This is KPBS Midday Edition I am Maureen Cavanaugh How early should young person questioning gender identity begin a transition? In our discussion last week with Dr. Meyer Markovich from waiting children's gender management clinic there is no medical consensus yet on that question. Hopefully with more research and in future years, will have better answers. What is the ideal time? It's silly not same for every patient. We have to understand that families are not at the same level of acceptance and times oftentimes, child is the one pushing parents are holding back because they're just not ready. 10 people and their families have to decide what's best for them. That's just what my next test have done. Kathy look at her son Sam are from Rancho Pineda. Or to know Sam was born female was the first patient and the gender clinic. To getting us to talk about the questions they had, the decisions they make, and what life is like now. Kathy and Sam, welcome. Let's start from the beginning, you were born a girl, and your adopted when you're just two months old. To the memory of the first time you felt there was something wrong about being a girl. I always knew it from a young age. I didn't know how to adjust it. It was, I'm a boy but at the young age of three or four, I never had the words to say it. It must be very difficult to describe. Can you help us figure out what kind of healing that you had. Was it this was just not right? Yes. It was mainly something is different about me. I'm supposed to be a boy, why can I not be one? It was just confusing. It took a while. Did that Billy grew as you got older? Yes. Very much. I did it affect you at school? That wasn't an issue because I'm homeschooled. Then with your friends? With my friends, I assumed they thought I was a tomboy and I stayed that way for a very long time. They never had any issues, they would say Sam is a girl who acts like a boy, that is okay. What does it mean to you to be a boy? I know that's a weird question Can you give us an idea? Dean born female, getting to have the biggest wish in my life come true, it was -- I woke up and thought -- I get up in the morning and I'm happy. I can be proud of who I am and that's how it always should be. Kathy, what did you first think when Sam started saying he was a boy? Very early age, we allowed them to express himself and the went with, he's a timely. Including, in choice of toys, and types of play, it wasn't until puberty hits started changing his body that he became extremely depressed and anxious, refusing to leave the house, having hour-long crying fits the It took us a couple of years to figure out what was going on He didn't have the words that many other trans kids have to say but I'm a boy. It wasn't in his way of thinking. When it was introduced that there is a thing called trans gender, what did he shop the rooftops that finally gets to be who he knew he is the While this behavior was going on, while Sam was being accepted as a tomboy, through his formative years, to ever have concerns about that? Did you ever look at that and say this is Tim gets a phase? We had concerns, not until the depression hit. Up until that point, he seemed like a happy kid and he was because his allowed to express himself as he saw himself. It wasn't until the changes in the body started changing that it caused him to be hashtag become more distressed. That's when I sought professional help and the only thing I could get wrapped around was there a gender issues. I didn't know the term transgender at that point. That we bring in a gender third -- therapist to our conversation. Thank you. There lots of little girls who want to play with trucks and countries and their little boys who play with dolls and make cookies. How is gender dysphoria determined? Is it determined by these types of behaviors? No. We talk about those behaviors, that's gender expression. If there's interest our way of liking to dress or the type of peers you choose to play with, that's on the spectrum of gender expression. Everyone is different. When it turns into an identity thing and it causes distress, that's when it looks more like gender dysphoria. How does this distress manifest itself? Is different for every child. They told lineup with the boys or girls and very uncomfortable, they can put their down and say I don't belong in that line the Otherwise, it can look from bathroom heavier, sitting or standing to go to the bathroom, or pronouns, being called a brother or sister or he or she, kids really explained to lead to their parents. Sam, can you describe -- you would get really depressed and have bouts of depression. Can you tell us what was prompting, white to fill such deep oppression? Like she said, it happened when puberty hits. That's hard on any teenager or preteen around my age. That was typical. My first thought was why is this happening to me? I thought I was being punished or something. I knew at that age, puberty starts but, I didn't feel I was growing up. I felt I was being held like and it sucked. [ Laughter ] Around the edges, did you build this change your body was going through was going to force you into a certain identity that you didn't want? I knew that purity is having belong to me. I thought guys don't grow rests, I'm a guy, why do I have been asked That was confusing for me because as arty on the edge and that didn't help. I'm wondering, Kathy is interesting because you are on familiar with trans gender at the time he brought Sam in to discuss the problems he was going through. What did you think was going on? I wasn't sure. Sam had a rough start with being born to homeless alcoholic. A lot of the things we saw happening with his anxiety and depression, we treated it to that's was going on. In the intake with the psychiatrist, the first time it was here's a larger list of things we happened to his entire life. This 11 at the time. At the end of the intake, I said there's some kind of gender issue going on. It was the psychiatrist who said I just read this paper from the AMA that entered chronologies are doing work to block comments A.B. should read that paper to As major direction to this is what's going on. The more research I did, the more I realized those explaining what was happening for Sam. Last week we spoke with two endocrinologists. They told us they didn't diagnose the patients were referred to them. Do you as a therapist have some markers that you look for the patients, to you that make you say to yourself this could be a case of transit gender and not just a means or smothered depressive kind of elements that a child is going to pick a I keep tabs on the distress being expressed. Usually it comes after a long period of asserting themselves as the opposite sex and opposite gender. Feeling there's so much distress being called to sign sex at birth. Is not just a phase