“Congratulations, It’s a Human”

When a baby is born, one of the first questions people ask the new parents is this: “What is it?” Gender is unquestionably the most salient feature of a person’s identity. It’s most often the first thing we notice about someone and it is certainly the first characteristic infants learn to discriminate.

“One of the most important pieces of adolescence is identity formation,” says Cole Rucker, who holds a Master’s degree in Counseling Psychology and is the co-founder and CEO of Paradigm Treatment.“ Oftentimes young people come to us with a good sense of who they are, yet they may have a lot of conflict around that. It may be that who they are doesn’t fit in with how their family or the world sees them. They have to figure out if they can live an authentic life. Other times youth come to us and don’t have a good understanding of who they are. They just know something is wrong, things don’t feel right. A piece of that may or may not be associated with identity.” This idea of authenticity is something Cole frequently brings up when discussing his treatment philosophy.“ Living an authentic life is a very big piece of having good mental health,” he says.

A New Gender Revolution

Society may now be on the cusp of its most transformational shift yet—the end of categorizing people as either male or female. Some people who are redefining gender identify as both male and female, others as neither male nor female, or as sometimes male and sometimes female. “They” is often the pronoun of choice. These individuals may use any number of terms to describe their gender identity: genderqueer, gender-fluid, gender-creative, gender-expansive. While definitions fluctuate, “nonbinary gender” has emerged as an umbrella description.

Cole sees what’s happening as a sort of new gender revolution: “There is no question that it’s happening. People are recognizing that gender, like sexuality, is a continuum. It’s not a matter of two polar opposites. We have youth who come to us for gender identity issues treatment who don’t want a specific label, and that’s fine because it’s not about labels, it’s about how do you live authentically.”

Treatment at Paradigm for Gender Identity Issues

Paradigm is situated at the forefront of this movement, providing sophisticated, evidence-based treatment for adolescents struggling with anxiety, depression, trauma, body dysmorphia, disordered eating, substance use, and addiction resulting from the challenge of affirming their gender identity. The classic model simply isn’t appropriate for the many youth who struggle with issues of identity. “The bulk of what is available for adolescents in the treatment world is behavior medication, focused on things like point and phase systems. It’s not about doing the kind of deep work required to address these difficult issues. It’s an important distinction. We are focused on helping young people figure out who they are, what they want to be, and what the best path towards that is,” Cole explains.

Paradigm also has on its team many professionals who have expertise working with LGBT+ youth. They are experts in the field who have been invited to speak all over the country on these topics. “We are at the forefront of providing gender identity issues treatment that is not just inclusive, but that also addresses the very special needs that come with those identities.“

Paradigm has facilities that are assigned to meet the needs of gender nonconforming youth. For example, private rooms are available if someone needs one. “We are also very cognizant of the fact that for someone who is transgender or gender nonconforming, experiences that are very exciting for some youth are terrifying for them,” Cole explains. Something as seemingly simple as putting on a swimsuit to go swimming can be a difficult experience. “We have created a safe environment that is very sensitive to those needs so that a young person doesn’t have to point out to us that a situation causes stress. We think about it beforehand.”

New and changing identities can be confusing not just for teens, but also for their parents and family members. It is key to include the family as part of the learning process, to normalize the fact that people get confused around things like pronoun usage. What matters most is that there’s a foundation of mutual respect and love to build on. “If that’s the case, then someone is not going to get jumped on for using the incorrect pronoun, and it creates a space for people to grow and learn together.”

According to national surveys conducted by the Williams Institute, More than 40 percent of transgender or gender non-conforming people have attempted suicide, with school bullying playing a significant role. Paradigm understands the seriousness of these statistics, and Cole is acutely aware of the problem that bullying presents in a youth treatment center: “It’s one of the reasons that we have such rigorous exclusionary criteria in terms of who we allow into our program—we don’t allow youth to come into our program who have a history of bullying other youth. We say all the time our Program is for the kids who get bullied, not the bullies. Bullies are very comfortable in the behavioral modification programs, but they don’t belong at Paradigm.”

A Bright Look for the Future

While the situation may seem stark, things are changing for the better, according to Cole. “It’s very heartening to see that people respond to the treatment, in ways that were not there just not long ago. It wasn’t that long ago, that the majority of clients who came to us, came by way of hospital and suicide attempts. The families had no real understanding of the gender identity issues that were causing their children so much pain that they were ending their lives. Now, families are much more aware of gender identity issues, so they’re able to proactively give them the support and treatment they need.” Treatment at Paradigm is all about acceptance, and making sure young people have a place at the table and that they’re able to be themselves.