All mental health care, all health care, needs to be TRAUMA INFORMED CARE.

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I’m feeling frustrated about the barriers to receiving high quality, publicly funded, trauma informed mental health care.  Especially the barriers faced by trans and gender non-conforming folks.

I know that I’m blessed to live in a country that has free universal health care, but we still have a two-tiered system.  Psychological care, social work and counseling that happens outside hospital settings is fee-for-service.  There are many barriers for those without finances or work place insurance in terms of accessing mental health care.  Based on my own experiences, I believe that medication alone should almost never be the first line of treatment for mental illness, and that medication should never be used without corresponding counseling of some type.   This does not mean that I’m anti-medication or anti-choice or even fully anti-psychiatry.  It just means that I see mental health as more than just a chemical imbalance in the brain.  It means that I know that supportive, validating counseling can be helpful in treating most illnesses.  I highly value feminist based counseling, intersectional approaches, peer support models and any type of counseling where the patient has a say in what happens and is treated like the expert in their own lives.

I’m personally quite negatively biased against cognitive behavioural therapy.  That does not mean that I don’t think it has a place, or that it can never be useful.  I believe it can be helpful with certain types of issues, such as OCD.   But CBT leaves a LOT to be desired in relation to trauma therapy.  It focuses too much on the individual thoughts, feelings and behaviours and too little on trauma, societal oppression and practical barriers.

When I was younger, and I first entered into the mental health care system, my parents found a clinic and doctors that supposedly were experts in the field of eating disorders.  Now, maybe they were good doctors, but I can say with absolute certainty that they were not trauma informed.  I don’t really remember every being asked exactly WHY I had developed anorexia, or if anything had happened to me.

I’m not an expert, by any means, but I know that young people rarely (if ever) develop eating disorders and self harm just on a whim, out of the blue.  Generally eating disorders are symptoms of a larger problem, generally eating behaviours are coping techniques to deal with something.

I was a smart teenager.  I knew to some extent why I wasn’t eating.  I had learned that it was an effective way to zone out, feel lighter, feel empty and take up less space.  I became addicted to that feeling of zoning out, it helped me cope with the sexual abuse I was experiencing.  It wasn’t about my looks, it wasn’t about losing weight and it wasn’t about existential angst (per se).   I’m not sure if anyone actually ever asked me why I wasn’t eating.  And after a certain amount of time had passed, it became irrelevant to everyone.  Nobody cared why, they only cared about me eating so I wouldn’t die.  I didn’t believe I could die.   I’m not sure I REALLY cared if I died. I think I did at that time, but I certainly didn’t care by the time I started taking anti-depressants.  I pretty much welcomed the idea of death and started to think about suicide at 17.

These psychologists I went to see worked from a CBT model.  I remember being 16 and sitting in the psychologist’s office while he drew diagrams of how thoughts impacted feelings which impacted behaviours which further influenced thoughts and feelings.  I quickly picked up on the pattern of it.  I realized that a very specific set of responses were the desired outcome.  I followed the pattern and started saying what he wanted to hear.  I didn’t internalize any of it.  It became a game to me, not a game to manipulate or hurt anyone, but a test to see if I said what was expected if I’d be allowed to go back to school and stop missing music class for the appointments (which to me appeared pointless).

Fairly soon after that, I became physically starved to the point my brain wasn’t really working rationally anymore.  The physical side effects of the disease confused my brain and the restricting and exercising became obsessive to the point of OCD.  The behaviour self perpetuated and I lost track of why I started doing it.  I lost track of what happened to me.  I lost track of the abuse.  I lost track of everything.  I felt panicky most of the time.  I was always cold.

When someone is that sick, no type of therapy is going to work.  Eating is the only treatment.  I went to an inpatient program, started the process of weight restoration and my mind gradually cleared.  I don’t remember being asked in treatment why I starved myself to the point of near death.  I think people were relieved that I was eating and that I returned to some level of semi-normalcy.   I was still thin.  I still had strange eating habits and anxiety around food.  I still avoided eating with most people.  But I was well enough to “pass” as recovered.

