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were harassed or bullied in school, had
low household income or were the vic-
tims of physical assault, the suicide rates
were even higher.
Within that same study, 90 percent of
the respondents said they had experi-
enced harassment, discrimination and
mistreatment in their places of employ-
ment, and the instances of bullying from
peers also was much higher.

Bodily Changes
Transitioning from one gender to another
involves a unique set of medical and
health care issues. Treatment options
vary according to many factors; there is
no one-size-fits-all approach to get from
here to there.
Hunter is currently taking hormone
blockers to stop his menstrual cycles
and wears a chest binder to achieve a
more masculine appearance. For younger
transgender children, there are puberty
blockers that prevent the normal devel-
opmental changes from occurring.
"It's a way to buy time Roz said.
"Once you go through puberty, you can't
go back:"
By the time Hunter confided in his
parents, he knew he wanted to begin tes-
tosterone hormone therapy, which causes
changes that include a deeper voice,
growth of facial and body hair, and mus-
cular changes typically associated with a
male physique.
He is seeing a psychotherapist, which
is required for transgender individuals
who are considering hormone therapy.
"They need to know you're not plan-
ning on going back:' Hunter said.
Like many transgender individuals,
Hunter suffered from body dysphoria;
there was a huge disparity between the
self-image in his mind and the reflection
in the mirror.
"You look in the mirror and you don't
see you:' he said. "That's not right. That's
not supposed to be there. It's crippling:'
Changing his appearance, which
included a haircut and a new wardrobe,
and becoming open about his gender
identification has increased his confi-
dence and improved his self-image.
"I used to hate having my picture
taken; now I'm jumping into pictures and
photobombing all over the place he said.
According to psychotherapist Alicia
Mindlin, body image issues are common
for many adolescents; for transgender
teens, the problem is magnified from
years of feeling different and knowing
their bodies do not
reflect the way they
feel inside. She helps
clients validate their
emotions and decide
on the best course of
action, which is often
transitioning from one
gender to another.
Alicia Mindlin

Roz Keith and her son, Hunter

"Being transgender is not a pathologi-
cal condition:' Mindlin said. "It's like ...
oops, nature got it wrong, so how do we
correct it so things are right."
In addition to testosterone therapy,
Hunter wants to have surgery to remove
breast tissue, but he is undecided about
genital surgery, which is generally more
successful for male-to-female transitions.
For now, he is more concerned with feel-
ing comfortable with himself and living
authentically.
"Gender is in your mind, not your
pants:' he said.
Using public restrooms has presented
some challenges. Hunter has been told
he was in the wrong line while waiting to
enter the ladies room in a public venue.
Now he uses a stall in the men's room
most of the time, except when he is with
people who knew him before his transi-
tion, such as classmates. Then he uses the
ladies room to avoid making any of his
peers uncomfortable.
While there are a variety of treatment
options available for transgender people,
obtaining health care comes with its own
challenges. Certain drugs and procedures
are not covered by insurance plans, and
finding specialists who are trained in this
field can be difficult.
"It's important to find a pediatric
endocrinologist who understands and
is willing to treat transgender kids," said
Roz Keith, who put together her own
team of local and out-of-state health care
professionals.
She also stressed the importance of
finding a therapist who is knowledgeable
about transgender issues.
"There's a big missing link when it
comes to fmding therapists and orga-
nizations that help younger people in
the early stages [of transitioning]; said
Richard Keith.
Last November, the Jewish Fund,
established with proceeds from the 1997
sale of Sinai Hospital, approved $52,440
for the first year of a three-year $158,630
grant to Affirmations, a Ferndale-based
organization for LGBT individuals and
advocates. The grant will be used to
improve access to quality healthcare for
LGBT people through training programs
for medical personnel.
"There is a high level of dispar-
ity and discrimination; a lot of treat-

Hunter on page 12

10 July 31 • 2014