About a Boy
For kids who identify with a gender they weren’t born with, resources are
scarce—and critical. How Vancouver is leading the way for trans youth.
By danielle egan
Photographs by carlo ricci
Mason and his mom sit in a waiting
room at BC Children’s Hospital. The
12-year-old with rosy cheeks and
bright brown eyes—dressed in a
baggy T-shirt, droopy soccer shorts
and Converse All Star high tops—
looks like the picture of health. But
looks can be deceiving. Mason and
his mom, Lisa, are about to consult
with a specialist about a medical
intervention that could save his
life. Lisa starts to cry the moment
she starts chronicling their uphill
journey since her firstborn child
started preschool, or perhaps since
the moment he was born and the
doctor exclaimed,
“It’s a girl.”
40 VA N M A G . C O M S E P T E M B E R 2 0 1 6
VA N M A G . C O M S E P T E M B E R 2 0 1 6 41
M
ason
does not identify as a girl. He says he feels like a boy “stuck
in a girl’s body.” Six months ago, that peripubescent
body started its biological march into womanhood, when
Mason got his period. After many years of silent suffering,
it was the catalyst for him to come out of the closet,
starting with a desperate cry for help to his younger sister,
asking, “Do you think Mom and Dad would prefer a son or
a dead daughter?”
If you think that sounds like typical overwrought
tween drama, consider these staggering statistics. Suicide
attempt rates among transgender youth are as high as
45 percent, according to a 2014 U.S. national survey.
An Ontario study from 2010 found that 47 percent of
transgender youth had seriously considered suicide in the
past year (compared to 11 percent of non-trans Ontario
youth in a separate study). Of 923 transgender Canadian
youth who participated in a 2015 survey, one in three
attempted suicide in the past year and 70 percent suffered
sexual harassment. Almost half of these Canadian youth
42 VA N M A G . C O M S E P T E M B E R 2 0 1 6
felt “quite” or “extremely hopeless and overwhelmed,”
and 71 percent hadn’t accessed support services because
they didn’t want their parents to know. Conversely, those
with supportive parents were four times more likely to be
mentally healthy, which ranks as a key factor in the overall
health of transgender youth, according to the survey.
When Mason came out to his parents at age 11, there
was no question they would support his needs. But they
had no clue how to do that and soon discovered that
even gender specialists have contradictory theories and
protocols when it comes to childhood gender variance.
Mason’s family was lucky to find a groundbreaking local
program for transgender children and their families,
which helped plot a path forward. Indeed, Vancouver is
a better city than most in providing resources for trans
youth—but it’s not without work to be done.
For Mason, his path included a hormone-readiness
assessment, which gave him the rubber stamp for today’s
visit with endocrinologist Dr. Dan Metzger at the BCCH.
Mason is here to receive a drug treatment that will stall
At Mason’s photo
shoot, he decided he
wanted his face to
appear in this story.
VA N M A G . C O M S E P T E M B E R 2 0 1 6 43
When people are stigmatized by a transphobic society
and treated like freaks or not allowed to be who they are,
naturally they will suffer.” — dr . wa l l ac e wong
his puberty by temporarily stopping production of
estrogen and progestins. For trans girls, it’s used to block
testosterone. Blockers have been used in young children
with precocious puberty since the early ’90s. It might
temporarily decrease Mason’s bone density, but it will
curb his psychological stress and help the family buy time
until he’s 15 or 16, at which point they will contemplate
partially irreversible cross-hormone drugs and, after age
18, perhaps also irreversible breast and genital surgeries.
Yet prepubescent transition is still considered a highly
contentious subject. It’s so controversial that there are
few resources available to trans kids and their loved
ones in North America. This is true even in Vancouver,
a transgender pioneer since 1984, when Vancouver
General Hospital’s transgender clinic helped pave the
way for medical protocols that have since informed the
World Professional Association for Transgender Health’s
“Standards of Care” guidelines, considered the global
bible for trans health care.
Vancouver is a transgender-progressive city on
many other fronts. We have had a handful of youth and
adult support groups and a range of services through
the Provincial Health Services Authority since 2003.
In 2014, the Vancouver School Board formalized a
transgender-inclusive policy, and the Vancouver Park
Board is working on a similar plan. Yet there are still
no government-sponsored programs in Vancouver
for gender-variant children and their families. The
Provincial Health Services Authority says it’s in the early
stages of starting one. There is also currently a six-month
backlog for the hormone-readiness assessments required
to receive BCCH medical interventions. Among the
handful of private therapists in Vancouver specializing
in transgender youth, meanwhile, wait-lists are up to six
months. That wait could be a death sentence for some
transgender children. We know that since the BCCH’s
program began in 1998, 12 percent of their 84 patients had
attempted suicide prior to their first consultation—after
consultation, it dropped to five percent.
