Disclosing gender transition to a grandparent with Alzheimer's
December 12, 2016 2:40 PM   Subscribe

My grandmother is elderly and has Alzheimer's. I grew up in a different country to where she lives and we don't share a common language, so our relationship has never been very close, but I love her immensely and I know she adores me too. Every Christmas we send each other a card - a tradition I look forward to very much - and since I started cohabiting with my partner six years ago, I have always signed the card from both of us.

My wife is transgender, and this is the first Christmas since she came out as trans. I have not talked about my wife's transition with my grandmother, and neither have my other family members. My mom just asked me if I had sent my grandmother a Christmas card yet, and what names I had used to sign it. I've already written the card, but not yet mailed it, and it's signed from me and (wife's name). My mom told me that because my grandmother has Alzheimer's, and because she is "from a generation when people didn't know about being transgender", that receiving this card would be very confusing for her. She - hesitantly - told me she thought I would have "put (grandmother's) needs first", by signing the card "as normal", from me and (wife's deadname) instead. I reacted very badly to this suggestion, we got into a big argument about it, and now I don't know what to do about the card.

My grandmother's illness has worsened quite quickly over the past year, and my mom thinks anything that could confuse or upset my grandmother will be a very damaging for her, and should be avoided at all costs. If it's relevant, she hasn't been shielded from hearing about other major life-events in our family, including another of her grandchildren recently getting divorced. After a lot of fighting about whether or not it was ok for my mom to ask me to use my wife's deadname, I offered to scrap the existing card and just write a new one signed from only myself, but my mom didn't like that idea because she thought it might make my grandmother think we had separated. I reluctantly asked if it would be better if I just don't send a card this year, and she wasn't on board with that either. The conversation got increasingly more shouty and emotional (on both sides), and we agreed to end the phone call and try to talk again tomorrow.

My mom (who also lives in another country to me, and not the same one as my grandmother) has been pretty lukewarm about my wife's transition. She's progressive in some areas but more conservative in others, and she's never had any exposure to trans issues, so this came as a shock to her and I'm being as patient as I can while she gets up to speed. She's very protective of me and was extremely worried about how it might impact me, so I had to go through "trans 101" with her and really argue the case that this is honestly not as much of a big deal for me as it seems to her. She jumped to some common misconceptions and asked a bunch of way-too-personal questions, but she also made an effort to listen to what I had to say, assured me that she supported us and would be there for me if I ever needed to talk, and has been using the correct name/pronouns (although it hasn't escaped my attention that she never asks me any more how (wife) is doing, which was always a standard part of our weekly phone calls). She's never developed a close relationship with my partner, but it's not occurred to her to reach out to my wife directly to offer any words of support.

I know she's really worried about her mother, and is terrified that she's losing her to this horrible illness. We also had some concerning news about another family member's health today, so both of us were already a little preoccupied and worried before this kicked off.

I'm still pretty worked up, and I need some perspective on this. Do I need to educate myself better about Alzheimer's? Is this a reasonable "sacrifice" (as my mom put it) that my wife and I ought to consider making, in order to be kind to my dear grandmother? It's really important to me to actively and visibly support my wife in her transition. I haven't yet had a chance to ask her for her thoughts on it, but I'm 99% certain that my wife would be very hurt by her deadname being used, but wouldn't care whether or not her name is on the card (she and my grandmother have never met in person and likely never will). Christmas is rapidly coming, and I need to make a decision on what to do about this greeting card and get it in the mail (or not). If you happen to have direct experience with trans issues and/or Alzheimer's, it would be particularly helpful if you mentioned this in your answer, although all are encouraged to reply. Thank you.
posted by gin and biscuits to Human Relations (38 answers total) 3 users marked this as a favorite
My grandfather had Alzheimers. It's not so much that he had trouble with new information, it's that new information flowed in and out like a sieve. I really doubt this will cause her stress, but it might cause confusion. If it's important enough to you to put your spouse's name on there, do it (her new name.) If not, I think keeping her name off entirely would be fine - your grandmother should get that card from you, and what else it has on it besides you isn't going to register much for her.

