Hi Brady,

It sounds as if you are struggling with a family member who questions their gender. From your tone, you seem resolutely opposed to this point of view. I don't know if I can sway your position about this, but there are two things I implore you to observe in my letter to you.

First, that I feel you are misinformed about many aspects of the experience of people who are gender non-conforming, particularly for children and their parents.

And second: please reach out to the medical and support community around you, who will open their arms in trying to support you and help you navigate what IS a difficult challenge in your life and your loved one's life. If you want this person to remain a part of your world, your careful consideration is absolutely essential.

RELATED: Opinion: Injustices to the mental health of the Transgender Community

Let me speak about some specific points you raised previously, regarding the World Health Organization (WHO). That organization did change its classification of a condition called "gender dysphoria." Transgender is an adjective that may be used to describe a person who is experiencing gender dysphoria, whether they seek treatment or not, whether they transition or not. There's really no such thing as "transgenderism." It is neither a condition by itself, nor an ideology.

Gender dysphoria is a condition in which the individual feels a profound sense of uncomfortableness with their gender, how they interact with the world, and what expectations are placed upon them. The way this looks— besides the victim saying they feel more like the opposite sex — can be a whole host of unfortunate problems: depression, self-destructive behaviors, and suicide are the most common behavioral symptoms, and they often become more extreme as time goes by, without treatment.

I need to tell you that WHO changed its classification only AFTER virtually every medical board in the world changed their classification first. In particular, the American Diagnostic Statistics Manual, Volume 5, the guiding document for the American psychiatric profession, published in 2013 changed its classifications to list gender dysphoria as a health condition, not a mental disorder.

Other international organizations like WHO followed suit. Please understand neither WHO, nor the DSM, "diagnose" patients with any condition. But both the organization and the book promote the best information the health community has collected, debated, and published. This is all done for the successful outcome of people who are suffering; not to service a fashion fad, and not to ruin relationships between parents and their children.

I am very sorry that you have clearly read some of the most disturbing tall tales about transition, which is only one of several possible treatments for gender dysphoria. I would be alarmed too, if I read those accounts without a reality check.

The best I can tell you, I have read no actual evidence of these things. We're talking about medical procedures that are private — and doubly so, when it involves children. But many of them just don't even make sense in a clinical situation. I wish they weren't repeated as fact.

Let me tell you how treating a child's gender dysphoria should go.

For starters, no reputable organization would ever try to contest a parents' rights to make decisions for their child. This is a very elemental right, and any authority in the nation will uphold a parent's authority for their children.

If a child expresses feelings of gender dysphoria, there is no hurry. Don't worry. One only has to respond as quickly as one wishes to relieve the suffering of the child.

And, the response should be to speak with a licensed therapist who specializes in gender dysphoria. They will tell a parent exactly how they would try to verify the child's condition, in a lot more detail than I can supply. Even if the child therapists near you are not "specialists" in dysphoria, they can still help.

Whatever decisions come next would be made with the parents, a physician and the therapist from step one. For many children, puberty blocking medications are prescribed so that the dysphoria can be explored more carefully, over time without bringing on the (often traumatic) effects of puberty.

With or without blockers, the child and parents can attempt limited experiments with gender presentation, to see what feels right, and to explore how people will react to this.

This process does not necessarily lead to a full transition, with hormone replacement therapies or surgeries.

There are plenty of people who question but eventually decide they do not feel gender non-confirming, or that they would not want to make changes.

Some decide they are fully transgender, but find alternate ways to express themselves.  

A therapist will be able to lay out an array of choices that children and their parents can make, as safely as possible, that could alleviate gender dysphoria.

There is absolutely no need to rush into any kind of surgery. Puberty blockers would make things like the fabled "double mastectomies" unnecessary, and most physicians will talk honestly and openly about any sort of expectations a parent can have.

These are difficult choices to be made but a parent would be so much better off making them with their child, with the support of professionals with whom you have developed relationships.

Now, the biggest caution I can give you: a parent only really has until a child's 18th birthday to be a part of this decision-making process. 'Cause (and I think you know this) kids will run away if their needs are not being met. They might do it earlier than 18 if one creates too much negative pressure.

And these children are most likely to end up on the streets. Their unacknowledged dysphoria probably ruined their time in the classroom, so there's that. Or they've been bullied so hard, rejected by their loved ones to the point, they try suicide as a way to stop their pain.

And, Brady, it is pain.

Sometimes we get so accustomed to living with it, we don't realize how much suffering we have shouldered until it's relieved. If there's a child in your life who is calling out for help in addressing this, please listen. It's a big deal to be able to do that.

I know you don't want this kind of pain for your child. I know you don't want them to leave your life in the next few years and never look back. But something like this will happen if you don't pay attention right now, and build the bridges to keep a family together.

An easy first step would be to contact a local chapter of PFLAG, Parents and Friends of Lesbians and Gays (and gender non-conforming people). This organization is meant for parents who are having trouble with all this. The members have been there before, will share their stories, and give you advice of where to find even more help. They'll give you plenty of hugs too, if you'll accept them.
 
I've reached out to PFLAG officials in Middle Tennessee about our conversation and here is some contact info for the Murfreesboro chapter. They look forward to hearing from you: pflag.org/chapter/pflag-murfreesboro.
 
So, Brady, I'm sorry this is so long. Please feel free to ask questions if you like. A dialogue is better than just thinking we have all the answers, right?

Photo by Magda Ehlers (pexels.com)