Mason is lucky to live in Surrey, where approximately
35 kids aged three to 12 currently receive support through
the Ministry’s Child and Youth Gender Program, which
offers an innovative group session called Learning About
Me and Myself. Operating on a shoestring budget since
44 VA N M A G . C O M S E P T E M B E R 2 0 1 6
2014, it’s headed by Dr. Wallace Wong, one of only six B.C.
mental health specialists with expertise in providing
transgender children and youth the clinical assessments
necessary for kids like Mason to receive puberty blockers.
“Very few specialists want to work with this population
or even talk about them,” Wong says of trans children.
That’s because many specialists recommend a waitand-see approach, based on dubious historical research,
which presupposes that many gender-variant kids will
ultimately identify as gay. Some specialists even believe
that gender is pliable in young kids, and they endorse
conversion therapy of the type once done on gay people.
Wong’s methods are controversial and revolutionary
because he takes an altogether different approach.
“I provide affirmative therapy, which isn’t about
encouraging or discouraging children to pick a gender.
It’s to help build confidence and resilience, find a place on
the gender spectrum and eventually develop a plan to live
in the gender they fit.” He says that while some gendervariant children experience no psychological distress,
even when they go through puberty, many of the kids he
sees “have serious behavioural and developmental issues
because they’re under such emotional distress. They’re
anxious, ashamed, depressed, suicidal”—particularly if
they’re not allowed to express gender variance and have
little to no parental and community support.
Wong’s Learning About Me and Myself group
sessions give kids a safe, nurturing environment to
explore gender identity. “The focus is on creative play,”
he says, “activities that help kids discover and realize
the authentic self without stress or shame”—including
everything from making snowflakes (to explore the notion
that all of us are unique) to playing Mr. Potato Head (to
experiment with gender identification). “Another goal
is to facilitate friendships among kids that share gender
variance so that they realize, ‘I’m not alone, I’m not a
weirdo,’” Wong says.
“You should have seen the joy on Mason’s face when he
met a boy just like him at Dr. Wong’s group session,” Lisa
says. “Suddenly, he realizes it’s OK to be who he is.” Wong
also counselled Mason and his family privately to rule out
family dysfunction or mental health issues. “He had so
many questions,” Mason says. “Like, ‘What kind of person
do you want to be? How do you feel about your body?’
I said, ‘I want a beard. I want a deep voice. I want all the
boy things. I want to be happy.’”
Mason’s unhappiness started at preschool. He wanted
to play with the boys, and he felt “weird” and “sad” that
he couldn’t do so. He became so withdrawn that his
kindergarten teacher thought he was a selective mute.
As his grades got worse, his parents suspected he had
a learning disability and spent more than $10,000 on
extracurricular tutoring. By Grade 5 he was saying things
like “I’m so stupid” and “I want to die.”
“I looked in the mirror and I didn’t like what I saw,”
Mason recalls. “I hated the long hair, the dresses, the
[Catholic] school uniform.” Mason’s parents didn’t force
him to look and act like a girl. His sister is a tomboy
who prefers trucks to dolls, and he understood that it’s
perfectly acceptable to be gay or lesbian. But he’d never
even heard the word transgender until 2014. His mom
happened to be watching a video on YouTube. “I was so
happy to know there were other people where the outside
doesn’t match the way you feel inside,” he says. “I knew I
wasn’t weird.”
Mason’s school grades immediately improved, but he
didn’t come out to his parents because he “didn’t want to
disappoint them,” he says. “I like to keep people happy. But
then all the girly things started to happen. In December
I got my period and it was really, really bad.” In January,
he came out to his parents. “It felt like a thousand pounds
went off my shoulders.” Three days later, Mason got nine
inches of hair cut and they went shopping for new clothes.
“In the mall, I used the boys’ washroom for the first time
and I got no funny looks,” he says. “It felt so good.”
Lisa’s tears start to spill again. This is an exciting day
for Mason, but for his parents it’s the culmination of a sixmonth crash course with a steep learning curve. Wong’s
parents’ support group has provided a safe harbour for
them to share their highs and lows and plot the road
ahead. “We do a lot of crying at the group—‘Why me? Why
us?’” Lisa admits. “A lot of us feel like we’re mourning.
I’m mourning the daughter that I thought I had. But I’m
also very happy now with the son I didn’t know I had. We
know his safety and happiness are at stake. So when I hear
that we shouldn’t let kids transition early, I think that’s a
bunch of baloney. These kids know who they are. Why can’t
we let them be themselves?”
Lisa is alluding to the conventional theories that
gender may not be fixed in children and that many gendervariant kids will outgrow it and identify as homosexual,
based on historical research done in the ’70s and ’80s,
when transgender was considered a mental disorder.
The brave few who did come out faced discrimination
and abuse, which led to high drug addiction, joblessness,
prostitution, homelessness, violence, murder and
suicide—and a scarcity of safe medical interventions.