My guess is that you had the reaction you had because you might have felt your mother's reaction was a lack of support for your spouse. That seems to me to be an entirely distinct issue on what should or should not be on the card, however.
posted by Happydaz at 2:50 PM on December 12, 2016 [23 favorites]

I would reframe the issue. Given she has Alzheimer's, she's not likely to handle the news well. How will you react to potential distress and confusion? Will you feel hurt and angry? Will you feel like you've stopped hiding your wife from her, or will you feel exhausted and isolated that she might not ever have the cognitive capacity to understand and react in a loving way?
posted by politikitty at 2:53 PM on December 12, 2016

Holding aside, as Happydaz suggests, your feelings about your mom's lukewarm reaction, could you sign the card "Love, the two of us" to avoid misgendering your wife or using her deadname?
posted by Exceptional_Hubris at 2:54 PM on December 12, 2016 [39 favorites]

I don't have direct experience with trans issues, but I do have direct experience with a grandparent with dementia and upsetting/confusing news toward the end of their life. In my case, my mother decided to tell my granddad that my (now ex) spouse and I were splitting, when I was content to tell him a little white lie of me moving out of state for "a new job." My mother insisted that the truth was better, and that if I was ending my marriage then everyone should know about it. Evidently (I was not there for the conversation; it was undertaken without my consent) my granddad was very confused and upset by the news. He had not known my spouse well at all, but he had become attached to the idea of being close my spouse, for some reason. After he was told that we were splitting, he became somewhat fixated on the information for the last few months of his life, and I feel it exacerbated a sense of fear and abandonment that he was feeling as the disease robbed his mind. I'm still angry that my mother prioritized the unvarnished truth above his peace of mind in his final days, even 20 years later.
posted by the return of the thin white sock at 2:55 PM on December 12, 2016 [52 favorites]

My sense of Alzheimer's is that while discomfort with trans issues may play a large part in your mom's resistance, she also may be right about your grandmother's ability to retain new information: she may look at that card and think "who on earth is [wife's name]?" nine times out of ten if she's having trouble with short-term memory loss. It's your call whether you want to potentially make your wife come out over and over again--or make someone else explain your wife's name change in whatever way they're comfortable with, on her behalf. ("Wait, who is [wife's name]? ten times an hour on the day she gets the card, then every time she looks at it afterward. Repeat three weeks later when she picks up the card to read it again.) Obviously YMMV. My own solution would be to sign "your name + wife's name ([deadname] is going by this now!)." That way the explanation is baked in and you all can choose to engage with what it means to be trans each time. But that also presumes that your grandma won't be scandalized by this news each time, which also presumes a lot on the part of your grandma.

I guess what I mean to say is "think about the least stressful way for the both of you to engage with this issue repeatedly, repetitiously, and at basic level over the holiday season. And potentially for your family members to engage with it on y'all's behalf. On preview, "Love, the two of us" may be the perfect side-step.

Also on preview, I realize that my experience with Alzheimer's and dementia is with my own grandmother, whose short-term memory loss was so severe that I could tell her anything and all that remained five minutes later was the emotion it caused. Maybe approach differently if your grandmother is at a less-advanced stage.
posted by tapir-whorf at 2:57 PM on December 12, 2016 [13 favorites]

given your final para i think i'd sign it just from me (you). i doubt that's going to be confusing - your mom can say something like "oh, she was in a hurry" or similar.
posted by andrewcooke at 2:59 PM on December 12, 2016 [3 favorites]

Write a new card. In the text of the card write about how "we both hope you have a fantastic holiday etc. etc...We're so looking forward to the new year...We plan on going on vacation, etc. " Then just sign the card with your name.

I think the problem with coming out to someone with Alzheimer's is that they might not remember it happened, so you'd have to do it over and over again. And whatever their reaction is, that will be their reaction every time. I've known people advised not to tell people with advanced Alzheimers about deaths in the family for this very reason: Imagine hearing your child has died. Then imagine hearing it again and again. Obviously the trans thing is very different and is not likely to cause the same kind of distress if it causes any distress at all, but if her reaction is bad, then you will have to deal with that bad reaction over and over again.
posted by If only I had a penguin... at 3:18 PM on December 12, 2016 [12 favorites]

I agree with others that it's important to separate out your feelings that your mom isn't being as supportive as you would like (which you guys should absolutely deal with, but probably has a longer timeline than the next couple of weeks), and a realistic assessment of what your grandma is cognitively capable of right now. I'm not sure what stage your grandma is at, but my grandma also had Alzheimer's and -- especially in the advanced stages -- I think this is probably something she simply would not have been able to absorb in any meaningful way. I realize this might be tough for you to assess because you're living in different countries and don't speak the same language! But, keep in mind that processing any sort of new information is likely to be really hard and confusing for her, even if that information is completely unsurprising. As just one example, my grandma was convinced that I was her daughter, not her granddaughter, and really didn't call me by my own name very often toward the end (she called me by my aunt's name instead -- from looking at pictures, she did look sort of like me when she was the age I was at that time). My grandma just couldn't comprehend that it wasn't many decades earlier when she had a daughter who looked sort of like me! That is the level of confusion she may be dealing with -- which means that really absorbing this information would mean your grandma being able to do the following things:

a) Remember you exist! And you are her granddaughter, not someone she knew 50 years ago
b) Remember you are married and who your spouse is
c) Understand what being trans is on any sort of meaningful level
d) Understand that your wife is transgender, and learn and remember a new name and pronoun for her

I'm not meaning to be cruel, but even step (a) could be hard for your grandma depending on how she is doing. And while whoever is sharing this card with your grandma can likely explain "Yes, you've got a granddaughter, she lives in [your country] and loves you very much! Isn't this card wonderful?" anything beyond that is likely going to be massively confusing.

