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Original Art featuring an illustration of two people of color, an adult comforting/embracing a child/young adult. Credit: Courn Ahn
In 2023, Kirin Clawson’s endocrinologist placed a puberty-blocking implant in her arm, a medical intervention that is associated with improved mental health for many trans kids with gender dysphoria. In February, Indiana joined several other conservative states banning this treatment for minors. In the first of a 2-part series, we hear from the Clawsons how the ban has impacted their family. And, we hear from psychologist, Dr. Myeshia Price about how all adults in the lives of children can support gender diverse youth, despite increasing discriminatory anti-trans laws aimed at kids.
Featuring: Episode Credits:
Transcript:
[00:00:00]
Show Button: The system is in too many ways broken. The way we see the world shapes the way that we treat it. This is Making Contact.
Amy Gastelum: Hello.
Kirin Clawson: Hi.
Amy Gastelum: I’m sorry we’re a couple minutes late.
Amy Gastelum: The Clawsons are a middle-class family in a small college town, Bloomington, Indiana. Their neighborhood streets wind through soft hills dotted with two story houses. When we arrived, the family greeted me and my co-producer, Emily at the door with smiles. Beth, the matriarch, has kind eyes and short gray hair.
Her husband, Nathaniel, was wearing a shirt that said, “gender affirming care saves lives.” The Clawson’s three kids were there [00:01:00] too. Izzy is home from college, Max lives at home while he attends Indiana University, and the youngest is 11-year-old Kirin.
Amy Gastelum: I’m Amy.
Beth Clawson: Beth.
Nathaniel Clawson: I’m Nathaniel.
Amy Gastelum: I came to see them because I wanted to talk about an Indiana law banning medical gender affirming care for minors. The Clawsons, along with the ACLU, some other families, and a family practice doctor, sued Indiana over the law when it was passed. The Clawson’s daughter, Kirin, was receiving gender affirming care, and they were worried about what the law would mean for her, and they were angry. They weren’t the only ones.
In this clip from one of the bill’s hearings, you can faintly hear protesters chanting under state rep Bradford Barrett’s opening remarks.
Indiana State Rep Bradford Barrett: I would ask people in here to please remain seated, to please limit, uh, um, I’d like for no signs, banners or flags. I would like people to please stay seated, uh, and then [00:02:00] outbursts of any kind will not be tolerated.
Amy Gastelum: The lawsuit the Clawsons brought resulted in an injunction, meaning the law was stopped from going into effect. So, at the time of this interview, Kirin was still seeing her health care providers in Indiana, but the Clawsons knew a ruling could come at any time. Any day that would force them to seek care out of state.
When the bill was first brought, Nathaniel particularly was ready to take action. He knew he was in a privileged position in many ways and felt obligated to take a stand. For one thing, the company he works for supports his advocacy for trans youth. He says in Indiana, that’s rare.
Nathaniel Clawson: I get to speak out, and it’s considered one of our caring values. And we really felt like we had to speak up to protect the other families with trans kids that we know about.
Amy Gastelum: The Clawsons never [00:03:00] expected to be activists or to sue a whole state. Beth admits she really likes when everyone just gets along and she isn’t a fan of change, generally. But she and Nathaniel Clawson are also devoted parents.
Max and Izzy, the older kids, are both cisgender. They’re only 18 months apart. And when Izzy and Max were school aged, Beth and Nathaniel added Kirin to the mix. Max and Izzy said when Kirin was a toddler, she was adorable and loved to be the center of attention. And they were happy to give it. Nathaniel showed me a video of Kirin on his phone.
She was two years old, wearing a dress up skirt and dancing. You can hear Izzy laughing in the background.
Nathaniel Clawson in video: Hey Kirin, can you do the hula hula?
Kirin Clawson in video: Hula hula! Duh da da da da
Izzy Clawson: featuring one of the dresses she had stolen from me.
Amy Gastelum: Oh really, that was yours, the skirt?