Improved resources, research and our growing
cultural acceptance have brought higher rates of
healthy transition, often galvanized by loud and proud
transgender kids like Tru Wilson, who came out to her
parents in 2012 at aged nine (and was featured on the
cover of Van Mag in December). The Wilsons sought
counselling and attended Wong’s children’s program,
and Tru started taking puberty blockers. Later that year,
the family lodged a complaint with the Human Rights
Tribunal against Tru’s Catholic school, Sacred Heart
Elementary, when the school refused to accommodate her
transition. Ultimately, the Catholic Independent Schools
of Vancouver Archdiocese agreed to pay the Wilsons
an undisclosed settlement and initiated a new genderinclusive policy in 2014, the same year the Vancouver
School Board formalized one of its own.
Despite scientific evidence that transgender people
have genetic and biological characteristics matching their
transgender identity, families are still often cautioned
against early transition. And conversion therapy, which
strongly discourages transgender expression and
behaviours, is still endorsed by some experts, including
Toronto-based Dr. Ken Zucker, former chief of the Gender
Identity Service at the Centre for Addiction and Mental
Health, Canada’s biggest transgender clinic. Conversion
therapy caused a public uproar in North America after its
use led to the suicide of an Ohio teen, who left a note begging,
“Fix society. Please.” Ontario ultimately banned conversion
therapy and Zucker’s clinic was closed late last year.
“Sadly, Zucker’s theories on conversion therapy
changed the way many psychologists have practised,
and it could have done a lot of damage to kids with
gender dysphoria,” says Wong, who explains that some
parents come to him as a “last resort,” wanting him
to “punish or fix” their child. Some have already tried
conversion therapy. “They find that it actually makes
their child’s core [transgender] identity stronger,” he
Some of them talk about running away because their
parents won’t accept who they are. I’m lucky because
my parents want me to be happy.” — m a s on
46 VA N M A G . C O M S E P T E M B E R 2 0 1 6
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EVA AN KHERA J
says. To Wong, the historical theory that a majority of
transgender kids are merely confused about sexuality
is plagued by bias against both gay and trans people and
lacks a strong evidence base. Modern gender identity
specialists understand the critical distinction between
gender and sexuality—the oft-used idiom is that gender
is who you go to bed as, while sexuality is whom you go
to bed with. “More than 90 percent of the kids I see with
gender dysphoria stay on the transgender spectrum,” he
says. “Transgender isn’t a pathology or a mental disorder
needing a cure. Many trans people have gender dysphoria,
and some have mental health issues, but when people
are stigmatized by a transphobic society and treated like
freaks or not allowed to be who they are, naturally they
will suffer.”
As of April 2016, the BCCH clinic had seen more than
250 youths. “Typically I meet them at puberty, when
transgender kids often start to fall apart. There’s a lot of
stress around those unwanted physical changes,” says
Dan Metzger, the BCCH endocrinologist who provides
pre-approved youth hormone therapies. “We need more
services for the growing number of transgender kids,”
he adds. “Often safety is a big issue for early transition,
especially in smaller, less tolerant communities. But in B.C.
that’s less of an issue as long as parents are supportive.”
B.C.’s progressive approach appears to be bearing fruit.
According to the 2015 Canadian survey of almost 1,000
trans youth, including more than 200 in B.C., those in
this province are the most likely to be living in their felt
gender. Over 50 percent are full-timers (compared to 31
percent in Atlantic provinces), and they’re more likely
to report good or excellent health. Generally, kids are
twice as likely to report good mental health if they have a
supportive school environment, with B.C. youth reporting
the second highest rates of that, after Quebec.
After a three-hour consultation with Metzger,
Mason gets his first puberty-blocking shot, which he’ll
take monthly until he’s 15 or 16, when he can consider
switching to cross-hormones. They’ll discuss the potential
risks, including cardiovascular disease and Type 2
diabetes. Mason will also have to consider whether he
should freeze his eggs in case he wants to have children.
But today, he’s still a kid and those decisions can wait.
A few weeks later, at Wong’s end-of-year social, Mason
is towering over a gaggle of little girls in frilly dresses
and boys wearing ties or fedoras. Compared to the
majority of us, wearing our more gender-neutral clothing,
they look like throwbacks to a bygone era. Yet they’re
representatives of a new wave, a cultural paradigm shift in
the way we define and think about gender.
And while Mason has yet to come out officially at
school, he recently told his classmates. It wasn’t a surprise
or a big deal to them. He also graduated to Wong’s youth
group. “The older kids were cool and made me feel good,”
he says. “They talked about getting weird looks or being
teased. Or good stuff, like their voices changing from
hormones. Some of them talk about running away because
their parents won’t accept who they are. I’m lucky because
my parents want me to be happy. They want the outside to
match the way I feel inside.”
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