I get why it is important for you to get love and validation from someone you clearly care a lot about. But, I would be realistic about her capacity to do that given her current illness. It sounds like the validation that really matters here (and that is actually possible to attain) is from your mom, and that's do-able but probably a longer term thing and also something that probably won't be helped by sending a confusing Christmas card to an elderly Alzheimer's patient.
posted by rainbowbrite at 3:19 PM on December 12, 2016 [10 favorites]

Just write a nice note and sign the card with only your name, to avoid potentially confusing/distressing your mentally fragile grandmother. This really, really isn't the venue for hashing things out with your mom.
posted by fingersandtoes at 3:31 PM on December 12, 2016 [6 favorites]

Send the card as it is. My grandfather (and his mother before him) has Alzheimer's and he doesn't even know who people are if they don't visit often. If your grandmother even asks you "wife's name" is when she reads the card, whomever is with her can say "gin and biscuits' roommate" if they think the explanation would be too complicated. And I truly think "complicated" is what your mom is worried about. My grandfather is pretty happy when people keep things simple, and has been for a while. It's when people go on a long-winded explanation that he won't remember anyhow that he gets upset.
posted by DoubleLune at 3:31 PM on December 12, 2016 [2 favorites]

So, your original solution (card with wife's name) wouldn't have solved the problem which seems to be causing you some anguish (grandmother doesn't know some major life news, and family seems content to keep it from her). To her, it would just be some random new person and she would have no idea what happened to [deadname]. Were you hoping that this confusing card would push your grandmother's caretakers to finally pass along the news about your wife? Because that doesn't seem right, either-- it's unfortunate that you don't have the language to explain to your grandmother yourself, but it's unfair to place that burden on other family members who deal with her day-to-day care and would have to deal with any ensuing questions/confusion/distress.

Try to find the solution that prioritizes your grandmother's comfort first, while not hurting your wife's feelings (talk to her!), and not turning this really wrenching situation into a test of how well you or your mom are actively supporting your wife's transition.
posted by acidic at 3:33 PM on December 12, 2016 [9 favorites]

My grandmother had early onset Alzheimer's and got very angry and upset at minor changes to her world. Preserving staus quo is incredibly important. My first vote would be signing the card from you and your wife's "deadname". Your wife is in a much better position to understand doing something distasteful as a kindness for a beloved, elderly, easily confused grandmother than your grandmother is in a position to understand why your husband is now your wife. Second choice is sign it from yourself only and let mom explain it away.
posted by cecic at 3:39 PM on December 12, 2016 [9 favorites]

I am trans (male). All my grandparents died before I came out. Two of them had Alzheimer's. One of them frequently asked about my aunt's dead husband, decades after he died. But he couldn't remember my (then-current) husband at all. The other grandparent never understood that his own wife had died and he started calling another woman by my grandma's name. You just can't predict what they're going to latch onto and what will float away.

I think this is about your mom, and not about the specific card. My mom was under enormous stress when she had to take care of her father. She lived in a different state so she was traveling quite a bit to see him and take care of practical matters. Your mom is also apart from her parent, and that must create anxiety.

As a trans person, I rarely cut family much slack. And I understand 100% how important it is to you and your wife that both of you be treated with the respect you deserve, including name and pronouns. However, I would have a very honest conversation with your mom about where she's at emotionally with your grandmother's condition. Leave your wife and trans stuff out of the discussion, just really listen to her. I understand there may be underlying resentments that make this difficult, but try to push through it. Maybe if she feels understood and heard, she will also understand and hear you. At the very least, you'll have a better gauge if she's acting this way due to stress and anxiety about your grandmother, or because she disapproves of your wife's transition.

This is not the hill I would die on, frankly. I would sign the card generically (Love from Both of Us) and if your grandma asks you directly about [John] I would tell her honestly but casually that she's going by Jane now and then change the subject. She'll probably forget and it's probably way too late for Trans 101 with Grandma.

