I have no idea what the right thing is here. My 16 year old, K, is genderfluid and has struggled with suicidal thoughts for about a year now. They are also on the autism spectrum and has been an extremely challenging and defiant child to raise. Despite that, we had a strong and trusting relationship up until last year, when they suddenly distanced themselves from me and all other adults in their life. A few months later they came out to me.

They have been in and out of therapy for years. They were regularly seeing a counselor up until the beginning of the pandemic. Right before lockdown their counselor said there wasn’t anything more she could offer for my kid and suggested finding a psychologist. I was eventually able to find someone last summer but K refused to keep attending after several sessions, saying it was a waste of their time. This was only weeks after their most recent suicidal episode which had resulted in a hospital admission.

Meanwhile…we’re going through the process of starting HRT this spring. The clinic requires an initial visit with a therapist and then strongly recommends continuing talk therapy during the treatment. Although K has not voiced suicidal intent for several months now, they did indicate suicidal thoughts on the intake form. They had their first session today, and while I was not present for most of it, the therapist called me in at the end. I have a feeling K was pretty hostile during their conversation as the therapist was clearly angry and frustrated. K is still insisting therapy is a waste of their time and is adamant about not continuing.

I had been very hopeful that K would be willing to go to sessions in this gender-affirming environment. I told them I was very worried and wanted them alive and safe, and asked what would it take for them to feel comfortable talking with someone. They shot back that their mental health problems are all *my* fault because of my poor parenting and things I do and say to make them feel worse about themselves. I asked what I am doing and what I need to stop… and of course they cannot come up with any recent examples. They only thing they cited was one time six months ago when I explained I had stopped buying junk food because I didn’t want them pigging out on junk all day and not eating dinner. That was twisted around into me calling them a pig. Still, I have been careful not to comment on their eating habits since.

The only other thing they were able to point to was that they are occasionally grounded, which apparently constitutes emotional abuse because restricting their social life is detrimental to their mental health. We only use grounding as a punishment when they shout and curse at us. I explained that, and they said they are merely expressing their disagreement and we’re not allowing them to have an opinion (yes, kid, you can have an opinion, but you cannot share it by shouting and swearing in my face).

So…I don’t know. Logically I don’t see how therapy is going to be useful for them if they are an unwilling participant, but doing nothing isn’t helping, either. It doesn’t feel right to insist they continue as a condition of getting HRT (I think that’s what the therapist wanted from me although she didn’t say it? I don’t even understand why she brought me in on the conversation at all).

Not even sure what I’m asking for here except maybe commisseration or stories from others who have been through this. It’s just so frustrating to have done so much work these past six months to support them in their transition and reestablish trust, and have it thrown right back at me like it meant nothing. Not to mention, I’m scared for my kid.

Ugh.