Asking questions and maintaining curiosity: Embracing gender exploration in youth
The content of this podcast is for informational purposes only and should not be considered medical advice. Always consult with a qualified health care professional for any health concerns. Take care of yourself out there. Welcome to Unraveling, a podcast that sees the world through the lens of mental health. I'm Curt White, a social worker and psychotherapist.
Mary:And I'm Mary Wilson, a journalist. And we're excited to bring you our third episode for pride month. Today, we'll specifically be talking about youth and gender exploration and how caregivers and parents can really support and be affirming.
Kurt:Yeah. I think this is something that a lot of people maybe hear about, maybe they have some personal experience with it, or maybe not, but maybe have a lot of questions about and don't know where to go to get those questions answered. And it's a topic that for me is, you know, really important, especially when we're talking about young people because, you know, as a psychotherapist, we worry about some of the health disparities in the mental health realm that affect this population in particular.
Mary:Yeah. According to the Trevor Project, who conducted surveys of more than 30,000 LGBTQ people ages 13 to 24, seventy three percent reported symptoms of anxiety. Fifty eight percent reported depression. Forty five percent reported seriously considering attempting suicide in the past year, and fourteen percent reported attempting suicide in the past year.
Kurt:Yeah. Those are alarming numbers. I mean, I think we should worry about things like that. It's a topic that's so much in the news, and there's so much fighting and arguing back and forth about this. And today, we really wanted to try to go at it through a different angle, to to talk to somebody who's actually really working with this population, listening to them, learning from their experience, as well as with experiences of of their own.
Mary:And I had the pleasure of speaking with doctor Marley Belasco, who does this really important work every day. She is the inpatient psychology specialist at the Bratteboro retreat. She received her master's degree in counseling for mental health and wellness at New York University and her bachelor's degree at Norwich University.
Mary:Marley's experience comprises a myriad of treatment settings, including wilderness therapy programs, community mental health clinics, and residential programs, university counseling centers, and at an outpatient adolescent medicine program. Her clinical research interests are broadly focused on the experiences of adolescents who struggle with the residual impact of trauma, identity based depression, anxiety, and depression.
Kurt:Well, she sounds like just the right person to talk to here. We're very lucky to have her here at the Brattleboro Retreat, and I'm looking forward to your interview with her.
Marley:Yes.
Mary:Doctor Balasco, welcome to unraveling. Thanks so much for being here.
Marley:Of course. Thanks for having me.
Mary:And you're an inpatient psychology specialist here at the Brattleboro retreat. Can you
Marley:tell me a little bit about what you do and how you came to it? Yeah. So I am a psychologist. I'm technically in my postdoctoral year. I originally started in the fields working in residential programs and group homes, so that was kind of my intro to mental health.
Marley:I worked in wilderness programs, I've worked a lot with adolescents and youth and families who are navigating crises. So when the opportunity opened up for a doctoral position, an internship position, I found the Brattleboro retreat and wound up here. So now I work as the psychology specialist on the inpatient units in the adolescent program, working with kids who are experiencing acute crisis.
Mary:And was there something that really got you into this kind of work?
Marley:Yeah. So my research area and my clinical interests have really been about how resiliency arises among individuals and groups who hold marginalized identity or or more vulnerable identities. In educational settings, we like to say, you know, research is me search. So I I am a queer identified therapist. I I talk pretty openly about that when it's appropriate or necessary.
Marley:I think I really like to support people who are in process of discovering who they are just by virtue of knowing what it was like to feel a little bit different or feel like an outsider in some way and to not necessarily have the language to describe that or know that there was another option available to me other than fulfilling binary expectations. And so just being part of that process for other people is something that I've always wanted to support.
Mary:What do you mean by binary expectations?
Marley:Yeah. So the binary is an old way of thinking about gender and sexuality. So you were either in one category or one camp or the other. It's male or female or masculine and feminine. And so being and presenting and existing within a spectrum is more about like I fall somewhere into a camp somewhere between, but I don't fall hard and fast into stereotypical presentations or expectations.
Mary:Yeah. I'm looking forward to talking with you about gender exploration and how families can help support those youth. Tell me first to just the basic definitions here because I know sometimes it can be conflated, gender and sexuality.