(Also it's really, really weird and kind of patronizing that you have not discussed this with your wife. I wouldn't want someone making decisions about whether or not to disclose my transition. Ask your wife directly if she's okay with you signing the card generically. You seem sure she'll say yes, so... problem solved with one conversation and none of this drama needs to happen.)
posted by AFABulous at 3:44 PM on December 12, 2016 [27 favorites]

(I'm a trans woman and) I think you should ask your wife what she wants. People have a lot of different attitudes towards that sort of strategic deadnaming, from "Eh, whatever, if you're talking to someone I'll never meet then do whatever keeps you safe and un-hassled" through "Ugh I don't like it but I guess it's okay in this situation" to "OH FUCK NO NOT UNDER ANY CIRCUMSTANCE," and I feel like your wife ought to have a chance to decide for herself what she's comfortable with here.

For what it's worth, if it were me in your wife's shoes, I'd want you to stand up to your mom on the issues that actually affected me — the not-asking-after-me and the not-offering-congratulations and so on — and that would matter a lot more to me than a symbolic gesture involving a Christmas card. But again, everyone's different on this stuff.
posted by nebulawindphone at 3:46 PM on December 12, 2016 [12 favorites]

Try to find the solution that prioritizes your grandmother's comfort first, while not hurting your wife's feelings (talk to her!), and not turning this really wrenching situation into a test of how well you or your mom are actively supporting your wife's transition.

Seconding this heartily. Don't turn this into some sort of test of your mom's support.
posted by AFABulous at 3:48 PM on December 12, 2016 [2 favorites]

I think you need to talk to your wife. I know deadnaming is a sensitive topic but if take a step back from all the baggage you have with your mum over your wife's transition, I think you might see she has a point. This is a small gesture (in the grand scheme of things, its 1 word on 1 card to a old lady that neither of you are that close to and you don't even speak the same language as) that could prevent some amount of harm to your grandmother. With Alzheimers, you've really no way to know whether your card with your wife's correct name on it will be damaging and confusing or forgot before the card is even closed.

Your wife might be totally fine with you deadnaming her, under these very specific and completely understandable circumstances. If she's not them you two need to work together to find come up with a solution that is acceptable to both of you and respectful of your grandmother's illness.
posted by missmagenta at 3:59 PM on December 12, 2016 [1 favorite]

To her, it would just be some random new person and she would have no idea what happened to [deadname].

Depending on her state, she might not only be confused, but quite upset, if she thinks your spouse has actually died or left you (and believes that "now gin and biscuits will be alone", etc.) Because in addition to stability around them, what a lot of grandparents want/need most is to know that their children and grandchildren are safe, happy, and secure. I don't think there's a way of knowing how it might get interpreted, or what it might mean (if it can even be registered).

My grandmother (also far away) has got issues with short- and long-term memory issues (related to a necessary heart medication, not Alzheimer's). She doesn't know that her daughter died of a very aggressive cancer. (She did know, and then didn't.) There were some early attempts to gently align her understanding with reality, but this (obviously) caused such distress that it was decided it was kinder to keep her in the dark. (I'm not comparing your wife's transition to dying of cancer! But who knows how it'll be understood or what it could mean to her.)
posted by cotton dress sock at 4:04 PM on December 12, 2016 [4 favorites]

My teenager is trans. I can and do love and support my trans kid and his evolution, which is happening on his timeline. I also reserve the right to have my own process of integrating his transition, on my own timeline. I can and do advocate for my kid at school, in the community, with family and friends across the country who aren't here to observe him firsthand; I am supportive and proactive about hair, clothes, binders, support in therapy, so much more. And also I have conceptualized him as a girl since he was in utero, so it took me a while to adjust my words and my thinking, and I probably have more to go.

I think a big part of love is accepting people where they are, from where you are. I love and respect my kid even though once in a blue moon I still slip up with a "she". My kid loves and respect me even though I do, because I demonstrate my respect in other ways. And when I talk about my kid's life in years past, I sometimes will say, "Back when R-- was R--", because that's the simple fact of our history. It's not a disgrace to transition and it's ok to recognize the past.

I use this example because I think it would help you to resolve this tense issue if you accept where your mom is in her process, and her grandmother in hers. Your mother may need a lot more time to settle her understanding about your wife. Stay grounded and steadfast. You know what's right and if your mother isn't there yet, it doesn't change anything about your marriage.

Likewise your grandmother. Lots of people have talked in their replies about the realities of memory loss and the emotional reverberations from that. Respect where she is in her process. It has no bearing on where you and your wife are in your own. Stay steady and know that what happens with her doesn't affect your legitimacy. If what she has the best grip on is the past, then consider using your spouse's former name in honor of that. That name may not represent who your spouse is now, but it is historically the name of your spouse during the time period that your grandmother can recall. It's not a dishonor to your wife and her transition to remember that name; it's just her history. And it meets your grandma where she is.

