LondonIsABurningFire asks:

I’m a girl, but I’ve always felt like I’m in the wrong body. Every time I picture myself, I see a boy. I want to get a sex change, but I know how much it can cost. My parents are also Catholic, and are already angry about me not being religious, and every time I try to bring up the subject, they get angry and tell me that I was “made a girl”, so I should only feel like one, and that everything else I feel is wrong. But my friends are very supportive, and I even have a guy friend who wants to be a girl. Who do I listen to?

Heather Corinna replies:

You listen to your own feelings and sense of self. You’re the expert when it comes to your own identity.

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While a sex is assigned to us at birth, and people may have the idea that also determines our gender, that stands in conflict with the fact that sex and gender are different words that mean different things, and the only ultimate authority on our gender is us.

Sex (not the do-me-baby kind, the other meaning) is a classification most accurately made with what’s called a karyotype, a test that identifies the size, shape, and number of our chromosomes by examining our cells. That test can tell us if someone is XX or XY, female or male, respectively, or other combinations, like XXY, XO, XXX or XYY. Even just when we’re talking about sex, not gender, the world is made up of far more than just male and female. But most people don’t have karyotypes done, so for most of us, sex is assigned to us at birth via a doctor who just looks at our genitals and decides if they look female-bodied or male-bodied in their estimation.

I know: it’s totally whack that something that is such a huge deal in our lives and to the world is something determined in but a brief moment by a fleeting glance.

One of the many troubles with that way of determining sex is also that sex is not always so clear based on genitals. Some people are born with what is currently called “ambiguous genitalia,” which is what it sounds like: tough to class as male or female. Some of those folks are XX or XY, some are intersex, but regardless, docs still sex a person on paper as male or female in those cases.

So, people’s idea of sex as binary is already incorrect, but the idea that gender identity is (or is determined by sex) is even more off-base. As I explain here:

Gender isn’t about biology or science. Gender is a variety of concepts and ideas about how we or others may or do look, act, relate and interrelate, based on sex and/or gender identity or other’s perception or understanding of sex or gender. Gender isn’t anatomical: it’s intellectual, psychological and social (and optional); about identity, roles and status based on ideas about sex and what it means to different people and groups. As part of that set of concepts is also the idea — even though we know by now it’s flawed — that gender is only male or female in the first place. Like sex, gender is often presented as binary: as being only one thing or the other, without any overlap or grey area in between. When we talk about sex, we’re talking about what we consider or call male, female or intersex based on chromosomes and/or reproductive systems: when we talk about gender, we’re often talking about what is considered masculine and what feminine. If our doctors or midwives were to call out our gender at birth, rather than our sex, they would instead be shouting “High heels!” or “Sneakers!”

Gender or gender identity isn’t just about masculine or feminine, either. Many — if not most — people’s experience of sex or gender, and ideas about sex or gender, are not that binary. There’s no one way or right way to experience or conceptualize our sex or our gender, and even for those who stick only to masculine and feminine as ways to describe gender, people don’t all universally share the same ideas of what those words or concepts mean.

Some people’s gender identity feels like a “match” with what their sex is or was assigned as. Cis gender is the current term we have for those people. It sounds like your mother is probably cis gender. It may be that she was “born a girl” and also feels like a girl, or, more accurately, feels like what she thinks girls feel like. I’m also someone who was assigned female sex at birth and who identifies as a woman. But I know the way I experience, present and conceptualize my gender as a woman is not the same as how all other people who identify as women experience, present and conceptualize theirs, whether they are cis gender, trans, genderqueer or something else entirely (personally, I often feel somewhere between cis gender and genderqueer).

I also know the way I experience sex and gender as someone assigned female at birth who is not trans is very different than the way someone who is trans does, even though I have also had times where I felt my gender and my sex were at odds. The idea that “girls should feel like girls” doesn’t recognize the inarguable fact that not all girls look, act or feel the same way, aren’t all embodied the same way, nor do all people who were “born as” girls conceptualize gender or identify their gender identically.

Let’s get you up to speed with a few other things you asked about before we talk about your folks. “Sex change” is a vague term and is language we don’t really use anymore. When it comes to surgery to change or adapt someone’s genitals, that’s what we call gender or sexual reassignment surgery (SRS). Some people say “sex change” to mean that surgery or any number of the medical procedures or processes involved in making changes to the body in regard to sex or gender. “Transitioning” is the current term which refers to the whole of someone’s intentional intellectual, emotional, interpersonal and physical process in aligning their life and body with their gender identity.

Transitioning is usually a long process over many years, much like puberty is, and it’s one where not everyone takes the same steps or does the same things. For some people, a transition may only involve changing how they dress and what language or names they use for themselves. Others may do those things and do hormone therapies to change the chemistry of their bodies. Others still may do all of those things and have certain kinds of surgeries to change the external appearance of their bodies. For those who choose to have surgery, therapy is also part of those things as part of their protocol, and even people who don’t do surgeries or hormones often use some kind of counseling or talk therapy for support and help in their transition.

