Anthony, the first SA child to legally reassign gender, talks about his journey as a transgender teenager
Anthony is in most ways a typical 14-year-old boy who loves video games. But he was born a girl — and today is one of several South Australians who tell the Sunday Mail about their experience living with gender dysphoria.
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Adelaide teenager Anthony likes video games and dreams of becoming an elite STAR Group police officer.
“He’s a typical 14-year-old boy,” teases his mum, Ash. “He’s probably lacking vitamin D,” she says of the time spent in front of the screen.
His bedroom has a decent desk housing a nice-sized computer screen and a serious gaming headset with mic. His favourite video at the moment is a multi-player tactical shooting game.
Negotiating through the virtual realm, however, constantly presents Anthony with evidence the world does not view him as he views himself.
“When I join a video game and the other players hear a feminine voice they straight away say — ‘Oh, it’s a gamer girl’.”
He then has to explain he’s not. It’s a tough and repetitive cycle for a teen just wanting to play a game. Anthony is a transgender boy. His assigned gender at birth was female.
“I’ve always felt like a he,” he says.
Anthony is funny, articulate and sensitive, and has chosen to reveal his name and face in a bid to destigmatise transgender children, as more seek support for a mental health condition called “gender dysphoria” at hospitals nationwide.
“Why is it so wrong for me to feel this way?” he says.
“Why are you allowed to be born straight or born ‘correct’ and like things and do things, and I can’t like or do those things because I wasn’t born that way?”
In February last year, Anthony affirmed his gender as male to his family. In September 2017, he became the first child to legally change gender under South Australian law without having to undergo invasive surgery thanks to law reforms instituted in May last year.
Anthony’s decision to affirm his male identity has divided his family. Some of his siblings and extended family members will not acknowledge his affirmed gender. His mother and stepfather are supporting him.
Anthony says although he has always identified as male, it was not until about three years ago that he understood his gender identity. He began to Google.
“I wanted to get the information first and I wanted to know I was sure about it,” he says.
He soon learnt his experience was named transgender and the thought of impending female puberty was terrifying him.
Anthony was diagnosed with gender dysphoria by the Women’s and Children’s Hospital last year.
While waiting four months for WCH assessment and treatment, Anthony began to develop breasts and his hips began to widen. “I didn’t like it,” he says. “That’s when the depression started. “I wanted to cut off my chest.”
He received his first puberty blocker more than one year ago. It’s a drug called Lucrin, injected every three months to halt puberty in its tracks.
The process, known as Stage One, is not permanent.
TRANSGENDER TRAILBLAZERS
Anthony is not alone. More and more children and their families are seeking medical help for gender dysphoria in both public and private sectors across Australia.
Paediatric psychiatrists, paediatricians and academics believe the rise in demand stems from a more socially acceptable gender-diverse society, giving rise to young role models courageously standing up and speaking out despite the very real risks of harassment in the real and online worlds.
Among the most prominent transgender teenage trailblazers is Georgie Stone.
Her determined stand for the rights of gender-diverse youth has earned her the title of the Royal Children’s Hospital Gender Service Ambassador and 2018 Victorian Young Australian of the Year. She’s currently finishing her final year of secondary school.
Ever since she was 2½, Georgie knew she was a girl.
“For a while I thought I was a boy because everyone told me I was a boy, but it felt wrong,” Georgie told the Royal Children’s Hospital Foundation in March this year.
“Eventually, I told my mum I was a girl.”
Georgie went on to become a pivotal game-changer in national transgender law reform.
In 2011, she and her parents applied to the Family Court seeking permission to begin using puberty blockers. She was 10 at the time.
Her case became the basis for the 2013 landmark decision to remove the court’s jurisdiction from stage one medical treatment of transgender children, and later two medically-based opinions required up until 2017.
In 2015, Georgie and her family returned to court to access stage two treatment. Georgie was deemed competent to make her own medical decisions.
She then began the fight for legislative reform in accessing stage two treatment for all transgender children in Australia.
In November last year, the Family Court authorisation requirement for stage two treatment was removed, enabling transgender youths to receive gender-affirming hormones (oestrogen and testosterone) with parental and medical team consent. Some say the law changes have also driven more children and youth to seek out help.
The Royal Children’s Hospital in Melbourne has reported more than a 200 per cent increase in new referrals to its Gender Dysphoria Service since 2003, according to the most recent Children’s Rights Report by National Children’s Commissioner Megan Mitchell.
The jump in demand has stretched gender dysphoria services across the nation, with significant delays in accessing treatment.
Ms Mitchell says as the number of children and young people identifying as transgender increases, so too does the demand on specialists assisting youth to transition at a time in their lives when identity and sexuality are being defined and shaped by many aspects of their lives.
“It is concerning that these young people may be waiting for several months to get the help they need and deserve,” she says.
“We know that young people who identify as LGBTI+ are at greater risk of negative mental health experiences and sometimes outcomes, and we need quality data specifically looking at the wellbeing of transgender youth and the impact of delays in assessment and other aspects of sexual identity.”
The Women’s and Children’s Hospital predicts it will have received up to 180 new referrals by the end of this year, compared to a handful about five years ago.
There is currently a nine-month wait at WCH for psychiatric assessment for gender dysphoria. It’s the only public service provider in SA offering assessment, counselling and medical treatment for children and adolescents.
Child and Adolescent Mental Health Services clinical director Dr Prue McEvoy says the WCH is now triaging referrals to make sure treatment can be made in an appropriate time frame.