You and your wife have undergone a big transition and it surely feels new and tender. However your grandma's challenge is bigger and the threatening outcome is assured. You can still honor yourselves and make a concession that will ease things for her.
posted by Sublimity at 4:12 PM on December 12, 2016 [14 favorites]

My mother has Alzheimer's and I give you permission to just sign the cards with your true names and not worry about what your mom says. Keep showing your grandmother love and patience - that's what matters. You don't have to explain the whole transition story to her, nor do you need to hide it. Your mom probably has good intentions, but it's not up to her to decide this. Nor can she shield your grandmother from any new information.

Anecdotally, I know someone (kind of a friend of a friend) who's mom has Alzheimer's, and she herself just transitioned in the last couple years. They continue to have a close relationship. There is nothing inherent about Alzheimer's that says that it's incompatible with trans-ness!

Again, I'd gently say to your mom something that communicates that you hear her concerns, but you are going to sign the card with your real names. If grandma asks about it, you can encourage your mom to give a very simple, honest, one-sentence answer and then change the subject. The issue isn't up for debate, and surely if she's caring for someone with Alzheimer's she's learned the art of diversion.
posted by latkes at 4:23 PM on December 12, 2016

I have some experience with both ends of these issues. Have had a couple family members go down the alzheimers and dementia paths, also have had a couple folks within the family (one way or the other) transition.

I think, aside from the rest of the issues it's worth learning more about what to expect from your grandmother's condition and also perhaps trying to converse with her to assess where she's at in terms of mental status. A good barometer is... does she refer to you by name and does she ask about your partner? It'll naturally vary day-to-day, she'll have "good" days and "bad" days throughout most likely.

For one family member, just a year or two into his Alzheimer diagnosis... everyone he knew was "gone". Who we were didn't really matter too much, what mattered was that my sibling could play the instrument he wished he could still play and that I looked something like the image of my grandfather 50 years or so prior he held in his mind. There was a certain element of it being easier for everyone to not worry much about who was who, we would hug him or shake his hand and tell him we loved him, doing things like trying to assert who I was would cause confusion and frustration -- to him, I would forever be the baby the year I was born or a complete stranger.

For grandmother with dementia, her clarity would vary much more widely. She never integrated the name of my siblings partner. She would sometimes recognize me as myself, sometimes confuse me for one of my dead uncles, and sometimes would think I was a stranger. A series of three or four girlfriends who accompanied me on caretaking trips were all collapsed into "that beautiful young woman" when I had a familial identity and "your assistant" when I didn't. When a family member began a transition, an explanation was attempted, but the only thing that came across was that an additional person would be joining us for dinner which created an odd scenario wherein we all just gave up and had to continually tell my grandmother that everyone who was coming to dinner was there and that it was OK for us to start eating and that we weren't being rude to start before this mysterious stranger arrived.

Anyhow, to the meat of your question. Your mom is struggling with unknown territory, big time, it sounds like if she had to explain trans stuff to a peer that'd be a struggle and she's terrified she's going to have to explain it to someone with alzheimers (even if she's not going to have to explain it). Depending on your mom and grandma, maybe it would actually be a good thing for her to have to try to explain it over and over again to someone who's forgetting, but I sure wouldn't count on it or expect that.

I'd probably sign "your grandchild $name and family" followed by two or more unique and florid signatures (so she knows an approximate number of people who care) and then use the response as a barometer for tailoring future interaction strategies.
posted by Matt Oneiros at 4:31 PM on December 12, 2016 [1 favorite]

I totally get where you're coming from. And I also remember having to explain to my grandma that it was Thanksgiving and that's why I was in town 10 times over the course of 15 minutes. It meant when she got fighty and angry (dementia sucks), we could just change the subject and she'd forget she'd been upset. But it also meant new information did not stick. Might be something to consider depending on the stage of your grandma's disease - having to come out over and over and over and over again each time she notices the card might be a drag for everyone.
posted by cnidaria at 4:37 PM on December 12, 2016 [2 favorites]

I'm trans and both my surviving grandparents had Alzheimer's growing up (long before I transitioned). I remember briefly a time where they knew who I was when they came by for holidays, but there was a couple years before they passed, while they were living in assisted living facilities, where they didn't know who I was at all. My mom or aunt would say, "that's your grandkid!" and they would be so pleasantly surprised!

I think you are conflating how your mom does not seem very supportive of your spouse with the reasoning behind her stance on this card. I think it's great that you are standing up for your wife, but I think signing the card "from the both of us" is probably the easiest solution here. There's a chance that next year she won't remember who one or the both of you are, let alone keep track of the fact that your spouse transitioned. It is true that people with Alzheimer's/dementia get agitated pretty easily and I would just let it be. You said you and your grandmother do not share a common language so it would be your mom needing to explain this every time and it does not sound like something she is comfortable doing. It would probably just cause upset for your grandmother and for your mother in trying to explain the situation every time it comes up. There was a significant death in the family that never got mentioned to my grandfather for this same reason.

