While the work of transgender icons and activists such as Laverne Cox, Janet Mock, and Chelsea Manning have done an incalculable amount to bring the experiences and struggles of the trans community out from the shadows and into the mainstream, the experiences of transgender children are still largely undiscussed outside of the perennial alarmism around school bathrooms. PBS’ Frontline documentary, Growing Up Trans, centers on the stories of eight transgender youths as they attempt to navigate family, friends, gender, and the medical decisions that they each face as they approach puberty.
While the documentary largely provides the young men and women, aged between nine and 19 years, the space to articulate their feelings, thoughts, and needs, it also spends a lot of time with the kids’ parents and peer groups. The result is a balanced depiction of the difficulties that trans youth face in making themselves understood by those around them and the barriers that those closest to them must overcome to do so. Friends and family who use the wrong pronouns or can’t bring themselves to accept their child’s identity are humanized without being excused, and the specifics of each child’s physical transition and bodily experience are handled with tact while still being directly addressed.
Growing Up Trans does stray into problematic territory once or twice, as in one scene where an underwater camera follows the body of a transgender girl named Ariel as she swims with her friends at the local pool. The viewer is treated to a neck-down shot of the bikini-ed bodies of three teenage girls, which is questionable even without the implicit invited comparison between Ariel’s body and that of her cisgender friends. The documentary also employs other transgender “transformation” tropes, such as shots of trans women applying make-up in a mirror and trans men lifting weights.
However tired these tropes may be to those keyed into representations of transgender people in the media, they do show the reality of the amount of beauty labor that often goes into our gender presentations. Because people who identify with the gender they were assigned at birth are socialized into the norms for that gender in a manner that is essentially invisible, it’s startling to see the concerted way in which transgender kids have to learn new ways of being in the world. This was particularly poignant in the case of Daniel, a young trans man whose friends said very specifically that they were showing him “the ropes of how to be a guy”.
Other trans kids, like Ariel, transitioned so early in their adolescence that they were already fully socialized into their gender identity, although this often creates an entirely new set of difficulties they must face. Ariel’s mother moved her to a new town after she transitioned so that she would be able to create a new social life in which she was only seen as a girl. Her friends candidly tell the camera that no one thinks of Ariel as being transgender, and yet Ariel tearfully provides another perspective from which to view the supposed ideal of “passing”. Conversations about pregnancy and childbirth, which are commonplace among girls entering puberty, cause Ariel a great deal of emotional pain. Many medical resources are available to normalize her life as a woman, but this is the threshold of what science can make happen right now.
The medical aspect of transition is by far the most controversial aspect of Growing Up Trans. Overall, the kids’ families are supportive and interested in helping them to thrive. Name and pronoun changes happen largely uncontested, and social adjustments are made as identities change. However, the real issue brought to light by the documentary is exactly how little is known about the medical procedures available to trans youth. In 2009, the protocols relating to “gender dysphoria” (the medical term for transgender identity, which is contentious within the trans community) were modified to include children, although hormone replacement therapy (HRS) was only approved for those aged 16 years and older.
Often, the course of treatment prescribed for kids who know they are transgender at an early age is first to take a hormone blocker that will delay the onset of puberty to provide the child with more time to explore and establish their gender identity before seeking further treatment. The next phase of medical treatment involves “opposite-sex hormone therapy” to stimulate the physical changes associated with the puberty of the child’s chosen gender.
As the doctors at the Lurie Clinic detail the treatment to the kids and their families, the stakes of these decisions become very clear. Some of the physical changes that HRS causes are irreversible, even if the child later chooses to cease treatment or even return to their assigned gender. HRS often causes infertility and can increase the risk of a host of other medical conditions, although very little is known about the long-term effects, as little actual research has been done in this area. As a result, parents of transgender kids essentially have to weigh the risks and benefits of denying their children medical treatment.
Denying treatment, we are told, can result in immediate risks of depression and suicide; consenting to treatment may be putting their child’s long-term health in jeopardy. If there is a moral to Growing Up Trans, it is that the marginalization of communities has very real impacts on the medical options available to them. Regardless of the political or religious implications related to gender transition, the reality shown in this documentary is that there is a very immediate need for increased research in this area.
Even among supporters and allies of the transgender community, there is often ambivalence and the question of whether children ought to be given access to HRS and other gender-affirmative procedures. On this point, Growing Up Trans can shed quite a bit of light. Each of these kids has an awareness of identity and gender theory that few cisgender adults twice their age do. Because of their marginalization within society, they are forced to come to terms with gender and all its social meaning, even in the most quotidian of ways, and they are all extremely savvy in using the Internet to both increase their knowledge and their base of social support. Put bluntly – they’re often more informed on the issues than those who would like to use their age as a reason for denying medical transition.
Finally, it should be noted that, as with any documentary on such a highly charged topic, the film’s subjects are somewhat self-selecting. The worst-case scenarios, which are all too common in the trans community, are not depicted here. Kids are not abused, turned out of their homes, or murdered, despite the fact these things happen to trans teens at alarming rates. In a way, this is a welcome change from the preoccupation with violence and oppression that seems to mark representations of trans experience in popular media. It gives one hope to see so many parents, both single and coupled, genuinely open to non-traditional experiences of gender, and even more so to see the stalwart and religious conservatives eventually come to understand that their child’s well-being is more important than ideology.
As is reiterated by the Lurie Clinic professionals, the children undergoing gender-affirmative therapies now are the first generation to receive this treatment as such a formative period in their lives. As such, they are the pioneers of what is our collective, evolving social understanding of embodiment, identity, and gender. To paraphrase one of the parents in the film, we must listen to the child in front of us and take seriously their description of their lived experience. Growing Up Trans offers exactly that opportunity.