Izzy Clawson: It was a dress up skirt when I was a kid and then it had been in my room. And as soon as Kirin was old enough to walk, she was [00:04:00] like, oh my God, it’s pink, and it has a flower on it. And then she stole it.
Amy Gastelum: At two, Kirin dressing in skirts for fun was not an issue for Beth. She thought it was a phase. It was cute and funny. But whether trans, non-binary, or cisgender, many kids have some internal sense of their gender by the time they’re three years old. And when she was just learning to walk, Kirin often wrapped a towel around her head as if it were long hair and then admired her reflection in the oven door.
When she was a little older, Kirin raided Izzy’s dress up clothes and wore them around the house. Eventually, if she wasn’t wearing a dress up outfit, she refused to leave the house. When Beth would try to put boy clothes on Kirin, she would go stiff and not move, a silent but complete boycott. Beth remembers texting her friend, who has a son only two years older than Kirin.
Beth Clawson: When do they get out of this temper tantrum age when they don’t want to put their clothes on? And she was like, [00:05:00] that never happened with her youngest son. And then I thought about it. I was like, that never really happened with my older two either. Like, this is definitely a new thing.
Amy Gastelum: The conflict sometimes kept them from going out. I asked Beth what that was like for her.
Beth Clawson: It was a little scary because we started, we realized, you know, I started, we started noticing things were a little different and then she started not being her happy self. Um, She started, you know, withdrawing and as the tantrums – not tantrums, I hate saying that word because it sounds like she was just being petulant and that’s not what it was. Um, the distress of wearing clothing that she didn’t feel, feel, describe her. And if you’re asking me how it made me feel, I, it made me feel scared. Not because, oh I am gonna cry. [00:06:00] It made me feel scared because I didn’t want anything to be hard for her. And I kind of was gathering that things would be scary for me and her and hard. And so, I was scared. Um, and I think I felt also felt bad for being scared. I remember specifically I had taken, I was like, it’s not that Kirin wants to wear girl clothes, it’s that she just wants to be dressed up. So I, you know, I started buying button down shirts and corduroy pants, so Kirin would look, for lack of a better word, handsome. And then I had a friend say, sorry, I had a friend say, they [00:07:00] just, Kirin didn’t seem like Kirin, like, like herself because she was, it was just a day where I put my foot down and I said, we’re just going to wear these boy clothes. It’s And they just talked about how Kirin, even at two and a half, or I don’t even know how old she was, she was not three, just like all of the light was out of her. And I was like, oh my gosh, you’re right.
And then that’s when I decided that I just, I can’t be scared. And we had, or we can’t be scared. We just had to like, do the thing that made my kid be the happy kid that she was when it, all I had to do was let her wear a dress.
Amy Gastelum: Izzy shifted in her seat and raised her hand.
Izzy Clawson: I think that my parents aren’t giving themselves enough credit with the amount of research and time they [00:08:00] spent looking into it because it wasn’t them just going, oh, we’re going to stick you in these clothes. It was, we can’t find a reason for this. It’s new and we don’t know what it is.
Nathaniel Clawson: The watershed moment where we realized that we had to do something was, Kirin got out of the bathtub and was running around the house and grabbed a pair of scissors and said, can I cut my penis off? I don’t like it very much. And I mean, comically, I don’t think any boy has ever wanted to cut their penis off. And so we realized right then that she wasn’t a boy and it was at that [00:09:00] point that we let her transition, socially.
Amy Gastelum: And what did that look like? What did that mean for you?
Nathaniel Clawson: So, we went to a local shoe store and we bought her some Elsa and Anna shoes and they were silver and blue and she was so excited, she slept in them.
Amy Gastelum: After that, they let Kirin shop in the girls’ section at stores.
Nathaniel Clawson: Seeing her smile and seeing her excitement was so powerful because, as Beth said, she had started to get a little depressed. And we said, okay, if she changes her mind later in life, she’ll at least know we love her and listen to her.[00:10:00]
Lucy Kang: You’re listening to Making Contact. Just jumping in here to remind you to visit us online if you like today’s show or want to leave us a comment. We have more information at radioproject. org. And now, back to the show.