Marley:Mhmm. So, yeah, gender and sexuality in in research terms are often talked about as if they're like one thing. I think the the best way to really conceptualize the difference between gender and sexuality is that gender is more of an expression of who we are. So the way that we present ourselves externally or the way that we behave, the way that we act, There's, you know, biological gender which is typically assigned to people at birth based on external anatomy. Then we have gender identity, so it's terms, it's language that people are using to really self identify.
Marley:It's their experience of themselves internally. And so sexuality is more about an expression or communication about who we love. And that might be based on things like who we are sexually attracted to, so like arousal is experienced, just like general attractions based on outward appearance and how someone is presenting based on their gender. But I think it's really important to really understand the two as distinct because just because someone might wanna communicate a bit about who they are based on gender doesn't necessarily mean that it's tied to their attractions.
Mary:What sort of other issues arise when people do conflate the two?
Marley:You know, that's a good question. I think people feel like they're put in boxes. I don't think anyone really appreciates when assumptions are being made about them in general, but I think we lose our sense of curiosity about people or our ability to really connect and understand who someone is or to get to know them on an authentic true level when we're just making assumptions based on how they might describe themselves or how they might present one way or another.
Mary:And gender development starts at a really young age, right? Yeah. It's just a natural part of growing up. Can you tell us more about that?
Marley:Yeah. Everyone has a process of forming their identity, and so gender really isn't any different than forming any other part of your personality or expressing who you are. But at 18 old, as early as 18, we start to figure out and differentiate between male and female. So my mom is this or my dad is this. By age three and four, we typically have some kind of sense that identity is stable over time and that gender is a constant.
Marley:So my mom is this or my dad is this or boys are this and girls are this, and that those things are just consistent with who we are and it's going to be experienced as these people won't change or present any differently. And then by the time kids are in school, we really start to understand what's stereotypically male, masculine or feminine, what's socially acceptable as a boy, what's socially acceptable as a girl. Kids kind of just like play with this as they're growing up too. So gender play is something that all kids do to some extent.
Mary:Give us some examples of gender play.
Marley:Yeah. So boys who might be curious about girls' dresses or playing with bright shiny tutus, oftentimes girls might play with trucks or be more interested in building blocks. Again, things that are stereotypically only accessible to boys or things that we might offer more to boys.
Mary:Yeah. Because the social conditioning, the messaging starts so young. Mean
Marley:So so young.
Mary:I'm gonna have a baby girl in a month, and so it's all pink. And, you know, it just starts right off the bat. Yeah.
Marley:And people ask you too, like, do you know what you're having?
Mary:It's
Marley:like, what does that really change for you? Right. To know what some what someone else what like the child's biological sex is going to be. But like there's a curiosity that exists really early and it's automatically before the child is even born, like there are feelings of excitement or joy or like expectations that might be laid out before a child even enters the world or has an opportunity to figure out who they are. Right.
Marley:You'll get plenty of cards, I'm sure, that say, congratulations, it's a girl. Yeah. Or clothing that is purchased from the girl's section. Mhmm. And it's things that we never really consider.
Mary:Mhmm. Yeah. There's whole parties now. The gender reveal parties have gotten so popular.
Marley:Yeah. So it's and it generates a lot of attention and excitement over these things. And so like, again, like the expectation can set in really early when, you know, you you imagine a life for this child based on their gender and like things that you wanna purchase or buy or ways that you want to present this child to the world that might not actually be congruent with the way that the child experiences themself.
Mary:When you're witnessing as a parent the gender play, the exploration, when do you distinguish between this is just exploration and maybe it's more of a persistent gender nonconformity.
Marley:Yeah. So I mean, there is language out there that if it's persistent, insistent, and consistent, then this is something that is likely going to endure over time that this might be more indicative of what someone might call a true self. I don't know how much I necessarily buy into that particular language. I think it's important to monitor and be aware of, But I think also that kind of loses the joy of just being curious and exploring every step or phase of a person's process. I think it's important to pay attention to and monitor, but I think we so quickly as parents or caregivers or as clinicians who are really trying like, we're always thinking about assessment, and we so easily just get into we start to pathologize or judge or criticize or start to yes.
Marley:Just start to think that something is wrong, and it might not necessarily be that anything is.
Mary:Yeah. And you mentioned process. This whole process of finding your identity, it can take a long time. Right?
