Sunday, September 25, 2011

Natalia, my daughter, was only six years old when she came running home from school one day, eager to tell me what she had just learned in art class. I was in my early thirties at the time. I'd had her when I was twenty-two and then graduated from med school as a doctor at twenty-four, with her and my son in tow. So when she told me this story, I was a young mom as well as a young doctor training in psychiatry at the time.

Natalia was so excited, she didn't have enough breath to tell me everything that had happened to her in the one minute she got to me. It was odd for her to be so thrilled, almost agitated by whatever she had to tell me.

Her excitement suddenly made sense when she told me she had learned about Vincent Van Gogh and his amazing story. She loved his art, but wow, what a story she had to tell about his personal life! Almost immediately after talking about his art, she blurted out: "You know, Mom? He cut off his ear and then he killed himself."

I was in shock. This statement was obviously the core of her agitation. I continued to listen and asked her to tell me the rest of what she learned about him. She did in much detail, particularly focusing on why he cut his ear—he was hearing voices—and that he had killed himself. I just listened.

I called the art teacher the next day and asked her what had led her to share Van Gogh's entire story with a room full of six-year-olds. I realized immediately I wasn't the first parent to contact her. She was in attack mode, defending her decision. My main question for her was why would she reveal Van Gogh's mental illness and suicide without discussing her intentions with the parents, given the kids' young age and the sensitivity around suicide.

She arrogantly said she was a teacher and, as such, she had an obligation to teach the kids the truth.

After letting her lecture me, I calmly said: "So, did you also tell the kids that Van Gogh was rumored to be homosexual and in love with Gauguin?"

There was deadly silence on the other line. I calmly continued:

"Just like you believe six-year-old children are young to understand sexuality issues and homosexuality, parents may want to be ready to discuss suicide with the little ones."

I had never discussed suicide nor sexuality issues with my children at that age, even though I dealt with patients struggling with suicide or homicidal ideation in my work. My husband and I had always had great relationships with gay friends and family members, but we decided that our kids weren't read to discuss sexuality issues yet.

Years later, a similar situation occurred in home when my children were in their mid-teens. I was now a specialty-trained psychiatrist and my husband was a specialty-trained neurologist. Two good friends, also physicians and surgeons, came home for dinner and brought a colleague as a guest. Christine was welcome, a beautiful surgeon-in-training. I immediately noticed there was something a bit odd about her looks. From the front, she looked every inch the lovely woman she is. From behind, her shoulders and back were broad, like a man's. Beth, my surgeon friend, prompted Natalia to say what she thought about Christine. Natalia shyly said Christine struck her as being kind and lovely, but she also sensed there was something odd—she used the word "creepy" at the time, to our surprise. What was "creepy" to Natalia was probably that Beth was setting her up to try to figure out something obviously different about Christine, who was sitting right next to her.

As the conversation evolved, my husband and teenage son, Marcos, joined us around the table as we heard Chris' story. Chris had been born a man and was in the process of transforming into a woman. Calm and composed, she told us her life story and we listened, awed. We had a lovely dinner and Chris left us a tape, a television show that described her life before being Christine and now.

My kids couldn't wait to watch the documentary. After our guests left, the four of us watched her story around the television set, and afterwards we talked about what we thought. Growing up with strong best friends, her story outlined her career as an outstanding (male) flight surgeon in support of NASA, her love life before and after making the decision to transform, and interviews with family members, friends, and previous wives. Today, Dr. Christine McGinn is a renowned surgeon whose expertise is transgender transformations.

I was thankful to have been involved in this learning experience with my kids this time. The reality for my family is that sharing dinner with someone extraordinary is an ordinary event. As such, I need to be prepared to talk to them about many subjects, since we meet many interesting people. Parents need to be ready to discuss matters that they find sensitive. Contrary to Dr. Ablow's unfortunate statement (should I use Lewis Black's assessment?) in a recent interview on Fox with Dr. Ablow, kids will not want to be transgender just because they will find out that you can have hormone treatments and surgeries to transform into the other gender. When, as physicians, we make public appearances in the media, we need to ensure we are knowledgeable about medical and psychological matters without forcing our own judgment. An expert in transgender issues, Dr. Drescher beautifully describes scientific facts around transgender issues. Ignorance and bias are dangerous tools in the expert's hands because of the power we have in shaping public opinion. Dr. Ablow should have said that parents should be ready to openly listen and discuss these matters with their children without judgment. If the kid is already wondering about his or her own gender and has fantasized about changing, then watching someone talk about how he or she made their transformation will only make up the kid's mind. By judging others who have transformed, you are only forcing your own children to live a lie and suffer in solitude.