Not everyone has any kind of surgery at all, or gets all the kinds of surgeries they could have. Some FTM (female-to-male) trans people only have top surgery (surgery that removes the breasts), but not bottom surgery (which changes the appearance and function of the external genitals, like creating a penis). Some have both, and some FTMs have their uteri, fallopian tubes and/or ovaries removed. Sometimes people just don’t want or feel the need for some or all of those surgeries, while other times they want them, but can’t access them for various reasons, the biggie being that they are usually very costly, another being that in most places a person has to qualify for these surgeries, not just be able to pay for them. Not everyone will be given permission through the healthcare system to have those surgeries.

What surgery costs will vary on what someone chooses to do, and can range anywhere from around $7,000 to over $50,000. The cost of other parts of transitioning and qualifying for surgery, like hormones and therapy, are additional costs. In some parts of Canada (and in some other countries), though, national healthcare will cover the cost of some or all surgeries for trans people who have met the criteria as well as for talk and hormone therapies. However, someone in their early teens is not going to be able to have most of those surgeries yet, and if and when you can per your health, until you’re a legal adult, you’d usually need parental consent.

I know all of that may be overwhelming. It’s tough to say what you will want to do with all of those options, and tough to figure without spending more time talking with you and being in this process with you what your unique gender identity is. As well, your parents being so closed to all of this is going to make it tougher for you to figure it out for yourself, because that’s much harder to do without real freedom to explore all the possibilities.

I’m sorry your parents are being so unsupportive and also have ideas about gender that are in conflict with your gender identity. Those ideas are also in conflict with the most current medical, scientific and sociological data, study and thought on sex and gender. Some parents handle having gender fluid children very well. Many, unfortunately, do not. Why parents and other people can have such a hard time is both simple and complex.

The simplest reason others have a hard time most often seems to be because someone gendervariant can feel like a challenge or a threat to the gender identity of someone who is not (even though it isn’t), and to the whole system of binary gender or assigned sex, which some people are very deeply invested in when it comes to how they understand themselves and the world. It’s kind of like how people who grow up with and surrounded by lots of wealth who cling to the idea no one is actually poor can react when they accidentally drive into a ghetto. Suffice it to say, throwing gobs of money out the window is not what usually happens in that situation.

For people who weren’t raised understanding gender to be fluid and anything but binary, it usually takes time and effort to adjust to and accept that their ideas weren’t realistic or correct, and a lot of people are very resistant to that kind of big change.

But this is often more complex. For starters, as with many other aspects of personality and identity, parents often have a very hard time when they have to accept that their idea of who their child was or is is different from who that child turns out to be and/or identifies themselves as. This doesn’t just happen with gender. During the teen years, parents are usually facing this in one way or another, whether it’s about how a young person dresses, what interests they have (or don’t), what their belief system is (or isn’t), what relationships they choose for themselves, what they want to do with their lives, around sex or sexual identity…and yep, with gender. Accepting that children are separate and different from them is a part of parenting all parents sign on for, and the onus is more on them than you to deal with that, but it is tough for a lot of parents to adjust to those changes and differences, especially when they’re unexpected or major, or when they challenge something they consider central to their own belief system and their understanding of you, themselves and the world.

When it comes to people who react very strongly to non-binary sex or gender, the impression I usually get is that those people were either raised with or adopted very limited ideas of sex and gender they made a big part of how they think about and react to everything; that it’s something in life they decided was very simple and could be easily ordered, just like the way some people think about race or sexual orientation. Of course, none of those things or many other of the “easy” ways some folks people think others can be classified really are simple or easy: they’re all very complicated and some people are just simplistic in the way they think about them.

If someone had the idea they can easily divide everyone into this group or that one, and in doing so feel they can always quickly and surely know their place, the place of others, how to talk to and relate with this person or that one, then we can probably get why finding out that none of that is actually true is a serious whammy. I wasn’t raised to think of sex or gender as binary or simple, so I have to work to try and understand people who were. I figure that for them, this would be a whole lot like if I suddenly was told that the earth wasn’t round, that half of everyone I knew was actually an alien from outer space or that the people I knew to be my parents for 40 years weren’t my parents at all. I’d probably be seriously freaked by that information, and probably wouldn’t react so well myself.

Many parents also worry that when a child is trans or gendervariant, it’s because the parent did something horribly wrong, or that something is wrong with them that rubbed off on their kid. I hate having to explain this to young people, because I know it can sound like that means there is something horribly wrong with you. Please know there isn’t, and that’s not what I’m suggesting. However, not everyone feels that way. Some people do feel that anyone outside a gender binary is someone gone horribly wrong, but if and when they do, it’s got a whole lot less to do with you and a whole lot more to do with a lot of deeply flawed ideas about what gender and sex are, what they mean or can mean, and hat some people really want them to mean or accomplish.

With you feeling the way you do, I don’t need to tell you this is challenging, difficult and uncomfortable. But while it’s going to feel that way for you far more than the people around you, it’s also all of those things for parents and families, too. I don’t say that to excuse the way your parents are reacting: I feel they are parenting poorly right now and without the kind of love and understanding you need and deserve as the child they chose to raise. But just like you may have a transition ahead of you, or even started on some of that, so do they. Just like yours may be rocky, theirs probably will be, too.

