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Antioch University Dissertations and Theses

2021

Parents of Non-Binary Children: Stories of Understanding and Parents of Non-Binary Children: Stories of Understanding and

Support Support

Brooks Bull

https://aura.antioch.edu/etds/705

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STORIES FROM PARENTS OF NON-BINARY CHILDREN

A Dissertation

MARCH 2021

STORIES FROM PARENTS OF NON-BINARY CHILDREN

been approved by the committee members signed below

who recommend that it be accepted by the faculty of

in partial fulfillment of requirements for the degree of

Dissertation Committee:

Lucy Byno, Ph.D., Chairperson

Justine D’Arrigo, Ph.D.

STORIES FROM PARENTS OF NON-BINARY CHILDREN

Copyright © 2021 by Brooks Bull

STORIES FROM PARENTS OF NON-BINARY CHILDREN

Parents of non-binary children undergo profound changes as they learn to first understand and

then support their child. In order to provide family therapists with a foundation from which to

and challenged within each methodological category, and how non-binary youth and their

families are described or excluded from the discussion overall. Chapter three is a narrative

research study that answers the question: what are the stories parents of non-binary children tell

about how they came to understand and affirm their child? Stories of parents confronting core

beliefs, stepping into leadership, and feeling like they do not fit in or belong in ostensibly

supportive spaces are presented. Relevance to narrative therapy is highlighted as well as the need

for more research on family processes that enact support for transgender and non-binary

children. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and

OhioLINK ETD Center, https://etd.ohiolink.edu

STORIES FROM PARENTS OF NON-BINARY CHILDREN

STORIES FROM PARENTS OF NON-BINARY CHILDREN

families. This project was shepherded by Dr. Lucy Byno, a steadfast voice of support throughout

my years of study at Antioch University. To her as well as the other members of my committee,

Dr. Justine D’Arrigo and Dr. Janet Robertson, I offer my sincerest thanks. Other mentors whose

voices I carry with me into every client session and research interview are Dr. Judy Davis and

Dr. Walter Lowe.

STORIES FROM PARENTS OF NON-BINARY CHILDREN

CHAPTER II: LITERATURE REVIEW ................................................................................ 16

CHAPTER III: NARRATIVE RESEARCH STUDY ............................................................. 42

APPENDIX: IRB Approval ....................................................................................................... 81

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child, and stories about how it became an important part of their own personal development.

Family therapists, and especially narrative family therapists, are alert to the power of

storying in determining how a family thrives or flags in the face of difficulty. Families with non-

binary children are up against powerful cultural forces that dictate that there are only two

genders, and that those two genders hew closely to biological sex. In the face of that pervasive

cultural discourse, how then do parents come to understand and support their non-binary

children? What are the moments that open up understanding, and what are the actions taken that

enact support? For any family therapist looking to study these questions, the current academic

literature will not help; indeed, there is a dearth of research on the processes within families with

non-binary children.

STORIES FROM PARENTS OF NON-BINARY CHILDREN

review of stigma determinants, mechanisms, and interventions. Social Science and

Medicine,147, 222-231. https://doi.org/10.1016/j.socscimed.2015.11.010

STORIES FROM PARENTS OF NON-BINARY CHILDREN

overlap among them. In this review of the literature, the categories of binary transgender (for

instance a trans boy who was assigned female at birth) are separated and recognized as distinct

from non-binary people who do not identify with either pole of the gender binary.

Non-binary children are a vulnerable demographic not only because they are under-

represented in the professional literature and therefore do not always get the mental health

support they need and deserve (White Hughto et al., 2015), but also because when they are

included in studies, they are often lumped in with their binary transgender counterparts thereby

masking their uniqueness and particular needs. This review of the literature seeks to illuminate

sampling issues in some of the literature, and identify gaps for future study. The quantitative

literature in general has two main sampling problems: lumping non-binary children into a larger

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consequence of this emphasis is that non-binary children are rarely centered in the literature.

Moreover, systemic research that looks exclusively at the relationship between parents and non-

binary children does not yet exist, even though parental support (as perceived and reported by the

child) has emerged as a vitally important predictor of mental health outcomes (Olson et al.,

2016).

