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2012 Weiner Award: Helping transgender youth live happier lives

2012 Weiner Award: Helping transgender youth live happier lives Established by Boston Children's Hospital's Board of Trustees, the David S. Weiner Award for Leadership and Innovation in Child Heath provides a $30,000 grant to a program or person dedicated to improving the health and well-being of children through advocacy, community child health or health services research.

This year's winner—Francie Mandel, LICSW, SW-III, social worker with the Gender Management Service (GeMS) Program at Boston Children's Hospital—certainly lives up to that standard. Since 2006, GeMS has been committed to the principle "that all children deserve to grow into confident and happy individuals who are able to take their rightful place in society," and Mandel has personally evaluated 320 youth in the past three years alone. It's a mission constantly complicated by widespread misunderstanding and confusion about the conditions the program treats and the population they serve.

Co-founded and co-directed by Norman Spack, MD, and David Diamond, MD, GeMS serves youth with disorders of sexual differentiation—a group of conditions that occur when a fetus goes through an atypical stage of sexual development, starting in the womb—and youth with gender identity disorder (GID)—a conflict between a person's actual physical gender and the gender that person identifies himself or herself as. GeMS was the first program in the United States to provide psychosocial, psychiatric and medical services for gender-questioning or transgender youth.

In particular, Spack has focused on the use of medical therapy to delay the changes brought on by puberty in potentially transgender youth, giving them time to evaluate their options and decide on the best course of action. "It's more important to make the best decision than to make a fast one," he says. "It take months to decide what's best for a child and it's ultimately a team decision." The GeMS team also works to remove the stigma that a diagnosis of transgenderism carries for their ever-growing patient population and their families.

GeMS has provided services to over 400 youth and their families since it was established in 2006, and the requests for consultations and training are on the rise. With this in mind, Mandel proposes to use their Weiner Award to develop two full-day conferences that will even more firmly establish Boston Children's as the world's leader in not only treating gender issues, but also training others to treat them. In an unprecedented move, the Weiner Award selection committee was so impressed with Mandel's proposal that they requested that the conferences be funded for two years.

The first conference will be geared towards medical and mental health providers from New England and across the nation. "We've been asked repeatedly by clinicians to provide training opportunities," says Mandel, "as more distressed youth and their perplexed parents ask for guidance and services these clinicians feel unprepared to deliver." The full-day program would include presentations and break-out sessions led by Spack and other members of the GeMS team, including Scott Leibowitz, MD, attending physician in Psychiatry, and Mandel herself. The goal is to provide the knowledge, skills and resources to guide attendees through in-depth exploration of gender issues in their future practice, whether they're doctors and nurses or social workers and school counselors (whom the GeMS team view as often being the "first-line" providers when it comes to gender issues). The conference will also offer a unique forum for providers to compare notes on treatment methods and potential research opportunities.

The second conference will provide support where it's needed the most: directly to families. "It's been clear from the beginning of GeMS that our families feel isolated in their experiences," says Mandel. "They're desperate to form connections with others in similar situations." With the help of Boston Children's Child Life Services, the GeMS team will provide a day of age-appropriate support groups and activities for parents and adolescents, as well as explorations into available resources and treatment options.

With the $30,000 provided by the Weiner Award, Mandel and the GeMS team will be able to better deliver the education and care they provide to underserved and vulnerable youth and their families—care so critical that many GeMS parents credit the program with saving their children’s lives. "The freedom from having a body at war with who my daughter actually is would not have been possible without GeMS," says one mother. "Without the assistance we received from GeMS, a beautiful life would have been wasted."