Q:  Could This be Gender Issues?

My teenage son (now 16) has been diagnosed as BP NOS with ADHD. When he was younger and not stable i.e. not treated - I would occasionally find women's clothing in his closet - hidden in the dark corner. Now that he's older and treated by a very competent psychiatrist and therapist, I recently started finding these items of clothing again. He always has a girlfriend and I've found the usual magazines in his room as well. So I'm confused about this,  how to bring this up with him. If there is an issue, then how best to discuss it so he can be who he is - however that may be? If it's a sign of being unwell and needing to go back to the doc or is this something else altogether? 

Thanks,
Lynn


Dear Lynn --

Not sure what to make of this. You describe "the usual magazines", a delicate euphemism. We might also include in this realm of "usual" erotica the attraction of women's clothing. Therefore I do not think we can assume that there is necessarily something strongly concerning from your discovery. If he is successfully negotiating gender relationships in other ways, this too lowers the level of concern, just as you have implied.

In general, family members and significant others can pass information to a treating psychiatrist and/or therapist without a "release of information", as long as they make clear that they understand that the therapist or psychiatrist may not even reply. I use this mechanism to make sure that family members, for example, know that they can leave me information of concern to them and know that I will incorporate it into the treatment process.

However, I also make it clear that any information thus passed along can not come with the restriction of "don't tell Sally I told you this". In other words, information received from parents or friends will have to be acknowledged in terms of its source, if there is a direct inquiry from the patient. Nevertheless, I can often use family concerns as part of my general background information, alerting me to particular areas which may warrant greater attention. In that fashion I do not always have to acknowledge from whence my concerns might have originated.

Therefore one way you might approach this would be to call or e-mail the therapist, and perhaps the psychiatrist, and just let them know that you have made these discoveries, but that you are not expecting immediate action to explore issues related to gender identity or her sexuality in general; backspace. Only if these providers find other reason to attend to this realm would they then need to ask for more information or make your concerns known to your son.

I hope that might be of some use.

Dr. Phelps



Published May, 2007