In traditional Navaho culture, individuals with the physical or behavioral features of both genders are considered “two-spirited” and often arbitrate in marriage disputes because they’re trusted to see both sides of the story. In the broader American culture, though, identifying with a gender different from the one assigned at birth—what we call transgender—is not fully understood or accepted.
That’s changing—slowly. Recent cultural developments—including the rise of transgender characters in TV shows such as “Orange is the New Black” and “Transparent” and the high-profile transitions of celebrities like Bruce Jenner, who is being interviewed by Diane Sawyer on ABC’s 20/20—have brought about a heightened interest and awareness of the transgender population and their journey towards acceptance.
That journey can be especially challenging for transgender teens and young adults, a population with a startlingly high rate of suicide attempts and mental health struggles. We sat down to learn more about transgender youth and adults from one of the leaders in the field, endocrinologist Norman P. Spack, MD, co-director (with Urologist-in-Chief David A. Diamond, MD) of the Gender Management Service (GeMS) program at Boston Children’s Hospital—the first of its kind in the nation.