Amy Gastelum: Hey there, welcome back to the show. I’m Amy Gastelum. You’re listening to Making Contact. After Beth and Nathaniel Clawson Clausen started to support their trans feminine daughter, Kirin’s social transition, they informed their friends and family first. They told me everybody was pretty accepting and willing to learn, but helping Kirin come out as trans was a process. Pretty soon after they bought the Frozen shoes, Kirin got sick, so Beth took her to a clinic to get checked out. She stumbled over Kirin’s pronouns during the visit and the nurse noticed.
Beth Clawson: And she called me afterwards, and she was just like, I noticed that you were struggling with how to talk about Kirin, and she’s like, would you and Kirin [00:11:00] like to talk with someone about Kirin’s gender? And so, I said, absolutely. Um, I didn’t know where I’m blooming to find that. And it was, it’s always meant a lot to me and I still see her at the grocery store. I don’t ever say, do you remember that time? Um, but yeah, she took the time out of her, um, her own personal time to find my number and call me and reach out with the therapist who she knew would be, um, understanding and affirming. Um, and so we made an appointment. with that therapist, and we’ve seen that therapist off and on ever since.
Amy Gastelum: Kirin’s health care providers in Bloomington eventually referred her to Riley Children’s Hospital in Indianapolis and their Gender Health Program. There, Kirin received wraparound, multidisciplinary, collaborative care from pediatricians, psychologists, and social workers. This is in line with best practice, according to health experts. And while having a [00:12:00] supportive mental health and medical team is important, affirmation from other adults in the lives of gender diverse kids is crucial. I asked Kirin what school’s been like for her.
Kirin Clawson: School has been great because my school is very acceptive. My preschool was also pretty acceptive, and so is the school that I went to before I transferred.
Amy Gastelum: When it was time for Kirin to start kindergarten, Beth wanted to inform some people at the school that Kirin was trans and would be attending as a girl.
Beth Clawson: We met with the school social worker, we met with the principal. The social worker had had experience with trans students in the past, so she knew what it meant to, you know, affirm and accept Kirin to school.
Amy Gastelum: The social worker worked with the teachers. She made sure that people understood it was okay for Kirin to share her information if she wanted to. It wasn’t a secret, but it was for Kirin and the Clawsons to share, not anyone else.
Beth Clawson: So really, we were set up [00:13:00] from the beginning for success.
Amy Gastelum: The American Academy of Pediatrics says the decision of whether and when to start gender affirmative treatment is personal and must consider that each patient and family is unique. They say caring for transgender youth ideally happens on an ongoing basis with the entire care team. There is no prescribed path, sequence, or endpoint to this care, but they recognize the positive impact of affirming treatment and care on gender diverse kids who suffer disproportionately from drug use problems, STIs, and suicidal ideation and attempts. According to the latest data on transgender youth from the CDC’s Youth Risk Behavior Survey, just over one in three trans respondents attempted suicide in the year prior.
Amy Gastelum: Knock, knock. Hello.
Dr. Myeshia Price: Just up the road from the Clawsons, Dr. Myesha Price is studying LGBTQ+ [00:14:00] youth, specifically resilience. When I met them at their office at Indiana University, they were just settling in after moving here from California. The office was completely bare.
Dr. Myeshia Price: I don’t, um, I literally brought supplies here today.
Amy Gastelum: Oh my gosh! Yeah, I’m I feel like I’m accosting you, like before you can even get, like, settled.
Dr. Myeshia Price: No, no, no, it’s fine. It’s good.
Amy Gastelum: Dr. Price is an Associate Professor in the Human Development Program at IU as part of the Counseling and Ed Psych Department. And she’s also an Associate Research Scientist at the Kinsey Institute.
Dr. Myeshia Price: I share this because it informs the work that I do, but I am black, queer, and I’m also a solo parent to a five-year-old who was assigned male at birth, but enjoys, um, wearing skirts, tutus, and has specifically asked me for a Barbie Dreamhouse with a slide, to be exact. And is currently navigating which bathroom to use at school, so that’s exciting.[00:15:00]
Amy Gastelum: Dr. Price confirms LGBTQ plus youth experience poor mental health and suicidality disproportionately. And she’s careful to point out the reason why.
