There's Still Little Help for Those With Gender Crises

Transgender teens in Southwestern Ontario face as many obstacles now as they did 15 years ago when Angela Heddington's parents tried to get help for her, experts say.

While specialists say it's never too early to address gender dysphoria -- the feeling of being of the opposite gender -- qualified help is difficult, if not impossible to find in the London region.

"Outside of Toronto there is nothing," says Douglas St. Christian, a University of Western Ontario professor specializing in rural health care.

"In most smaller towns, they can't even deal with common, garden-variety gender and sexuality issues that young adults are dealing with, so imagine something as complex as what (Angela Heddington) was going through.

"Having to explain why you think you are supposed to have a penis, when you have a vagina -- is frowned on, and that can cause stress that can lead to breakdown."

A lack of mental health services in smaller Ontario cities is a factor in such breakdowns, St. Christian said.

"There is a limit to what Father Frank can talk about."

While it would be irresponsible to blame Heddington's behaviour on her gender dysphoria, it may have been a factor, said psychologist Ken Zucker, head of the child and adolescent gender identity clinic at Toronto's Centre for Mental Health and Addiction.

"In general, people who struggle with gender identity issues do experience a lot of psychosocial stress and psychological issues," said Zucker, adding a lack of proper counselling could have a tragic effect, "depending on how isolated one is feeling."

His clinic averages one new assessment a week, but most are from the Greater Toronto Area, Zucker said.

"It's less common to get (youths from the London area) but that is probably a function of lack of familiarity with the clinic, concern about distance (to Toronto) or local clinicians feeling they are comfortable enough," he said.

Regional Mental Health Care London and St. Thomas, the area's best-equipped psychiatric hospitals, don't have programs that would help people like Heddington.

"We do not have a gender dysphoria program and do not have an expert in that area," said spokesperson Jane Graham, referring queries to Toronto.

But Toronto is far for a London family that isn't sure what the problem is.

Zucker said the gender identity clinic suggests psychotherapy for most people with gender identity issues -- the sooner the better.

"Younger kids are better able to sort out these issues than adolescents," he said.

If a client insists on sex-reassignment surgery, the clinic will recommend a trial period first, during which the person tries living as the opposite sex.

Then cross-gender hormone therapy can begin.