Practice Q&A: Responding to the Special Needs of Youth

By Sam Piha

Being a youth worker is a very difficult job. They face a variety of challenges and dilemmas, as they work with a diverse group of young people. We collected a number of questions from youth workers and promised to engage experts and field leaders for their answers. Below are some of the questions we received and the answers that we sought out from field leaders, content experts and innovative practitioners. If you want to submit your own question, click here.

This blog is part 3 of our Q&A series. To read part 1, click here or part 2, click here. Stay tuned as we continue to explore questions from youth workers. (Note: we know that there are many answers to any question. Below, we offer some well-thought-out answers that we received. Because schools and agencies may have specific policies, we recommend that youth workers share their questions with their immediate supervisor. At the bottom we provide a brief bio about the respondents.)

Q: When an elementary student has different feelings about who they are sexually, how can we as a staff go about addressing the issue in a positive manner without being offensive toward the student? - Youth Worker, San Joaquin County, CA
A: “Most importantly, don’t intrude on the student if they do not want to talk about it.  If they do want to talk about it, best strategy is to listen and then reflect positively about all the different ways people feel about who they are sexually. If you’ve observed their different feelings yourself but they haven’t expressed them, still take the opportunity, if available, to offer the same reflections with a number of students together, not connecting it directly to that specific student but as a learning moment for all students.”

- Diane Ehrensaft, Ph.D.

Diane Ehrensaft, Ph.D.
Source: City Arts & Lectures

Q: Regarding sexuality, how should you respond to a child (elementary school) "coming out" to you directly. What is appropriate and what should be avoided? - Youth Worker, Kanawha County, WV
A: “If a student is sharing with you their sexual identity or attractions, it typically means that they trust you. What is appropriate is to first listen and also ensure confidentiality. Second, explore what support or help that student would like from you (e.g., helping them talk to their parents). Third, make sure the student is feeling safe and has not met up with any negativity. And most importantly, mirror back to them positive regard. What to avoid:  negatively judging them for their feelings; offering support you’re not really able to provide.”

- Diane Ehrensaft, Ph.D.

Q: I am new in a program but I do have one kid who is really bossy. I am still unsure how to manage that kind of behavior since she even wants to tell me what to do in each activity. I only spent a day with that group because I was new and then the school shut down but I am still thinking about that kind of behavior and how to manage it. She is only 7 years old. - Youth Worker, Imperial County, CA
A: "So, kids' behavior always makes sense, if only we knew the rest of the story.  This kid, and others like her, have a need behind their drive to control things.  Sometimes it's because they are anxious about the unknown and if they take charge, then they can control the narrative which makes them feel less anxious.  Another example would be kids who have trouble following direction or instructions (lots of kids with learning glitches have this issue) so they get "bossy" because they if are the deciders about how something is going to be, they don't have to be able to "follow" a set of instructions which is actually hard for them.  This happens a lot when kids want to control the game and the rules when they are playing with peers---it's easier to lead on their own terms than to understand when someone else describes how it's supposed to work.  And yet another example would be a kid who is given too much authority at home and is used to that role, thinks it's expected of them, so that's how she operates outside of home too.

The best approach to handling this is to have compassion for the child (as annoying and disruptive as their behavior might seem) and recognize that there is actually a vulnerability or confusion that kid is having that is prompting the "bossy" or controlling behavior.  Rather than challenging the child or pushing back on the behavior, thank the child for his or her intentions to be helpful and clarify "how it works' (i.e, that actually YOU are going to be directing things. For example, "Thanks for your ideas and help, but I have a plan in mind and I'll be the one leading the activities today.  If you have some ideas you'd like to share with me, you can let me know about them at the end of the day and I'll be glad to consider them for another time." Meanwhile, keep an eye on that child to see if he or she is struggling in the role of "follower" or even "equal" because it's either difficult for them to process the rule or because they don't have the social skills to manage until they feel on top.  Help them learn."

- Sheri Glucoft Wong, LCSW

Berkeley, Ca

Q: I have a student (elementary school) who is always doing some type of motion out of the ordinary and makes noises. He himself doesn't catch what he's doing, the rest of my group notices and from time to time gets frustrated. How do I deal or go about this situation? - Youth Worker, San Joanquin County, CA 
A: "This sounds like a child with some neuro-physiological issues. Perhaps this student has tics, which can be single repetitive motions or "marching tics" which are a series of various "out-of-the-ordinary" movements. There are also vocal tics (throat clearing, yelping, sniffing, etc) which may explain the noises. It's sad for the child when other kids respond with frustration or alienation since more often than not, these behaviors are involuntary. That's why the student himself isn't aware of them.

