1. Transgender Parents: Legal, Clinical and Social Implications Clinical Elective: Advanced Study of Transgender Issues Spring 2011 Melissa Lawson Carla Smith

4. Legal Implications

5. Legal Loss of Custody Transgender parents may face the possibility of losing custody of their children According to TransParentcy.org No federal, state or local legal protections explicitly protecting Transgender Parents In previous cases: Transgender Parents have been denied complete contact with children Required to have supervised visits Dress and presentation was monitored by court while parent is interacting with children http://www.transparentcy.org/Custody-TransLegalRights.htm

6. Divorce Happens… But a divorce including a Trans parent may be treated differently Validity of marriage may be questioned, the validity of adoption may be considered Instead of focusing on children’s best interest, court may focus of the trans parent “Maybe transformed into a public nightmare in which the individual is forced to defend the authenticity of his or her gender in the face of relentless, brutal, and humiliating questions about the most intimate details of personal anatomy and sexual practices” (Flynn, 2003).

7. Case Examples Divorce of Michael and Linda in Florida (2002) Michael transitioned at age of 23 (SRS: hormone therapy, chest reconstruction, removal of F reproductive organs) Married Linda-informed her of trans status->legally adopted Linda’s son and had another son with alternative insemination Divorce was televised on court TV (duration: 3 ½ weeks) Michael and others were questioned about: appearance of his genitalia, his sexual capacity and practices, his ability to urinate standing up, and the details of his medical diagnosis and treatment as a trans person. Judge found Michael to be legally male, affirmed validity of marriage and granted him custody of both children (Flynn, 2003)

8. Case Studies April 2003- Divorce of Sterling S. and Jennifer Another case with similar facts resulted in OPPOSITE decision Sterling S. had SRS, lived as a man for more than 20 years Judge declared Sterling S. to be legally female, his 15 year marriage to his wife was INVALID and he was NOT a legal parent to their 10 year old son (Flynn, 2003)

9. Video Clip http://youtu.be/oNItDx4Md5U

10. Video Clip Although the clip was of a lesbian couple, it highlights some of the issues faced by gender-variant parents, social reactions, child reactions, and offers insight into the complexities involved in these custody cases.

11. Questions If this family were your client, how would you help them? What would the treatment goals be? What would you focus on first? Would you see them as a family or the couple and child separate? What challenges could you anticipate?

12. What can be done to Maintain Families? Educate the courts regarding clinical and research findings of transgender parents and effects of children Transgender parents engage children in counseling prior to and during transition- children’s questions can be addressed Help other parent place feelings (disappointment, loss, anger) into perspective of the benefits of child having contact with both parents http://www.transparentcy.org/Resources-Refs-TSChldrn-RGreen.htm

13. Research by Green, R. (n.d) Research does not support claims that Parents transgender directly negatively impacts the child HOWEVER There is extensive and clinical evidence that shows a disadvantage to children in when contact with one parents is terminated after a divorce http://www.transparentcy.org/Resources-Refs-TSChldrn-RGreen.htm

14. Factors that can Influence Custody Proceedings Although these factors do not always put the child’s best interest first, they are a reality of today’s courts Mental instability or incapability of parenting because of transgender identity Lawyers and assessing psychiatrists and psychologists have little info or experience with transgender issues (Israel, 1999)

15. Issues that Should be Brought Up These issues put the child’s best interest forward and does not place the parent’s trans status at the center of the attention Does the transgender or cross-dressing issue interrupt a parents ability to provide and care for the child? Is the parent psychologically stable? Also, a Gender Specialized Mental Health Declaration can be submitted to the court to help the trans parent and quicken the process (Israel, 1999)

16. Gender Specialized Mental Health Declaration What is it? Document written by expert in the field Approved by someone with legal writing experience Courts appreciate this because: Provide relevant review of situation Written in format and language recognizable to courts Body of document Attests to gender expert’s background Provides an overview of relevant information Contains references to academic writing which support the experts observation (Israel, 1999)

17. Clinical Implications

18. Ethics of Helping Transgender Adults Have Children There is currently not any evidence that suggests being born to and raised by a transgender parent causes the kind of harm that would justify excluding these individuals from having children (Murphy, 2010). Several Factors and Risks will be identified (Murphy, 2010)

19. Ethics of Helping Transgender Adults Have Children – Risk Factors Risks to the Pregnant Party Medical Risk to the Fetus or Child Psychological Risks to the Child and Family Wronged but not Harmed The Significance of Risk for Clinical Practice (Murphy, 2010)

20. Child’s Perspective Children from gay or lesbian families most often need help coping with the issues of anger and embarrassment. They may be angry with one or both of their parents or because of society’s perception and treatment of the family structure. Child’s belief that his peers will label them on the basis of his gay or lesbian parents.