I think maybe my opinion would be different if you and your partner saw your grandmother regularly, but it seems like this is not the case. The path of least resistance would be signing it "the two of us" and your mom can explain things to her as she feels is most appropriate if she ever forgets who "the two of us" is, and you don't have to feel like you are betraying your wife, as she is still the same person, after all.

Also, I would speak to your mother at another time about how you feel about her reaction to your wife's transition -- maybe after the holidays -- because it seems like this has been a long-running issue. Have you and/or your partner visited your mother recently? Do you visit regularly? I wonder if maybe her cool reaction is because she is having a hard time conceptualizing who your partner is if they are trans and, until recently, she really didn't know what "trans" means other than some awful caricatures from the media. Obviously, we're still just people, but some people just don't have a framework for this kind of thing and maybe seeing that your wife is still the person she met before (likely a more comfortable, confident version of the person she met before) would help.
posted by sevenofspades at 4:40 PM on December 12, 2016 [5 favorites]

nebulawindphone:(I'm a trans woman and) I think you should ask your wife what she wants. People have a lot of different attitudes towards that sort of strategic deadnaming, from "Eh, whatever, if you're talking to someone I'll never meet then do whatever keeps you safe and un-hassled" through "Ugh I don't like it but I guess it's okay in this situation" to "OH FUCK NO NOT UNDER ANY CIRCUMSTANCE," and I feel like your wife ought to have a chance to decide for herself what she's comfortable with here.

nebulawindphone is totally right in that each person has different feelings (that can change!) about deadnames. I really want to emphasize this point because I think your wife's response will be key in formulating the next steps. If she is fine with her deadname being used, then you can do that. If she'd prefer to be left off the card, then that is probably a better way to go.

An alternative might be to use the "From Both of Us" framing, with a short post script signed with just your name. Then, anyone who needs to explain to her who sent the card can do with in the best way for her day-to-day care.
posted by Excommunicated Cardinal at 5:17 PM on December 12, 2016 [2 favorites]

My experience:
My mother died of Alzheimers. About 2.5 years before she died, I got divorced. She half-remembered for a while, but as her disease progressed, she once again forgot that I was no longer married and she would ask how my (ex) husband was doing. For a while I would remind her that I was no longer married. Her reaction varied; sometimes, as a staunch, lifelong Catholic and in the throes of a terrible disease, she got very angry with me and berated me. Other times she would ask very invasive questions about how and why we were splitting up (for her, it was always immediate-- in my timeline, it was between 6 months to two years in the past). And other times she would say she was sorry and leave it at that. It became exhausting. So after a while when she would ask how (ex) husband was doing, I would tell her he was great, his job was fine, etc. etc.

My father died 3 years before she did. For her, hs death was always somewhere between 2 weeks and 4 months in the past. There was nothing we could do about that, no lying and telling her dad was fine or whatever.

I agree with everyone upthread that notes how your wife's coming out will not be a one time thing. I will add that your grandmother's reactions can and will vary every time she relearns the news. I advise you to sign the card From the Both of Us.
posted by oflinkey at 5:19 PM on December 12, 2016 [3 favorites]

How is your wife going to know what you wrote in your Christmas card to your grandmother, unless you make a big deal about telling her? My husband wouldn't have any idea whether I called him Billy Bob, That Bastard or Hey You in the card I sent my grandma.

If it were me, I'd sign it like you always have and stick it in the mail without mentioning it to your wife. It would be a kindness to both your mother and your grandmother at a difficult time.
posted by Serene Empress Dork at 5:20 PM on December 12, 2016 [3 favorites]

Yes you should educate yourself about Alzheimer's Disease.

I feel like you have zero clue how horrible this disease is, and you have limited contact with your Grandmother who is suffering from this disease. This is someone your wife will never be able to effectively come out to because of their disease.

Separate your feelings and your wife's feelings + your Mom's problems from your poor Grandmother's condition. If the card is sent already, hope your Grandmother is not experiencing tremendous distress over the worsening of her condition. Your position is only explained by inexperience with someone in end stages Alzheimer's. This isn't about you and your wife.

Educate yourself about this disease because once you do, you won't need to debate with yourself what is the right thing to do here.
posted by jbenben at 7:07 PM on December 12, 2016 [17 favorites]

The number of people making the point that "new information might not stick" have an experience that's somewhat different than my own with my father's Alzheimers, which he (and my family) have been dealing with for several years not. It is the case with him that new information might not stick, but it's also the case that old information might not stick, either.

The last time I visited, he consistently mistook me for one of my siblings. For a couple of years, he's been unable to remember where I live, and I lived in my current home for about 20 years.