The binary reigns supreme in our literature. As Richards et al. (2016) observed, a

PubMed search (including literature on all age groups) brought forth 5 articles that used the term

“genderqueer,” 54 that used “non-binary,” and 264,531 that used “transgender.” The academic

literature remains solidly aligned with the gender binary, despite the fact that many people who

would be labeled transgender in academic literature would likely identify in their personal lives

STORIES FROM PARENTS OF NON-BINARY CHILDREN

identify as non-binary may transition hormonally or make some changes to their bodies

surgically, while others may not. In this review, non-binary will be used as an umbrella term that

includes genderqueer, gender fluid, and all other gender identities that do not fit neatly into the

existing binary system with the understanding that this particular term may not fit for all people.

The target of this review is peer-reviewed literature on mental health treatment that includes non-

binary young people under the age of 18 in either the sample or theoretical discussion, with

special attention paid to those articles that also include caregivers and families since that

literature is of particular use to systemic therapists.

Different methodologies produce different results; this review seeks to clarify what

STORIES FROM PARENTS OF NON-BINARY CHILDREN

children and adolescents under the age of 18. Articles that used the term LGBT but did not

directly address the mental health of treatment of transgender, gender non-conforming, or non-

binary children were not included. Only peer-reviewed literature was included in this review.

The following keywords were used to search databases: transgender, youth, mental health and/or

mental health treatment and/or therapy. Adding non-binary as a search term did not yield more

results, highlighting how transgender is being used as a large umbrella term in the literature.

Mental health outcome research. Of the 20 quantitative research articles included in

this review, nine used parental or familial support as a variable that affects mental health

outcomes of transgender youth. Ryan (2009) brings together quantitative studies on suicide risk,

STORIES FROM PARENTS OF NON-BINARY CHILDREN

themselves, data show that the transgender children showed no difference in terms of depression

to their cisgender counterparts, and only slightly elevated levels of anxiety (Durwood et al.,

2017; Olson et al., 2016). More recently, Weinhardt et al. (2019) further confirmed the

relationship between support and health outcomes in their mixed methods study which identified

a relationship among resilience, social support and wellbeing. Looking outside of familial

support, de Vries et al. (2016) identified the lack of peer support as a critical variable in their

sample of transgender children and adolescents, finding participants without peer relationships to

have higher levels of internalizing (anxiety and depression) and externalizing symptoms

(behavioral issues more akin to oppositional defiant and conduct disorders).

The strong relationship between familial support and child well-being was consolidated

STORIES FROM PARENTS OF NON-BINARY CHILDREN

consistent affirmation of her identity from her family, teachers, and peers via the use of

correct pronouns, support in her gender expression (e.g., hairstyle; clothing), and so

forth…Such shows of support may buffer the potential negative effects of minority stress

for these children. In contrast, the children in our study who held nonbinary identities, or

who, for example, identified as boys but liked to wear dresses, may have received more

limited affirmation (p. 8).

This strain of the quantitative research is valuable for how it definitively shows the link

between acceptance of gender identity and psychological wellbeing in children in a community

sample. Olson et al. (2016) and Kuvalanka et al. (2017) provide evidence that when children are

supported in their gender identities early in life, they show lower levels of depression and

STORIES FROM PARENTS OF NON-BINARY CHILDREN

suicidality in their sample of 129 older adolescents and young adults from a clinical sample.

Persistence and desistance research. Underlying the discussion about whether or not

transgender and non-binary children exhibit more symptoms of mental illness than their

cisgender counterparts is the more foundational question of whether children who present as

gender non-conforming really are transgender, or if they will “desist” in that identity over time.

This vein of the academic literature is perhaps among the most harmful to the transgender

community since it repeatedly interrogated the validity of transgender as a concept. And again,

sampling issues are present—in some of the most cited studies, children who displayed gender

nonconforming gender expressions but who did not report any distress about their identity were

included in the same category as children who not only expressed gender nonconformity but also

STORIES FROM PARENTS OF NON-BINARY CHILDREN

do not report any distress, which very likely accounts for the 88% desistance rate they claim.

Additionally, in all three of the studies, participants who dropped out of treatment were labeled

“desistors”, or as Steensma et al. (2011) explained, “…45.3% did not reapply for treatment at the

Gender Identity Clinic during adolescence…we assumed that their gender dysphoric feelings had

desisted” (p. 510). This points to the need for long-term cohort studies of gender non-conforming

youth (Olson, 2016) to definitively answer the question of persistence rather than assuming (as

Steensma et al. (2011) seem to), that treatment attrition signifies a change in gender identity.

