Pembroke, Ont. teenager one of the youngest to receive gender affirming care at CHEO

Emma Pinto is like every other 13-year-old you would meet; napping after a long day at school and her cellphone never out of reach.

The Grade 8 student in Pembroke, Ont. has accomplished a lot in her 13 years. At the age of 10, Emma wrote a fiction novel that was published and for sale at Coles bookstores and on Amazon. Since then, she has also appeared in local films and had photographs of hers published in local magazines.

Emma says she is aiming to be an author or actress when she grows up.

The 13-year-old is also transgender, becoming one of the youngest people to receive gender-affirming care at CHEO.

Assigned as a male at birth, but identifying as Emma since the age of 9, the Children's Hospital of Eastern Ontario is now helping Pinto lead the life she has wanted.

"I think it was when I was 10 I made the decision to start hormone blockers and recently I just started on estrogen," Emma tells CTV News Ottawa.

"It did feel really right to finally transition."

"Emma's really known who she was since she was about 4," mother Sky Pinto says.

For Pinto, a mother to four teenagers, the transition of her youngest from male to female was one no parenting book could prepare her for.

"It's honestly very scary at the beginning because you don't ever want your children to go through any kind of torment or grief because of who they are," Pinto says.

The process has been a lengthy one for the family at CHEO.

Emma Pinto, 13, of Pembroke, Ont. (Photo courtesy: Instagram/The Big Shroom)

Starting at the age of 9, Emma underwent four consultations with social workers and paediatricians over the span of two years. At the age of 11, both and Emma and her parents signed consent forms for her to begin taking the hormone blocker drug Lupron. Two years after that and as recently as December, Emma and her parents again signed consent forms for the 13-year-old to begin taking estrogen.

"Around ages 10-11, we are seeing some that are younger," says Dr. Karine Khatchadourian, a paediatric endocrinologist at CHEO, on the age of referrals being seen at CHEO's gender clinic.

"But because they are in an age of puberty that is distressing and we've had these long visits with them that it's not unusual to start it at that age."

CHEO says it mostly sees youth between the ages of 14 and 16, but it is seeing youth coming to the gender clinic at younger ages of 10 and 11.

Dr. Khatchadourian tells CTV News she has been working at CHEO's gender clinic for eight years now. At the beginning of her time at the clinic, she recalls seeing roughly a dozen referrals per year come in for gender affirming care.

In recent years, she says that the number has ballooned to anywhere from 200 to 250 referrals annually. The paediatrician cites a knowledge of available services, a more accepting society, and social phenomenon's and peer influence as possible reasons as to why.

"I think it's probably pretty complex right now where there's numerous components to that, and I think time will tell us in the coming years what is really at play," Dr. Khatchadourian says.

She adds that gender affirming care would not proceed if a youth is not experiencing distress in relation to their gender, allowing them more time to explore their identity.

"Her age had nothing to do with her decisiveness," Pinto says, who adds that her daughter was starting puberty early, and waiting would bring some changes that would be irreversible.

Now, in a world where teenagers are dialled into social media and surrounded by social pressures, Emma is stepping forward to share her story, hoping to bring courage to others who may be contemplating a path similar to hers.

"Usually on social media I'd be seeing a lot of older trans women, and they would be telling their stories of how they wished they transitioned at a younger age," Emma says. "And I just realized that I was very lucky."

"I just wanted to make people realize that they can also do the exact same thing I'm doing at a very young age and have a very good life."

With Emma sharing her journey online and so publicly, there were worries from her family of backlash and harassment.

"Publicly we haven't met the kind of resistance I was worried we'd meet in a small town," says Pinto, noting Emma's supportive friend groups and school environment.

"I've only encountered a few transphobic comments in real life, like twice," adds Emma.

Being public online with her transition is part of Emma's process to empower others to follow their true identity. So far, the 13-year-old says two people have reached out to her online to ask about her journey.

"I thought that was a really enlightening experience because I actually got to change someone's life in a way," Emma says.

Emma and her family are set to leave Pembroke at the end of her school year, though, following her father's new job posting. Despite the unknown years of high school in a new community that lay ahead, Emma is confident in moving full steam ahead.

"I think right now I'm pretty happy with who I am."

The following resources are available to individuals and families:

https://www.cheo.on.ca/en/clinics-services-programs/gender-diversity-clinic.aspx

https://gendercreativekids.com

https://familyservicesottawa.org