She says the upward trend of children and adolescents presenting with gender dysphoria is likely to continue and that the increase in demand is not a sign of more transgender children in the community.
“There are more role models; there’s more written and spoken about it publicly and children and their families are feeling more comfortable seeking medical services for help and advice,” she says.
Dr McEvoy says this cultural shift is reflected in recent law changes in SA and nationally.
Last week, the Tasmanian Government became the first to move amendments aimed at reducing discrimination against gender diverse people by making gender optional on birth certificates.
WCH child and adolescent psychiatrist Dr Georgie Swift says the bulk of cases and new referrals are children entering or undergoing puberty — usually aged 10 to 17, who may require puberty blockers.
“It literally puts a pause on puberty; it doesn’t undo puberty that has already happened,” she says.
“It decreases the distress and dysphoria to allow children and adolescents the time and space to explore their gender identity.”
Flinders University social work professor and psychotherapist specialising in transgender children aged under 12, Damien Riggs, says his next available appointment for new clients is February next year.
He currently sees up to 20 regular clients each year.
Prof Riggs says transgender and gender-diverse children and adolescents face significant barriers, including increased risk of self harm, depression and anxiety due to discrimination, social exclusion, bullying and physical assault.
He says the Trans Pathways study which examined the mental health of young trans people in Australia found very high rates of depression (74.6 per cent), anxiety (72.2 per cent), post-traumatic stress disorder (22.7 per cent), and almost 80 per cent reporting self-harm and 48 per cent attempting suicide.
But, he says, increasing evidence shows supportive, gender-affirming care during childhood and adolescence can significantly improve mental health and wellbeing.
Parents of Adelaide teenagers have told the Sunday Mail they fear for their children’s lives as they wait for stage one and two treatments.
“They are children in limbo, waiting for months and even years to receive treatment and going through the wrong puberty,” says one mother, who did not want to be identified.
Another mum, “Sarah”, says her transgender daughter, aged 12, approached her 18 months ago declaring she could not go through a “normal” puberty.
“She came to me and asked how do I stop it and how do I live as a girl,” says Sarah.
“I felt really, really worried because to me, at that time, I thought it was the hardest life possible she could have chosen and at that point I still thought of it as a choice.”
After extensive research, Sarah came to the realisation the worst thing she could do as a parent was obstruct her daughter, who was clearly struggling with her identity, and give her the time she needed to figure it out and not under duress.
Her daughter received her first suppression injection a month ago.
“She is doing very, very well — she is thriving in a way that she wasn’t before,” Sarah says.
“It’s a real pleasure to see her blossom.”
‘I WAS MEANT TO BE A MUM’
“Please God, make me a girl” — it’s what six-year-old Tamsin Anspach wished for many, many nights before bedtime.
“I went to bed praying that I would wake up ‘correct’,” she says.
Tamsin is a 24-year-old transgender woman from Adelaide whose assigned gender at birth was male.
Her wish never came to fruition through divine intervention, instead it was a long, hard journey that was realised at age 20, when she gained financial independence.
“I had an innate feeling when I was a child that I was meant to go through a female puberty and become a mother,” she told the Sunday Mail.
She says she would have been about eight when she first realised her gender identity, but kept it hidden for several years after.
When puberty hit in Year 8, Tamsin’s life began an “inward spiral” into darkness.
“I really felt like I was trapped in a cocoon — I was six-foot tall and growing chest hair.
“I would look in the mirror and see my body but feel like it belonged to someone else.”
Tamsin says her teenage years of medicated depression were “miserable”.
“All my energy went towards repressing my thoughts and feelings,” she says.
In hindsight, Tamsin says she was definitely experiencing gender dysphoria.
She says access to stage one and two treatment would have saved her seven years of emotional, physical and mental unease.
“There are parts of my body now, because of the exposure to testosterone in puberty, that I’m just going to have to live with,” she says. “And it does feel like the start of my adult life was stunted because I was living a fallacy — I was really performing for survival.”
Tamsin, founder of peer support group Transfem SA, says timely access for medical transition was just as important as support and wider education for smoother social transitioning for gender-diverse South Australians.
BEFORE PUBERTY
Treatment focuses on assessment and counselling the child and their family and support for home, social and schooling environments.
AT OR AFTER PUBERTY
Stage I: Once puberty has started, options include puberty blockers to stop the physical changes that the adolescent finds distressing. Stage one is reversible. Age: usually 10-16. Injections every three months with ongoing, routine psychiatric care.
Stage II: Using gender-affirming hormones (oestrogen or testosterone) to change the body to be more consistent with the teenager’s affirmed gender. This is partly reversible.
Age: usually 16 and up.
TERMINOLOGY
Gender identity — a person’s concept of self as male, female, both or neither. It can be the same or different to assigned gender at birth.
Assigned male at birth — a person who was thought to be male when born and initially raised as a boy.
Assigned female at birth — a person who was thought to be female when born and initially raised a girl.
Transgender — Someone whose gender identity is different to their gender assigned at birth.
Cisgender — someone whose gender identity is the same as their gender assigned at birth.
Trans boy/male/man — someone who was assigned female at birth who identifies as male.
Trans girl/female/woman — someone who was assigned male at birth who identifies as female.
Non-binary — doesn’t identify exclusively as female or male.
SOURCE: The Royal Children’s Hospital Gender Service and Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents.
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