Medical Support for Trans Youth

Lurie Children’s Hospital will launch a program for gender-nonconforming children of all ages.

by JD Fernandez

This summer, Lurie Children’s Hospital of Chicago will officially launch a program that seeks to help gender-nonconforming children under the age of 13—becoming one of only three medical institutions in the United States to provide these resources. Jennifer Leininger, 28, has worked with transgender adolescents alongside Dr. Robert Garofalo, the Gender Program’s director, for the past seven years. Now she has an essential role for the new Lurie program as senior coordinator.

The Medill Equal Media Project sat down with Leininger at the Center for Gender, Sexuality and HIV Prevention in Chicago’s Uptown neighborhood to find out more about the program and its role in the Midwest. Excerpts:

MEDILL EQUAL MEDIA PROJECT: CAN YOU DESCRIBE THE WORK OF THE GENDER IDENTITY CLINIC?

Jennifer Leininger: I think [Dr. Garofalo] prefers the term Gender Program because we’re taking care of the whole person, the whole patient, the whole family; everything from mental health referrals to starting a play group to me talking to schools. Part of that is inclusive of disorders of sex development.

CAN YOU EXPLAIN THAT?

Disorders of sex development, from what I’ve been reading, describes folks who are born with ambiguous genitalia, folks whose chromosomes might not match their outward genitalia, how it looks. So someone might have XX, but they might actually look like a boy.

IS THAT SYNONYMOUS WITH “INTERSEX”?

Exactly. So, we’re expanding that program. That’s why we’re trying to make it the Gender Program instead of the Gender Identity Clinic.

WHAT’S STRIKING ABOUT THIS PROGRAM IS THAT IT’S FOR YOUNGER CHILDREN. HOW DO THE SERVICES FOR GENDER NONCONFORMITY AND GENDER VARIANCE WORK?

Gender-nonconforming, gender variant, transgender, those are basically the terms we use [to describe] when someone’s assigned sex at birth doesn’t match up with [the gender] they identify with. We try to separate sex from gender and gender identity. When someone comes into our clinic and identifies as transgender and is in need of resources, we’re not going to turn them away because they’re not 16. A lot of folks we know of have identified as transgender or gender-nonconforming since they could talk. Other folks have come out later. It is on a spectrum.

IN AN ARTICLE FOR THE CHICAGO TRIBUNE, IT WAS MENTIONED THAT YOUR YOUNGEST PATIENT WAS 3 YEARS OLD. HOW DO YOU WORK WITH A PATIENT THAT YOUNG?

We would never do surgery on a 3-year-old or give a 3-year-old hormones, because there’s no reason for that. We like to engage them in care, make it a continual conversation, [but] there’s never any medical intervention for children of that age. We do puberty blockers, [which] stop someone from going through the puberty that their body would normally do. We have someone who is 11, and this young person came in and identified as a male but was assigned female at birth. Instead of making this person go through a female puberty, you can put it off. When the time is right, when a decision has been made, when they feel comfortable with it, they can start taking testosterone to go through the puberty that affirms their gender.

SO IT’S NOT AN IRREVERSIBLE PROCESS?

Puberty blockers are definitely not. Hormone therapies do have long-term implications in terms of fertility and things like that. You could theoretically go on puberty blockers for quite a while, but at some point it becomes strange to be 25 and not have gone through puberty. We have had folks [for whom] going through puberty was really traumatic. It’s a consistent reminder; it makes you engage with the genitalia more. Getting to avoid that avoids a lot of trauma for folks, and it avoids surgery in the future, in terms of feminizing surgery or masculinizing surgery.

WHAT TYPES OF PEOPLE CONTACT YOU?

All different kinds. We have folks who are on Medicaid, we have folks who are really well off. We have folks who are Spanish-speaking only, we have folks who aren’t. We have a family who might be coming in from Hong Kong. We have folks of color, folks who are white. We have folks who are different ages. It just runs the gamut. And we have people coming in from all over the Midwest. Cleveland is far, but it’s a lot closer to come here than it is to go to Boston. Like anything else, it impacts everyone across the board.

WHEN WERE YOU PERSONALLY FIRST INTRODUCED TO GENDER NONCONFORMITY IN KIDS?

Working at Lurie was the first time I had interaction with transgender children, as far as I know. [But with] transgender children, it’s really hard to tell. I mean, I probably did [come into contact with them], and I just didn’t know it.

HOW DO YOU ENVISION YOUR FUTURE INVOLVEMENT WITH THIS PROJECT?

As the clinic grows, my involvement will also grow. We don’t really know exactly how big it will get. Things like the playgroup and parent support group that we’re starting, a year ago we didn’t know that we needed to do that. I think as the clinic grows, I’ll be in a position to do more outreach, so that more people know we’re a resource. People still have to do quite a bit of digging to find us, and I would like to make that not as hard.

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© 2012 Medill Equal Media Project
Medill School of Journalism | Northwestern University
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