22. Risks to the Pregnant Party Artificial Insemination risks: infection, cramping, puncture wounds, ovarian hyperstimulation syndrome, multiple conceptions Risks of pregnancy: ectopic pregnancy, hypertension, hemorrhage, infection Risks can be minimized and managed with clinical care NOTHING about these risks that pose more risks to the party simply because of their transgender status (Murphy, 2010)

23. Medical Risk to the Fetus or Child Individuals who use assisted reproductive treatments (ART’s) face risks of multiple pregnancies, certain risks to developmental and genetic disorders in children, and low birth weight Wide variety of individuals use ART’s- not just trans families Transgender Men face risk of exposing fetus to male hormone-> risks diminish if a washout period if held and the body is able to metabolize and excrete the hormone (Murphy, 2010)

24. Psychological Risks to the Child and Family Not a lot of research in this area The evidence that does exist does not show significant harm for the children Possible reasons Children of transgender parents do not know any other life and they adapt Protection from social stigma because their parents’ transgender identity may not be known to family outsiders (Murphy, 2010)

25. Wronged but not Harmed Some argue these children are “philosophically harmed” and children have the right to be born to opposite sex parents through intercourse Questions remain about the validity of wrong that does not produce signs of harm Based on religious, spiritual and philosophical beliefs (Murphy, 2010)

26. The Significance of Risk for Clinical Practice Clinicians have two options when asked to help transgender clients have children Decline because evidence regarding the safety of pregnancy in transgender men is lacking Accept because the evidence is lacking that shows helping these individuals is causing harm to anyone The knowable risks do not set this group of parents apart from all others It is unfair to require that transgender parents have children under ideal circumstances when people everywhere else are having children that involves risks to children (Murphy, 2010)

27. Conclusions Regarding Ethics Helping Transgender Adults have Children When in doubt, Clinicians should rely on the standards that guide their decisions to help prospective parents Whether the clients understand the nature and consequences of ART’s? Are the clients healthy enough to have children? Do they exhibit any psychological deficits that pose dangers to themselves and their children (Murphy, 2010)

28. Conclusions Regarding Ethics Helping Transgender Adults have Children Implications of GID and ethics of helping parents have children with “mental disorders” Will APA look back and consider GID in the DSM a mistake like Homosexuality? How does that affect those who want to have children now?(Murphy, 2010)

29. Social Implications

30. Social Implications Transgender Parents in the School Systems “Schools need to be better informed about these families, including the wide variety of family constellations they comprise, social obstacles they face, and reasons why a functional parent may be excluded or be invisible when the family presents itself” (Ryan & Martin, 2000)

31. Obstacles to Serving Sexual Minority-Parented Families’ Needs Prejudices and Beliefs School professionals and administrators may hold homophobic prejudices or religious beliefs that does not allow an atmosphere of acceptance Heterosexism Heterosexist assumptions can create a belief in these families being inferior Hesitancy Individuals who have biases may be unwilling to admit them and miss opportunities for education (Ryan & Martin, 2000)

32. Obstacles to Serving Sexual Minority-Parented Families’ Needs Anxiety People may experience anxiety regarding male and female gender roles Discomfort Discomfort around any notion that challenges the binary gender system Fear Fear of discomfort of discussing sexual material that they view as embarrassing, private or inappropriate to children. (Ryan & Martin, 2000)

33. Obstacles to Serving Sexual Minority-Parented Families’ Needs Fear of incompetency Fear that by opening up the discussion, they will be asked questions that they are not able to answer Discomfort Discomfort when discussing something new or something they have not discussed before (not sure what language to use or scared of offending someone) Lack of Resources Lack of information available to school personnel (Ryan & Martin, 2000)

34. Obstacles to Serving Sexual Minority-Parented Families’ Needs Fear of Retaliation May be concerned about backlash from other parents who are not trans friendly Administration Afraid of violating administration policy and not sure if the administration will support their choices and actions (Ryan & Martin, 2000)

35. Addressing the Needs of Families with Trans Parents Provide anti-bias training for school professionals Have specific education goals and topics. These issues are unique and complicated and should be taken seriously as well as structurally Address written administrative policy and procedures of the school in regards to gender, sexual orientation and diverse family constellations (Ryan & Martin, 2000)

36. Addressing the Needs of Families with Trans Parents Training in how to talk about these issues with children New curriculum for teaching family issues in the classroom Ongoing open discussion among and between professionals, and school parents so the anxieties, and concerns can be directly addressed (Ryan & Martin, 2000)

38. Resources

39. Resources for Trans Parents and their children COLAGE: People with a Lesbian Gay Bisexual Transgender or Queer Parent www.colage.org Family Equality Council: “Works at all levels of government to advance full social and legal equality on behalf of the approximately one million lesbian, gay, bisexual, and transgender families raising 2 million children” www.familyequality.org TransParentcy- information and resources for transgender parents and their children www.transparentcy.org

40. References Flynn, T. (2003). Protecting transgender families: strategies for advocates. Human Rights, 30(11), 11-23. Green, R. (n.d.) Transsexuals’ children. Transparentcy. Retrieved from http://www.transparentcy.org/Resources-Refs-TSChldrn- RGreen.htm Israel, G.E. (1999). Child Custody Issues for the Transgender Parent. Gianna Israel Gender Library. Retrieved from http://www.firelily.com/gender/gianna/custody.html Murphy, T.F. (2010). The ethic of helping transgender men and women have children. Perspectives in Biology and Medicine, 53(1), 46- 60. Ryan, D., & Martin, A. (2000). Lesbian, gay, bisexual, and transgender parents in the school systems. School Psychology Review, 29(2), 207-216