I began to recover some memories around the age of 18.  But they weren’t concrete at first.  They were flashbacks, physical reactions, nightmares.  I remember talking about it indirectly to my boyfriend at the end of high school.  Telling him that something had happened with my last boyfriend.  I don’t remember if I shared many details.  I think the idea was only slightly formed in my head.   I didn’t connect the dots and fully disclose until I was 20.

Then I was thrust into the psychiatric, medical model.  I was drugged and drugged and drugged more.  The worse I got, the more drugs were given.  I was medicated to the point I could barely stay awake during the day time. I felt foggy.  I gained weight.   I was diagnosed with PTSD, but I still didn’t receive trauma informed care.

I did an inpatient program for PTSD.  It helped a LOT.  I learned a lot.  But I couldn’t fully actualize the learning because I was on too much medication and I was in an abusive unhealthy relationship.  I knew by then that the trauma piece was at the centre of my struggles, but I didn’t fully comprehend that my current situation was a major factor.

All this to say, that my life story is a testament to the perils of practicing medicine without considering the impact of trauma on physical and mental health.

I’m so passionate about looking at the roots of why people cope in the ways they do.  What societal circumstances and traumas caused them to cope in the ways they do?

Now I’m a parent.  My children struggle with anxiety.  My younger child is transgender.  She has secrets.  There are things she won’t talk about to anyone.  She struggles with focusing sometimes.  I see a lot of signs of trauma and of the impacts of things she has lived through.  Experiencing transphobia in and of itself is trauma.  Being misgendered, people using her old name, being treated as less than a real girl, being told that her mom is crazy for “forcing her” to be a girl….I could go on, but it’s a lot.  A lot for a child.  Rejection by a parental figure is one of the clearest predictors of mental illness in trans children and youth.  Acceptance is the highest predictor of mental health.

Again.  It’s not rocket science.  Of course a child will feel safer if they are accepted.

Now I’m the one trying to find the doctors, trying to access the care, trying to get referrals, wait on lists, be taken seriously.  20 years later, I’m still fighting to find a mental health care provider who truly understands the impact of trauma on a child and who is willing to practice trans positive, trauma informed care.  I don’t want her forced into CBT.  I don’t want her to be medicated.  I want someone to help her feel safe enough to express what is on her mind.  I want someone to hear why SHE uses the coping she does.  I don’t want doctors to guess and assume.  I don’t want them to misdiagnose her as well as mis-gendering her.

She deserves to be heard.  I don’t want her to be writing a post like this in 20 years.

Kids will say what they think adults want to hear.  They may do it consciously, or unconsciously or for their own reasons.  They do it to please, to stay safe, to feel a sense of control and many other reasons.  It takes a special type of doctor or counselor to help a child feel safe enough to tell their truth.   Because after enough time hiding, even she will be confused about what her truth is.

Mental health care for children should be free.  The practitioners should be trauma informed.  There should be enough funding that kids can access the care they need without lengthy wait lists.  There should not be a two tiered system where those who can pay can access things those in poverty cannot.  Poverty is a risk factor as it is, without it also limiting access to care.  Ideally there should be a system that is easier to navigate, where parents don’t feel they are fighting and advocating to the point of exhaustion.

Mental health care is a right, not a privilege.

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Photo: https://makingmomentsmeaningful.blog/2017/04/13/trauma-informed-care-values-youth-worker-values/

Living Outside the Binary.

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There have been an enormous number of changes in my life over the past 3 months.  I haven’t been blogging as much, but I hope to create some new posts about those changes soon.

I’ve been reflecting a great deal recently on how much society wants to squish people into binary boxes and categories.  Either/or.  Society doesn’t promote the shades of grey, the spectrum, the people living at the intersections of multiple gradient scales and who do not fix neatly into categories.

It’s quite difficult at times, being a person who doesn’t identify with many binary categories.   I sometimes feel invisible, different, crazy, or like my identities are not real or valid.  In some situations, I don’t even feel safe or comfortable challenging the binary norms which are coercively placed on me.

In terms of sexual orientation,  I’m non-binary.  I identify as queer, which means I’m not exclusively heterosexual or gay.  I’m open to relationships and dating with people of any gender.  I don’t fit neatly into a box.

