Rethinking Gender Boundaries

Rethinking Gender Boundaries


The team of professionals at the Oakland gender center, with Ivy Aslan and Diane Ehrensaft in front.

UCSF Benioff Children’s Hospital expands gender center services to Oakland, spreading awareness for gender-expansive kids.

Twelve-year-old Chanel likes watching Disney movies, baking cupcakes, and going on sleepovers. Her favorite places to shop are Justice, for the trendy tween styles, and Claire’s, for the earrings. She loves to draw, especially girls in skirts, dresses, boots, and heels that she designs. When you meet Chanel, what you find is a shy, sweet, well-adjusted girl, but this wasn’t always the case.

Chanel (not her real name) was born a healthy baby boy in 2004. Lori and John (also pseudonyms) began fostering the baby boy at 5 months and adopted him three years later. (Chanel changed her birth name, a boy’s name, legally in 2014.) “As soon as Chanel could crawl, she went right for the girls’ toys, the dolls,” John said. At 3, Chanel became fascinated with mermaids, fairies, and princesses and wanted to dress in girls’ clothes. “It was about that time that she would correct me and tell me that she was a girl,” Lori said. By 4, he rejected anything that was boyish, such as short haircuts and boy’s underwear, and was prone to angry outbursts. Then Lori saw a talk show about a family that had a transgender child. “We had never heard of transgender,” Lori said. “It was as if they were telling our son’s story.” Between second and third grades, Chanel informed her parents that she was going to go to school as a girl the next year. Lori and John agreed. That summer, she changed her name and wardrobe and grew her hair long. “Her whole nature transformed overnight,” said John. “She was calm and happy, all of the frustration melted away.”

Diane Ehrensaft is a Bay Area developmental and clinical psychologist, author, and expert on gender nonconforming and transgender children who has been a gender specialist for 40 years. She describes children like Chanel as “gender creative.” A child may be transgender, like Chanel, in that he or she identifies as a boy, a girl, or mixture of gender, but not the same as the sex listed on the birth certificate. Or the child may fall somewhere else on the gender spectrum not fitting squarely in the standard male or female checkboxes. Some of these children prefer gender-neutral pronouns and to be called they instead of he or she.

To support these gender-expansive children—kids pushing the traditional gender boundaries—in the East Bay to get the specialized health care resources they need, Dr. Ivy Aslan, a pediatric endocrinologist and clinical professor of pediatrics at UCSF Benioff Children’s Hospital, and a multidisciplinary team including Ehrensaft, launched the Child and Adolescent Gender Center at the Oakland campus of Children’s in September. The gender center is an outgrowth and sister program of the Child and Adolescent Gender Center at Children’s in San Francisco, which has been operating for several years and now has gender clinics in Mission Bay and San Mateo as well. For John and Lori, who had been making the often three-hour-plus round trip from their East Bay home to the gender clinic in San Francisco since Chanel was 8, the Oakland-based gender center makes life a lot easier.

In the past year, the number of patients tripled at the gender clinic at Children’s in San Francisco, which treats Bay Area patients, said Ehrensaft. It now has 425 active patients, she added. Aslan said the 35 pediatric gender centers she knows of nationwide are growing quickly.

The goals of the gender center at Children’s in Oakland are to provide its patients and families with the psychological and medical support that they need, give legal advice, and help families navigate the insurance system. Another important goal is educating local pediatricians about gender issues. Appointments at Oakland’s gender clinic are already full, and so Aslan expects to expand the number of clinic days soon. On the medical front, clinic patients may take puberty blockers to stop the onset of puberty and give the child and family time to consider next steps. After that, when indicated, hormone replacement therapy may be given to transition the youth’s body to be more like the gender he or she identifies with.

Chanel started puberty blockers, which were covered by Medi-Cal (but not without a fight) at age 10—first shots, then an implant. Six months ago, she began taking an estrogen supplement. “That was a happy day for her,” said her father. When asked why, Chanel responded softly with a smile, “Boobs.” Now in seventh grade, Chanel said she dreams of becoming a fashion designer and traveling to New York and Paris one day. She has no plans for marriage at this point, but she wants to have at least one child, a girl. She thinks maybe she will adopt.

For parents who want more information about the gender center at Children’s in Oakland, contact Juliet Gervacio, 510-428-3654.


Published online on Dec. 8, 2016 at 7:00 a.m.