Gender Dysphoria in Adolescents

Gender dysphoria is a sense of unease that a person may have because of a mismatch between their sex assigned at birth and gender identity. In adolescence, especially around puberty when young teenagers’ bodies are changing, and they begin exploring their sexual and romantic identities, gender dysphoria typically increases around this time. Included below are some helpful definitions to include in discussions around gender dysphoria, a visual aid tool to discuss how someone may feel if they experience gender dysphoria, and helpful resources from transgender people talking about their gender identity.

Definitions to incorporate while discussing gender dysphoria:

  • Biological sex – label assigned at birth based on physical characteristics (e.g., chromosomes, hormones, and reproductive organs)
  • Primary sex characteristics – changes in the reproductive organs (males: growth of testes, penis, scrotum, and spermarche; females: growth of the uterus and menarche)
  • Secondary sex characteristics – visible physical changes that occur during puberty (males: broader shoulders, a lower voice; females: breast development, hips broaden)
  • Gender Expression – learned roles, behaviors, and actions of women/girls and men/boys (i.e., how society expects certain genders to act and look like)
  • Gender identity – our sense of who we are and how we see and describe ourselves
  • Transgender – people whose gender identity does not match their sex assigned at birth

*For clarification: based on your biological sex (what physical characteristics you are born with), society assigns you a gender (how you should act, what you should be interested, and your role in the world)*

Title: Gender Dysphoria. A single text box titled "What is it?" with the definition below: gender dysphoria is a sense of unease a person may feel when their gender identity does not match their biological sex. A single-column table titled "How you may feel:" In descending order: your gender identity conflicts with your biological sex, you are comfortable only when in the gender role of your preferred gender identity, a strong desire to hide or be rid of physical signs of your biological sex (e.g., breasts or facial hair), discomfort with your body or anatomy, and/or a preference for gendered clothing.

Helpful Resources:

Teen Vogue has an article discussing what it’s like to be transgender and living with gender dysphoria.

The Guardian also has an article where people who identify as transgender discuss their experience with exploring their gender identity. Although gender dysphoria is not the main focus, it is thoroughly discussed in the experiences of the transgender people featured.

This article from BuzzFeed includes people with disabilities exploring their gender identity and how it intersects with their disability. Gender dysphoria is mentioned, but the article mainly focuses on how society has created barriers for transgender people with disabilities. It would still be beneficial to use, as it brings attention to an often overlooked area of the disability and transgender community.

Accessible Mental Health Services

Accessible mental health services can be a challenge for people with disabilities, as there can be a lack of specialized provider training and difficulties with financial costs. We are defining accessibility in terms of disability and financial costs. This post provides a few mental health services for people with disabilities, with some services offering in-person services and others offering both in-person and online services.

Envision Unlimited

Mission Statement: “Envision Unlimited is a certified Community Mental Health Provider offering a full complement of behavioral health services to people with a variety of mental health concerns. We are committed to assisting clients in their best and meaningful lives.”

  • Offers outpatient therapy services to adults and adolescents, both in person and via telehealth
  • Based in Chicago, Illinois

Envision Unlimited emphasizes that no one will be denied access to services due to an inability to pay, and a discount is available.

There is also a program called ENVISION MORE for people with disabilities.

Title: ENVISION MORE. Year-long campaign to promote greater choice, independence, and inclusion for individuals with disabilities and mental health challenges. Provides comprehensive, high-quality services to help members "Envision More" of what they want in life. Box 1: More Ways to Thrive; Specialized programs like art-making, exploring nature, recovery-focused services, and cooking classes. Box 2: More Choice; Increased autonomy over daily life, such as personal living arrangements, community engagement, and hobbies. Box 3: More Independence and Inclusion; Assists members in becoming active participants in their communities. Box 4: More Support Services; Full spectrum of care on the community level, and includes day programs, employment services, mental health services, and specialized foster care. The logo for Envision Unlimited is in the upper right-hand corner.

NYSTART (New York Systemic, Therapeutic, Assessment Resources and Treatment)/CSIDD (Crisis Services for Individuals with Intellectual and/or Developmental Disabilities)

Goal: “…to build relationships and support across service systems to help people remain in their homes and communities and enhance the ability of the community to support them.”

  • Offers crisis prevention and response services to people who have both developmental disabilities and complex behavioral needs, as well as to their families and those who provide supports
  • Services are available 24 hours a day, 7 days a week to OPWDD (The New York State Office for People with Developmental Disabilities) eligible individuals age 6 and over who meet NYSTART/CSIDD eligibility
  • Based in New York, must be a New York resident 

The Arc

The Arc company logo.

