Free Falling

It's been a good run. Over 45 years. It all came to an end quite accidentally, when my mother found one of my business cards for my consulting company, Excellence in Transgender Care (E.I.T.C.) that also has my picture and my last name. There was no mistaking that this was me.  She found this on Monday, and called Patty Tuesday to ask about it. She hadn't been able to sleep that night and was crying while she spoke to my wife on Tuesday. Patty reassured her that she and I are fine, that she is OK with me and she knew about me and that I had a lot of support from my own therapist Dana. 

Patty called me at work and told me to sit down, she had bad news for me and told me what had happened. I was not really prepared to hear this, but was able to continue to be professional and see my last three patients, without any clue that I was upset about this development. It was not the way I would have chosen for my parents to find this out about me and, in fact, have been working in my own therapy on how to go about informing them specifically.

This was also Valentines Day. I had brought cards for Patty from me and the dogs and cats (they each sent a card to her), and I had a card from both of us to Mama. Patty suggested I call her and see if she wanted to talk, but I felt that it would be best to do this on the weekend when I could talk to her alone and without my father who suffers from moderate dementia.

I did want to take her the card from us I had gotten and asked Patty to go with me. I waited a bit to settle down and then called and asked if I could bring her card up to her. She began to cry and told me no. So there was an awkward  silence as I was actually quite stunned that she would not just want me to bring her card to her. So I just said goodbye and told her I loved her. She just said "Ok" and I hung up.

My heart was broken of course over this turn of events. In my two worlds, having worked with families of transgender patients for years, I know how often this scenario ends badly, but often it can work out very well too. The key to a positive outcome seems to lie in allowing parents to work out the emotional trauma that comes along with an unexpected discovery. It's so hard for a parent to realize that they thought they knew this child of theirs who they raised and launched and seen their successes and failures in life, only to discover they really didn't know such an important part of who their child is. They wonder if they ever really knew this child at all. Make no mistake, this is a tremendous loss for most parents and they deserve compassion in order to make sense of this and regain the wholeness of their relationship with their child, if at all possible.

Now they begin the grieving process and go through the stages of grief that Elizabeth Kubler- Ross defined in the late 1970's. In her seminal work, she out lines this process as:         

1. Shock and Denial: Sometimes this manifests as a feeling of surrealism or a factual belief that what is happening isn't or that it can't be true.

2. Anger: This can be directed towards the person or situation that created the perception of  loss, whether it is a death, the loss of an ideal, or can just be a feeling about the situation that really isn't attached to any specific aspect that the person can identify.

3. Bargaining: This can be seen in situations where the person attempts to strike a deal in an attempt to make the painful situation go away and is closely related to the denial process.

4. Depression: During this stage, the process involves losing the cherished ideal of someone or of a situation and despair sets in. In this situation, my parents will never see me again as they once had and are experiencing the loss in an exquisitely painful way. Sometimes people are never able to move past this process in their grief.

5. Acceptance: This comes about when the person is able to reconcile themself to this new concept of how things will be from here on out. It is the healing that comes about from moving through this process and being willing to create a new relationship with the person in the situation. Again, some people are never able to achieve this resolution of what has occurred.

We have to be mindful that people will often move back and forth between these stages as a part of their grieving and that is quite normal. Sometimes people skip some stages and others may never even resolve the first state of this process.

We also must be mindful that people resolve their grief not on our time frame, but their own and we need to be sensitive to that.

When one comes out to someone with such a close relationship, especially not at the time and field of our choosing, we also go through this process. It would be nice to be able to say, "Well OK, it's done and over", but that isn't reality for most of us in these situations. We need to find as much support as we can find for ourselves during this time and we need to really do a super job of taking care of ourselves. That means we need to pay careful attention to our nutrition, don't skip meals even if you don't want to eat. If you can't eat very much, please be sure to supplement with vitamins, especially B vitamins, as they are rapidly depleted when one is going through a crisis. Getting the proper rest is crucial and if one isn't able to sleep, I would advise you to seek medical help because if you can't get your sleep hygiene right, nothing else is going to get better very quickly.

One of the things that is helping me is the tremendous outpouring of love and support I am getting from you, my readers and from members of the transgender community across the country. Please know that I am greatly comforted by this and I'm so grateful and also humbled that there are so many people who care about me. I'm also fortunate to have Patty to lean on and my professional friends and colleagues here who know about me at my hospital. I also am getting tremendous Pastoral care from the clergy of my church who are in daily contact, and of course, Dana too.

I am realistic about this situation. It will be resolved one way or another. While my experience is that many times there are sad and even tragic outcomes with family members, there are many many very happy outcomes as well, even though the process to get there seems bleak at times before it works out successfully and I've learned from my practice that this may take a long time to occur.

Although I am in tremendous emotional pain at the moment, I do know that I will be OK and that what ever way this works out, it will be for the best and my life will be better.  That's the thing about my walk through these two worlds; while I am a well seasoned therapist and have worked with people on these situations, having lived it myself makes me an infinitely better psychotherapist, and all my patients will benefit from this experience, not just my transgender patients. It's one of the gifts I'm being given.