Descriptive research. Thus far, much descriptive data on youth focuses on

psychopathology and comes from clinical samples (e.g., Edwards-Leeper et al. 2017; Wallien &

Cohen-Kettenis, 2008), with Kuvalanka et al. (2017) and Olson et al. (2016) representing the

STORIES FROM PARENTS OF NON-BINARY CHILDREN

type of work is the Canadian Trans Youth Health survey, which sampled over 900 youth aged 14

– 25, and provided rich data on how the sample population languaged their gender identities.

They used the question, “what is your gender identity?” and provided a long drop-down list of

options, allowed respondents to choose more than one option, and provided opportunities to

write in other options.

…just under one third checked one option on the list, and about half checked two or three

options on the list. Younger participants were more likely to choose only one option from

the list. Participants could also write in additional options if they felt their identity was

missing from the existing list. More than 1 in 5 trans youth wrote in an identity that was

not on the list. Some of the most common additions were: non-binary, agender, gender-

STORIES FROM PARENTS OF NON-BINARY CHILDREN

studies that sought to describe the experience of transgender youth lumped together what

Kuvalanka et al. (2017) so aptly described as cross gender identified (CGI) and non-cross gender

identified (non-CGI) children. As a result, clinicians who meet non-binary youth may not have

literature at hand to guide their work since many of the interventions detailed are oriented toward

transition. There is a crucial need for more research and clinically-informed theory that describes

the experience of these children and families.

Overall, the category of quantitative research on transgender youth largely revolves

around questions of validity of trans-ness itself. The descriptive research seeks to make visible

what is questioned culturally by creating statistics to describe demographics and identify health

risks. The mental health outcome inquiries reviewed here at times both bolster and challenge the

STORIES FROM PARENTS OF NON-BINARY CHILDREN

This review suggests that the pernicious and harmful questions about validity of

transgender identities have been answered. However, as researchers sought to clarify how

transitioning—both socially and medically—affected the mental health of children and

adolescents, non-binary experiences were repeatedly eclipsed and sidelined. There is still much

work to do in order to fully describe the experience of these children and families, including

studies that explain how parents come to understand and affirm non-binary children and

adolescents. Specifically, there is a need for literature that shares the experiences of families with

non-binary children on a larger scale. Grounded theory studies that organize and map family

processes at play as parents move from questioning to supporting their child would be helpful for

STORIES FROM PARENTS OF NON-BINARY CHILDREN

STORIES FROM PARENTS OF NON-BINARY CHILDREN

Coolhart, D., Baker, A., Farmer, S., Malaney, M., & Shipman, D. (2013). Therapy with

transsexual youth and their families: A clinical tool for assessing youth’s readiness for

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Coolhart, D., Ritenour, K., & Grodzinski, A. (2017). Experiences of ambiguous loss for parents

of transgender male youth: A phenomenological exploration. Contemporary Family

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Coolhart, D., & Shipman, D. L. (2017). Working toward family attunement. Psychiatric Clinics

of North America, 40(2), 113–125. https://doi.org/10.1016/j.psc.2016.10.002

de Vries, A. L. C., Steensma, T. D., Cohen-Kettenis, P. T., VanderLaan, D. P., & Zucker, K. J.

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Diversity, 4(3), 374–382. https://doi.org/10.1037/sgd0000239

Ehrensaft, D. (2009). One pill makes you boy, one pill makes you girl. International Journal of

Applied Psychoanalytic Studies, 6, 12–24. https://doi.org/10.1002/aps.185

Ehrensaft, D. (2013). “Look, mom, I’m a boy—Don’t tell anyone I was a girl.” Journal of LGBT

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Olson, J. (2013). The gender affirmative model: What we know and what we aim to learn.

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transform these discourses” (Chase, 2005, p. 659).

Dialogic analysis as defined by Riessman (2008) takes aspects of the hows and whys of

stories, but adds another set of questions about “who an utterance may be directed to, ‘when’ and

‘why,’ that is, for what purpose?” (p. 105). In this way, analysis of participant narratives begins

during interviews, and continues through the process of transcribing, theorizing, and writing.

