There are hopes that children will follow an educational legacy, to assume control of a family business, to live and holiday in communities where the family has deep roots and traditions, to marry, start a family and live within the confines of religious proscriptions.

Every generation, however, has challenges to these expected trajectories. Typically, these challenges come when a new identity construct is introduced into the family lineage. In the 1950s and 1960s, stresses to family coherence came when a member fell in love with someone outside the family’s race, religion or social class. In the 1970s, 1980s and 1990s, issues of sexuality came into the fore. In these situations, rather than coupling with a person of the opposite sex, a son or daughter fell in love with a person of the same gender.

Over the last decade, a new challenge to family cohesion and a family’s business legacy has arisen. This is where a child struggles with issues of gender identity and identifies as “transgender”, “gender non-binary” or “gender non-conforming”.

Like past challenges, these issues are difficulty for everyone involved. Sons do not come into the world expecting they will manifest gender markers of a daughter. Mothers are terrified what will happen to a daughter who is compelled to live her life as a son. Family business leaders fear economic repercussions from cultural ostracisation.

Everyone in the family finds themselves crushed by intense and uncomfortable emotions that include feeling betrayed, damaged, alone, attacked, and misunderstood. Far too often, family members are pulled into destructive behaviours as they attempt to deny or mask the pain of a truth they wish would go away or that causes their loved ones to reject them.

But wishing away or denying this reality will only cause damage to the family and push its members in disparate directions, deeper into high risk and destructive behaviours. Yes, the issues presented in gender identity are challenging, stressful and overwhelming, but when properly addressed, they can be successfully negotiated. The key to this success is implementing culturally competent psychological services that reground the family in a respectful, properly resourced frame. Once this frame is in place, the proper assessments can be made and supportive psychological services employed.

Family business heir to heiress

Nearly two years ago I was retained to consult with a leading Asian family when the eldest son of the family’s business leader, embarked on a course of self-destruction after announcing to his parents his intentions to transition to a woman. The family, highly visible in their country and deeply Christian in their beliefs, had a highly emotional reaction to his announcement. They threated to disown and cut him off from his financial resources, spewed damning religious rhetoric and told him he was unlovable.

I entered the family system in the midst of this chaos and division not to change anyone’s mind, but rather to move the family from a place of emotional reactively to a strategic course of action that was grounded in logic, science and cultural realities.

In this regard, my first order of business was to honour every person in the family’s position on the issue of gender and queer identity while creating a culturally respectful and clinically relevant frame within which the family could process the experience.

Over the years that I’ve dealt with these issues, I’ve found this frame needs to contain the following four elements:

1.            An understanding of the science on gender and the clinical diagnosis of Gender Dysphoria.

It’s important to know that gender is different from sex. A person who identifies as transgender or gender non-conforming lives with a sense of self that is described by the clinical term, Gender Dysphoria. For these people, their sense of self conflicts with their biological sex. The weight of this dissonance between how they feel and how they look becomes a burden that overshadows their life, drains the joy from it, diminishes their sense of self and prevents them from having meaningful connections with other human beings.

2.            A generous timeline and structured process to sort out the intense emotions that arise from the new reality.

The adage, ‘time heals all wounds’ is one that is highly applicable to resolving the issues that arise from Gender Dysphoria. Research has shown that when the family recognises and honours that it—in addition to the individual who suffers from the diagnosis—has a distinct process of dealing with the family member’s identity transition outcomes are exceptional. But this process, takes time. The family will not find a new equilibrium in a few months or even a year. It will come slowly, and haltingly. There will be steps forward, steps back and even sideways. Resolution will come provided there is an articulated path and an overarching commitment towards family well-being.

3.            A deep respect for every family member’s reality and a simultaneous willingness to suspend judgment on things one does not and cannot know.

In times of relational stress, we want to impose our thoughts and feelings on those with whom we are in conflict to bring them in line with our desires and expectations. As such, the person living with the gender conflict will be compelled to demand his or her family accept them and grant them permission to move ahead with their decision to live as the gender with which they identity rather than with the gender in which they were born. In turn, the family will demand the person stay stuck in a gender identity that for them has become oppressive and unsustainable.

Recognise that these binary positions, while completely valid based on a snapshot in time, will and should change as the family explores the new reality as a narrative that will evolve as additional information is gathered and supplemental resources brought in to help with the resolution. It’s also important to challenge yourself to develop empathy for the family member’s binary position. Parents should spend time considering what it must be like to live in an incongruent body while children will benefit from considering what it’s like for a parent biologically wired to keep their children safe and out of harm’s way.

4.            An avoidance of damning or pathologising descriptions and a fierce commitment towards the safety of self and others.

No matter how strongly you believe it to be true, parents and children should never, but never, tell each other they will go to hell, die alone, or be condemned to a life of misery for their reality. Studies have proved that family acceptance of the gender identity process leads to higher outcomes in the realm of health, social support and positive self-concept. It also provides protection against negative outcomes such as self-harm, substance abuse, suicide, and suicidal ideation. Even though it will be difficult at times, you’ll need to allow space for your connection and respect for each other to deepen, evolve and grow. During this time, care of self and concern for others must become the number one priority for every family member.

By adhering to these guidelines, the family I referenced above has been able to change the course of their journey from one pitted with destruction and negative outcomes to one of cohesion, support and positive identity integration. While this process has yet to reach its conclusion, enormous progress has been made in reconnecting the family though love and respect for individual expression and family legacy.

The journey has not been easy, but like other challenge’s high-performance families have overcome, it has enabled the family to cultivate resilience, grit and to deepen their appreciation for the mental health of each family member and the overall health of the family as a unit.