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We have a lovely child who is very motivated in their schoolwork. They are getting straight A's, and are loved by all their teachers. They are autistic, and it seems that schoolwork is their new 'special interest'. It doesn't seem like a problem, until you look at the child themselves. We often have to remind them to eat, go to the bathroom, or sleep, because they are constantly doing homework. If we tell them to take a break, they panic because they don't want to ruin their grades. We can barely get them in the shower. Not to mention they get next to no sunlight or exercise.

I recently sat down and asked them why they were so worried, and it was summed up that they want to have exceptional grades because of "all the things wrong with them". They are transgender, openly gay, and autistic, and they are worried that no one will ever hire them because of these things. They refuse rewards, literally sobbing if we buy them a little gift as a "good job!" sort of thing. They are in counseling, but I'm still so worried. How can we help them?

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    Have you had any discussions with their instructors? Perhaps if you can get clear feedback from them to relay to your child that they're not at risk of their grades dropping, it might help. Numbers, might, too. For instance, I track my assignments and their grades in a spreadsheet, which lets me estimate my final grade and if I need to work harder to get the one I want. Sometimes I can see that I'm doing very well and can relax a bit, and focus on something else. Perhaps you can get a list of assignments and grading scale/syllabus from the instructors? – user11394 May 5 '15 at 18:14
  • It seems that they don't feel "normal" so they are trying to block it out by getting good grades. Try and get them to take an interest in a new hobby like computer programming, sports, animating or art. Just something to keep them from spending all of their time studying. – one2three May 6 '15 at 12:02
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If you can afford counseling, that might be a good idea. Be sure to find someone with experience with transgender and gay issues. It sounds to me as if your child is having anxieties due to gender and disability issues (something (s)he can't control) and is transferring to something (s)he can control.

It will be important to find a place where (s)he can safely deal with the root cause for his/her anxieties instead of focusing on side issues. By this I don't mean to imply that you are not making their environment safe, but that strangers can be safer than those we love when we are dealing with sensitive issues. We don't want to disappoint those we love so it is hard to be completely honest sometimes.

Transgendered and gay children often end up with poor self esteem. It is important for you to help him/her build up self esteem. One interesting and extremely useful fact that I found out when researching how to build up a child's self esteem is that telling them they have done a good job and reassuring them and complementing them and rewarding them are good things to do, but the number one most effective way to build a child's self esteem is to spend time together.

That really floored me, but after thinking about it for a while, it made sense. Telling them, not with words but with actions, "being with you is a pleasure and I enjoy it" tells them that they are a person with value. Since then I have tried to work harder at making time to do fun things as a family.

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It kind of sounds like your child might feel a bit out of control and needs a bit of help forming structure around their life. Something you can do is to sit down with them and discuss solid achievable goals. They need to differentiate between achievable and useless goals. Tell them that having goals, such as being "not good enough", aren't achievable and won't help them. Then give them structure by together forming reachable and plot-able goals, for both short term and long term. Set up mutually agreed upon rewards as well as consequences. Goals without consequences, no matter how trivial are fairly useless when someone needs the structure. You need to get through that taking care of themselves is apart of the long and short term goals that also have consequences. List out for them some of the possible social consequences of poor hygiene. List out the possible academic consequences for poor sleep and nutrition. You can then list out the "rewards" of both a clear head, met nutritional needs, and clean body.

Another thing that might help is having him research into the affects of poor nutrition and hygiene. Is he taking Biology or anatomy? If you are in good communication with their teachers? You might ask that the teachers assign your child a report on what the body needs to function properly. Your child may not internalize what you are saying unless they researches it for themselves. Try to get them to connect the research to their own performance.

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    In addition, talk about how not maintaining proper hygiene is a reason to not get a job. I would also recommend you find gay, transgender and autistic role models. Look up big companies policies on diversity and non-discrimination. Point out successful business people like Apple's CEO (Tim Cook) who is openly gay. – Ida May 5 '15 at 18:30
  • Agreed a good role model figure might help – scrappedcola May 5 '15 at 18:43
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Counseling as well as behavior therapy would help a lot with the anxiety. The therapist should be working on coping skills especially as it relates to transition times from preferred activity.

Make a schedule and make her stick to it. Make a time for everything including leisure activities. It will be a fight and her behaviors will increase but it will get better. In the long run it will help give her the skills she will need as an adult.

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Plenty of good answers here, but I didn't see this mentioned, so I'll add:

A lot of people of all ages (with or without other disabilities) have a hard time keeping track of what their real priorities are or should be. Obviously teenagers are often more vulnerable to this, but it really is quite common.

They can get into a "tunnel vision" mindset that reduces their perspective on life to a very short list of factors or traits and really limits their ability to maintain a healthy balance in life.

For instance, if your child thinks of themselves, first and foremost, as a transgender kid that will never get a good job (or must exert superhuman effort to get one), it's difficult for them to pull back and look at all the other aspects of their current or future life.

This may come off as harsh, and probably isn't the language you should use with them, but I think the logic is sound:

There is more to their life (now, as well as in the future) than their GPA and their sexuality. What kind of plumbing you like on your sexual partners and what you do for a living are important things, in certain circumstances, but there is so much more to life (and to people) than that. There can be overlap, for instance, between work and hobby, and that's fine, but LOTS of people don't really get to have that, and even if your job isn't a never-ending fountain of personal fulfillment, it's still more than possible to have an awesome life.

So I guess my 'take away' here is that they need help finding other things to focus their energy on. Hobbies, low-pressure social interactions, etc...

I tend to take the stance that long-term happiness is the real goal, and work, grades, relationships, and even short-term happiness are just different tools to try and make it happen. They can all be important tools (and this varies by person, as well) but none of them are really that important on their own, and they're only worth anything insofar as they get you closer to that long term happiness.

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