Q: I recently learned that my granddaughter considers herself to be a “trans” man. She started dressing like a man, and I think she is dating a woman. Does this make her lesbian? I have heard that some “trans” people change their sex. What does that really involve? I’m not a prejudiced person; I try to treat all people fairly. But this is completely outside my experience. I am confused and I am upset, and I’m not sure what to do or say to her or to her mom (my daughter). Help?

A. I can understand your confusion. Until pretty recently, most of us viewed gender and sex as having only two varieties: male or female. What we know now is that gender and sex can be viewed as being along a continuum, along several different scales. These include our actual physical sex (some people are born with sex organs that are not specifically male or female), our sexual orientation (straight, bisexual, gay/lesbian), our gender identity (male/female/both/neither), and our gender expression (dressing and behaving more traditionally “masculine” or “feminine” or a combination of both).

To make things more complicated, “trans” can mean very different things. A “transsexual” usually means someone who has had surgery and/or hormone therapy to change their sex-assignment, but not always. “Transgender” might only be changes in self-identity and gender expression, or it can indicate someone who is also taking sex hormones or moving forward with surgery. And when there is surgery, it might just be “top” (breasts removed or added), just “bottom,” or both.

As for your upset, this too can be a normal response. Often family members experience loss or grief when someone ceases to be their “daughter” or “son” or “granddaughter.” We all carry hopes and dreams for our loved ones that might no longer fit their story. Hopes to see your granddaughter as a bride or a new mother might have to be grieved and released.

As for your upset, this too can be a normal response.

As you adjust to that reality, realize that you now have a grandson. If he considers himself a trans-man, then that is what he is now, no matter how he dresses or acts, or who he dates. I encourage you to immediately begin to refer to him as a man, to use male pronouns when you speak with him or about him, and call him by whatever name he chooses. It takes practice! Years of habit are not easy to change, especially for something we didn’t realize could be changed. But I am sure he will appreciate your efforts … even if it’s a struggle for you.

Since your grandson is a man, it is pretty unlikely he identifies as a lesbian. But you never know; the only way to know for sure is to ask him. If you show that you are open, curious, and interested in what is going on for him, he may be happy to fill you in. Keep in mind, though, that sometimes this can be such an intensely personal and challenging time that he may not want to talk about it. He may not be able to give clear answers yet. Be open, be loving, and give it time. Find a trusted person to talk to so you can process your own upset and confusion and come to terms with this exciting, important unfolding for your grandson.