Well I like to use the word gender expansive over gender creative. And I actually feel like it's important to distinguish that from the use of the word transgender. I think it's become very popular, both in research and clinical, as well as popular media to use the term transgender when referring to kids. So you hear a lot of transgender children, that transgender kid, that trans kid. And I feel really strongly that that's probably not the best idea at this point in time. Because we don't really have the research to understand or back up the idea that a child, pre-pubescent child, is actually going to end up to be identify as trans in adolescence. And actually the research base that we have right now, which some argue there are lots of flaws with, which there are, because there's flaws with all research. Kind of doesn't even support that trajectory always. And so I think by using the term transgender to refer to children, we're kind of not respecting the developmental differences that we need to respect. And when you start to do that, a lot of people think that what applies for adults in transgender health care should apply for adolescents. And what applies for adolescents should apply for children. And so, if we use those terms that we're using very freely and I think appropriately, with adults and adolescents and we start using them with children. We're not taking into account the really important developmental differences that exist between children and adolescents. So I like to use the term gender creative [COUGH] or gender expansive, or something rather than trans kids, but I know that that's being used a lot. Well I think gender creative is just a kid who doesn't conform or follow, what we like to kind of call the fake rules, around what you're supposed to do if you are assigned boy or assigned girl in our society. And so gender creative kids just don't follow those gender norms and those gender rules. And that might mean that they're going to end up to want to transition, or be gender nonconforming, or non-binary in adolescence. Or it might be that they're just gender creative, and they're going to be, end up to be cisgender, and we don't really know. But they're kind of just, kind of messing with the rules, and I think that that upsets adults a lot more than it upsets other children. I think children are much more fluid in kind of allowing kids to just be whoever they're going to be. And it's the messages that we get from society, and the messages that they start to internalize that they then begin to think, I'm not supposed to do this because I'm a girl. Or I'm not supposed to do this cause I'm a boy, which was all based on their assignment at birth, and might not have anything to do with how they really think and feel about themselves. Well I guess it's interesting, because I think parents and adults have, and rightfully so, I'm a parent I understand wanting to kind of know what their trajectory is. And being able to have the best understanding that you have at the time of your child. But I think that this whole idea of should is part of the problem, rather than just allowing children to just kind of be where they're at, and express their gender in whatever way is comfortable to them. So we kind of really advocate for children to be supported and allowed to kind of do a range of expression. What we try not to do is to try to lock that into any certain one expression or one type of trajectory. We want these to be really open over a period of time. Because what we know from the research is that, it's not until adolescence that the research shows that if an adolescent is identifying as trans, it's likely that they're going to keep identifying as trans in some way. We don't really know that in terms of children, so our kind of approach is to work with parents to be supportive, to be affirming wherever the child is at. But to know that that can shift and change, and that that's good and that we kind of want that. Because that's what development does, it shifts and changes all the time. And so how do we create spaces where children can do that rather than make them get into the fake rules? Or the other side of that is, transition them and then say, and now you gotta follow the rules of the other set of boxes. Does that make sense? >> Mh-mm. >> I think some kids are in distress. What's hard to parce out is the extent to which the distress is based on the messages that they're getting about how their supposed to be. And that a lot of stigma and discrimination comes from being gender nonconforming or gender creative. And so it's hard to know how much of, I think there's a ton of distress that comes from that. And so then if they internalize that, then they begin to kind of feel like there's something wrong with them. And I'm not doing what I'm supposed to do based on what these messages are. So a lot of what we are trying to do is to prevent, or give them the tools to deal with that sense of stigma and discrimination that comes at them, when they're just kind of being them.