In terms of gender identity, I’m non-binary.  I identify as genderqueer, which means I do not feel exclusively like a man or woman, but something else.   A different place on a spectrum, and outside the realm of female or male

In terms of sexuality, I’m non-binary.  I identify as demisexual, which means I’m on the asexual spectrum.  Not entirely interested in sex, but not completely disinterested in it either.

In terms of my health/disability status, I’m non-binary.  I identify as having both physical and mental health disabilities.  But I don’t “look sick” and I am extremely “high functioning” despite the level of symptoms I experience daily.  I’m able to work, but I don’t always have the energy to do all the things.  Some days I feel pretty good and others I feel barely functional.

The reality is, I think a huge number of people identify as non-binary in some ways.  Maybe you haven’t explicitly thought of it this way, but very few people exist solely in all the normative, expected boxes and categories.  No person has just one single identity.  Life happens at the intersections of our identities.

I’ve experienced some level of not being believed or validated for my identities.  I’ve felt not queer enough to fit in with gay people, but not straight enough to exist comfortable in heteronormative spaces.   I feel too feminine to be non-binary.  I feel like I’m “lazy” if my symptoms cause me to struggle on a given day.  I feel like I SHOULD be something very specific and it’s definitely not what I am.

The worst part of it is how I don’t consistently believe and validate myself.  Internalized oppression is something I struggle with constantly.  I tell myself that I’m not “queer enough” or that I don’t “look non-binary enough.”  I tell myself that I’m not functioning well enough to be normal, but I’m way too “able” to identify as disabled.  I put myself down.  I tell myself I don’t belong. I tell myself that folks won’t believe me.  I tell myself that one day I’ll be found out, and that others think I’m a fake or a fraud, or lying to get attention or to gain an advantage.

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Internalized oppression leads me to gaslight myself.  Internalized oppression means I don’t often accept myself.  Some of the worst pressures to fix into the neat clean boxes of normal society comes from my own internal critic!

I don’t believe in binary systems.  I don’t believe the messages of ableism, homophobia, transphobia and patriarchy.   On one level I don’t believe them or believe in them, and yet I put so much pressure on myself to “pass” as “normal” when I don’t even know what normal means.

I don’t actually want to be normal.  I want to be myself.  I want to be accepted as the person I am.   On one hand, I love the fact that I’m diverse and have experiences that can exist on a rainbow spectrum, rather than in black and white boxes.  But at the same time, I feel pressure to confirm, to choose, to fit in, to pick sides.

I’m not going to fit neatly into boxes.  It’s not possible.  I would have to deny so many aspects of myself that I wouldn’t be me.  I would have to compromise my own deeply held truths, just to be fully seen by society as valid.  I reject that option.

Instead, I’m creating communities and groups of friends who do accept me as I am.  People who do see me as valid, just the way I am.  People who aren’t trying to place me into categories that don’t fit, like uncomfortable outgrown clothing.

The spectrum is beautiful.  I like to think this is part of the symbolism behind the rainbow pride flag.  We are all part of a spectrum, like the light spectrum which creates a beautiful rainbow. Without each individual colour, the spectrum would be incomplete and neither the bright light or the rainbow would exist.  Spectrums are all around us and within us.

Embrace the non-binary.  Embrace the intersections.  They are beautiful and valid.

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Bill C-16. Passed!

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Photo credit: (Adrian Wyld / THE CANADIAN PRESS)

Today the Canadian Senate passed Bill C-16!!

This bill adds gender identity and gender expression as protected grounds to the Canadian Human Rights Code, and correspondingly changes the Criminal Code allowing protection to trans and gender non-conforming people experiencing discrimination, harassment and hate crimes.

Today, my trans child is now protected and has equal rights to my cis-gender child.  Both my children have equal rights and protections in the eyes of the law of our country.  As a parent, this means SO much to me.  We’ve advocated for this.  Our community has advocated for this.  Our community members across the country have advocated for this. For years, these proposed protections have been struck down and previous bills died on the floors of Parliament.

Today I’m proud to say that my country has become a better and safer place.  Today I’m proud to say that my country is leading the way, demonstrating globally the value of tolerance, diversity and equality.

