“How Can I Support My Trans Brother As He Gets Surgery?”

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My younger sibling came out as a pansexual trans man a few years ago. My family took the news extremely well and has been supportive of him. He has saved up enough money to have his top surgery soon. I am torn between being there for him during his surgery and keeping my distance because of our tense relationship.

There are multiple factors to our relationship. As an immigrant family, my parents relied on me to take care of my younger siblings. I became the “third parent” to my younger siblings. My family also sees me as the “successful” one while my brother is the “black sheep,” which leads to unfair comparisons between the both of us.

My brother also struggles with many mental issues. His trans identity, his extreme anxiety, and his severe depression make it difficult to connect to him. When I try to talk to him, he immediately reacts very defensively. Sometimes he overreacts to the point of screaming and running away from me. During college, he also attempted suicide. He now goes to therapy for his issues. But because of these mental issues, my brother and I are never on the same wavelength, and I feel that I’m always the “bad guy” in his mind. It’s impossible for me to have a decent conversation with him without arguing soon afterwards.

Regardless, he might need someone to be there with him during his top surgery to take care of the logistics. I care about him enough to at least try and put in the effort, but I’m honestly lost on what I should do. I donated money to his surgery, but do you think I will make things worse if I ask him about being there for him? Given our not-so-perfect relationship, a part of me is unsure if I should even offer to be there. I live a few hours away and my parents are there, so he’s not completely alone. While I’m not the greatest sister in the world, I just want to do the right thing for my brother whether that means I should be there or not. — Trying to Support My Trans Brother

There are lots of ways you can support someone without compromising your boundaries. You’ve already shown support by donating to your brother’s surgery fund. You could also send a small care package, call before and after the surgery to wish him well, and ask your parents (or whoever will be immediately caring for him) if there’s any support they need. I would not offer to be there, especially since: it would require traveling on your part (and missing work or school, maybe?); you say it’s “impossible” for you and your brother to have a conversation without arguing; there are already unfair comparisons between you and your brother (which, I think, would only be highlighted during a surgical step in his sex reassignment process); and you both reject your “third parent” role in his life.

Stepping in as a caregiver while he recovers from major surgery could have some benefits to your relationship, but given your history and the dynamic between you, it’s more likely that this role as caregiver while he’s physically vulnerable will further complicate your relationship. I’d avoid it. Lend your support from a distance and be grateful there is (hopefully) someone else in his life who can provide the physical support he’ll temporarily need post-surgery.

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16 Comments

  1. LW, go with Wendy’s very good advice. 🙂

    Since conversations with your brother are difficult, the one-way nature of support from a distance might actually help soothe things between you. Send a supportive note or e-mail, an encouraging card. E-mail articles on subjects he’s interested in, or silly cat pictures. Wendy’s idea to send a small care package is wonderful.

    It sounds like he has a great deal of trouble interacting with people, due to his anxiety, and the nice thing about e-mailed pics of silly cats is that they don’t require interaction. They just make people smile. Be the person who sends him a smile on a regular basis. I can tell you, that makes a huge, huge difference when someone’s going through a rough time.

  2. Just to put it out there. LW, he may have mental issues, however, being trans is not a “mental issue” it’s who he is.

    1. Avatar photo Dear Wendy says:

      Good point, and I’m sorry I overlooked that!

    2. I don’t think that’s what the LW was implying whatsoever. She said he has mental issues and then said what he has going on that makes it hard to connect with him, not “he has mental issues like such and such.”

      1. That’s how I read it at least. I could be wrong.

    3. RedRoverRedRover says:

      People who are trans have a higher incidence of mental issues though, because until they figure out that they’re trans they spend their life feeling like they’re not “right”. And then they either fight themselves to try to conform, or end up an outcast. In that way it’s similar to how someone who’s undiagnosed with something like autism feels. They’re always trying to fake that they’re “normal” and hide who they really are. It’s pretty hard to escape mental issues if that’s your day to day life.

    4. While we need to be cautious about being correct and sensitive in our use of language, we also need to be wary of being afraid to say anything meaningful. Example: from a certain point of view, being trans is a mental issue. One’s conscious sense of one’s identity doesn’t match the physical body, and that causes distress and pain. That is a mental issue, and a physical one. Being trans comes with lots of mental and physical issues. That doesn’t mean that there is anything wrong with realizing issues in your sexual identity and taking steps to resolve them, but it also doesn’t mean they aren’t issues. In some ways, i think the bigger issue around your comment is the ongoing stigma that mental health “issues” have in our culture. It is SOOO rude and wrong and mean to say that someone suffers from mental illness (even though one in six does), so we soften it to “issues.” But why is it even wrong to plainly say someone suffers from mental illness? That doesn’t have to be a value judgment. (I am not saying that being trans is a mental illness, so don’t bother attacking me there.) I don’t think I have a mental illness, but i might have depression to a degree, borderline personality disorder to a degree. I don’t really know, as I have never been formally diagnosed. But I sure have a boatload of mental issues. (Not my sexual identity – i’m boring old straight there, but other stuff about my identity and self image, for sure.) I don’t think twice about mentioning I have a physical illness, like being a migraine sufferer, for example. But mental illness? Mental”issues”? Oohhh, NEVER say that! It’s still so stigmatized, it’s like admitting to a crime, rather than an illness which is not your fault. To sum up my point: Yes, always focus on being kind, understanding and supportive of your fellow humans, or even Donald Trump, but lets’ not get too hung up on correct language – it doesn’t help society nearly as much as we want it to, and it erodes meaning and value to outlaw too much language for the sake of being cautious. As to the LW, I think Wendy’ advice is solid, and I hope you are able to maintain and grow a good relationship with your bro.

