My four year old sees a psychotherapist.
Those aren’t words I ever expected to say as a parent. Of course, I also never expected to say “I have a daughter with a penis” or “My three year old says he’s so sad he doesn’t want to live any more.” Having an anxious and depressed transgender child is certainly a situation where professional help is warranted. As someone who has a history of depression, I’ve seen my share of therapists, but having your young child see a therapist is a new and different experience. Middle doesn’t even know the terms therapist or psychologist. All Middle knows is that every so often we visit a nice, grandmotherly lady who she talks with while she arranges figures in a sand tray. It’s a nice “playdate” of sorts for Middle but something of a frustrating experience for me. I want the therapist to help Middle work through her problems but that’s hard to do when at every appointment Middle is the model of a happy, well adjusted child. Middle is so good at putting up a front I don’t even think that she is aware of it. Then at home, she falls to pieces every few hours.
Middle has been having some serious behavioral issues lately. Epic tantrums over seemingly innocuous things: potatoes for dinner, telling her to wash her hands when she comes inside, not getting to open every spot on the Advent calendar RIGHT NOW. I certainly don’t expect perfect lockstep compliance or constant cheerfulness from a four year old, but I do expect I should be able to serve her lunch without having her throw herself to the floor and wail “Why are you always giving me lunch?” for half an hour. One of the most common phrases heard from Middle right now is “I can’t stop crying!” and it seems that at some point, every day, she truly can’t. We’ve tried everything: holding her, talking with her, sending her gently to her room, distracting her. It is as if she has a huge reservoir of tears that build up every few hours and she simply must cry until there are no more left.
When you have a child in therapy I think that as much of the work is done with conversations between the therapist and the parents as with the conversations between the therapist and the child. To that end, last month Husband and I went to see Middle’s therapist without Middle present. We talked at length about Middle’s past. It came up that I had had antepartum and postpartum depression during my pregnancy and during Middle’s infancy. And then, as if the ghost of Sigmund Freud was whispering in the room, the therapist started talking about primal attachment wounds and a lack of bonding between myself and Middle as causing gender dysphoria. The therapist expounded upon the stereotype of the distant, detached mother with postpartum depression and how that might cause a disruption in attachment and thus a gender dysphoria and anxiety. I countered that I actually didn’t have that particular type of postpartum depression. I nursed and co-slept and rocked little Baby Middle as much as I had her siblings. We spent every moment that I wasn’t working together. I didn’t feel depressed and distant when I was with the baby. The therapist then mentioned that in that case perhaps my depression put too much burden on Middle to care for me. I just nodded along trying to hurry the discussion to the problems of our present, rather than our past.
On the drive home Husband, ever the logical scientist, asked me what thought of the therapist’s hypotheses as to the cause of Middle’s issues. I told him that I agreed that parental emotions influenced the emotions of children but that I just didn’t care about finding a root cause for Middle’s transgenderism. I told him that I thought any one explanation for such a complex issue would be too simplistic and, moreover, a rather pointless exercise in speculation. Middle is who she is and nothing is going to change that. I have thought that the very notion that something “wrong” causes transgenderism implies a biased sort of “wrongness” and disapproval to the concept of transgenderism itself. It wasn’t so long ago that the prevailing medical establishment thought that being homosexual was wrong and looked for ways to cure it. While our therapist supports transgender children in expressing whatever they feel is their true gender identity, I wonder if one can be truly supportive if they believe in anything other than a biological explanation in the first place.
I have thought about this conversation a lot over the past few weeks. I don’t recall the therapist asking about Husband’s work schedule or mental state or bonding with Middle. As soon as the words “postpartum depression” fell from my lips it became the overarching focus of our therapy session. Thankfully, I feel pretty good about my parenting. Long before we saw Middle’s therapist I had asked myself, many times, if anything I had done had contributed to Middle’s gender change or to her general unhappiness. It is unequivocally true that I was very depressed during Middle’s first year of life and I have often had a hard time identifying with her. Personality-wise, she is my child least like me (she is very much a mini-Husband in many aspects). From her earliest days I worried to Husband that there was something about her which never seemed to fit for me; her name, her behavior; something ethereal about her very self. But my love and devotion for her was never in doubt, I loved her in the same way I loved her siblings. Now, with Middle as a girl, I find that I understand her much better. I don’t think think that there was any lack of attachment between Middle and I caused her transgenderism. On the contrary, I think I, as her mother – the person closest to her in the world, sensed something different about her from the very beginning. I never imagined that Middle might have been born into the wrong gender, but knowing that now actually makes some of Middle’s first two years make sense. Long ago I came to the conclusion that we had done everything we could to support Middle as a gender creative boy and then everything we could to support her as a girl when it became clear that is what she needed and longed to be.
We are switching to a new therapist. Our old therapist is nearing retirement and I want Middle to be able to have a relationship with someone for a long time. Our old therapist was also quite a drive to get to and it was difficult to see her on a regular schedule. I told myself that is why I asked for a new therapist for Middle and it is true but honestly I realize I also want someone who will not default to “What went wrong?” and “It’s the mother’s fault”. I find myself angry and disappointed by that conversation with the old therapist. I expect a female therapist with a PhD and years of experience working with kids with gender dysphoria not to fall back on the old “blame the mother” explanation for everything. I wish deeply that Middle didn’t have this fundamental conflict between her brain and her anatomy in her life, but I can honestly say that I wouldn’t do anything differently. I don’t think that there is anyone to blame.