18 & Trans
By James Mullinger

Jack was born misgendered in the year 2001. Aged 16, he applied for gender-confirming surgery but was declined because he was not 18 years old. Being told by your elected officials that you can’t be who you are would break some people. Not Jack.

He vowed to make a difference.

This is his story.

Photographs By Denis Duquette

Jack’s story is a powerful one. And an inspiring one. And possibly — for people who struggle to understand what it is like to be born a different gender — an educational one.

But know this. Being told you can’t be who you are is a heartbreaking ordeal.

I have known Jack’s parents socially and professionally for five years. They are wonderful, intelligent, kind and loving people. Only recently did I learn of the plight of their son. They have been supportive and strong for Jack. But what surprised me most was how positive they have all remained as a family.

Over lobster rolls at Isaac’s Way restaurant in Fredericton, New Brunswick, I ask Jack how he has stayed positive, even when he was denied the surgery that he needed to be himself. “It was so hard to hear that I knew I had to work hard to not fall into a very dark place. For me it's easier to be more on the positive side of things, especially when people around me are being negative. Even before we applied, I was expecting the outcome, but I still had hope, and I think that is important. But it was still a letdown. I think now I understand that I can't do anything about it. It happened, and I can move on from it.”

Jack is very clear on what needs to change. “It is very important to recognize the trans* community here in Fredericton,” he states. “People have been trying to make changes, which is really good, but changes like this really come slowly here. I think making decisions case by case is super important because to judge a group of people based on their age is wrong, especially with changing maturity levels. I think that one of the big things in having an age barrier is not believing that we are ready to make that decision. It is a big decision and I understand that. But this is something that a lot of trans* people think about for a very long time, even before they can talk about it or ask for help. I think that taking it case by case, following the standards of care more closely, is the best thing to do. I understand that is time-consuming and more expensive, but it is more important to see the human side of things.”

Not all parents are as supportive as Jack’s. The high rate of homelessness and suicide amongst trans* teenagers is testament to this. “Providing a safe space is incredibly important for any kid. In any situation, not just in the trans* experience,” he says. “I was super lucky to have cool people who helped me through everything. They fought along with me. Being supportive of your child in any situation is super important. So is being open to things and helping them when they need it, taking their worries seriously and never brushing them aside, even if it's a small phase of their life. It is so rough. Especially if you were already going through a hard time, especially if you're trying to navigate all of this and you don't have the support of people who can help you. I think it's a very big thing for a lot of people, not having an accepting space to live in. Especially for trans* people. If they don't live in a safe space, they are forced to deal with the pain that comes with this. They don't want to end up homeless, which really sucks. But this is the reality for a lot of people. They have the choice of living in a potentially abusive household or trying to figure out where else to stay.

“Having support is crucial, but it doesn't always have to be from parents. Friends really helped me through a lot. Some people who were living the same experience helped me also. When I was struggling with mental health issues, I had friends who were going through the same thing, and they were all very supportive. Surrounding yourself with people who love you no matter what is super important. If it isn't your parents, that sucks, but there are people who care about you.”

Of course, Jack needn’t be defined by what he has been through. He — like any teenager should be — is planning for his future. “I'm going to university to study biochemistry, which is super nerdy and something I'm very excited about! I love science and learning new things. I really want to learn more about biochemistry and specifically endocrinology, which is the study of hormones. Endocrinologists help people with diabetes, but I also want to focus on the trans* side of things. I want to contribute to the research around hormone-replacement therapy. I did my senior project on this topic, and there wasn't much on trans*-specific bodies. I want to pursue that and provide information for people who want to understand more than just the changes that they see on the outside. I want to be able to support the trans* community in my area.”

Jack’s mother, Aly, is frustrated by the attitudes of elected officials she has encountered. “They talk about seeing people on a case-by-case basis, but I do not feel like that is happening. We have the support of his acting doctor at Clinic 554 in Fredericton, his surgeon, and a psychiatrist: there is a no more perfect case than Jack’s. They say no across the board. They keep referring to the age limit, and when I ask, ‛Why, why is there an age limit?’ no one seems to be able to give me a concrete answer. That is very frustrating. Other provinces are granting surgery to kids under the age of 18. The fact that they are unwilling to discuss it here is very discouraging.”

Attitudes are changing but far too slowly for Jack. “A couple of times, people from the government have told me, ‛Well, we only started granting this surgery three years ago.’ It's like they're patting me on the head and saying, ‘Well at least you got that.’ Trans* people must still pay a portion of their surgery even after the age of 18, and that is also a barrier for trans* people. There are kids in their twenties who don't have the money to pay for the surgery. It's very sad.”

As we take our leave, I hug Jack on the steps in front of the restaurant. He pauses, looks down, then looks me right in the eye with a confidence and directness that few of us are blessed to have. “I just wanted to say again how grateful I am that I have this opportunity to tell my story in a globally renowned magazine.”

I am touched, but before I have a chance to say it was our privilege, and what an honour it has been to get to know him and how much I look up to him, he continues. “Representation for trans* people around the world has been growing so much lately, and it’s really giving me hope. Hearing stories of other LGBTQIA2S+ people has helped me through my entire journey, and I hope that mine can reach others. People in my community have been talking about this for ages — I’m not the first. I don’t know if this will make a difference at all, but I sure as hell am going to try. I’m trying to channel all of my heart and hurt into this and make it worth it, if not for me then for another trans* kid who needs it.”

