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HERITAGE FLORIDA JEWISH NEWS, JANUARY 27, 2012 By Penny Schwartz Boston doctor finds treating transgender youth a transforming experience BOSTON (JTA)--In a fam- ily of prominent Jewish educa- tors, Norman Spack could be called the rebel. He became a doctor. "I'm the only one who didn't go into Jewish education," quips Spack, a senior associate in the endocrine division at Boston's Children's Hospital, where he has worked for 39 years. Spack's father, Abraham, was a nationally acclaimed Jewish educator in Boston, and his brother, Eliot, is a rec- ognized Jewish educational leader. But now the 68-year- old physician and assistant professor at Harvard Medical School in his own fashion has joined the family business, As the co-founder of the country's first clinic devoted to treating children with gen- der disorders, and as a leading authority on transgender youth, Spack has found him- self at the forefront of efforts to educate the public about a widely misunderstood condi- tion and to help transgender people secure their funda- mental rights. "If we shun people, we never get the experience of knowing how special they are and un- derstanding how courageous they are," Spack told JTA. Apediatri endocrinologist By Deborah Hirsch Jewish Exponent Penny Schwartz Dr. Norman Spack with deep roots in Boston's Jewish community, Spack was first exposed to transgen- derism, a medical condition in which individuals do not identify with the gender into which they were born, in the mid-1970s. Spack at the time was treating street kids as a volunteer on a medical van in Boston. Many of the young people were "throwaway kids," Spack said, having been shunned by their families and schools for gender variant behavior. A decade later, a colleague referred a transgender patient to Spack--a young adult Spack referred to as M. Unlike the street kids he'd seen ear- lier, Mwas a Harvard graduate. PHILADELPHIAIWin Htay gives a glimmer of a shy smile as she holds up a delicate, hand-crocheted yarmulke. The 28-year-old had never heard of a yar- mulke until she came here four years ago, resettled by HIAS and Council Migra- tion Service of Philadel- phia as she fled political and military repression in Myanmar. Nor did she expect that crocheting the round head coverings would become a modest source of income. Over the past few months, the National Museum of American Jewish History purchased 11 of her kipot to sell in its store. Htay has a personal agent to thank for the connec- tion, longtime HIAS vol- unteer Resa Rudney. Rudney began mentor- ing Htay and her husband, Aung Thwin, shortly after the couple arrived in 2008. She went to their South Philly apartment to teach them English vocabulary words, drop off donations and help with whatever else they needed. During a visit, she no- ticed Htay crocheting a scarf. The next time she came, she brought her yarn to make more scarves, which she sold at her shul, Main Line Reform Temple in Wynnewood. This fall, Rudney hap- pened to notice hand- crocheted yamulkes in the museum gift store. Maybe, she thought, the store man- agers would consider sell- ing similar products from a local artist. To her delight, M would open up a whole new world for Spack. In ex- change for medical care, he introduced the doctor to his friends, other young adults who were transgender. "It was this unique op- portunity to see life from a different perspective," Spack told JTA. "M did it for me." The experience proved to be a turning point. Spack began providing medical care for young adults and later older adults who were transgender. At the time, many physicians were reluctant to take on transgender patients; it's a problem that continues today. In 2007, Spack co-founded the Gender Management Service Clinic, or GEMS, at Children's Hospital. The clinic has treated nearly 100 pa- tients, most for birth disorders or other sexual development conditions. About one-third of the patients are treated with hormonal suppressants that delay the onset of puberty--a controversial treatment that is fully reversible. Spack ac- knowledges the opposition to this sort of early intervention, but argues that transgender youth have high rates of self- harm and suicide attempts. Nearly a quarter of the pa- tients who come for a firstvisit have committed some act of violence against themselves. Treating these young peo- ple with hormonal suppres- sants is a way of buying them precious time, Spack argues. When they are teens, they are better able to decide whether or not to take the next step of taking the hormones of the opposite sex that triggers permanent physical change. "If your neighbor is bleed- ing by the side of the road, you shall not stand idly by the blood of your neighbor," Spack said, quoting Leviticus as his inspiration. It's a lesson Spack learned the hard way. About six years ago M, his first transgender patient, committed suicide. Raised in a Jewish family, M's parents initially had great difficulty accepting him. Nev- ertheless, Spack learned that M's rabbi had officiated at his funeral, which was a source of great comfort to the family. To help avoid such tragic outcomes, Spackworks to re- assure children facing gender disorders that God has not played a trick on them. "I say, 'nobody has played a trick on you," Spack said. "I say, 'things happen. It's notbecause of anything you did. It's our job to find a way for you to be balanced, foryou to be happy.'" Spack describes his own childhood in suburban Boston in adulating terms. His small Brookline neighborhood was like a little shtetl, he says, and he grew up half a block from Kehillath Israel, where his father was education director and where he attended reli- gious school. Summers were