Marley:Yeah. You know, one of the the theories that I really appreciate about just gender affirming care or gender care in general is her name is Diane Arenzaft, and she created what's called the gender web and talks about how gender really unfolds over time as a subtle interplay between someone's biological nature, their socialization, and just general development, and culture. Culture being a big piece. I think the language that kids are using now is like they're really exploring pronouns or talking about existing within the spectrum of the binary system or really just being gender expansive. And I think the more options that become available to people, the more they can start to explore who they are.
Mary:Gender expansivity.
Marley:Mhmm.
Mary:What does that mean?
Marley:Yeah. So I again, like, culture plays a huge role. And when there are people depicted in the media as being gender expansive or being non binary or identifying as transgender, I think people who have that internal sense that, like, I don't really necessarily meet masculine or feminine norms or I don't feel like my body is mine or there are parts of my body that just like feel really inconsistent with who I experience myself to be internally, I think all it does is creates a space for people to get a little bit closer to who they are. And it might not even necessarily fit the language that's out there. They might not necessarily feel or want to identify in non binary terms, but I think just knowing that things are on the table, it just gives people a little bit more option to explore.
Marley:It might just be at this time and in this space, I'm gonna explore this a little bit because maybe this is something that might apply to me and it may or it may not.
Mary:Do you see parents and caregivers struggle with that when it's not sort of a black or white answer when things are sort of on the spectrum and possibly even changing day by day?
Marley:Yeah. I think all the time. Even even the most, like, accepting parents, parents who really understand what's happening culturally and the shifts culturally and parents who really wanna be on board with that and champion it completely still have struggles and still have questions. I think, you know, like the way that kids are kind of playing with gender, if you'll say, is really different from what you or I may have experienced growing up. And so when you don't have a language for it, it's really hard to understand that concept for yourself.
Marley:And then talking to kids about it is just hard because one, children after a certain age, typically around as early as six or seven, kind of start to conceal who they are or conceal parts of their lives from from their parents is just again a natural part of growing up and trying to figure out who you are. So it gets harder to have those conversations too. So again, even the most validating parents like have questions or are grieving the child that maybe they expected or expectations that they may have had or just general fears of what it's like to live in a world that isn't entirely understanding or accepting.
Mary:And I think we've heard the narrative of people saying, oh, I don't know what their pronouns are. Maybe they change day by day. Yeah. What does that sort of mean, and what is your advice for someone who might be dealing with that?
Marley:Yeah. I mean, to me, when if someone is changing pronouns or exploring it with more frequency, to me that suggests a pattern. Right? And so then I would just be curious why? Like what's happening there?
Marley:That someone is really might be struggling with who they are and they're struggling in this instance, you know, in terms of like a gender identity, like it's a communication about who we are and someone is really struggling to communicate who they are to the world. Like how do I explain what's happening for me internally and how do I share that with other people in a way that I feel is is actually accurate and authentic? What happens is a lot of people might be inclined to invalidate that process. Like, this isn't true. Know, it's like, they're switching pronouns so frequently that, you know, who's to say what's gonna be stable and and what's not?
Marley:It's like and it actually doesn't matter. I think, again, the more important focus is like, what is the communication in this moment right now, and what is what does this person need, and how can we support them in that process?
Mary:And we can't overstate just how important that family support is. Right?
Marley:Yeah. Yeah. Family support, there's so much research and data that shows just one I think the statistic is that it can reduce suicidality by like forty percent by just having one engaged person and one accepting person in somebody's life. So the role of parents is so important. You know, as kids reach elementary level and when social relationships start to become more important, it's important to recognize that kids can experience rejection.
Marley:And kids can be cruel as they're all in this process of trying to figure out who they are and that's chaotic for anyone. And so having a place to come home to where you can just kind of relax a little bit and let your guard down and feel connected and feel a sense of belonging is so important. So if you're feeling rejection across multiple social domains of your life, I mean, it's not healthy for anyone.
Mary:Yeah. And it could be coming from a well meaning parent, right, who just is still getting it wrong.
Marley:Yeah. And a lot of times when I talk with parents who are, you know, outwardly rejecting of their child's gender exploration process, what's mostly coming up is fear of really not understanding something and being worried that they can't protect their child or keep them safe or that their child's life is going to be harder in some way because they're operating in an identity that is either stigmatized or marginalized or not well understood.
