The Journey of Belonging Starts in the Family

As a child and adolescent psychiatrist, pediatrician, and developmental neuroscientist, I have learned that everyone has a story. Each story is unique and shapes the decisions, opinions, and lenses through which we make sense of the world. We can only view one another’s stories through our own eyes, which are informed by our personal lived experiences. By understanding our own stories, demonstrating active listening, and considering the stories of others, we can get a glimpse of the authentic lives of others.

In mid-1990, I began attending a support group for individuals with issues related to gender and gender identity. I remember meeting a woman who was early in her transition. She told me that she did not experience gender dysphoria during her childhood, but rather, her gender dysphoria began during her mid-teens. I recall being very puzzled about this at the time. Through my lens, my gender identity mismatch was fixed very early in life, at least by four years of age, likely even younger. It was always there—relentless, and the best way for me to describe it would be constant grief.

My own experience filtered my interpretation of her experience, which she relayed in all honesty to me. I thought she must have something else. Today, nearly thirty years later, and after hearing many stories across many different domains, I have grown to appreciate our differences and celebrate our uniqueness. Each of us has our own valid stories, and that diversity of thought and lived experience is a gift to humanity. To truly understand others, we must recognize how our own experiences can filter how we interpret and make sense of people’s stories.

This year, the NIH Office of Equity, Diversity, and Inclusion (EDI) theme for Pride is “Pride in Belonging.” Sense of belonging is a powerful and critical element to the human experience, and while “belonging” during Pride may be interpreted as belonging to the LGBTQIA+ community, as it should, I would like to discuss belonging within a more fundamental context for me, which is the context of my family.

When I started my transition nearly 30 years ago, over half of those in my support group had families who wanted nothing more to do with them. They were considered “dead” by their family for transgressions made against the gender binary. They were cast out of their families and cast out of belonging so the families could forgo the shame of such a transgression. This was my greatest fear related to my transition. After coming out to my family and friends, I was told that I would never again find work as a physician. This view was supported when the president of the university where I was working told me that if I transitioned, I would be let go, and fired. There were no legal protections for me at the time. Despite the gravity of this news, it was the fear of being cast out by my family that was the most terrifying.

I come from a wonderful family and should have given them the benefit of the doubt, but as I was born into a Midwestern family with strict gender roles, it was a scary time. The unrelenting nature of a discordant gender identity required intervention. My family saw this, and while it took them time to learn and ask questions, they were eventually very supportive over time. Giving them the space to adjust and not forcing new changes upon them, such as pronouns and even my new name, was extremely beneficial for their eventual acceptance. I understood that my transition while terrifying for me on one level, was in some sense easier for me than it was for them. After all, it resulted in me being more comfortable with myself and a decrease in my gender dysphoria. Meanwhile, my family had to readjust their perception of me and their perception of my identity. Since the sense of belonging begins in the family unit, I am proud of my family for their acceptance and contribution to my continual belonging.

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