In my work with children and their families, I have found that most challenges stem from a common root. A root so integral to each person that without it, we would not be us. That root is our identity or how we see ourselves in relation to our world.
We define ourselves by how we look, what we do for work, whether we’re shy or outspoken, the foods we eat, who we spend time with, and even how we feel. When our identity is challenged, it can feel like the ground we stand on isn’t secure enough to hold us.
Identity fuels a sense of esteem and belonging. When a person’s identity is ignored or invalidated, a loss of esteem and isolation tends to percolate. The question then becomes: how do we support identity development during childhood and beyond? And how do we respond when our child expresses questions related to their gender identity?
Understanding and honoring the complexities of identity development is critical, especially for parents navigating this terrain with their children. This blog is designed to provide insights, support, and resources for parents who are exploring the possibility that their child may be transgender.
Part 1: Recognizing the Signs: Is My Child Transgender?
Identifying if a child might be transgender is a layered process. Children express their gender identities in a variety of ways, and behaviors that might seem to suggest that a child might be a trans person can sometimes simply be part of typical child development. However, certain persistent signs more likely indicate that a child’s experienced gender differs from their assigned gender at birth.
Consistent, Insistent, Persistent: These are the three key words often used by experts in gender identity. If a child consistently identifies with a gender different from their assigned one, insists on this identity over time, and shows persistent distress (known as gender dysphoria) when they are treated according to their birth-assigned gender, this could indicate they are transgender.
Interest in Clothing and Activities: Kids may express their gender identity through their choice of clothing, toys, and activities. A preference for clothes or toys traditionally associated with the opposite gender can be a sign, though is not definitive. It’s important to look at the consistency and intensity of these preferences as they may indicate gender expression that is different than gender expectations you may have for your child. Are they occasional or a persistent pattern?
Social Transition: Some children express the desire to transition socially. This can involve changing their name, pronouns, hairstyle, and clothing to align more closely with their gender identity. They may also show a preference to socially transition and participate in activities/adopt roles that are traditionally associated with their experienced gender. This step often indicates a deep commitment to their gender identity and can be a crucial part of gender diverse children’s overall well-being.
Communication and Expression: Listening to how children talk about themselves and their identity can offer important clues. Do they refer to themselves using language or terms associated with a different gender? Are they expressing a clear desire to be seen or recognized as a different gender? These verbal expressions can be as telling as their choices in clothing or play.
Remember, every child is unique, and the expression of gender identity can vary greatly from one child to another. For parents seeking a more detailed understanding of these signs, resources like the Polaris Teen Center’s guide on transgender youth signs and Vox’s article on what parents need to know can be incredibly informative (Polaris Teen Center, 2018).
Part 2: Gender Identity Development: When and How it Forms
Research indicates that most children have a solid sense of their gender identity by the age of three. Keep in mind that one’s gender identity can differ from the gender they were assigned at birth.
Stages of Development: The formation of gender identity begins early for all children. By the time kids are between the ages of 3 and 5, they start to express their gender identity. This expression tends to evolve as kids get older. It’s often during these formative years that parents might first notice signs of their child identifying with a gender different from the one assigned at birth.
Differentiating Exploration from Affirmed Identity: It’s common for young children to explore different aspects of their identity, including sexual orientation and gender. They may experiment with roles and behaviors associated with different genders as part of their developmental process. However, there’s a significant difference between typical gender exploration and a child consistently and insistently declaring a gender identity different from their assigned gender at birth. This consistent expression is a key indicator of a transgender identity.
Impact of Environment and Society: The environment in which a child grows up can significantly influence their ability to express and understand their gender identity (and eventual sexual orientation). Supportive and accepting environments can facilitate a child’s exploration and expression of their gender identity. On the other hand, restrictive or negative environments may cause a child to suppress or hide their gender identity, which can have significant negative long-term outcomes. According to one study, less than 40% of LGBTQ youth found their home to be LGBTQ-affirming (The Trevor Project, 2023).
Professional Insights: The Mayo Clinic offers a comprehensive discussion on children and gender identity, which is an invaluable resource for parents (Mayo Clinic Staff, n.d.). Understanding the nuances of gender identity development can help parents support their child’s journey with empathy and understanding.