Your mother's judgement of how your grandmother will re-act to new information may be correct, but I don't think that it necessarily is. Judging by my experience with my father, there's every possibility she will find your wife's deadname as confusing as her current name. Your mother's own level of comfort with your wife's transition may be (consciously or unconsciously) affecting how she imagines your grandmother will react to it.
posted by layceepee at 7:37 PM on December 12, 2016 [1 favorite]

Wrt giving someone with dementia bad news, my telling my grandmother that I now lived in NY would trigger her asking if I saw her sister. I would always respond with "she died x amount of time ago" , she would say "oh, that's terrible" and go back to what she was doing.

I would tell your grandmother that dead name is now called new name and repeat as needed.
posted by brujita at 7:44 PM on December 12, 2016

There are so many variables her that it's hard to give advice...like
-your grandmother's country of origin and how progressive or conservative it is
-if your grandmother reads her own mail or if someone reads it to her
-how progressive or conservative your grandmother is as an individual
-same for any caregiver who might read her your card or give her an explanation

If I had had this situation come up in my family when I lived with my grandmother who had Alzheimer's, the biggest problem would have been balancing your wife's needs and being respectful with using language my grandmother could understand, not the fact of transgender people existing. Like, I would have recommended signing the card "Grandchild and Wife ( this is [deadname]'s new name, and she really loves it!)" because that would make it clear that you don't have a new wife, but I understand that might not be ok with your wife. A cheerful, matter of fact explanation would have been fine for my grandmother (if her reaction to gay people is a reliable barometer). At the end of her life, she stopped vocalizing any kind of moral or social judgment and was delighted by novelty (like a profession she had never heard of or an animal she had never seen before). Imagining the conversation we could have had about being transgender is quite delightful, actually. I think the issue here is the individuals involved, not something fixed about Alzheimer's.
posted by Snarl Furillo at 7:44 PM on December 12, 2016

Also, in terms of comparing this to a death...my grandmother took on the knowledge of people's deaths, but only first-order relatives. She never remembered A SINGLE THING about grandchildren's spouses, or even more distant grandchildren, positive or negative, beyond being delighted to get photo greeting cards from them or to have them fuss over her if they visited. I just introduced them every time and said their names and relationships frequently when we talked and that worked fine for us. The disease affects people differently.
posted by Snarl Furillo at 7:53 PM on December 12, 2016

Regardless of everything else in this story, your grandma is not up to processing and remember this new information in the way that you would like. I second educating yourself on this and adjusting your reactions and expectations accordingly.
posted by jenfullmoon at 8:59 PM on December 12, 2016 [1 favorite]

I think you and your mother are both being very fierce protectors of the people in your life who are vulnerable right now: you are being a champion for your wife in the socially vulnerable first part of her transition, and your mother is trying to protecting your grandmother's emotional state during a terminal illness. I think you are both coming from a good place, but as other people have pointed out, there's an element of infantilization going on with both of you making decisions and speaking for the people you care about-- your mom is trying to make calls about what your grandmother can or cannot handle; you haven't even spoken to your wife about this issue and are already getting into major family fights on her behalf.

I think you need to ask your wife about this, learn more about the realities of Alzheimers and adjust your expectations, and I think you and your mom would also really benefit from channeling that intense protective instinct into taking care of one another. Both of you need real support from each other right now: you need your mom to step up and support you and your wife; your mom needs you to help her with the huge emotional blow of losing her own mother to a horrible disease. The way you talk about your mom's feelings about her mother-- "worried" about her-- says to me that you don't quite understand how serious this is.

Do more research on Alzheimers-- it's likely that your grandmother is not going to have the cognitive capacity to understand or retain information about your wife's transition. You are probably going to have to go with the "from Both Of Us" message not as a sacrifice, but out of practicality. I think it's going to be a lot more helpful for you to try to engage your mom about supporting your marriage and your wife in literally any other facet of life than her own mother's cognitive decline and death, and trying to make one into a referendum about the other is going to hurt the both of you at a time when you need each other. Best.
posted by moonlight on vermont at 10:03 PM on December 12, 2016 [10 favorites]

I'm trans myself, and I'm afraid I have to side with your mother that putting your grandmother's well-being first is what's most important here. Your grandmother's just not in a state to deal with this, change is only going to make things more difficult for her. Send a nice card, but don't write your partner's former name. Use an initial or just sign your own name, or something like that.

I agree with others who say this is probably more about your issues with your mother than anything else. You can hash this out with your mother, but your grandmother is losing her mind to a cruel disease. Do whatever you can to make her remaining time simple and peaceful. Send a card with a nice picture of a puppy wearing a Santa hat, wish love "from both of us," and know that you're making an ailing old lady happy without disrespecting your wife.
posted by Ursula Hitler at 12:26 AM on December 13, 2016 [8 favorites]

There's a couple distinct and separate things to consider here: the comfort of your Alzheimer's-stricken grandmother, and your mother's acceptance (or not) of your partner being trans. They're separate problems, and they need to be dealt with separately.