Sheri Glucoft Wong, LCSW

I would share your observations with the adult(s) in this child's life by simply describing the motions and sounds you have seen, as well as describing that the child doesn't seem aware of them and that you are concerned because other children are having a negative response to behavior they don't understand. Ask the adult if they are aware of it as well. If they are, perhaps you can discuss ways to manage the situation that won't embarrass the kid with the tics (or whatever the issue might be)---for example "Sometimes his body or voice expresses itself in ways he didn't mean it to, and he is so used to that happening that he doesn't notice. His family has learned to work around the motions and sounds and we're going to learn to do that too." You can see it as an opportunity to support acceptance of differences with kindness and generosity. If the student's grown-ups weren't aware, you may be giving them info they didn't have and can let them know it would be helpful if they checked in with the pediatrician to understand what might be going on so you can work with them to better support the child in the social setting of your program."

- Sheri Glucoft Wong, LCSW

Berkeley, Ca

Sam Piha, MSW
Temescal Associates

A: I agree with Sheri's answer above, with one additional thought: parents can be very touchy when learning of information about their child that they may view as "negative". These are very delicate conversations. It is best if you only share your observations and maybe concerns, while avoiding any medical terms or diagnosis.

-Sam Piha, MSW

Temescal Associates

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MORE ABOUT…
Dr. Diane Ehrensaft is a developmental and clinical psychologist, Director of Mental Health at the Child and Adolescent Gender Center and Associate Professor of Pediatrics, University of California San Francisco. She has been a frequent contributor to our LIAS blog and the How Kids Learn conference. You can review her blog responses here and view a video presentation here.

Sheri Glucoft Wong is a Licensed Clinical Social Worker and family therapist. She’s known nationally for her parenting workshops and consultations with school leaders. In addition to her clinical practice, she has led workshops and seminars for childcare centers, medical centers, and private industry for over 30 years. 


The Gender Creative Child: A Radio Interview with Dr. Diane Ehrensaft

By Sam Piha

Sam Piha

It is important that educators and youth development specialists understand the latest thinking on the needs of transgender youth. To support this, we worked with Diane Ehrensaft to develop a briefing paper entitled Understanding Gender Identity in Young People: A Briefing Paper for Afterschool Programs. We also interviewed Dr. Ehrensaft, which we posted on our LIAS blog in two parts (see Part 1 and Part 2). 

Dr. Ehrensaft, co-founder of UCSF’s Child and Adolescent Gender Center, coined the term “gender creative child” to describe children whose gender identity is not reflected in the male or female box that was checked on their birth certificates. 

Mina Kim (Left) | Dr. Diane Ehrensaft (Right)

Dr. Ehrensaft talked with Mina Kim on KQED’s Forum program about the experience of gender nonconformity and discussed her new book, “The Gender Creative Child: Pathways for Nurturing and Supporting Children Who Live Outside Gender Boxes.” We thought our readers would benefit by hearing Dr. Ehrensaft in her own words. This radio broadcast can be heard by clicking below. 

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Diane Ehrensaft, Ph.D. is an associate professor of Pediatrics at the University of California San Francisco and a developmental and clinical psychologist in the San Francisco Bay Area, with a private practice in Oakland, California.  She is Director of Mental Health of the Child and Adolescent Gender Center and chief psychologist at the Child and Adolescent Gender Center Clinic at UCSF Benioff Children’s Hospital. She specializes in research, clinical work, and consultation related to gender-nonconforming children, lecturing, publishing, and serving as an expert witness on both topics nationally and internationally.

Dr. Ehrensaft is author of Gender Born, Gender Made; Mommies, Daddies, Donors, Surrogates; Building a Home Within (co-edited with Toni Heineman); Spoiling Childhood; Parenting Together; and the new release, The Gender Creative Child.  Dr. Ehrensaft serves on the Board of Directors of Gender Spectrum, a national organization addressing the needs of gender-expansive children and their families. 

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You can read other blogs by the LIAS project by going to: 

• Expanded Learning 360°/365 Project website 
• LIAS Blog written for the California AfterSchool Network

Gender Identity and Implications for Practice: An Interview with a Child Development Specialist, Part 2

By Sam Piha

Sam Piha

We have produced a briefing/background paper on gender identity. We invite you to download this paper by clicking here.

Below, we continue our interview with Dr. Diane Ehrensaft to shed more light on this topic, and ask her about the implications for youth program leaders. You can find part 1 of this interview by clicking here. 

Dr. Ehrensaft specializes in research, clinical work, and consultation related to gender-nonconforming children. She is an associate professor of Pediatrics at the University of California San Francisco and a developmental and clinical psychologist in the San Francisco Bay Area.  

Q: Can gender identity be chosen―or even changed?

Dr. Diane Ehrensaft

A: We do not choose our gender identities—we discover them. No one can take that away from us, they can just demand that we bury it underground. And yes, our gender identities can change over time. Gender is a lifelong process. But truth be told, gender identity is typically a pretty stable part of ourselves, once we clarify what it is, albeit not necessarily immutable.  