      1. RedRoverRedRover says:

        Agree on your characterization of society vs mental issues. It’s not an insult to say that someone’s suffering from mental issues.

    5. Trying to Support says:

      LW here: I didn’t mean to imply “trans identity” = “mental illness”. I should have said “Along with his struggles with his trans identity, he has extreme anxiety and severe depression.” My bad, poor wording on my choice. Like RedRover said, I think his trans identity exarcebated his mental issues. As a heterosexual cis-person, I can’t even imagine what life must have been like for him when our family and friends were telling him our whole life that he should “act like a girl” or “dress more ladylike.”

    6. Trying to Support says:

      LW here: I totally did not mean that. What I SHOULD have written was “Along with his struggles with his trans identity, he suffers from extreme anxiety and severe depression..” Like many of what the users have said, his struggle with his identity made the mental issues worse.

  3. First of all, kudos to your family for being supportive of your brother through this process. I wish that was something all trans people experienced, but it’s not the case nearly often enough.
    .
    I’m sorry your relationship with your brother is so strained. I imagine that his experiences coming into his trans identity may have exacerbated some mental health challenges he has- and the hormones that are new to his system are probably also making his emotions feel especially intense. Some of that will probably settle down the further he gets into the process, and 1) his body gets used to his “new normal” hormone-wise and 2) his body becomes more in line with his identity.
    .
    I agree with Wendy that, especially given the distance, providing physical support is probably a bit much at this point in your relationship… and since your parents are there, probably not necessary. I will offer though, as someone who has supported a friend through his transition (we were close enough that I gave him his injections for a while, drove him to get drains taken out after his top surgery, etc)- one thing that really surprised me (in a good way!) was the marked change in my friend once he healed from his surgery. While the recovery was painful, he was over-the-moon giddy with the results, showing everyone possible. So one thing you can do is just be there to share the joy that will probably come from his body starting to confirm who he really is.
    .
    As a cis person, I want to be careful about trying to characterize someone else’s experience, but I think for a lot of trans people, it can be hard to believe anyone really gets what the journey is like- and so it can feel really lonely. One of the most important things you can do is let him feel heard. When things suck- when it’s painful and scary- just be there without trying to mother him or fix anything. When they’re awesome- which parts of this journey are going to be- be excited with him!

    1. Trying to Support says:

      LW here: One thing I didn’t say that he’s been on testosterone for almost a year now. Since he’s out with our parents, he’s started to dress more like his actual identity rather than what his sex assigned him to. His mentality has been much better compared to before. We actually have real conversations now, even if they’re a bit tense still. Things are much better between us than before, but still nowhere near where I wish it could be.

  4. dinoceros says:

    I agree that sending cards or things might be nice. I think there are ways that you can help in practical ways that doesn’t necessarily equate being his caretaker, though. I would just offer assistance. You could send him a nice note and then just add that if he needs any logistical help with transportation or whatever, that you’re around. That way he can decide whether it would be uncomfortable or not. I don’t want to make assumptions about the situation, but I wonder if you’ve found that certain topics set him off or that others are better, and maybe let that guide your conversation.

    1. Trying to Support says:

      LW here: Through the years I’ve learned that anything related to his career, friendship circles, or anything from his interactions with human beings is generally an unsafe topic. My parents got a cat last year and I got a cat 4 months ago, so my bro and I ocassionally send each other pictures of our cats. I generally wait for him to reach out to me, since he gets very stressed out if I’m the one who does.

  5. for_cutie says:

    I agree with Wendy’s advice. Since your relationship has been tense as a “third parent,” physically taking care of him reinforces that role. I think it might be nice to offer to take him out or do something nice for him after his recovery has progressed. He may feel nervous or apprehensive going out alone with his new body. Heck, most of us feel a little self conscious when our bodies change through regular weigh loss or gain. Maybe by supporting him emotionally – hello shopping trip for new clothes that make him feel great! – you can strengthen your bond. Most importantly, you are helping by giving him something positive to look forward to.

    1. This is a great idea. A gift card to a clothing store may also be good. Or going for dinner, though that may be too much conversating… Going for dessert? Hotdog and walk in the park?

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