LN – Adrián Helien: “Men and women are not categories that reach to understand diversity”


“Acceptance saves lives,” Adrián Helien, psychiatrist and coordinator of the Transgender People Care Group (Gapet) at Durand Hospital. Credit: Victoria Gesualdi / AFV

When a trans boy or girl makes his transition, the whole family leaves the closet: there is no way to hide it and you have to accompany them in that process, validate their experiences and their self-perception, because we all have to be accepted in our identity.
Acceptance saves lives“says Adrián Helien, psychiatrist and coordinator of the
Transgender People Service Group (Gapet) of Durand Hospital, the interdisciplinary team that created in 2005 and that became the first of Argentina and the region to specialize in the subject.

In 2016 and due to the decrease in the age of consultation, Helien also promoted the
Transgender Childhood and Adolescence Care Group (Ganat), that actually
accompanies more than 100 boys and girls and it has psychologists, endocrinologists, social workers, adolescents specialists, pediatricians, among other professionals.

“Boys, girls, trans children are those in which gender identity, that is, the way they perceive themselves, does not match the sex assigned at birth, based on biology. This is something absolutely normal, although there is a great ignorance on the subject, “says the specialist.

Helien, who in speaking chooses the “e” to encompass all identities, outside any binary division, also chairs the Sexology and Sexual Diversity Chapter of the Association of Argentine Psychiatrists (APSA). Explain that, in humans, gender defines identity over biology. ”
That is to say that if, for example, someone was born biologically male but self-perceived as a woman, it is a woman. And vice versa. This is also established by the gender identity law, “he says.

-In recent years and especially after the sanction in 2012 of the gender identity law, there was a key paradigm shift: the passage of the “pathologization” of trans people to the recognition of fundamental rights. How was this transition?

-In a moment in history and I would tell you that even in most countries of the world, being trans was and is pathologized. The history of pathologization has to do with the inclusion of what was called “sexual identity disorder” – notice what name! – and today it is called gender dysphoria, in psychiatry manuals. This begins to change in the health system near 2010, with some statements from the World Professional Association for Transgender Health (WPATH). Concepts began to deconstruct between the years 90 and 2000, with theoretical contributions from feminism and philosophy, such as those of Judith Butler. For example, when we talk about sex of birth, we basically talk about biology, of a body that was somehow defined in the worlds of pink (woman) and celestial (male). Before biology was imposed on gender and if you were born with male biology, for example, you had to self-perceive yourself as a male, but something was wrong. And on the feminine side, the same.

-Today we know that biology is one thing and gender identity, another.

-Exact. Before, to define gender identity we looked at the genitals. Currently, we ask the person who he is, how he perceives himself, and that is gender identity, which can be male, female, or out of binary. That is, gender may or may not coincide with biology, with the sex assigned at birth, and this is the product of the rich diversity that we humans have, that we are a huge and diverse range, with as many identities as we really perceive . Thus we began to deconstruct, to disarm that binary that he pathologized, stigmatized people who did not fall into the categories of normative male and female, and not only that, but that he excluded from the category of the human to trans people, what remains in evidence when looking at the expectation and quality of life they had just a few years ago.

-How do boys and girls usually express that their self-perceived gender does not correspond to the one assigned to them at birth?

-It is important to point out that they express it in a persistent, coherent and insistent way over time. Not as an occasional, game situation, “off the hook” of your life story. They do it in their own words, according to the vocabulary they have, for example: “I don't want to be a boy, I want to be a baby.” And, in addition, if not let them be, they are distressed.

-How was born the team of attention to children and adolescents trans Durán?

-In 2015 the consultation age began to drastically decrease. In 2005 it was placed above 34 years and, a decade later, below 18. In 2016, we already assembled the interdisciplinary team, with pediatricians, adolescents specialists, social workers, family support, among others. I remember a trans boy of 12 who came to the urology department and for a year came to demand attention and question why children were not treated. He was one of the boys who moved me by his persistence and insistence and clarity regarding the demand: he was pointing out something that was missing.

Helien warns that non-acceptance increases the risk of suicide eight times in the LGBTQ community and six times that of suffering from depression.
Helien warns that non-acceptance increases the risk of suicide eight times in the LGBTQ community and six times that of suffering from depression. Credit: Victoria Gesualdi / AFV

– From what age do they receive cases and what is the first thing they say to fathers and mothers when they arrive at the consultation?