Thank you Canada!  Thank you advocates in the trans* community! Thank you those who have come before us, trans folks who risked their own safety to fight for the rights of the trans* community.

Today, I am a thankful parent.  Thankful that my trans child will be growing up in a better, safer, more respectful world.  Today, we witnessed a historic moment.

Trans rights are human rights.

Rape Culture.

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Rape culture is so pervasive and it starts impacting children in primary school.  I felt extremely triggered by something my younger daughter shared with me last week after school.  It’s been bothering me all weekend for a number of reasons.  I find rape culture upsetting.  Sometimes I just want to scream, cry and shout about gender based violence and fight against it.  Other times I’m exhausted, burnt out, spent from trauma and secondary trauma and I want to curl up in bed and hide from the world.  Just take it.  Just let it all happen.  Just zone out and give up.  Because I can’t fight rape culture alone.  It’s too big and I’m just one individual person.

My daughter is in primary school.  She told me that the boys in her class were pinning girls up against the wall and humping them.  She told me that the girls were squirming and trying to get away and that they did not like it. The teachers did nothing.  I asked my daughter if the boys did this to her.  She told me they didn’t because they don’t fully see her as a girl yet (she’s transgender).   I asked her if she told the teacher and she told me “No, because the teachers tell me to stay out of other people’s business”

My daughter knows that this behaviour is wrong.  She was upset about it which is why she told me.  We talked about consent.  We talked about bystander intervention and the difference between tattling and telling to get help.  She told me she might talk to a teacher she trusts on Monday.

I’m triggered for a number of reasons.

This type of behaviour shows just how young the messages of “boys will be boys” and “boys chase girls because they like them” etc.  are ingrained, in students, and teachers don’t question them.  My daughter consistently tells me that teachers don’t intervene in situations like this, instead telling the kids to sort it out themselves.  This tells me that the school isn’t teaching consent culture, nor are they valuing bystander intervention, nor are they clearly teaching and demonstrating the difference between tattling and telling.  These are important skills in combating rape culture, preventing sexual violence and helping stop sexual assault in situations where risks occur (i.e bystander intervention).

Though I was very glad my daughter hadn’t experienced this unwanted behaviour, it also drove home a very clear message that women and feminine presenting folks are the main targets of rape culture.  Because my daughter socially transitioned this year, her friends still perceive her as a boy, thus they do not target her for this type of sexualized bullying.  She exists in an in between space, not perpetrating the violence and not yet suffering it either.  Though she does experience some bullying related to being trans or being different, because the kids don’t yet perceive her as a “real girl,”  she is not yet a target for the unwanted sexual bullying.

All of this is extremely upsetting for me.  I’m angry that the school isn’t being more proactive in protecting these female students.  I’m angry that the school isn’t being more proactive in teaching the male students that sexual bullying is not acceptable.  Rape culture takes root during these early years.  It’s far too late to begin education in consent culture in high school.  It’s important to teach school age children that “no means no,”  that games should stop if both people aren’t having fun, that chasing girls isn’t cool unless everyone has agreed on the game, and that humping people against a wall is assault, not a joke.

As adults, role models, mentors, parents and teachers, we can root out rape culture.  We can fight it at the roots by doing primary prevention.  Teaching consent culture to young boys and masculine folks.  Teaching bystander intervention to all kids.  Teaching young girls and women to build each other up, support each other and look out for each other.

I can be a radical feminist.  I can be a social justice advocate.  I can fight to end gender based violence until my last breath.   But very little will change, if young boys are being implicitly taught that humping young girls against a school yard wall is acceptable behaviour and young girls are being taught that nobody will stop it from happening.

What the parent of a trans child really needs to hear…

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There’s something I haven’t shared very much about in this blog.  I’ve debated for a year about whether or not to write about my children.  I have mixed feelings, even though my blog is anonymous, I want to protect their privacy.  I’ve decided not to write many specifics about them, but I do talk about parenting issues in general, including parenting through mental illness.  I do this because I want to break the isolation I have felt as a parent with a mental illness.  I know other parents out there have felt the way I have, judgment, fears of being judged, fears of not being enough, fears of relapse and more…

But I’m living with a different type of parenting challenge.

