Dave Ross gets (extremely honest) answers to all his transgender questions

From how to approach someone who may or may not be transgendered, to when is too soon for a kid to get surgery, KIRO Radio’s Dave Ross had plenty of questions about the oft-misunderstood community. And Dr. Linda Gromko, author of “Where’s my Book: A Guide for Transgender and Gender Non-Conforming Youth, Their Parents & Everyone Else” had most of the answers.

What is the present state of equality for transgender people?

Gromko said there was a study done a number of years ago that showed that transgender individuals do worse in every area studied &#8212 such as education, income and equity to health care &#8212 because of societal pressures and biases against them.

“It’s a struggle for a lot of people because it’s difficult to understand if it’s not an issue you have faced yourself,” she said.

Dave Ross: So what do I need to know?

Linda Gromko: It’s important for you to know that gender orientation represents a continuum. There are people who are born male and identify as male and there are people who are born female that identify as female and there are people all along the spectrum in between.

DR: Why?

LG: We don’t know.

DR: There doesn’t seem to be an evolutionary advantage to having female genitals and a male attitude or vice versa.

LG: I would agree with you, I don’t think there is an evolutionary advantage to that. But I can absolutely tell you from my experience of working with the community for 18 years that this is something that is very clear for people. Nobody seems to want to be the other gender if it’s something that isn’t their truth. It’s not a whim, it’s not recreational, it’s never a phase. It’s something very true for people, and I’ve seen it again and again.

Ross said he also couldn’t see an upside to faking such a thing, but questioned whether it was an illness. He noted that some feel that surgery is a radical solution to what could be a psychological problem.

“I don’t think it’s a psychological problem,” Gromko said. “I have to speak from what my clients are saying and what I see. My clients range anywhere from executives of companies, to physicians, to attorneys, to professional sex workers and everybody in between. What I see is a commonality between how individuals present what they want, what they need to survive. So I don’t believe that this is an illness. Now I will tell you that you do see more depression among the trans community. You certainly see more suicide and suicide attempts in the community. That’s absolutely true among transgender youth. And that, of course, is part of the reason why I wrote this book.”

What do you do when you’re genuinely unsure which pronoun to use for someone?

“Calling someone by the wrong pronoun or misgendering them, as we would say, can be very offensive to them,” Gromko said. “So if it isn’t very clear what I would say is, ‘How would you like me to address you?'”

DR: Are you allowed to find out the history? Because you know that people are trying to be polite, but are burning with curiosity. They want to know if you want to be called a woman, you want to find out if they were a man. Are you allowed to do that?

LG: That’s kind of a point of style. I suppose you could do that. I think, though, common courtesy, basically. If a person wishes to share that information they will. The need to know is if it’s simply prurient curiosity, if you simply want to know because you’re curious, that may be a little bit overstepping.”

DR: I’m the kind of person who if, for example, a parent doesn’t have the same name as a child, I want to know – was it a divorce, was it this, was it that. I don’t think I mean anything by it, but I’m just curious.

LG: In my opinion, I think, ‘Did you used to have a penis?’ is maybe crossing the line.

Bathroom issues

Ross noted that bathroom considerations have evolved over the years to a combination of family, handicap, gender-natural, single-stall bathrooms. Does that solve the problem?

Gromko said the solution is to be able to give people privacy in bathrooms, but that the bottom line issue is “if you’re not safe in a restroom, that’s a problem.”

She said a national transgender study done years ago showed that people were assaulted in doctor’s offices and emergency rooms.

“We’re not talking about a population that can assume safety,” she said. “We know that transgender individuals are more likely to be victims of violent crimes and murders, so we can’t assume that people are safe.”

She also told the story of a female client who was drugged by a man at a bar and sexually assaulted. Finding the woman’s unexpected genitalia added another element of shame.

“He then beat her to the point to where she had 42 bruises on her body,” Gromko said. “He called the police alleging that she had attacked him and they took her into jail. This is all real and this is information that I hear, unfortunately on a fairly regular basis.”

Where does the general disgust for transgender people come from?

LG: I think most reactions like that spring basically from fear.

DR: Fear that they’ll do what?

LG: I don’t know. Fear of what we don’t understand, perhaps.

DR: Fear that I might be like that, too and I don’t want be that way?

LG: I think that there’s some of that… but I think that basically when people don’t understand something, one of the pathways they will take is fear it and ridicule it, for example. This is especially critical when it’s a parent dealing with a child.

What happens in a marriage when one of the individuals realizes that he or she is transgendered?

Gromko said when she started working with the trans community, it was “almost assumed that when somebody came out as being transgender, that that couple was going to split. It was almost a guarantee.” But over the past 10 years, that increasingly it’s “the relationship that I love, it’s the person I love and the gender is less critical.” That means, married couples are staying together.

“Frequently when couples are parenting children… together, when one looks at the risks and the benefits of splitting up, the risks of splitting up can be pretty onerous,” Gromko said. “So what can happen, and what I’m seeing happen more and more, is that couples are staying together, because it’s the relationship that’s important.”

DR: How do children react to this?

LG: It depends. I see all variations on that, but in many cases the children are fine with it. In younger kids it’s more of an, ‘Oh, ok’ and move on.

Does undergoing a sex-change surgery make you happier? Or do people regret it?

Gromko said she asks all of her clients after surgical intervention or hormones what they would have done differently.

“Almost to a person, the answer that I get is I would have done it earlier,” she said.

How much does surgery cost?

Gromko said, a man-to-woman surgery is about $20,000. There are more variations for woman-to-man, but it’s generally closer to $100,000.

But not everything is fixable via surgery &#8212 shoulders, height, feet size, etc. &#8212 which is why Gromko believes in intervening before a child matures into an adult and develops full secondary characteristics. Gromko said that doctors can put puberty “on pause” &#8212 called a puberty blockade &#8212 which allows the individual and family to figure out how to move forward.

DR: How does somebody know at 12 years old if they are born to the wrong body, though. That’s a pretty big decision to make at that age.

LG: But it isn’t a decision. It’s more of a realization.

DR: But it is a decision to go ahead and decide to do something about it.

Gromko granted him that point, but said there are two waves: Children who know from the time of preschool that know they are of the other gender, who persist and insist about that from an early age.

“Then you have the wave of kids who come to puberty and they realize that the changes they hoped would happen in their bodies aren’t going to happen,” she said.

DR: So in other words, a little boy born with a penis who thought he was going to think it was going to disappear and he would grow breasts instead?

LG: Exactly, Yes. And I hear this quite regularly.

And, Gromko said, when this happens, that this is non-negotiably going to happen without some sort of intervention.

“And this is when trans kids can panic because they see that this reality is going to be developing and there’s not much they can do about it unless they come to somebody who is prepared to help them medically.”

When is an ideal time for this surgery to happen?

Gromko said best-case scenario for these individuals is to put puberty on pause to make sure everybody is on the same page, and look to do surgery at about 16.

“Now that doesn’t typically happen in this country,” she said. “Generally what happens is that gender affirming surgeries, as they are called, would occur probably after 18, but there are some exceptions to that.”

Gromko acknowledged that if you put five doctors in a room, you’d get five different opinions and perspectives on this topic.

“But when you listen to kids and families long enough, you realize that what they’re saying truly is their reality,” she said. “They don’t make this stuff up, Dave.

“When I ask (people), ‘What do you think? You have any regret?’ And I hear again and again consistently, ‘I’ve never been happier.’ And that sometimes happens even when there have been significant costs to the individual,” she added. “Maybe they’ve lost friends, maybe they’ve lost parents… there are significant costs, which is another reason why I believe very strongly that people don’t make this up.”