-Currently, we are serving boys and girls from 5 years to 17. The attention of children is the attention of families, their close ties and schools. Fathers and mothers are amazed, but the key word is “acceptance” as the best medicine or the best intervention, it is what we first work on. It is the word that saves lives in trans children. By accepting that boy or girl, we are helping them grow healthily. There are scientific papers that show how non-acceptance increases the risk of suicide eight times in the LGBTQ community and six times that of suffering from depression. We all need to be validated in our identity: we are very fragile human beings and accompaniment is essential, especially in childhood and puberty. The binary and the socially instituted is that we all enter the pink and the blue: that is the jail that we have to deconstruct, because we are all pushed in some way since we are born into those colors, when in reality we have a different arcresis. Acceptance, opening the heart, accepting and accompanying the chiques in their identity process is very important.

-How does the life of these boys and girls change when they are validated in their identity?

-Changes drastically and positively. Phrases such as: “He was a quiet, dark, isolated boy and today he is a girl who drinks mate with me, talks and is happy” or “was a sad and distraught girl and today is a boy with friends who goes out”, are frequent. But there are also many who do not identify themselves as male or female or have a fluid gender, or are defined as non-binary. And this is important especially in púberas or adolescents where non-binary expressions have increased, that is, they do not identify with the feminine or masculine genders, or they do not want to be cataloged in the traditional or binary categories.

-Some people are surprised that there are boys and girls who, from such early ages, state that their gender identity does not match the one assigned at birth. What would I tell them?

-In the service we have a survey that indicates that the vast majority of the people we serve were discovered trans in early childhood: 88% before 10 years and 67% before 5. Identity is a process that is It is building throughout life and it is not known how it is formed. We know that in a moment we begin to feel, to perceive ourselves in a gender. There are boys and girls who barely have a chance to speak, they begin to express their generic disagreement in many ways. Fundamentally, what I always say to parents is that we have to listen to the kids, that they will guide us. That is really the change. If you listen, they will tell you who they are, they will express themselves. That is very strong when you see it, for example, in a biological male who against everything and everyone will say that he is a baby. If you punish him, he will keep telling you that he is a baby, and if you punish him a lot, he will probably hide it, but the identity is there, it does not change or disappear. The whole society should leave the closet in the sense of accepting diversity

-What are the challenges in the health system linked to the care of trans people?

-The need for training and education remains a huge challenge, because there is no training in trans children, since it was denied and made invisible for a long time. At the end of last year we made a call to assemble the first Transgender Children and Adolescents Network (Rainat) of the city of Buenos Aires, an initiative of professionals to make visible, sensitize, inform and claim together the State that are provided More resources and supports. Today we are overwhelmed with the possibilities of attention and what we require is that we be structured to attend to the transgender childhood and adolescence. The network was joined by Durand, Elizalde, Fernández, Álvarez, Pena hospitals, among other professionals.

– And what happens in the schools?

-I think the topic was very visible. However, it is key that there is gender training beyond the binary, incorporating diversity in all educational systems. If teacher forms in that way will be much more natural that they understand that diversity exists, that it is perfectly normal for someone to be trans and they will not be astonished when they meet a trans child. Accepting sexual and identity diversity in the classroom is key. Once this is validated and accepted, work begins in non-binary social spaces, with sports that are not of children or girls, for example, because men and women are not categories that are enough to understand diversity. It begins to be a more human system, inclusive of all people. No one can live out their identity. If a biological male feels like a baby and does that persistently, persistently and consistently over time, he is a baby. And it must be respected as such and integrated. Everything else is stigmatization, discrimination, it's basically violent about that girl. The school has the obligation, today marked by law but basically because it is an institution that is made for that, to educate, integrate and socialize. You must accept and incorporate trans children into the education system. That way we would be building a better, richer and more diverse world for everyone. That is my greatest learning during these years and I owe it to the wisdom and life example of the trasn people who consulted me. They will always be in my thanks.


. (tagsToTranslate) Adrián Helien: “Men and women are not categories that are enough to understand diversity” – LA NACION

Publicado en el diario La Nación