When it comes to our gender expressions, yes, they can be both chosen and changed, either over time or depending on the circumstances. For example, when I was growing up I was both a ballerina and an avid student of math. When a ballerina, I was the essence of femininity. But when in my accelerated math class, I expressed myself in a competitive, driven manner more associated with male gender expressions at the time I was growing up. 

The terrible affront we do to transgender people is the same one that has been laid on gay, lesbian, and queer people—the accusation that they choose to be the way they are and they could stop it if they wanted (often with the help of harmful, reparative therapies). The reality is: that is who they are, they didn’t “choose” it, and it is the task of all around them to acknowledge, honor, and support that person for who they let us know they are.  

Q: Does gender have to be one or the other? 

A: Not only does gender not have to be one or the other—it isn’t. The only problem is that many people get nervous when we take that idea of only two genders away from them. The concept of binary gender—male/female--has been bedrock for many people; and now we’re taking that bedrock away and replacing it with gender as moving boulders. But that binary concept has never really held true in reality. When we look at the animal world, when we look at cultures across the globe and throughout history, and when we look at the phenomenal sea change that is occurring right now in our own culture’s redefinitions of gender, particularly among youth, we discover that gender, rather than binary, is actually infinite in its potential variations.  

On our own land, Native Americans have taught us about third and fourth genders. And these variations should be considered a healthy part of human existence, rather than something that has to be fixed or exterminated (as did the white settlers with the Native American third and fourth gender people). 

Turning back to youth, we now have children and teens who identify as agender, pangender, gender queer, gender fluid. Indeed Facebook has provided over 58 categories of gender to choose from, in addition to “other.”  And more will come. We now think of gender as a spectrum, a rainbow, a web, no more boxes.  

Q: What would you advise for youth workers regarding their work with gender fluid youth? 

A: More important than anything else, listen to the youth. It is not for us to say, but for them to tell us who they are and how they want to “do” their gender. Know that by the time they come to you they may have suffered years of teasing, harassment, or rejection because of their gender fluidity. Gender fluidity doesn’t always play well in a world that is genderist or transphobic. Alternatively, know that by the time they come to you they may have discovered support, acceptance, and pride in themselves, and that is to be celebrated. 

But going back to the negative, know that the risk factors for gender fluid youth are many. If not supported, gender fluid youth are at risk for anxiety, depression, self-harm, even suicide. And know that they depend on you to watch their back, to mirror back to them a positive sense of who they are, to use the names and pronouns they ask you to use for them, to step in rather than step aside as a passive bystander if others are giving them grief about their gender.

Q: What would you advise for youth workers as they look to create a safe and unbiased (gender) environment for all youth? 

A: First, look inside yourselves and check yourselves for your own biases and discomfort with gender-nonconforming and transgender youth. How do you really feel about a boy wearing a dress? A boy-girl? A girl who binds her breasts? All of us have “gender ghosts”—negative feelings about people who live outside gender boxes, a normative way of being that was instilled in us in our own socialization in a world that was not accepting of such gender differences.  

Photo Credit: Brian Peterson
http://www.startribune.com/

If we are to work with youth and afford all youth an opportunity to maximize their gender health—which means having the opportunity to live in the gender that feels most authentic to them - free of aspersion and rejection and filled with gender acceptance and support, it is necessary to expel our gender ghosts and replace them with gender angels—positive feelings and actions toward youth of all genders.

Anyone who works with a gender-nonconforming youth holds two responsibilities: 

• To make sure you function as an accurate mirror for the youth: No one wants to feel invisible, so make sure you reflect back to the youth the gender self they are, not the one you want them or expect them to be.

• To ensure that no insults or impingements/microaggressions come the youth’s way: The youth are counting on you to run interference for them and either not allow or be responsible for the minor or major insults that might come their way. So just make sure you step up to the plate.

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Diane Ehrensaft, Ph.D. is an associate professor of Pediatrics at the University of California San Francisco and a developmental and clinical psychologist in the San Francisco Bay Area, with a private practice in Oakland, California.  She is Director of Mental Health of the Child and Adolescent Gender Center and chief psychologist at the Child and Adolescent Gender Center Clinic at UCSF Benioff Children’s Hospital. She specializes in research, clinical work, and consultation related to gender-nonconforming children, lecturing, publishing, and serving as an expert witness on both topics nationally and internationally.

Dr. Ehrensaft is author of Gender Born, Gender Made; Mommies, Daddies, Donors, Surrogates; Building a Home Within (co-edited with Toni Heineman); Spoiling Childhood; Parenting Together; and the new release, The Gender Creative Child.  Dr. Ehrensaft serves on the Board of Directors of Gender Spectrum, a national organization addressing the needs of gender-expansive children and their families. 

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You can read other blogs by the LIAS project by going to: 

• Expanded Learning 360°/365 Project website 
• LIAS Blog Written for the California Afterschool Network