I’m raising a transgender daughter.

I wanted to write a post with a few tips on what to say and what NOT to say to the parent of a transgender child.  As I write this post, I want to clearly state that I don’t speak for all parents of transgender children, nor do I speak for trans folks themselves.  I’m speaking for myself, a queer, white, femme but not quite binary person, living with mental illness and raising a trans female daughter.

Things that I don’t need to hear:

  1. You are so brave! I don’t know if I could do it!  I don’t want to be put on a pedestal.  I’m not doing anything superhuman.  I’m parenting my child.  Supporting my child in her social transitioning wasn’t even something I debated.  I knew very early on that I could have a dead “son” or a happy, healthy daughter.  This was a no-brainer.  I’d like to think you would make the same choice, if it came to saving the life of your own child.  I’m not brave or special.  I’m just a regular mom, taking care of a slightly extraordinary girl.
  2. How do you know it’s not just a phase?  What if she grows out of it?  Maybe she’ll just be gay.  Please stop.  Don’t say any of these things.  First, it’s not your business.  Second, my child knows herself best and I guarantee I know her better than you do.  Even if it is a phase, which I highly doubt, she will have a chance to explore it and she will know I support her unconditionally.   These comments also irk me because they are laced with veiled transphobia.   They imply that being trans is something undesirable, that being cis-gender is normal and being trans is something deviant.  I reject this.  Gender exists on a spectrum.  We all have gender identity and gender expression.  Trans folks are no different.  Being cis gender is not inherently better.   I don’t wish my child would “just be gay.”  My child is herself, and I celebrate that.
  3. It’s so difficult for me/us to accommodate this.  This is something I heard from my child’s school.  It made me feel physically ill.  Grown adults saying that creating a universal, gender neutral washroom was SO difficult and using my child’s chosen name was so stressful for the staff.   I’m sorry, but this isn’t about you.  Using a person’s pronouns and chosen name is basic respect.  Mis-gendering a trans person is violent and aggressive.  It’s much more difficult for my child to go into school every day, worry about using the bathroom safely, worry about people respecting her, than it is for adults to adjust to using a name, or change a sign on a bathroom.  This is also another form of veiled transphobia.
  4. I understand.  Please use this phrase with caution.  Unless you have parented a trans child, or you are a trans identified person, please don’t say this to me.  If you don’t have lived experience you don’t really understand what my family is living.  An alternative to this could be to say “I hear you” or “I believe you.”

What I would like to hear as I parent my trans child:

  1. How are things going?  Would you like to go for coffee?  Do you want some company?   Parenting is isolating.  Any parent knows this.  Being a single parent is very isolating.  Being a single parent, with a mental illness, parenting a child who has some unique and special needs is extremely isolating.  Please continue to invite me to do things.  Ask me out for coffee.  Come over to my house and chat.  Let me vent about my fears, worries and struggles.  Be there to hear about our successes.  Because I need these things in the same way that any parent does.  I need a sense of community and so does my child.
  2. You are a good mother.  You are doing the right thing by supporting your child.  Sometimes I need reassurance, especially when I doubt myself or am overwhelmed with fears for the future.  Don’t jump in and give advice (unless asked for), don’t tell me my worries are irrational, don’t shut me down.  Just let me talk.  Believe me, validate me and hold space for the unique challenges my family faces.
  3.  Pretty much ANYTHING coming from other parents of trans children or other trans folks.  Its helps me and my child immensely to know that we are not alone. Hearing about the lived experiences of others and being part of an amazing community of LGBTTQ+ folks in our city has been nothing short of life saving.   If you are parenting a trans child, my one piece of advice would be to seek out a source of community.  Community is different than medical care/counseling, though your child may benefit from that as well.  Community includes online support groups, facebook groups, playgroups, youth groups, parenting groups, pride celebrations, camps etc…reach out and find one in your area.  If you live in Canada, you can contact me and I’ll help you get started. I guarantee you won’t be sorry and you’ll meet some of the most amazing people imaginable.

Best of all, if this is new to you, there are so many resources available.  Educate yourself.  Read.  Learn.  Because trans kids and youth are out there and they need our love and support.  And so do their parents!

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