Mary:Yeah. How do you work with parents to sort of overcome that fear and instead be accepting of their kids?
Marley:Yeah. I mean, psychoeducation, I think, is a big is a big point. So, like, again, really normalizing that this is just part of growing up, that every child goes through this in their own way and and your child's process is unfolding in this particular way. So really just trying to normalize, number one. And then two, validating that this is it's scary and that your fears are understandable.
Marley:And then, you know, exploring a little bit more, I think every parent is going to go through a process of grief. And I think, again, most parents probably under undergo that anyway. Anytime your child is, you know, going through something that's hard or challenging, I think You know, my dad has said to me before, like, every parent just wants their child's life to be easy, and like, that's not realistic.
Mary:Right.
Marley:Yeah.
Mary:Yeah. You want your kids to just have the easiest life and everything worked well for them, but then you realize that those hardships and having to overcome things are what make life worth living. Yeah. What do you witness as a relationship between a parent or caregiver and a child who have a really good open relationship and it's very affirming of a gender expansive youth?
Marley:Yeah. I think there is a lot of love and warmth that I witness. And I think you can also get caught up when you're being affirming and validating and you just want to champion your kid all the time. Again, this can show up in something even like sports, right? Anytime you're just adamantly behind your kid pushing them all the time, you still might be missing the point.
Marley:It's important to always ask questions and maintain curiosity throughout a child's process regardless. Right? Like, oh, you're making this decision or this choice today, and I agree with it. Like, cool. I'm not gonna explore that.
Marley:I'm not gonna ask. Right? But it's another missed opportunity to really get to know your child in meaningful way. And so I think that can happen with parents. I've I've seen it happen.
Marley:Like, really affirming and validating parents can still miss the mark. So, like, ask more questions and listen.
Mary:Yeah. So we've spoken about this on really the family, the individual level, and it sounds like you're saying a lot of the advice is really to be curious, to ask questions, and maybe it's not so hard after all to be affirming. But you look at the political landscape right now and things being criminalized, and there's just so much fighting and loud voices in the news coverage. How do you think that is sort of affecting people who are trying to explore their gender and their identity?
Marley:Well, I think it's affecting them to a pretty significant degree in terms of distress. People are feeling pretty polarized on this topic and in this subject, and it's creating a lot of division. And honestly, it comes across as more like fear mongering than anything else. I think folks who are in a gender expansive process or in a gender exploratory process, on their end it can feel like large scale rejection and stigma. And so I'm hearing it from young people who I work with in both the outpatient and inpatient setting is that they're feeling a really big sense of non belonging in a sense that they're profoundly misunderstood.
Marley:And unfortunately, what we see is it really drives mental health issues. And I think a lot of disparity between gender diverse young people in comparison to their gender congruent counterparts is that there's just a different layer of their experience in a societal context and in a broader context that is just not experienced by others who aren't being stigmatized because of something that is what they're feeling internally about a part of who they are. And what we know, again, what research will show and what we've seen anecdotally in our work here is that when people feel rejected in any way or denied who they are, that they're at risk of experiencing pretty significant mental health crises, and that can look like anxiety and depression, and it can extend well beyond typical anxiety and depressive symptoms. It might look like suicidality, I think young people are at greater risk for homelessness or socioeconomic disadvantage, substance use. I mean, runs the full spectrum of things like the worst case scenario is possible.
Marley:And I think what's really lacking in these conversations that are happening on a political scale is that it profoundly misinterprets the experience of people who are seeking those types of services or who are seeking and trying to pursue medical transitions. It really devalues and overlooks just how thoughtful people are being about this process in general. I mean, some of the people who I work with really young early on in their life had felt like, you know, if I could just push a button, I would be I would just be a boy or I would just be a girl. Like, that's the level of distress that they've had, and they've had to think about in terms of getting access to medical care, like, who do I wanna be thirty years from now, and is this something that I want on the table? And they've had to make really hard decisions about like, you know, maybe it doesn't matter what life I have for myself thirty years from now if if I can't even imagine living it the way that I'm living it now.
