Dear Dr. Archer,
I need psychological help in how to deal with my delusional, schizophrenic son who has disorganized thoughts, grandiose delusions, hears voices, hallucinations and has ongoing giddiness. He developed the disorder when he was 19.
This past year my son has had this new ongoing delusion that he was once a girl and has transgendered into a boy. His thoughts are very preoccupied with this particular delusion and all efforts to convince him on my part that he was always a boy have failed. Even showing him baby and childhood pictures fail to convince him he is male. He thinks the pictures were photoshopped.
He gets upset and agitated at anyone who mentions his gender in any way, including saying he, him, handsome, etc. He wants to be transgendered to a girl, "fully functioning so he can now have a baby." I know because of his schizophrenia he would never be accepted.
He's 25 and stabilized on injections, but still continues to have very disorganized thoughts and these ongoing delusions. I live in Canada, and since he has not signed forms to include me in his therapy and counseling, I'm not allowed to talk with his doctors or counselors in any way. Even off the record.
I'm at a loss as to what is the best way to deal with him. Do I continue to try to convince him his delusions are just that -- delusions? Do I ignore them or agree with them?
He's not a danger to himself or others. I tell him this is between he and his doctors, but he continually tries to draw me into this gender issue and only ends up getting upset.
I'm the only family he has to support him and I don't want to jeopardize that support in any way. Any psychological advice you could give me would be appreciated. We live in a small town where our resources are limited and his after-care is minimal, at best.
Gail
Dear Gail,
There is a very rigorous evaluation process that takes place before any transgender procedure is performed. A psychological/psychiatric exam is mandatory and as a schizophrenic, your son would not meet criteria unless he had been completely stable for a long, long period of time. Doesn’t sound like he would qualify.
His thoughts that he was formerly a female are clearly delusions, but since he has not signed the consent papers allowing you to talk to his doctor, let him know you cannot get involved. Tell him if he signs the forms, then you would love to help out, but until he does that your hands are tied.
From now on, any time your son brings up this subject, be pleasant but assure him you have nothing to offer unless you can directly talk to his doctor. After hearing this a few times, I bet he will eventually sign those papers.
Any time he insists he wants to be a female, don't argue with him. Just say you would like to be able to talk to his doctor, but until he signs the forms you cannot and then leave it at that, Gail. Like I said, he most likely will eventually agree.
Remember, Gail, to never give up hope. Also, remember to take care of your needs, so you will be able to care for your son. I sincerely wish you well.
Dr. Archer
