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December 2022 Advice to Be Well From Dr. Mark Bornstein and Dr. Paul Benson

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Hi Doctor. My adolescent child just told me that they are trans. I am unsure how to react. What do I do? 

I am so glad that you are being thoughtful about your reactions as this is an important time in your child’s life. This first and most crucial thing you can do, is be affirmative! While I understand this can be jarring, surprising or even confusing for you, it is important to remember that the emotions your child is currently going through are likely more meaningful and significant. I also want to assure you that it will be okay and that this is quite common. You are not alone.

Many times, when a child comes out to their parents they will want to start transitioning. It is often misunderstood that transitioning means hormone replacement therapy (HRT) and surgeries. While HRT and surgeries are definitely part of transitioning, it is not the only way to transition. It is up to your child to determine what constitutes transitioning for them. Perhaps coming out as trans is the start of their transition or maybe dressing like their gender around the house is their transition. I cannot stress enough, that there is more to being trans than just hormones and surgeries. 

That being said, it is important to talk about HRT as I assure you it is on your child’s mind and can be the most affirming part to their transition. I would encourage you to bring your child in for an office visit where I can talk to the whole family together and to your child alone. It will be helpful to discuss as a group to set expectations going forward. We also recommend coming in for an office visit to discuss different resources that are available to you and your child. There are support groups for both you and your child to attend that we should talk about. While we do not require your child to see a therapist prior to transitioning, we do strongly recommend having your child see a therapist to talk to during this long journey ahead.   Networking with other parents facing the same issues as you are can also be good.  Parents and Friends of Lesbians and Gays (PFLAG) is a great support group that meets monthly with parents and their children.  There are chapters in many cities and a local one for you can be found in a Google search.

In summary, please be patient and affirmative with your child. While I do not want to disregard the feelings you must be going through, the step that your child just took by coming out was likely the most difficult thing they have had to do in their life thus far.  This is a long journey that we will all going through together.  Remember, our goals are identical - to provide your child the best environment to thrive.

I just found out that I have HIV.  I have never been on therapy.  My friend recommended the new injectable medication Cabenuva.  My doctor says that I cannot use this medication at the present time.  My friend disagrees.  What do you think?

Your doctor is correct.  Cabenuva is an injectable medication that requires injections either once a month or every two months depending on preferences.  It is only approved for patients already on treatment with an undetected level of HIV in their blood for at least 6 months.  That is the only current indication because that is how it was studied in clinical trials before becoming commercially available.  I cannot comment or would I prescribe it in patients new to therapy.  It is also not indicated for persons with HIV medication resistance or history of previous HIV medication failure.  My recommendation would be to take oral medications without missing any doses and if it is still desired consider Cabenuva after 6 months of successful therapy.  Many people like the injectable form of therapy.  Others don’t.  Taking medication everyday is a constant reminder that you are living with HIV and have to remember to take your medications every day.  Also, with oral medications  there is a greater risk of people you don’t want to know your status finding your medications by accident.  Other people, such as many former IV drug users don’t like injections. 

The great thing is that there is now a choice.  The Be Well Medical Center does have some clinical trials available with injectable medications.

Since 1980 Dr. Paul Benson’s Be Well Medical Center has been an inclusive medical center celebrating diversity. Do you have a health related question for Dr. Paul Benson and Dr. Mark Bornstein? Submit your questions to [email protected]. This article is a sponsored editorial produced in collaboration with Be Well Medical Center. Between The Lines’s journalism is made possible with the support and partnership of advertisers like Be Well. Learn more about Be Well here.

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