Marley:Like it's even doing a social transition or a medical transition, it's still not pushing a button. It's still not giving them that option. Like it's a lot of time to be experiencing some kind of distress and a lot of time that people are taking to be thoughtful about how they wanna live their lives. And that is really, really dismissed when we're just looking at these bans that are being imposed on a national scale.
Mary:Yeah. And you almost wonder if the voices that are making up this really nasty politically charged climate, if they knew the impact, the devastating impact they could have on a child that maybe they wouldn't contribute in that way.
Marley:Yeah. And I've I've I've had conversations with people who are pretty affirming and caring and thoughtful people who fall in support and in favor of these bands. And again, what's happening is like they're profoundly misunderstanding what a person's process is and they're by large, just from my own experience, the people who really adamantly oppose any type of gender health care are people who have very limited interactions and experiences with people who are in this process.
Mary:So they would actually need to speak to some more people who know what they're talking about in order to understand the
Marley:real And people who live it. You know? Like, really trying to understand someone's lived experience before you make a judgment or want to decide and take away something that could actually save their life or improve their mental well-being.
Mary:What might you say to someone right now who is feeling alone and feeling not validated to give them some hope to hang on in those really difficult times?
Marley:I mean, I I would acknowledge that they have a lot of valid reasons right now to feel alone in this process, especially if there are folks in their immediate support groups or immediate social circles who really don't understand their experience. And you're not alone because there are other people like you, your story and experience may be subtly different or unique in its own way as every person's story is, and you're not alone in the experience of that. And really encourage people to find circles or to talk about it with someone who they do feel can understand and comprehend in some way. But there are some really great resources. I mean, in this state and in this immediate area for sure, but I always encourage people to like find your people.
Marley:In the queer community, we use a lot of language like chosen family, and you you will find your people if you just continue following a path that feels true and aligned with who you are, and it will eventually put you in contact with people who can relate and who are similar and who can express some some level of understanding.
Mary:Wow. Well, thank you so much for the important work you're doing, and thanks for being here on the podcast.
Marley:Yeah. Of course. Thanks for having me.
Mary:And thanks again to doctor Balasco. We're just so fortunate to have someone like her working here at the retreat. Joining me again is Kurt.
Kurt:And I'm just feeling very grateful that we have people like her working in the field at all, and also with young people like this. I can easily imagine her wisdom, her calming presence, her curiosity, her really wanting to know what someone else's experience is like through listening. It's really the best version of what a psychotherapist does. And it sort of lifts my heart, you know. It warms it in a world that threatens to make you cynical, make you hopeless, make you despairing at times.
Mary:Yeah. It feels like no matter how far we come on this topic, there's backslides every day and things we see in the headlines that make you wonder truly how far we have come.
Kurt:That's right. And I mean, you know, social justice issues, broadly speaking, intersect with mental health issues in really complicated ways. And social justice, it's a powerful word, but in in one one hand, it means just a world in which we could imagine that people are accepted for being exactly who they are. And how hard that has been for us to do. Will we ever get there?
Kurt:I don't know. I was remembering as we did this, actually an event we had in the hospital here a couple months ago for Martin Luther King Jr. Day, where we listened to his speech, Where Do We Go From Here. And he points out there are going to be times where the world is really hard, where it feels like the gains that we've had are lost. But he said choosing always to be hopeful, to choose love, to choose possibility, that things are in a very long term way bending toward justice.
Kurt:Right? That's that wonderful line, the moral arc of the universe is long, but it bends toward justice. And listening to Marley made me feel like may maybe it does. Maybe there is light even in very dark times. And
Kurt:Yeah. Please check those out. And thank you again to you, Mary, for this wonderful interview and to doctor Belasco. And I hope people will join us in our next episode where we jump into related issues and Disability Pride Month, a very special episode with two guests where Mary and I are both interviewers. And I think you're gonna love that one.
Mary:Yeah. Really excited to have everyone listen to that great conversation, and we'll see you then.
Kurt:Unraveling is brought to you by Brattleboro Retreat. Our producers at Charts and Leisure are Andrew Adkin, Hans Beuteau, and Jason Oberholzer.
Mary:And you can find us on social media by searching Bratteboro Retreat. Bratteboro Retreat is committed to exploring diverse perspectives on mental health. While we invite hosts and guests to share their insights, the views expressed are their own and do not necessarily reflect the policies or positions of the hospital or its staff.
