“I’m transgender. I’m supposed to be a boy. I picked Oliver as my new name.”
There wasn’t anything my 12-year-old could have said that would have shocked me more.
I couldn’t make my mouth form words, but my heart broke as I watched this beautiful blue-eyed, blond-haired child curled up in the opposite corner of the couch, holding on to a pillow for dear life, as if to provide some protection from my response.
But why? I had recently come out as a lesbian, and his older sibling had identified as gender fluid for a while, so surely he couldn’t think I would reject him?
“Of course I support you,” I said. And I meant it.
But I meant I supported him on my terms. I suspected this was a trendy move, not truly believing this was permanent. I would have known. I would have seen something. I hugged him and added, “I want you to know if you change your mind about this, it’s fine, and you don’t have to decide anything now.”
Scrambling, I tried to make sense of this. He had hit puberty recently and abhorred it, hiding any evidence and refusing any attempt I made to celebrate. Any conversations were shut down quickly, and I attributed it to him being more private than his sisters. Maybe this new hormone surge was just miserable?
I racked my brain, looking for any other hints that this new revelation was, in fact, real. Transgender children I knew of showed early signs of eschewing traditional gender expectations with protestations that emerged as early as 4 or 5 years old. We had none of that. What if my preteen’s refusal to embrace womanhood was because our small town didn’t offer enough versions of femininity that he could see himself in? What if my child wasn’t transgender, but, instead, I was just a bad feminist role model?
The truth is that while many trans kids do feel their gender doesn’t align with the gender they were assigned at birth from very early ages, others can begin to realize they feel “different” when they’re closer to puberty and may end up keeping it a secret for years. Years of living in a body that doesn’t feel right.
I scoured second-hand stores and filled a closet with boxers and “boy clothes” in a dozen shades of blue, and stuffed a trash bag of now-rejected clothes in my closet. Just in case, I told myself. I masculinized his bedroom, met with teachers and principals and school counselors.
His new name felt foreign to me. I had loved his now-discarded name, and I longed to love this new word, to link it to the person who had become my son. I had never had a son. How do I parent a son, I worried. I filled notebooks with rivers of letters arranged in new ways. I ran my pen over and over the curves and loops of his new name, tracing my finger on the ink, willing it to become familiar.
Sitting on the couch with the laundry basket, I would spend hours folding his laundry, saying over and over again, “This is Oliver’s sock. He likes the color blue. This is his orange sweater.” I was willing myself to imprint his new name on my tongue, my brain, my heart.
A “name jar” sat on the counter and I taxed myself $1 every time I messed up. A blue plastic spray bottle filled with water emerged and he would spritz me like a naughty cat when I misspoke. These were lighthearted reminders to get this right ― and I wanted to ― but I selfishly whispered his old name sometimes, late at night, to myself. I missed it, but the sound of it now felt like one more betrayal to this beautiful son I desperately wanted to feel loved and accepted.
I offered this double-handed acceptance for months. It must have seemed like an eternity for him. He would see me showing up at school and taking him to the barbershop, but at the same time, he would hear, “It’s OK if you change your mind. You don’t have to decide now. No one will judge you.” Or even, “We aren’t going to the doctor and making any permanent changes. You can do that when you turn 18.”
He wobbled on this tightrope of my ambivalence. On one hand, I was fiercely protective and publicly advocated for him. On the other, I desperately hoped he would change his mind ― that it was a phase ― because I imagined life for transgender people was hard. Lonely. Life is brutal enough without … this, I thought. We had recently lost almost everything in a house fire in the midst of a divorce. Could this small town that showered us with kindness in the ashes be trusted to show up even in this?
After a few months, Oliver expressed interest in going to the gender health clinic at our local children’s hospital. I agreed ― just to see what they could tell us. It took months to get him in, and I was unsure what to expect as I made the appointment. I am embarrassed to say even as a nurse, I hadn’t researched what health care options were available. I lumped them all together and naively assumed our only options were irreversible surgeries and hormones that would render him unable to have children.
I had no idea that puberty blockers — gonadotropin-releasing hormone (GnRH) agonists — are the first line of defense for young transgender patients. They block the brain from releasing key hormones involved in sexual maturation. The impact of these blockers is reversible, and they have been prescribed to youth for decades for other hormone conditions without ill effects.
The benefit? It simply puts puberty on hold and gives the young person time to get counseling, to transition socially, and to live as their authentic self without battling their body’s ticking clock. Some kids stay on them for several years. For Oliver, who had already started puberty, the puberty blockers would still buy him ― us ― some time before the decision would need to be made on whether to initiate a hormone treatment like testosterone.
I explained to a friend, also a mom of a transgender son, that I wouldn’t agree to anything that might affect his potential to have children. “That’s where I draw the line,” I said. Hormone replacement therapy carried that risk, and I wasn’t willing to let a then-14-year-old take that risk. What did I know about the life I wanted when I was 14?
“There are lots of ways to make a family,” said my friend. “But he has to be alive to do it.”
Forty percent of people who are transgender will attempt suicide. Forty. That’s almost as bad a flipping a coin.
What would you do to weight that coin toss in your child’s favor?
My friend knew what I didn’t yet ― that gender-affirming health care is both broad and personalized, as well as evidence-based and developmentally appropriate. It incorporates a team that includes social workers, therapists, child-life specialists, endocrinologists, psychologists and pharmacists. Transgender teenagers on hormone blockers show improvements in overall mental health and general functioning after the use of blockers, and a decrease in depression. You know what happens when depression is decreased in young people?
They are more likely to stay alive.
A 2019 study on transgender teens revealed that 21 out of the 47 trans teens surveyed had suicidal tendencies before starting hormone therapy. After treatment, that figure dropped to six. Another study two years later found that gender-affirming hormone therapy is significantly related to lower rates of depression, suicidal thoughts, and suicide attempts among transgender and nonbinary youth.
No one is passing out hormones like candy. The number of hoops Oliver has had to jump through to get medical care would be laughable if it wasn’t actually health care we were talking about. He had to prove himself over and over again ― with forms and letters and time and therapists ― before each new layer of care could be added.
It’s been six years, and my son has shifted into adulthood, living his authentic self in ways that continue to amaze me. The blond-haired, blue-eyed son that once cowered on a corner of the couch now radiates joy in his very being. He is at home in the world, creating art and laughter, tender friendships and stubborn hope. Life has been hard, but it is also beautiful and he is here.
He has never wavered in his truth. After five years, fewer than 5% of gender-nonconforming youth will revert to their gender assigned at birth.
When I look back, there had a been a dozen signs of gender dysphoria before Oliver’s announcement but I had overlooked them. He has forgiven me for my stumbling, though it took years for him to tell me how it impacted his journey. My early reticence had silenced him, made him hesitate to ask for what he needed, choosing to deprive himself rather than risk even the hint of rejection. He finally has the radical acceptance that he needed and deserved all along.
I thought my reluctance to seek medical care for my son was protecting him. Instead, that medical care likely saved his life.
Angie BestEgler is a writer, psychiatric nurse clinical educator, and mom of four. You can find her on instagram at @angiebestegler_.
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