Mission Statement: “Promoting and protecting the human rights of people with intellectual and developmental disabilities and actively supporting their full inclusion and participation in the community throughout their lifetimes.”

Delaware Disability Resources and Advocacy Organizations

  • All of the following services are based in Delaware

NAMI (National Alliance on Mental Illness)

Mission Statement: “NAMI Delaware supports, educates, and advocates for an improved quality of life for individuals and families affected by mental health conditions.”

  • Offers a variety of signature programs, an annual education conference, and special events (for individuals, families, and professionals to receive support and information)
  • Shapes public policy, has a toll-free NAMI Delaware Helpline, and works with media, educators, healthcare professionals, and elected and appointed officials (to raise awareness, fight stigma, and encourage understanding)
  • This link is for Delaware’s NAMI program, however, there are more than 650 NAMI State Organizations and Affiliates across the country

Division of Substance Abuse and Mental Health

Mission Statement: “To improve the quality of life for Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.”

  • Offers help for mental health issues (in which all services are free, and any referrals are available regardless of insurance), support groups and one-on-one counseling, suicide prevention resources, and other additional resources. 

Mental Health Association in Delaware

Mission Statement: “The Mental Health Association in Delaware strives to strengthen knowledge, resources and support around mental health and recovery.”

  • Offers education, support, and advocacy
  • Support: Offers wellness groups (one is a disability & chronic illness haven wellness group), mental health screening, and a peer support program with the mental health court (mental health court is available for people who have been charged with crimes because of a behavioral health disorder)

Guide to Romantic Boundaries

Red and white infographic: a how-to-guide for individuals with disabilities to navigate setting, recognizing, and respecting boundaries with their romantic partners.

We have created a how-to-guide for individuals with disabilities to navigate setting, recognizing, and respecting boundaries with their romantic partners.

The setting in which you touch someone matters. Do not touch someone without their consent. It is also important to give people time to open up about certain topics and give people time to put in effort into a relationship.

Recognizing that someone needs to be alone or is uncomfortable can take time to learn. If someone is not showing interest in a conversation, if they are giving short, snappy answers, or if someone is pulling away from gentle touches are all signs that someone may be uncomfortable or want to be left alone.

Respecting one another’s differing opinions is very important. Keep a discussion honest and open, and have mutual agreements on when and were to have certain conversations.

Finally, setting boundaries are important because you want to build trust in a relationship. This post includes an infographic that can support someone’s quest in finding and maintaining romantic relationships and boundaries.

To support teaching these concepts, we have created a presentation and lesson plan that are free to use.

Open Future Learning

Open Future Learning is a company that offers a wide variety of online training for staff, or anyone else working with individuals with disabilities. They offer modules in abuse prevention, communication, advocacy, and many more topics. They have staff training modules, 30 minute programs, and an audio learning module. Membership can range from $112-$2263 per month, depending on the amount of active users. Linked below is Open Future’s Homepage.

https://www.openfuturelearning.org/index.cfm?fuseaction=login.home

Sex Ed Rescue

Properly educating children on sex, puberty, and many other related topics can be challenging for parents. Many parents struggle with how they should speak to their child about these topics, and when the time is right. Sex Ed Rescue is a YouTube channel designed to educate parents on how to talk to their kids about these topics. This channel includes instructional videos, Q&A’s, children’s book reviews, and many other educational resources. It is a great resource to help parents educate their children on sex. It also helps to create a more age-appropriate environment for the child, and encourages comfortable communication between the child and the parent.

Linked below is the channel’s introduction video and the channel’s homepage.

Sex Ed Rescue: Homepage

Elevatus Training: Online and In-Person Training to be a Sexuality Educator

Elevatus offers a variety trainings staff, direct support professionals, educators, self-advocates and parents to teach sexuality education to children and adults with developmental disabilities. In addition to their trainings, Elevatus has a sex education curriculum that can be purchased.

Here are examples of some of their trainings and the costs:

  • For Staff and Professionals – Developmental Disabilities and Sexuality 101 ($397)
  • For Parents/Guardians – Talking With Your Kids: Developmental Disability and Sexuality ($47)
  • In-service/live workshops and a 3-Day Certificate Training ($725) for anyone who wants to lead sexuality education classes with people with developmental disabilities.

