Linda Gromko, MD
Where's MY Book Q&A


What is this book about?


Transgender youth need special information to help them through puberty. Never before has there been a puberty book that has provided such detailed information about the anatomy, physiology, and psychology of growing up, aimed specifically at transgender and gender non-conforming young people.


Why is this important?


Growing up – puberty, in particular - can be rugged for anyone. It’s especially tough if you realize that you’re going through the wrong puberty, i.e. the puberty of the gender you don’t identify as your own. Transgender youth have an unusually high rate of suicide. In youth between ages eighteen and twenty-four, forty-three percent have attempted suicide. This says nothing of the teenagers who have completed a suicide attempt – or those who suffer years of desperation.


What does it mean to be transgender?


Transgender people have an often overwhelming and non-negotiable sense of being “other than their birth gender.” Many realize this in their pre-school years. Others discover this in puberty – when it becomes clear that bodily changes they don’t want are beginning to happen. Still others realize this in adulthood. My patients range from 8 to 80!


What is meant by “gender dysphoria?”


Gender dysphoria is a sense of great distress that goes along with this gender “mismatch.” It can mimic or worsen depression – and can seem hopeless to those who experience it.


How can gender dysphoria be treated?


After this is diagnosed, individuals can be placed on the hormones of their proper gender. Some adults – but certainly not all – have “Gender Affirming Surgeries.” These surgeries help to change the appearance to that which is more consistent with their proper gender.


What can be done to help kids who are just beginning puberty?


Implantable or injectable “puberty blockers” can be used to put puberty on hold. This is a reversible process – meaning that when the blockers are removed or stopped, the genetically programmed puberty marches on. But it gives everyone a chance to catch their breath – and decide if a gender transition through “cross hormones” is appropriate.


How did you become interested in treating transgender individuals?


Eighteen years ago, a woman called my office to ask, “Does Dr. Gromko treat transgender women?” I said, “not yet,” but explained that I’d be willing to learn. Most doctors do not have training in transgender medicine. This year at the University of Washington, the third annual course on trans medicine will be offered. It is an elective course (not required), but still a great start. Many trans people find they have to teach their doctors.


Where’s MY Book? is rated ‘R” for Realistic. Is it too blunt for teenagers?


The kids I see have already been all over the Internet. The anatomical drawings in the book are real – real but not advanced for kids who need this information. Surgeries are discussed in detail, and plenty of resources are offered. For people who have already transitioned, I call this the “puberty book you never had.” And for parents, families, teachers, and health care providers, I hope this will provide a lovingly written realistic guide.