Dr. Myeshia Price: So I think a lot of people get a little bit mixed up because they feel as though, well, it’s because your queer identity that you’re, that you’re suffering. And ultimately there’s a middle person in there and that’s the way that they’re treated. So, one of the things we know and that we see over and over again is that it’s the discrimination, the stigma, the bullying, the physical harm, the rejection that they’re getting that is then causing these poor mental health outcomes that they see. It’s internalizing also the negative things that are happening in society. And so now you feel as though you’re a bad person because of the identity that you have.
Amy Gastelum: Dr. Price says the impact of bans on gender affirming medical care like Indiana’s new law have a sort of underbelly.
Dr. Myeshia Price: The ban itself isn’t really impacting that many young people. And I, [00:16:00] uh, and I think people would be surprised to hear me say that, um, but I think there’s this assumption that there’s like millions of trans young people who are flocking to medical facilities to get gender affirming care. And I want to back up and talk about what it even is.
Amy Gastelum: Dr. Price says all gender diverse kids benefit from the social aspects of affirming their gender. Things like using preferred pronouns, chosen names, and affirming their use of the bathroom that aligns with their gender. But everybody’s different. She says many gender diverse youth aren’t seeking treatment like puberty blockers or hormone replacement in order to affirm their identities, and they might never choose to do that. But the legislation banning care is still harmful to them.
Dr. Myeshia Price: So what we’re doing effectively is sending a message to millions of young people, even those who are not ever even interested in getting this care, that they are not worthy of being affirmed. Like we’re essentially saying, what we’re [00:17:00] gonna do is pass this law that says your value in our society is lesser than other people’s. And so that’s one of the conversations we’re not having about this is the mental health impact of not only the passing of these bills, but the debate, the very debate of them that’s happening.
Amy Gastelum: Beth and Nathaniel Clawson decided not to allow Kirin to speak during the law’s hearings. The hearings were contentious and they wanted to protect her. I asked Kirin if she’d like to share what she would have said, if given the chance, and she did.
Kirin Clawson: I may be a small child, but if you make me mad, I’ll make sure your eardrums burst with my screams.
Amy Gastelum: On top of experiencing the discrimination of anti-trans laws, some gender diverse adolescents suffer when they get closer to puberty that doesn’t align with their gender identity. Some kids experience increased isolation and depression. They may have problems with their relationships or [00:18:00] academics. In Kirin’s case, Beth, Nathaniel Clawson, and Kirin’s entire care team noticed she was having problems the closer she got to puberty. Kirin’s doctor has checked her quarterly for the physical and hormonal changes of puberty. Once puberty starts, an endocrinologist can prescribe puberty blockers, which simply stop it until the kid is ready to think about how to proceed with their development. Depending on the person and the care team, a teen may then eventually receive hormones that match the puberty of their gender identity, estrogen for transfeminine teens and testosterone for transmasculine teens. The hormones are the same that are used for cisgender kids who are experiencing early or precocious puberty. Children and adolescents have used these medications since the 1980s. The hormones are reversible, though there is some data to show that prolonged use poses an increased risk for bone loss in transfeminine kids who receive them. [00:19:00]
In April 2023, Kirin’s doctor placed a puberty blocking hormone implant in her arm. It’s a slow-release device, sort of like a contraceptive implant. It stopped her testosterone rich puberty so that she would have time to consider receiving estrogen later on.
Kirin says she hasn’t loved the visits to her doctor because of the puberty checks.
Kirin Clawson: But it’s mandatory and it’s making sure that I don’t want to go kasplat off a building. So. Yay.
Amy Gastelum: What do you mean when you say you don’t want to go kasplat off a building?
Kirin Clawson: Um, no comment.
Amy Gastelum: Okay, because I think that what you’re talking about is suicide. Is that right? Okay.
