Introduced as a comprehensive guide to the medical, emotional and social issues of transgendered children, this new book by Elijah C. Nealy provides a thorough introduction to issues in transgender health, regardless of age group. It goes on to identify and contextualise many of the pressing issues facing transgendered patients including harassment, physical violence, adverse employment status, HIV infection rates, inequitable access to medical care and high lifetime rates of mental illness. For a non-specialist audience, it surveys the social and cultural context of gender and identity, and provides a framework of understanding for all clinicians who may encounter transgendered patients.
The author's deeply personal introduction is an insight into the experience of growing up with, living with and ultimately embracing a gender identity that may not be readily understood by the world. There is a real sensitivity to patients and families who ‘struggle to understand everything or perhaps aren't entirely sure its truly OK to be transgender’. The author places his professional practice in the context of his own loss and a desire to help families and young people remain connected. This personal approach is used to invoke the reader's own experiences. He calls on us to reflect on our own gender identity, how this developed and the influence exerted by our family. He ultimately argues that such an approach encourages healthy exploration and discourages shame.
Much of the later sections' content is predicated on the reader providing specialist therapy to young transgendered people and their families. It provides an outline of the author's own practice, following roughly the phases of a young person's life (initial understanding, medical aspects of transition, establishing school and family supports, and ultimately making a transition to higher levels of education and work). Throughout there are brief prompts for reflection and vignettes drawn from clinical experience. The models of care, style of practice and resources are firmly rooted in North America.
There is much to be gained from a work such as this. It fundamentally humanises a population that has been long been pathologised. It presents a stark image of the damage that can be done to young transgendered individuals. More importantly, it stands as a positive framework to nurture young people and celebrate diversity in all its forms.
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