is not disruptive, not something that he’s preoccupied with. He’s just allowed to be a kid. Reese is doing what every parent would want their kid to be doing. He is enjoying academic success. He’s making friends, good friends. He’s exploring extracurricular interests, he’s a talented artist. He’s flourishing.
How does it feel to see parents who have advocated for far less than we have for Reese, who have been involved in this for far less time than we are, whose kids have been far less “mutilated” or “medicated”—to see these people lose their jobs, become the subjects of an investigation by state power? It’s fucking terrifying.