Kirin Clawson: I didn’t want to say the word because it is a sensitive topic for some people.
Amy Gastelum: It is. You’re right. And we’re going to be really careful about the way that we talk about it. [00:20:00] The mental health fallout of Kirin not receiving care has worried Nathaniel Clawson. His brother died by suicide in 2022.
Nathaniel Clawson: Puberty sucks for everybody. But to go through a puberty that doesn’t align with who you know yourself to b… I don’t want my kid taking her life because she has to go through a testosterone-rich puberty.
Amy Gastelum: At the time of this interview, the Clawsons were waiting to find out whether Indiana’s ban on gender affirming treatment would go into effect, forcing them to travel out of state for Kirin’s care. They were on edge. But here’s the thing. What happens to trans kids in conservative states does not rest solely with legislators. Dr. Price says there are [00:21:00] things that everyone in every community can do to support them. Things like what Beth’s friend did in pointing out Kirin’s distress, or what Kirin’s nurse practitioner did, what Kirin’s school administrators and teachers did. Even Nathaniel Clawson’s employer supporting his advocacy work is empowering.
Amy Gastelum: What does the literature tell us about proven prevention or protective measures for suicidality among LGBTQ youth? I mean, that’s a big question. Isn’t it?
Dr. Myeshia Price: They’re…broadly speaking, the protective measures are supportive people, supportive environments. I would say generally speaking, that’s letting people, young people be who they want to be. And I know that we can do that. We can do that when it comes to music, well, most of us can do that when it comes to music, sports, like, we can do that. We can. We can do that when it comes to gender identity and sexual orientation, like, I promise we can. So let’s just bring all that in, right? Like, teachers, coaches, all these people that young people spend time around, if they’re affirming and [00:22:00] supportive, like, it can literally save lives.
Amy Gastelum: Having safe, supportive schools is a moral imperative.
Dr. Myeshia Price: It is illegal to not be at school, so if we’re going to force them to be there, we have to make it safe for them to be there. That’s just baseline. So what does affirming schools look like? Again, there’s a lot of different ways, but we can think about gender neutral bathrooms. We can talk about making sure that, that young people have the option of using their chosen name, pronouns, and things like that are so important. Specifically addressing sexual orientation and gender identity in your bullying policies and being strict about them, not just saying it and moving on, training staff, all these things are so important when we’re talking about how to create a safe environment for young people.
Amy Gastelum: And this includes family functions.
Dr. Myeshia Price: If you’re thinking about holidays, you’re thinking about things like that, like, would you take your child or the young person in your life to a situation where someone’s gonna hit them in the head with a bat? No, you [00:23:00] would not expose them to something that’s physically harmful, so you shouldn’t do it if it’s going to be mentally harmful.
Amy Gastelum: A few months after our first visit, I called the Clawsons via video chat. Nathaniel Clawson and Beth sat down in front of the camera while Kirin danced in a gold skirt in the background.
Amy Gastelum: Um, Kirin, you look amazing today.
Kirin Clawson: Thanks.
Amy Gastelum: I really like that top. It’s really cute. You look very cute.
Amy Gastelum: Back in February, Nathaniel Clawson was driving home from work one evening, and he was just passing the Kroger in Bloomington when a lawyer from the ACLU called him.
Nathaniel Clawson: I pulled over and they were shaken up and in listening to them, it shook me up a little bit as well.
Amy Gastelum: The hammer had fallen. The injunction was stayed. The ban was immediately in effect. The law didn’t disrupt Kirin’s medical care as much as some other kids because her puberty blocking hormones were administered by an implant. But [00:24:00] many adolescents get puberty blocking hormones as shots.
Beth Clawson: So, you know, like families went to bed and they woke up in the morning and their prescriptions couldn’t be filled. Or they had doctor’s appointments the next day and the doctor’s offices had to call and say, you can’t come in, or if you come in, we can’t discuss gender affirming care because it’s all in place.
Amy Gastelum: And, and you know this because you were talking with other families?