working to dress a certain way, it's an identity unless it's addressed is going to be very distressing or child. Have you ever encountered a patient's that was suspected of having transgender issues and turned out I was not the case? Becca I don't think anything is -- I took the gets quite that definitive. You can let it play out as well. I encourage parents to follow the lead of the child and to what the child is saying they need a matter with stage. Every child is not raised to assert themselves that they need change or they are just unsure of themselves. Parents can wait and see what happens with that. It's not like a yes or no question. Sam was the first patient at the gender management clinic to go how did you come to the decision was time to begin the transition? Working with a therapist and educating myself through the Internet, support groups, people in other parts of the country that have been working with transit kids. I called up with each other before they had their measuring climate. I would know with all guns blazing, bleeding is going to have to really like to get my son that she needed. About five minutes into the equipment, Dr. looked up and said, you're going to be your guns away we will sit down have a different conversation because, humidity and 74 years old and even the heat was understanding there are some medical treatments those going to be necessary and he helped us. I went to get the medical committee on board but he helped us with the insurance company to be able to get the coverage and treatment of Sam needed covered. Sam is still pretty young. What does gender transition meeting at this young age? Is it all spectrum from name change to the hormone blockers? Their social transition where the environment, family school is things like that will change name and program that's used to Changing clothing for Sam we didn't have the clothing change because he was already dressing that way. We had the pronoun change. He has had a legal name change and illegal change of gender mark on his birth certificate. Medically, at his age, he start with hormone locker which simply just stops the puberty that was happening in his body and then add a further age when it's right and appropriate, you start the cross hormones easily go through pretty of their gender identity Sam, what has this been like for you? You got -- a legal process, your name is being changed legally, that getting hormones or blocker medication. Are there any side effects or is it all good? It's all good. I haven't had issues with anything and has been smooth from here to Any as our family put up some blockage? Mostly everyone has been accepting to go I haven't received a lot of negativity. Darleen, do trans kids find easier or more difficult when they begin their transition? I feel they find it much easier. It's a huge relief and they are ready to go and live their life and be happy and be free. A lot of times the parents are the ones who are logistically working things in the background with name change and insurance coming out to family and explaining things. The child usually has it pretty good I know many transgender young teens and younger go through a great deal of depression as you were talking about. Some commit suicide. One of Sam's good trends committed suicide, another transgendered teen. Did that prompt you in any way to move forward as strongly as you have on this? I don't know that it prompted me. I have an fully supportive of my son from day one. And the other chance youth within our community and their families. I think if anything, it's about educating our community for acceptance. It's not just our kids that are out there and they are being bullied or teased or having a hard time, it's all the families that have to deal with it whether it apparently trans youth was afraid to tell her employer because they don't know what the ramifications are going to be. The more we can educate the community at large, the safer this place is for all of our amylase. -- All of our families. I have a non-profit called trans family support systems. It is a journey because there are -- you start at different levels depending on the age of your child and acceptance. Every family's journey is unique in many different things at different times pick a Sam, where are you on this journey? Right now, I wouldn't say it's the end of the journey, it's at the end of the fighting things are starting to calm down and I don't have to be concerned about anything anymore. What would you like the public to know? The kids having a harder time then you pick out you have supportive mother, you got this pretty well in hand at this point pick a Which is like the public to do about whether other transgendered teens like you race? Their struggles. The best thing you can do is be honest with the people around you. Find the best support you can think it's better. Words into and on. -- Words to and on. I want to thank Salmon's mom agenda therapist.
Sam Moehlig’s 11th birthday was unlike any he had before.
It was the first time he was addressed as a boy.
Sam, who was assigned female at birth, had battled depression and anxiety over gender identity struggles.
The Rancho Bernardo teen is now 14. He was the first patient to go through Rady Children’s Gender Management Clinic, and after years of taking hormone blockers, the Moehlig family feels it is time for Sam to take the next step in his gender transition.
“I always knew it from a young age — it was ‘I’m a boy’ but I never had the words to say it,” Sam told KPBS Midday Edition on Tuesday. “It was just confusing.”
It was confusing for his parents too.
Kathie Moehlig, Sam's mom, said her son became depressed when he began going through puberty.
RELATED: Clinic Helps San Diego Transgender Youth
“He became extremely depressed and anxious,” said Kathie Moehlig who is starting a nonprofit to help other families. “It took us a couple of years to figure out what was going on.”
But when Sam was introduced to the process of changing his gender — he was able to be himself.
“I woke up one morning and I was happy,” Sam said. “I could be proud of who I am.”
The age as to when to change one’s gender is ultimately dependent on each person, said Maya Marinkovich, an endocrinologist from Rady Children's Gender Management Clinic.
“Hopefully with more research and in future years, we’ll have better answers what is the ideal time,” Marinkovich told KPBS Midday Edition last week. “It’s certainly not the same for every patient. We have to understand that families are not at the same level of acceptance, and sometimes, often times, the child is the one pushing and parents are holding because they’re just not ready."
On Wednesday, Midday Edition will interview Vicki Estrada, a woman who came out about her transgender journey 10 years ago in an interview with Tom Fudge on "These Days.”
