Stand with Trans to Hold Online 'Ask the Expert' Event with Dr. Toni Caretto

On Friday, May 1, from 1:30 to 2:30 p.m., Stand with Trans will hold a Facebook Live "Ask the Expert" event featuring Dr. Toni Caretto, a local authority on gender. Caretto is a fully licensed clinical psychologist in private practice for 25 years who will share her wisdom on the benefits of therapy for kids and teens who come out as transgender. Participants are encouraged to bring questions and engage in dialogue.


Addressing the Issues

"I think the number one question I get asked is, explicitly or implicitly, 'Is this really true?' Caretto said, referring to parents' response to their child coming out to them. "There's often a lot of denial and doubt, which is understandable. I think parents go through a grieving process when their kid comes out as trans. And oftentimes they look for 'evidence.' 'Well, they didn't show any signs,' or, 'Well, two years ago they said they were bisexual and now this.'"

"I think underlying that, perhaps, is some sense of guilt: 'What did we do wrong?' There's an implication that there's something wrong about this. And I think they also are subject to the cultural transphobia and just also fear and concern for their children. 'This will be a hard life; people will want to murder them; they can never have a normal future,' in terms of relationships or children," Caretto said. "A lot of misconceptions and … fears."

For a number of reasons, Caretto believes trans kids and teens are more like to need therapy than their non-trans peers.

"One [reason] is a phenomenon known as minority stress, which was first discovered in health disparities among persons of color, but certainly applies in mental health situations to any stigmatized or minority group," Caretto explained. "And that is the stress of being different, marginalized, ostracized, not understood. Having a 'secret' takes a toll on people and can create often symptoms of almost like a PTSD, anxiety, depression.

"We know there's research that shows that sexual minority youth — trans kids included — [are] more prone to both kinds of internalizing mental health disorders like depression and anxiety and also some externalizing difficulties or 'solutions' to their problems that often become problems of their own, such as substance abuse, self-harm, suicidal thoughts, risky behaviors," Caretto continued.


Parents' Concerns and Fears

While many of the reasons for needing therapy have remained consistent over time, Caretto has found that parents' concerns about their trans kids have changed somewhat. As with society as a whole, there's a trend toward parents being more accepting of their kids as trans than in the past. However, parents may have worries regarding how others will treat them.

"I see a lot more families coming in with … concerns with acceptance, like, 'I get that they're trans but what's going to happen when they go to college and how will their roommate situation work out?' Caretto said.  "For the most part, the majority of these parents have never … had to deal with this themselves personally. So they don't know how to navigate this. You know if you're a religious minority, you understand, you can coach your kid through how to deal with, for instance, anti-Semitism, but if your kid comes out as trans, there's no sense of what to do or what difficulties they may face and how to help them become resilient."

Caretto said she is seeing a backlash aimed at trans youth, not only as exhibited by an onslaught of anti-trans legislation across the country, but also within the psychological literature. And the concerns parents bring to her reflect that. For one thing, she said that articles about 'rapid-onset gender dysphoria' can serve to discredit young peoples' experience.

"WPATH [World Professional Association for Transgender Health] is being attacked — this organization that is attempting to provide services or provide guidelines for how to provide services to trans and gender-nonconforming people — and seen as this radical leftist organization with an agenda to recruit and promote — so I'm seeing more and more parents who are coming in also having read a lot of that anti-trans literature and taken it as gospel," she said.

"Social contagion" is sometimes a convenient explanation that parents buy into, Caretto said. Or, parents may mistake a trans identity as an attempt to resolve one's depression, when instead it's more likely the other way around: their kid was depressed because they were struggling with something they couldn't put words to.

More than anything, Caretto stressed that therapy is not a one-size-fits-all proposition. Further, it's the child, or patient/client, who knows themselves best.

"I know a lot about gender identity and how people come to understand their gender, and what the research shows," Caretto said. "But on an individual basis, I don't live anyone's experience; they live their experience. And so for a young person, their sense of gender identity, not their parents' sense, not my sense, not what Reddit told them. I see the value in therapy as being a place where all those assumptions are put aside. I see myself as like the tour guide or the travel agent: it's their journey."


What to Expect from the Event

Regarding the Facebook Live event on May 1, Caretto hopes that parents take away a sense of de-stigmatization of both transgender identity and of the utility of therapy itself.

"I think there's a certain group of parents who maybe feel like, 'I don't want my kid in therapy because there's nothing wrong with being trans, so why should we pathologize this?'" Caretto said. "I think there's also a group that probably … thinks or feels unconsciously maybe, 'I don't want our family's dirty laundry aired. I don't want the therapist to blame me for my kid identifying as trans.'

"I'm hoping what comes out of this is an understanding that there's some benefits that therapy has to offer for kids who come out as trans that are unique to that population, but in general that therapy can be beneficial to a lot of people," Caretto continued. "Just as a place to explore what they're thinking and what they're feeling with an objective listener who has some experience with this."

Caretto expressed appreciation for Stand with Trans and their president and executive director Roz Keith for bringing this event to the community, especially at this time of social distancing, which is challenging for so many. At the same time, she said that being unable to meet in person has lifted the organization's geographical constraints

"From crisis comes opportunity," Caretto said. "A lot of trans and even LGBT kids are really suffering during this shelter-in-place [order] because their peers and school were often the one place they could be themselves, and at home they don't always find acceptance. And so they're really struggling. I think helping parents is one way to help the kids and I really applaud Stand with Trans for that."

Ask the Expert is on Friday, May 1, 1:30 to 2:30 p.m. Click here to find out more.