Cristina Olivetti is the author of the new book About Bliss: Fighting for My Trans Son's Life, Joy, and Fertility. Also an educator and an advocate for gender inclusion, she is based in Northern California.
Q: What inspired you to write About Bliss, and how was the book’s title chosen?
A: I initially started writing my experience down so that my son had a written record of how our family made our decisions to support his gender identity. I knew I was going to make mistakes and I wanted to be real and honest about that.
Then as I was writing the book I realized that our family's story has a universal aspect to it. Raising kids is hard, raising kids whose needs are outside the mainstream is really hard. I wanted parents, especially parents of trans kids, to have good company for their journey.
The title comes from my personal response to the term gender dysphoria. I've never loved that term because the reason we felt so confident pursuing Jake's transition is that it was so obvious that being able to express his gender identity unlocked an authentic inner joy. It looked like bliss to me. That observation led to the title.
Q: For those who are not familiar, what are some of the issues surrounding fertility and gender-affirming care?
A: Gender transition for minors has a few phases. The first is social transition. Most kids change the way they present themselves to others and their name and pronouns before making any other changes.
Then if kids have not hit puberty yet, they have the opportunity to take hormone blockers that will pause puberty and give kids time to grow up a little bit before making decisions about hormone replacement therapy or surgery. If you ask my son, this step was crucial. It was the step that gave him the time to realize that he might want his own biological kids in the future.
The third step is usually hormone replacement and the final step is often, but not always gender affirming surgery.
Social transition is obviously reversible. Hormone blockers are also reversible. They are like a rest stop on the highway toward an adult body. Kids get a chance to slow down their adult development to refine their thinking about the consequences of a gender transition.
Importantly this step is reversible and the drugs that are used have been used to support kids with other pediatric endocrine issues. If kids stop taking their hormone blocker and decide transition is NOT right for them, then their endogenous puberty will proceed in a completely typical way.
The next step in a gender transition is for a young person to begin taking the hormones that will affirm their gender identity. This step may cause infertility and if a young person continues taking their affirming hormones as they become an adult, they are likely to grow up to be infertile.
The truth is, the kids who transitioned as minors are just now reaching child-bearing age. It's not known with certainty whether a transman who transitioned before puberty, but has not had his reproductive organs removed would be able to get pregnant if he stopped his testosterone.
We know that transmen who transitioned after puberty and still have their reproductive organs can become pregnant. And surgery is, of course, permanent.
So if someone has gender affirming "bottom" surgery (which some trans people do and some trans people don't) or has a hysterectomy, that is permanent.
I appreciate the space to explain this! One of the reasons this issue is so misunderstood is that it takes a lot of words to explain! In my family's case, I knew for sure that Jake would be best growing into himself as a man and I could not imagine him sometime down the road stopping testosterone.
About a year into taking hormone blockers he whispered into my year "Mom I think I might want my own biological kids." It was a very sweet and tender moment. And also very authentic. I knew he had been really thinking hard about his future. And so from that moment on, I went on a quest to figure out what was possible for him.
What I learned is that there were treatments already being offered to prepubertal girls who were going through other medical issues that might cause infertility in the future (the term is iatrogenic infertility, infertility caused by medical treatment).
So we asked a reproductive endocrinologist in San Francisco if she would do this with Jake. We found out it has already been done a couple of times before and Jake became the fourth (or who doctors believe to be the fourth) trans boy to save egg follicles for the future.
Q: What impact did it have on you to write the book, and what do you hope readers take away from it?
A: Writing the book gave me a chance to reflect. My favorite part though was that the interviews gave me a chance to pay homage to the trans adults who were totally key to helping me be the mom I wanted to be for my trans son. My hope is that readers feel encouraged and empowered.
Q: At a time when trans rights are under attack, what role do you see your book playing?
A: First of all, my book is proof that gender affirming care for trans minors, who know they are trans, who have great mental and physical health care, is the safest best option for them. Culturally we need this positive story of youth gender transition more than ever.
I especially want to encourage and empower parents of trans kids to keep on keeping on, even when the culture is creating a lot of confusion and misinformation.
And second, I hope that the book creates a bigger community supporting trans kids.
Q: What are you working on now?
A: I've launched a substack called Bliss Notes that, like About Bliss, is for parents of trans kids. But it covers a lot of universal themes about resilience, which I think most of us need right now.
I'm also writing a memoir about being the primary caregiver for my husband, who was diagnosed with ALS in 2020.
Q: Anything else we should know?
A: I just want to say again that the trans community, and the families of trans kids, need a lot of encouragement right now. This community will always need allies, and so if you are looking for a place to put your concern about the current administration to work, supporting the trans community is a good place to start.
This could be as simple as wearing a pride pin to signal that you see and believe in gender diversity, and can become more involved from there.
--Interview with Deborah Kalb
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