For your grandmother, the simplest, least-upsetting/confusing thing would be to sign the card with either just your own name, or you plus your wife's deadname. This isn't to deny your wife being trans, it's just to make your grandmother's remaining time smoother and less stressful --- Alzheimer's is terrible, mostly because its victims know they're missing information they used to know, and so anything that would make her life easier is a good thing: why upset the lady if you don't have to? Think of it as a little white lie that will give her peace of mind --- and honestly, whether Grandma, in an entirely different country from you, knows that your wife is or isn't trans won't make a bit of difference to you in your own country.

On the other hand, unfortunately you'll probably also have to make it very, very clear to your mother that you are doing this --- signing only your own name or using wife's deadname --- only to give your grandmother that peace of mind: any other usage of wife's deadname (by your mother or anyone else!) is totally unacceptable, as is any reference to your wife as anything other than her new name.

I get how not telling Grandma your partner is trans might feel a bit dishonest, but frankly, you're dealing with an elderly lady who will never meet your wife, and the information will only confuse and upset her. If this was a grandmother who lived close to you and saw you and your wife frequently, even with the Alzheimer's I'd probably recommend coming clean with her; but in your situation I'd make Grandma's comfort paramount.
posted by easily confused at 5:19 AM on December 13, 2016 [2 favorites]

I work with older patients a lot, a number who have had Alzheimer's. I've also had a couple of grandparents/great-grandparents who had dementia.

One thing that I've noticed, it can be very hard for family members to grasp how the disease changes their loved one, and that even applies to family who are present and interacting on a daily basis. Part of it is that the disease progresses, so what worked one day may not work the next.

Is it possible that grandma had a massively bad reaction to the most recent major life-event news, so now they're only going to tell her what she absolutely needs to know? Or do some family members not fully appreciate grandma's diagnosis? I frequently saw family members fly in from out of town who had no clue how the disease was impacting it their loved one and try to institute unrealistic changes for a few days until reality finally set in. If the family members sharing the news are doing so from a distance, they may be ignoring/unaware how it's agitating your grandmother.

I completely understand you being skeptical about your mom's request, she hasn't been the most supportive. But from a distance it's going to be hard for you to accurately assess how your grandmother is going to respond (and honestly your mother has to rely on more local people to give her information too). The good part of that is you (and importantly your wife) have a buffer if her reaction is hurtful. But it could still be stressful for your grandmother and her caretakers.
posted by ghost phoneme at 7:15 AM on December 13, 2016

I think you need to hear this, even though it's harsh. It's also true.

The two times I have been in close proximity to people with a loved one suffering from advanced Alzheimer's, one became an alcoholic and another committed suicide. And at 46, those are my only two experiences with the disease. I knew both afflicted loved ones well before the disease set in, so none of those involved were strangers to me. My experience with Alzheimer's is that it can be tragic for the family caretakers.

I offer this up because you may be totally misjudging your mom. Or she might be slightly unsupportive of you wife, but legitimately dealing with something else 50x more overwhelming from her perspective.

There's a lot of distance between you and what's going on, and you're only looking at this through your lens.
posted by jbenben at 7:25 AM on December 13, 2016 [7 favorites]

My husband was married previously. His grandfather was still alive when he and I met, and his family decided not to introduce me to him. He still would ask my husband about how Ex-wife was, and he would politely maintain the fiction (she's fine, thanks) and then come him to me. He discussed my introduction with his parents and they felt that at worst he would be confused and upset, and at best he would simply assume I was her and call me by her name. It seemed best to just leave him in peace for the time he has left.

I've always left matters involving my husband's family up to him to take the lead on, so I abided by this decision. Think of medical triage. The person with the highest need takes priority. It doesn't mean the others don't have needs themselves. But these are lower needs. The direst situation has to be prioritized. In the grand scheme of things, my potentially meeting him would have had less benefit to me than it would have been harm to him.

Post-script: I now have a child who was named after this man I did not meet. One of the nicer parts of that decision was how many people wrote or approached me after his birth to tell me how touched they were to see the name again. Many shared photos and memories with me of the man they knew. In a small way, I do feel a connection to him now that has been very sweet.
posted by ficbot at 9:33 AM on December 13, 2016 [2 favorites]

If your wife is OK with it, I would sign a new card with "love from both of us!" plus your name and an illegible squiggle. It's fair to support your wife by demanding support from your mother, but maybe not fair to expect the same from your grandma who is incapable of understanding.
posted by beandip at 12:07 PM on December 13, 2016

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