spent at Camp Tevya, where Spack met his wife. "Later I realized I was ex- posed to some of the finest role models a human can ask for," he says, rattling off the names of admired leaders in the Bos- ton Jewish community. Spack went on to become one of those leaders, serving as board chairman of Boston's Hebrew College, where he earned an honorary degree in 2002, and as chair of the medical team for Boston's Combined Jewish Philan- thropies, a post in which he led three medical missions to Israel. CJP executive director Barry Shrage says Spack was responsible for attracting younger members andwomen to leadership positions. In 2008, Spack was part of a coalition that included Jew- ish organizations such as the Jewish Alliance for Law & So- cial Action, Keshet and the Anti-Defamation League that persuaded the Massachusetts legislature to adopt a trans- gender rights bill. Spack's testimony before the legisla- tive committee considering the bill "was very powerful," said Rep. Carl Sciortino, who PAGE 15A introduced the bill, which was signed into law lastNovember. Transgenders have also made inroads in Jewish life in recent years. A growing number of trans-friendly Jewish resource and advocacy organizations have sprung up nationwide, including Jewish- Transitions.org and TransTo- rah.org, websites that provide resources aimed at helping transgender Jews assimilate more fully into communal life, including rituals and blessings for transgender ceremonies. "Both in health care and in the Jewish community, Norm is a true pioneer who has made it possible for so many transgender people to be their full, authentic selves," Idit Klein, the executive director of the Boston-based Keshet, an advocacy group for GLBT Jews, wrote in an email to JTA. "I remember seeing him stand up at a Jewish federation gathering and speak passion- ately about his commitment to trans health care and equal rights for all. What's more, I've seen people listen and learn." Spack says his work with the transgender community and their families has trans- formed his life. "I'd probably be retired or far less fulfilled in my work," he said. "I feel privileged to come into daily contactith people I think are heroes." Handmade kipot, with an immigrant touch them to interpret for the more than 200 Burmese refugees they've resettled in this area. Htay dreams of a career not as an artist, but a nurse. She trained to work in a clinic at the refugee camp in Thailand before immi- grating here. The link between her story and the Jewish com- munity is poignant, said HIAS director Judi Bern- stein-Baker. "Here is a museum that devotes so much to the idea of the immigrant experi- ence, the need for religious tolerance, the quest of the Jewish people for that kind of freedom," Baker said, "and here we have a modern-day person who's had to flee from persecu- tion connecting up to this experience in an artistic way." Deborah Hirsch writes for the (Philadelphia) Jew- ish Exponent, from which this article was reprinted by permission. andher talents are worth  something. She can do something that people will pay her money for." She didn't get the chance to experience that in Myan- mar, where the military regime was waging an ongoing offensive against ethnic groups seeking greater autonomy. She was a schoolgirl when soldiers came through her village to assert power and com- mandeer workers. "If they see a woman, they rape," she said. Or, "you can die. So we run in the jungle. After they stopped fighting, we would come back." Her father, a rice farmer, died from a fever he con- tracted doing forced labor as a military porter, she said. Her mother died shortly after from compli- cations of childbirth. The baby didn't survive either. Htay had just finished school in 2000 when she left the village, on foot, to seek safety in a refugee camp in Thailand with her brother, uncle and other relatives. It was there that she met and married Thwin. Though Htay and her family are Buddhist, she said it makes her happy to crochet a garment used in Jewish prayer. She's even gone to temple with Rudney. Htay and Thwin's 2-year- old daughter, Wendy, at: tends pre-school at So- ciety Hill Synagogue on a scholarship while she takes a bus to Northeast Philadelphia for daytime English classes. HIAS workers have also stayed in touch with the family, occasionally asking retail operations director Kristen Kreider agreed to look at Htay's work. Even though Htay isn't Jewish, Kreider said, her story fit perfectly with the museum's theme of immi- grants finding opportunity in America. Plus, Kreider said, she always tries to support local businesses and "this felt like it was a more personal level, more direct, really going right into her pocket and not a manufacturer." Htay studied a sample Rudney brought her and came up with a copy within two hours, similar, she said, to how she first taught herself to crochet as a teenager by looking at a finished scarf. She made six for Rudney to take back to the museum. Kreider purchased all but one and commissioned another batch. When she brought back the payment, Rudney said, Htay refused to take it at first. She kept saying, "It's too much,,' Rudney remem- bered. Even after four years here, Rudney said, the couple hasn't gotten used to the concept of "ask and you shall receive." "They don't ask for any- thing because in their culture if they asked, the answer was always no," said Rudney, a native of Jackson, Miss., who coordinates im- migration outreach from her synagogue, which maintains a warehouse of donated furniture, clothing and other goods. Rudney said she hopes this small introduction to entrepreneurship will help Htay realize that "she's worth something Win Htay displays her kipot with HIAS volunteer Resa Rudney.