A sharing by D Gowri
What is more difficult? Accepting your child for what they are or burying them because you couldn’t?
——Anonymous
Alvin
Alvin was a shy sixteen- year- old. I had been his family doctor all his life. His mother brought him one day, saying doctor, something is wrong with his mind. What followed was a long conversation with Alvin alone.
Alvin described a long-standing, intense dislike of the physical signs of his maleness and an instinctive comfort in the gender role of a female. His friends thought he was queer and he felt low, frustrated, and anxious. His school performance had suffered and his parents were at their wits’ end when his mother brought him to me.
His mother did not accept my provisional diagnosis of a gender dysphoria, but she eventually agreed to my referring her son to the psychiatrist. As he left my room, Alvin turned back, gave me a swift smile, and said, thank you so much.
Commentary
Being gender diverse is not a mental health problem. However, children and teenagers with gender identity issues often have mental health concerns, evidenced by higher rates of depression, anxiety, self harm, and suicide attempts. A supportive family and school environment can help protect young people and improve mental health outcomes.
The picture shows the inner turmoil of a young man trapped in his biological body, and the peace, happiness, and triumph over fear when he is a “woman”. This pretty much sums up what people with gender dysphoria feel. They are not becoming another person. They are already who they are. They just want their body to reflect what they have always been.
I can’t help thinking that in situations such as Alvin’s, acceptance must come from parents first. Among the many sources of tension and distress between Alvin and his parents, the fact that he may not fit society’s — and his family’s — expectations for his assigned gender is perhaps the greatest and hardest to accept.
Dr D. Gowri is a family physician with additional duties in care integration. In her spare time, she enjoys listening to others, having deep conversations, learning, and occasionally having some time alone.
The commentary and the vignette were reproduced with permission from the book “Being Human, Stories from Family Medicine” edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore. Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by A Prof Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