Beth Clawson: Yeah. Yeah.
Amy Gastelum: The Clawsons have decided to go to Boston for Kirin’s care. It’s not the closest place to get care, Chicago is. But they chose Boston in part because they thought the clinics there might not be as crowded as Chicago, a place that’s now a hub for folks from surrounding states with bans.
Amy Gastelum: The law, um, bans gender affirming care for minors, but it also states that physicians cannot refer their clients out to other providers. So like, how are people getting this information and, and resources outside of, um, from their, um, care providers, their, their [00:25:00] physicians? Do you know?
Beth Clawson: Uh, yes. A lot of it is word of mouth. Parents reaching out to other parents. Um, there’s organizations like Gender Nexus, um, Protect our People, um, GECKO. Another group would be Trans Solutions. They’re located in Indianapolis.
Amy Gastelum: Okay. For more information about the organizations connecting people to care and a national resource map, go to our website, radioproject.org, where you can find links in the show notes.
Beth and Nathaniel have continued their advocacy work. They say it helps them feel less powerless to help others. The organization Beth helps start, Protect Our People, has been connecting Hoosiers to gender affirming care outside the state.
Beth Clawson: We actually were able to help two people this past week get the care that they needed.
Amy Gastelum: She says donations to Protect Our People have increased too.
Beth Clawson: But I would say the greater population doesn’t have any idea what’s [00:26:00] going on, still. Families with trans kids and the trans community in general are kind of, are living an alternate reality, you know? Kirin still asks us questions like, wait a minute, I can still get my diabetes care, right? Like we, you know, we have to remind her or reassure her that it’s just this one kind of care.
Amy Gastelum: Kirin, can you hear me? Would you feel comfortable sharing, like, how you’re feeling right now?
Kirin Clawson: About what?
Amy Gastelum: Just with the changes, now that everything’s gone into the, that the ban has gone into effect in February, like, how do you feel about that?
Kirin Clawson: Oh, I don’t really care. I’m used to this. I’m used to being hated on.
Amy Gastelum: That sounds hard.
Beth Clawson: Yeah. Yeah. I, you know, I think she, she doesn’t want to talk about it. She doesn’t want to hear about it. Like, she’s, she’s done.
Amy Gastelum: Yeah, that’s totally fair.
Now, [00:27:00] the Clawsons are turning toward each other, and toward joy. I asked them, besides this law, what’s new?
Beth Clawson: We spontaneously got a new puppy a couple of weeks ago. It was the most impulsive puppy adoption ever.
Amy Gastelum: Impulsive puppy adoption!
Beth Clawson: It was totally worth it.
Amy Gastelum: I asked Beth how our listeners could get involved.
Beth Clawson: Talking to their legislators. They don’t have to understand what it means to be transgender, to have a transgender child, but they need to talk to their legislators about how wrong it is for them to be making decisions for people’s children. Um, there’s doctors for that reason. They are not doctors.
Amy Gastelum: She says another thing anyone can do is support organizations that help trans kids. And also, speaking up.
Beth Clawson: And telling people that we are all on the same side. We all love our kids, and we all want what’s best for them. If we could just get that message across.
Amy Gastelum: Great. Is there anything else you [00:28:00] think I should know?
Beth Clawson: Um, Kirin would like to show you the puppy if that’s okay.
Amy Gastelum: Oh my gosh, yes. Show me the puppy. Oh, she’s huge. Oh my gosh.
Kirin Clawson: She’s not very cuddly.
Nathaniel Clawson: Yeah, but we named, we named her Socks…
Amy Gastelum: What a cutie!
Nathaniel Clawson: …because her front two paws.
Amy Gastelum: I get it. Very cute.
Amy Gastelum: I’m Amy Gastelum. Thanks for listening to Making Contact. Next week, we will continue the conversation with Dr. Myeshia Price and get into one factor that may help Black, trans, and non-binary youth, particularly from suicidality. If you or someone you know needs confidential support with suicide prevention, call the free 24/7 National Hotline, 9-8-8. Until next week.[00:29:00]