Ideally, what they’d be able to do is tell you they are having a very hard time with this, but reassure you they love and accept you no matter what. Ideally, they’d tell you their issues are exactly that, their issues, and that they will take responsibility for them like adults, doing their level best to support you and not take their own upset out on you, even when it’s hard for them because they have their own transition. I know it may look like they’ll never do things like that. It is possible they won’t, some parents never do, but it’s also possible that they might, especially if they can get some sound information, education and support from someone who can help them better understand you, your feelings and your identity. There are parents who have come around over time who started out saying and feeling exactly the kinds of things your parents are.

My best suggestion is for you to get connected with a therapist who works expressly with trans and gendervariant people. The aim of that therapy isn’t about “fixing” you. When I say someone who specializes in this, I mean a therapist who’s accepting of the range all of gender can be who wants to help patients to explore and figure out their own identities and help them decide if they want to transition, and if so, help them with that process. That person can help you with your parents, including being an advocate for you with them and providing family therapy to help all of you.

You can ask your parents if they’d help and support you in getting that care, but if you don’t want to or they refuse, that doesn’t mean you have to go without. I see you’re in Canada, but I don’t know what province you’re in. So, here are a few solid and safe places you can phone or email who will be able to fill you in on how you can access that care. If none of them are in your province, they can refer you to services which are.

The Sherbourne Health Center in Ontario has a phone line specific for their LGBT youth programs and care at: 416-324-5077 or you can email them at: [email protected]. The Canadian Rainbow Health Coalition can be reached at: 1-800-955-5129 or you can email them at: [email protected]. The Transgender Health Program in Vancouver is another resource you could call for information, at 1-866-999-1514, or you can email them at [email protected]. You can call or email any of those, and let them know that you are a gendervariant young person who wants to know how you can find and access a trans-friendly therapist.

There are also good books and information available for parents with trans or otherwise gendervariant children. I don’t know how heated the situation is at home right now, or how comfortable you feel giving your parents information, but if that feels like something you can safely do or want to do, I think it would benefit them. Two good books to start with are The Transgender Child: A Handbook for Families and Professionals by Stephanie A. Brill and Rachel Pepper and Transparent: Love, Family, and Living the T with Transgender Teenagers by Cris Beam. Central Toronto Youth Service has a wonderful booklet you can print out for them here, and there’s an Canadian organization for parents of trans children online here: http://www.transparentcanada.ca/ One more resource that may help is Fortunate Families, which is specifically for Catholic parents of LGBT children.

I want to make sure we cover one other base. I didn’t see anything you wrote that suggested your home was expressly abusive or unsafe, even though it’s clearly very emotionally unsupportive of you right now. But GLBT children and teens are often abused or maltreated in families, so I don’t want to make any lazy assumptions. Your safety is very important. In the chance you are or do earnestly feel unsafe now or later, like you are at risk of being harmed by your parents because of this, or it seems like you might get kicked out of the house, 1-800-268-9688 is the number for the fantastic LGBT youthline in Canada. You can also feel free to call them even if you just want someone else to be able to talk with about any of this, not just if you’re in serious crisis. It’s great your friends have been so supportive of you so you are not completely alone in this. Be sure to lean on them as you need to, and you may find that some of their families might be willing to give you extra support, too.

(For our American readers who want or need a similar hotline, you can call the Trevor Project at 866-488-7386, the GLBT National Hotline at 1-888-843-4564 or the GLBT National Youth Talkline, 1-800-246-PRIDE. For readers in the UK, there’s the London Lesbian and Gay Switchboard at: 020 7837 7324. In other countries, use a search engine to search for GLBT or queer youth hotlines or crisis.)

I’m going to leave you with a few links to look at. I want to qualify one of them first, though. I noticed that you’re 13. It’s common for pre-teens or teens to find that’s a time when gender dysphoria and awareness of being gendervariant comes to a head. The process of puberty visibly genders us to others, so it can also make what already felt like a bad fit of sex and gender feel even more uncomfortable. But some people, too, who turn out not to be trans, can experience gender dysphoria because the process of puberty is so uncomfortable for everyone, even if you’re not trans, but feel better over time without any kind of transition or surgery at all.

I’m not sharing the link about that with you to question how you feel about your gender identity. I’m also not suggesting it’s somehow better or worse for someone to be cis gender, trans gender or gendervariant, because I don’t think that. I think it should be okay for any of us to have and hold whatever our gender is and feels like to us, and that any identity that is ours and feels true to us is the right one. I just want to include it in case that’s what’s going on; to let you see one other possibility in the hopes that all I have said here, what other help and info you get, and your own process — hopefully with your parents eventual support, but even if you have to go without it — will help you figure out for yourself what feels best and is true for you. Like I said right at the start, you should put your own feelings and sense of self first. You’re the expert when it comes to your own identity, and I hope in time your family and everyone around you will recognize and embrace your authority in that.