And with that he bounds off down the street with a spring in his step and a smile on his face. People often scoff at the younger generation, at millennials, but they have built a resilience and an outlook that generation Xers and baby boomers failed to. One of inclusivity and support and strength. Call them “snowflakes” if you wish. But the opposite is true. History will judge them well.

Us, less so.

Jack in his own words

At the beginning of my transition, I only really heard negative things about people’s experience with their own transition and the medical care available in New Brunswick, and I was so fortunate to not have the same experience. I am so lucky to have the support that I do and honestly, I couldn’t have made it here without that, I’ve had nothing but positive experiences with my family, friends, and doctors in my area. I applied for Medicare coverage of a double incision mastectomy (commonly referred to as “top surgery”) in July of 2018, but this was something I had been thinking about for years prior. At this point, I was aware that it was unlikely that I could be covered, but I was so excited by the possibility that this was attainable that I had hope.

At the time of sending in the application, I was sixteen and surgery was the only thing I could think about. Through my self-discovery and coming-out process, I spent a lot of time on the internet, reading other people’s stories and experiences, connecting myself with labels that I felt fit me. I'm a very analytical person, and while I recognized that I would be valid with or without a word to describe me, I felt I needed a box or even just a definition to fit into, even if it was outside of the norm. I have a few different things I identify as, but I often just label myself as queer, I feel the most comfortable with that, because I feel it encompasses all of me and is way easier than explaining what “panromantic means.” I’ve pretty much always been open and proud of my identity, especially with the help of my friends and family. I knew I was queer around grade 8 or 9, but I’ve been experiencing discomfort around my chest since I was in grade 5. It feels like it’s been an incredibly long journey, but I only just graduated high school.

Dysphoria is a really weird thing for me and has only in the past few years gotten really bad. The beginning of high school was really rough for me from a mental health standpoint, and while I have been doing so much better these past few years, it has taken a dip in recent weeks. Besides the stress of a full course-load of science classes, I received an email stating that I will not be covered by Medicare for surgery anytime soon. As mentioned, I sent my official document of application in July of last year, and had an appointment with the surgeon five months later, in December of 2018. That consult actually went very well, and while I had started to get nervous about it, I felt worlds better afterwards. I felt I had the complete support of the surgeon and was feeling good about hearing back from Medicare, but the wait between my consult and hearing a “no” was torturous. I was losing hope fast and would ask my mom if she had heard anything more than once a week. Showering was becoming harder, my mental health was going downhill, the stress of school was getting to me, and binding my chest started to feel like it wasn’t enough (again). I waited for another five or six months, and started to wish I hadn't had hope in the first place.

I once heard someone say that because of their chest, they couldn’t see themselves as whole and at the time I felt it was a bit of an over-dramatization, but I now understand it completely. I can’t even leave my bedroom without a binder on without feeling uncomfortable, even if it’s to get water in the middle of the night. When I heard that I wouldn’t be able to get surgery, I felt numb and completely hopeless for a few days; the school year was getting intense, and I tried to brush it off so that I could focus on all of the work I still had to do, but it didn’t work. I dropped the ball on my schoolwork and final projects, and I had a really hard time taking care of myself without thinking that there was no way I could let myself slip into the same situation I had been in in early high school. I couldn’t imagine myself graduating back then, and it wasn’t because of grades. I didn’t see a future for myself at all.

I’m still kind of recovering from it, especially because I thought that maybe, just maybe, I could have surgery before I went to university, just one more thing I didn’t have to worry about. I know it wouldn’t cure everything magically but I was hoping that maybe I could feel a bit more myself. My eighteenth birthday was in October, and while I could technically get surgery as soon as I’m old enough, I'm now doing a Bachelor of Science degree at UNB, and can’t miss that much time out of school. This means that I can either risk that I could recover enough over the winter break to go back next term and get surgery in mid-December, or wait an entire year and deal with the physical, emotional, and mental pain that I am currently in for that long, while giving up a lot of my first-year experience because I don’t feel comfortable enough in my own skin.

I’ve actually written many research papers on the issue that an age barrier causes, and while talking to activists and doctors this common problem arises. New Brunswick Medicare has placed an unnecessary age requirement on this surgery, despite claiming to follow WPATH (the World Professional Association for Transgender Health) standards of care, which state in reference to adolescent patients:

“Chest surgery in FtM (female to male) patients could be carried out earlier, preferably after ample time of living in the desired gender role and after one year of testosterone treatment. The intent of this suggested sequence is to give adolescents sufficient opportunity to experience and socially adjust in a more masculine gender role, before undergoing irreversible surgery. However, different approaches may be more suitable, depending on an adolescent’s specific clinical situation and goals for gender identity expression.”

As such, the standards of care recommend that these situations are looked at on a case-by-case basis, rather than just an age of majority.

I can bore you with statistics and research (because honestly, I’m a nerd and would love to) but I’ll leave it to saying that top surgery is life-saving, even if my body isn’t dying. I’m super privileged to have the encouragement and resources that I do, and I am so grateful for this opportunity, I never thought that I would be the type of person to become an activist but if this year taught me anything it’s that healthcare for transgender and LGBTQIA+ people in New Brunswick needs more attention. After all, trans* rights are human rights, and I would go as far as saying that I’m being denied mine.

www.wpath.org

“The term transgender can encompass many different identities, not just female-to-male or male-to-female transgender. people. To better include other identities such as non-binary or genderqueer people, the use of the asterisk in trans* helps to cover all identities under the transgender umbrella. Both trans and trans* are used and acceptable, but when I personally refer to myself it is with trans, and when referring to the community it is trans*.” Jack

This story originally appeared in [EDIT] magazine. To subscribe, please click here.