Gender Odyssey’s longtime friend and eminent leader in transgender health, Dr. Michele Angello, will be presenting two workshops next week in L.A. The depth and breadth of her experience make these “do not miss” sessions! Guest blogger, Nathan Tabak, recently chatted with her about her practice.
First, a little about Dr. Angello. Angello offers individual, couples, group, and family therapy, as well as corporate education and training on a variety of issues concerning sexuality. She has presented internationally on her work with transgender and gender-diverse youth. She facilitates several monthly support groups for transgender adults, youth, and parents and offers sessions to people around the world via webcam. Dr. Angello has appeared as a guest expert on Dr. Phil, Larry King Live, The Tyra Banks Show, ABC Primetime, Dr. Oz, and many more shows and documentaries. She is also an adjunct professor at Widener University and has developed the first graduate course in the U.S. that focuses on clinical issues in transgender communities. Her private practice is in Pennsylvania.
Describe your background with the trans/GNC community.
I began seeing gender-nonconforming (GNC) youth in 2001. It was never my intention to work with kids but after several frantic phone calls from parents who sounded loving but confused about their child’s gender desires, I sought supervision from my colleagues who were trained to work with children and slowly took on a few cases. This has grown exponentially over the years, to the point that this particular group is the fastest-growing contingent of my private practice. I identify as a queer, cisgender woman and I am also a parent of three children (up to this point, all have identified as girls, which is their sex-assigned-at-birth).
What I’ve found over the last 16 years is that these young people are both some of the most challenging and most rewarding clients. Challenging not because they are especially difficult, and certainly not because they experience different levels of complex differential diagnosis than any other clients. Rather, they are challenging because I find myself walking a tightrope of clinician, advocate, peacemaker, educator, and spiritual mediator that I never imagined would be a part of my everyday work. And rewarding, of course, because it’s an absolute privilege to see children as young as 4 years old articulate, in no uncertain terms, more things about themselves and their core identity than many of us are able to do in a lifetime.
What subject(s) are you presenting on?
My two workshops at the Los Angeles GO conference are Assessing Gender Identity in Youth (at 8 AM on Wednesday) and Supporting the Whole Family through Transition (at 1:40 on Thursday). The first is really a fun assessment for both those who are pretty “green” and the folks who have been doing this for awhile. Most well-intentioned and competent physicians and behavioral health practitioners have very little experience working with transgender or gender-nonconforming individuals. This can inadvertently fracture a relationship with the transgender individual, because the majority of them have faced marginalization or outright discrimination from family, friends, schools, spiritual institutions, and other physicians.
It’s true that not many youth are brave or self-aware enough to present. So, it makes sense that when a young person comes in for help, the physician commonly gives the patient a “wait-and-see” approach to treatment (i.e., “Let’s wait until you’re 18 to see if you still feel this way.”). For young people in distress, this can be devastating and often leads to self-harm, suicidal ideation, or a suicide attempt. There are evidence-based best practices that can be implemented to reduce risk and support both the youth as well as the family. Some of the most common questions for healthcare providers are: What if this is just a phase? What is the difference between a social and a medical transition? How will other children (both peers and siblings) be impacted by a transition? Is it ethical to block the child’s puberty until he or she is old enough to be prescribed cross-sex hormones? Will child protective services be involved?
What takeaways from your presentation do you hope attendees will come away with?
I hope the participants will understand that there are unique variables when working with trans* and GNC youth. That this isn’t something to jump into lightly and that we will strategize ways to work with parents, siblings, extended family, and schools to make this as effective as possible for everyone brave enough to undergo it!
In a climate of unprecedented visibility and new challenges confronting our community, what makes your topic(s) particularly relevant?
Both of these topics are relevant always, and particularly so when the Obama administration’s recommendations have been dismissed. Trans kids feel (rightfully so) particularly vulnerable, and having a supportive network is exponentially more important now than ever.