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Dear Abby: My 87-year-old mother is narcissistic, self-absorbed and extremely cruel. Her physician has consulted with my sister and me and verified these challenging traits. When she says something or acts out, she’ll say, “I am who I am, so don’t expect me to change.”

How can my sister and I deal with the needs of an elderly parent who continues to verbally and emotionally mistreat us and others? My sister is beginning to react in a defensive, angry manner (rightfully so), and all I do is cry and feel guilty for wanting to get away from her.

– Reached Wit’s End in Loma Linda, Calif.

Dear Reached Wit’s End: Because your mother is behaving the way she always has, her unpleasantness can’t be blamed on old age. The next time she acts out and tells you, “I am who I am, so don’t expect me to change,” respond by saying: “That’s right. You are who you are, but I don’t have to subject myself to this. If it happens again, I’m out of here.” Then follow through.

If that doesn’t discourage her unpleasant behavior, consider hiring a social worker or licensed caregiver to see her needs are attended to. That’s not abandonment; it’s self-defense.

Confusion over ‘transgender’

Dear Abby: I recently came out to my family as transgender (male to female). However, they still call me “gay.” I have told them repeatedly that “transgender” and “gay” are not the same, but they won’t listen. They accept and love me “as I am,” and I’m grateful for that. But I need them to accept me – the REAL me – as I am in my heart.

I am biologically male, and there are people in my life who don’t care about that; they care about me as a human being and want to spend their lives with me. It hurts when my parents keep calling me “gay” and their “son.” Please help me, Abby. My heart is hurting.

– Girl Needing Advice

Dear Girl: Believe it or not, your parents may need as much or more help than you do. Although you have told them you are transgender, they do not appear to fully grasp that gender identity and sexual orientation are two different things. A terrific educational resource for them would be PFLAG. It’s an organization made up of parents, families, friends and straight allies united with gay, bisexual and transgender people. Part of their mission is education, and there are chapters in all 50 states. Contact them at www.pflag.org. Their literature will help your parents understand.

Dear Abby is written by Abigail Van Buren, also known as Jeanne Phillips, and was founded by her mother, Pauline Phillips. Write Dear Abby at www.dearabby.com or P.O. Box 69440, Los Angeles, CA. 90069.