Attention to the physical context of the interview and transparency from the researcher about

why certain questions are being asked is paramount in order to create a collaborative atmosphere

suitable for dialogic analysis. By using both sociological inquiry and dialogic analysis, and

thereby attending to the micro and macro level of meaning-making, I engaged each participant

about their personal experience of large social and cultural issues.

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emotions, and initial reaction to the experience. These documents are akin to memos in the

grounded theory tradition, and are crucial not solely for the role they play in analysis but also the

role they play in building trustworthiness in the final research report.

Interim texts. Clandinin and Connelly (2000) explain the importance of “interim texts”

(p. 133) as the researcher moves from field texts to a final research report. An interim text is a

document that aids the researcher in some aspect of the analysis but that may not end up in the

final report. In this project, interim texts were used as a way to bridge the gap between my

theorizing after the interviews and the final results section. Working from field texts as well as

my memory of the interviews, I wrote a short document summarizing the participant’s narrative

and my initial thoughts about how the narrative intersects with the dominant discourses about the

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Member checking. In order to increase the validity of the findings and remain consonant

with the collaborative spirit of narrative inquiry, all participants were given a copy of their

results section before publication in order to elicit their feedback and revisions. Participants were

invited to amend and add to the narratives as I had constructed them in the results section, and to

delete anything that did not feel resonant. No significant changes were made at this stage of the

process, although two participants expressed gratitude and pride at the experience of reading

about their journey.

Each participant shared their memories of coming to understand their child’s gender

identity, some fully articulated narratives with beginnings, middles, and ends, some less cohesive

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integral to her journey. Alex was assigned female at birth and began expressing a gender non-

conforming identity at age 3. They asked for a name change at age 5 and have been using either

no pronouns or they/them pronouns since that time.

This interview took place in Gabby’s home, a space that exuded both warmth and order.

Family photographs were hung artfully in every room, a visible timeline of the family’s growth.

One framed photograph in the entryway showed baby Alex in their older brother’s lap; Donovan

wearing a bowtie with matching vest and pants, and Alex dressed all in pink and wearing a

headband with a bow around their still bald baby head. In the kitchen, what looked like the most

current photograph was affixed to the refrigerator door with a magnet. In this photo Alex is

standing next to their brother, both children wearing hooded sweatshirts and jeans, arms around

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G: Yes,…I remember a moment pretty clearly actually. It was when Alex was about two

and a half, somewhere around there, maybe closer to three, actually, and she—they were

in the bathtub. And by this time Alex was already very vocal about not being a ‘she’,

that’s how they would say it, ‘not she, mommy’. And anyway, so during bath time, I

remember this moment when I let my mind just really go there, you know, like I was

looking at my child in all of their beautiful natural-ness, you know, and I let myself go to

the place of seeing them as…not a girl. At that point I thought maybe a boy? I didn’t

have the language yet for non-binary and genderqueer and all of that. But the point is, I

let myself see them as something other than their natal sex, and it hit me, deeply, like yes,

this is who they are, this is really the truth. And after I had that moment I was able to hold

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within her family as well as from professionals. In both contexts, she was met with differing

levels of understanding and fielded questions and criticisms.

G: My mom and dad, they had no framework, I mean none, to understand gender as a

spectrum, or even that gender and sex might be, you know, different. And I had a hard

time…I wasn’t in a position to educate them at that point. They are both highly educated

people, but not in this. I was just starting out myself, and also, I was, it all felt stressful.

Like I wasn’t sure and so how was I supposed to bring them up to speed?

BB: How did you get ‘up to speed’ so to speak? What helped?

G: Well, first a bunch of stuff didn’t help [laughing] before I found anything that did. I

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much it helped.

BB: Yes, I hear that. It was important to find some, some mirroring, no?

G: Absolutely, yes. Because a lot of those spaces –like the groups and what not that are

for families with gender diverse kids, a lot of those spaces are extremely White. I mean,

the camps, too. And as a Black family with two Black children, those groups weren’t

really for us. They were fine, in a way, but we weren’t leaving there with other parents’

number ready to set up playdates, you know what I mean?