To get more information about Elevatus Training:-https://www.elevatustraining.com/

Friendship & Dating Program: Helping Children and Adults to Acquire Relationship Skills

The Friendships & Dating Program (FDP) offers inclusive teaching plans for individuals with intellectual and developmental disabilities. A unique aspect of this program is its emphasis on preventing interpersonal violence. There is a version of this program for youth with serious emotional disturbance. The FDP focuses on skill development through experimental learning and group activities with an interactive 10-week curricular plan. Interested groups can purchase the curriculum on its own ($600) or purchase the curriculum in combination with a train the trainer support provided live online ($1,800). You can find more information about the FDP from the below link. Some module illustrations are available on the website.

https://www.fdprogram.org/

More Info. Less Weird. AMAZE Takes the Awkward Out of Sex Ed

These days, it is hard to find an age appropriate content about sex, dating and abuse. Children have questions about their bodies, gender and reproduction. Teenagers worry if their bodies are developing normally or not while older adolescents struggle with peer pressure, changing relationships and emerging sexual feelings. AMAZE is an amazing website for parents and educators which helps them to expose their child to age appropriate content about sex through short videos. The website provides an insight to young people to successfully understand puberty, healthy body image, distinguish between healthy and unhealthy relationships, concepts of consent and mutual respect. Video topics are designed to meet the learning objectives outlined in the National Sexuality Education Standards.

Parents are the primary sexual educators of their children. By answering children’s questions, a parent let them know that you are “askable” and establishes an open line of communication that will serve you and your children well as they mature into sexually healthy young adults.

AMAZE also has resources for younger children like the parents’ playlist from amaze jr. It is designed to help parents become comfortable and confident talking to their children openly and honestly at any age.

https://amaze.org/

There are some videos for parents reference.

This video will help parents to know when to talk about sexuality with their kids.

Do you think so playing “doctor – doctor” is safe or not? Check this video out which helps you to communicate your thinking and others about this game.

This video will model to the adolescents with disabilities to learn about manage their relationships with person they like or have attractions. This video guide them to deal with peer pressure and make healthy relationship.

This video helps your child to understand their body parts, difference between a male and female, and similarities between boy and girl.

https://youtu.be/wW627gpkWbw

Guest Room

Guest Room is a short film Written & Directed by Joshua Tate and starring Lauren Potter (“Glee”) and Michael Iovine.  It won the Audience Award (Competition Short) at SXSW 2015.

I think you are going to love this movie.  It’s beautiful, emotional, and honest.  I could easily see this being used in a human sexuality classroom to help discuss parenting, consent, and support from families.  It follows the story of a young couple who are faced in a situation many young couples find themselves in, an unexpected pregnancy.  Like many young couples, the response of their families  is shock and disappointment and this makes it difficult to determine their own feelings, hopes, and wants.

There was one statistic that was mentioned in the film that I had not heard before.  It said that a women with Down Syndrome has a 50% chance of having a child with Down Syndrome.  I did a little digging to see if I could find out more and received some help from The Tech Geneticist a  project from the University of Stanford which seeks to increase the public understanding of genetics.  About half of the eggs of a women with Down Syndrome will have an extra 21st chromosome (similar to what is described in this post http://genetics.thetech.org/ask/ask296).  Her actual chance of having a child with Down Syndrome is less than 50% because fetuses with extra 21st chromosomes are at increased risk of complications.  According to the National Down Syndrome Society only about 50% of women with Down Syndrome are fertile (ovulate).

It’s trickier when it comes to thinking about the father.  Much less is known about the heritability (chance of passing a genetic trait on) of Down Syndrome for men with Down Syndrome, but it may be that their sperm that carry two 21st chromosomes would be less viable than their sperm that only have one.  Both the Tech Geneticist and the National Down Syndrome Society suggested men with Down Syndrome seem to have much lower fertility rates than their same age peers with two 21st chromosomes.

Autism in Love

The 1 hour and 13 minute movie, Autism in Love, is about falling in love, wanting to fall in love, the struggle of understanding love, and heartbreak. More than that, this movie is about what it means to be autistic, how love shapes identity, and the support of family. There are multiple viewing options but it is currently airing for free on Independent Lens.  It follows the stories of four individuals on the autism spectrum as they navigate issues of love and relationships.

Here is a guide for using the film as a teaching tool: Autism in Love Viewing Guide

This movie is more geared toward adults as the youngest person featured in the film is in his early 20s and much of the film centers on marriage. If you were working with older teens, you may want to focus on Lenny.