White spaces did not provide the type of community Gabby needed not merely because she was

not mirrored, but also because she consistently had to field microaggressive questions and racist

comments from other participants and group leaders. Gabby recalled being asked if her family

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G: After I stopped going to the groups, you know, I just stopped and thought all I need,

all I really need, is my family. This was before I found the book [laughing]! And so I

decided to enlist Jeremy in my project.

BB: your project?

G: Yes, initially I had tried to keep it out of his zone, he had made it clear that he thought

it wasn’t going to last, a phase, something I was getting too wrapped up in. And I decided

I needed him in on my project of getting what we needed to, to parent Alex, I guess. I just

needed him in it with me is what I mean. And so I came home from one of those groups,

and I remember putting Alex down for a nap and saying to Jeremy, “I need you, babe. I

really need you on this one’, and you know what? He showed up! He showed up like all

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identifies as a White cisgender heterosexual man. They are parents to two children: Wren aged

11 and Paul age 5. Paul uses he/him/his pronouns and identifies as a cisgender boy. Wren uses

they/them/theirs pronouns and identifies as non-binary. Laura emphasized that Wren would not

want their natal sex to be disclosed in this study.

This interview took place outside at a campout organized by a local trans advocacy

group. We sat under a tarp while the June rain drizzled around us. Laura deposited her youngest

child with her spouse and took a seat at the picnic table under the tarp. It was early summer in

New England, and the light rain had driven most people back into their tents. This was the

second day of the weekend, and the feeling of the gathering had relaxed. People had loosened up

and begun to coalesce into natural groupings. The older kids claimed the woods, the younger

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wanna transition. That’s not who they, like, they did wanna transition but they didn’t

wanna transition binarily. And so that was really hard.

The feeling of being missed or mis-attuned to came up in stories about Wren’s school as well.

Laura grappled with wanting to rely on the expertise of teachers and administrators who had

good intentions, but who ultimately did not (or did not know how to) support Wren’s non-binary

identity. Not only were these school experiences painful for both Wren and Laura, but they

shook Laura’s previously steadfast faith and belief in teachers as safe experts who could help

her.

L: So Wren was getting constantly asked, are you a boy, are you a girl, are you a boy, are

you a girl, what are you really?

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child’s gender identity, or that she is responsible for directing its course. I imagine her crouching

down to talk to Wren who is still too big in the stroller, and letting them know that she sees them,

knows them, will make space for them even when it feels like the world is not built that way yet.

She knows that there is no camp counselor or elementary school teacher, no expert, who knows

better than she does who her child is; her locus of control moves from outside to inside, and she

experiences a resounding moment of clarity that she will “demand support, even though we can’t

find it we need to demand it”.

Sara is 47 years old, White, middle class, and works as an attorney and social justice

activist. She identifies as a queer cisgender woman. She co-parents two children with her ex-

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bisexual. This experience made an important, lifelong impact on her, and helped her consolidate

her values around advocacy:

I worked with a truly bisexual man who was comfortable, and I had lots of conversations

with him about bisexuality, really, and bi-phobia. And it was, like, the first real

conversation about bi-phobia that I remember having. And – …yeah. There have been,

very much, these touchstone people. And I never, sort of, wanted them to feel like not

them, right? Cause they’re people I, I deeply cared about and, and felt strongly about, so

it was, like, I’m, a mama bear a little bit about this, too. Like, ‘OK. So you’re one of my

people and, [laughs] so therefore I’m gonna learn as much about this, and now I’m gonna

take it on, and learn and read as much as I can, and become your biggest advocate”

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sort of, binary trans kids that I know who really were consistent, persistent, insistent on a

very binary gender identity from, you know, the age of 2 on. That’s not been Sam’s

experience so I am not gonna force any path like that for Sam. So, so yeah, so, advocate

but in a very open way. As opposed to, you know, for my friend who was bi, where it was

a pretty clear identity for that person that that was, at least then, and, and still now, how

they identify.

At times, Sara’s identity as a public advocate and attorney has caused other people to

misread her and Sam, and make wrong assumptions about what type of support is needed. She

tries to explain this in her recounting of Sam’s second grade year – a time in Sam’s life when

Sam described themselves as genderfluid and was expressing gender in lots of different ways

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story, the confusion and indignation she felt that she hadn’t been told immediately was still very

much to the surface.

BB: So did she, did you get a call? I’m trying to understand –

S: So I, it was a pickup and the paraprofessional, actually, in the class said to me, ‘So,

this happened.’ And I was like, ‘Wait. This happened three times?’

At this point in the interview, the question hung in the air for a moment before she

resumed the narration, and my hunch was that she was feeling a portion of the anxiety she felt at

the time imagining her child alone in their distress, trying in their best 7 year old way to be seen

and heard.

S: And then I called the full t-, the teacher, was like, ‘Why did, what—?' That was when I

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or contain it in some way? That the school staff knew Sara to be a supportive LGBTQ activist

actually led to a lack of communication; Sam received less support as their experience was

deprioritized.

BB: So there was an assumption that because of what you do and your beliefs, that you

[crosstalk]

S: That I wouldn’t care, right, that Sam was up on a chair, or on a desk, shouting,

shouting multiple days in a row, apparently, that, that they were trans. Because –

BB: Wow. So how’d you feel?

S: – because of their assumption – well, to me, it was like, well, their assumption is that

some, you know, for people who maybe it might’ve been an issue they would’ve called,

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S: …this was a big moment. I wanna say it was kindergarten. I was working First Event,

and both kids were looking very traditionally male at, at First Event. And Sam, at some

point, it was in the childcare session, so it wasn't any kind of session on trans anything, it

was literally just babysitting. And at some point I went in and checked in on them and

brought them out to just go for a walk or something. And Sam saw a group of trans

young teens, including this non-binary person who would become my staff member. And

they were at a table with name tags, and Sam had one preprinted. And Sam went over and

said, ‘Can you change this for me?’ And changed it to Ellie, asked them to change it to

Ellie. And that was the first Ellie moment, I think.

BB: [laughs] Wow, that is a big moment!

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maybe Sam needed this much of a safe space.

The importance of a larger community come to the fore in Sara’s First Event experience, and has

echoes of Laura’s Stroller story—both mothers are cast in observer roles in these stories. They

watched their non-binary child interact in a larger trans/non-binary-only space, and in so doing,

received new and important information that they otherwise would not have gotten.

Sara’s mother is not supportive of Sam, and Sara has minimized and, at times, severed

contact. The most recent cut-off happened just three months before the interview and was the

result of overt non-acceptance from Sara’s mother. In this story, Sara is doing the bedtime ritual

with her children; at this time Sam needed some extra support to wind down in the evening, and

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voice. This was clearly a painful moment for Sara that brought back layers of memory from

when she first came out as a lesbian 20+ years ago, and was met with homophobia, stonewalling,

and verbal abuse from her mother, and ineffective “peace brokering” from her father. Sara

recalled the years following her coming out with a shrug, which seemed to communicate

resignation. The relationship she ultimately accepted for herself, a relationship of tepid support

that enabled Sara to remain in connection with her parents even though she never received true

acceptance or support—a relationship like that was not acceptable to Sara when it came to Sam.

Sara’s trajectory of staying in relationship with her mother involved enduring abuse followed by

deep compromise, and in parallel to the moment with Sam in bed, often played out on the phone:

so periodically she would call and hang up. And then she would call and say she was

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shared themes came to the surface for me in the process of listening and relistening to the

interviews. All three mothers experienced some version of confronting some of their core beliefs,

feeling like they did not fit in to a group or category, and stepped into leadership roles in their

family. Lastly, they each described moments when they found help and offered those resources

to others.

Perhaps more than anything else, these participants told stories about confronting and

changing some of their core beliefs in order to better support their child. Gabby described pulling

apart gender and sex in order to see her child more accurately, the ‘gender-natal sex sandwich’ as

she called it. Laura came face-to-face with experiences that proved science (her chosen

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All three families told stories about not fitting in with parents of binary transgender

children, parents who centralized the importance of ‘letting your child transition’, and saw these

mothers’ acceptance of non-binariness as a symptom of subtle rejection or resistance. Just the

opposite, the mothers in this study saw their children clearly, so clearly that they needed to find

spaces within spaces, communities of families with genderfluid and non-binary children as

opposed to socially or medically transitioned transgender children. The experience of not fitting

in happens at multiple levels within the family, an isomorphic pattern that begins with the

dominance and power of gender conformity as a cultural discourse.

Many non-binary adolescents report feeling like they do not feel included or welcomed in

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