Part 3: Gender Dysphoria in Children: Signs and Responses
Gender dysphoria in children is a complex and deeply personal experience, characterized by a profound discomfort or distress due to a mismatch between their experienced gender identity and the gender they were assigned at birth. This condition can affect children in a number of ways, both emotionally and physically.
Signs of Gender Dysphoria: Children with gender dysphoria often exhibit clear signs of discomfort with their body, particularly as they approach and enter puberty. This discomfort can manifest in various ways:
- Dislike for Genitalia: A strong aversion to their own genitals is common among gender diverse children. They may express a wish to have the physical traits of the gender they identify with, which can intensify as they grow older. This may or may not impact their sexual orientation.
- Social Withdrawal and Mental Health Issues: Children experiencing gender dysphoria might withdraw from social interactions, especially those that involve gendered activities. They may also show signs of depression, anxiety, and in severe cases, self-harm tendencies.
- Discomfort with Assigned Gender Roles: A pronounced discomfort with the gender roles and expectations aligned with their assigned gender is often evident. This might include resistance to wearing traditional clothing of their assigned gender or participating in gender-typical activities.
Parental Response: The role of parents and caregivers is crucial in responding to a child experiencing gender dysphoria.
- Acknowledgment and Validation: Recognizing and validating the child’s feelings and experiences is the first step. It’s important to create a safe, accepting environment where the child feels comfortable expressing their gender identity. If this does not feel possible for the parent(s), it is imperative that parents get professional support from an affirming provider.
- Seeking Professional Advice: Consulting with medical professionals, pediatricians, therapists, or gender specialists who specialize in working with gender identity issues is crucial. These professionals can offer guidance on the best course of action and provide support for both your child and your family. Gender affirming care is critical and having a gender nonconforming child meet with professionals who do not affirm their gender identity can have painful and long-lasting negative outcomes (including the development of many different mental disorders).
- Education and Awareness: Parents should educate themselves about sexual orientation, gender dysphoria and transgender experiences. Resources like The Washington Post’s article on transgender children can offer in-depth understanding and practical advice for managing gender dysphoria (Schmidt, 2022).
Part 4: Navigating Transition – Supporting Your Child’s Journey
When a child expresses the desire to transition, understanding what this process entails and how to best support them is essential for parents. Transitioning is a multifaceted process that can involve social, legal, and medical aspects and is very often misunderstood by parents and greater society.
Social Transition: The first step in child transition often involves social changes.
- Changing Names and Pronouns: A child may choose a new name and pronouns that align better with their gender identity. This change is a significant step in affirming their identity. Parents generally need their own support during this time, and that is okay. More on parent in Resources and Support for Parents below.
- Clothing and Appearance: Transitioning may also include adopting a hairstyle and wardrobe that reflect the child’s gender identity. This outward expression can be vital for their self-esteem and mental health.
- School and Community Involvement: Parents may need to communicate with schools and community groups to ensure that their child’s gender identity is respected and that they have access to appropriate facilities, like bathrooms and locker rooms.
Medical Transition and Medical Treatment: Meeting with an affirming mental health professional during this time is very important. Involving healthcare professionals, the medical aspect of transitioning can include various interventions, tailored to the individual’s needs and age.
- Puberty Blockers: These medications are used to temporarily halt the onset of puberty, providing time for trans children to explore their gender identity without the added stress of developing unwanted secondary sex characteristics (including breast growth, etc.). If and when the puberty blockers are discontinued, puberty will naturally continue without problem.
- Hormone Therapy: For older adolescents, hormone replacement therapy (HRT) can be an option to develop physical traits more aligned with their gender identity. Trans girls sometimes prefer to get voice coaching in order to have a higher voice, though hormones can also help with this.
- Surgical Options: In some cases, and usually in late adolescence or adulthood, surgical interventions and other medical treatment might be considered to align physical characteristics with gender identity.
Informed Consent and Legal Considerations: The process of transitioning, especially for transgender youth (children and adolescents) involves careful consideration and often requires informed consent from the child and legal guardians. Organizations like the Endocrine Society offer guidelines on age-appropriate treatments.
Part 5: It’s Not a Phase: Understanding Persistent Gender Identity
The understanding of gender identity, especially in children, is a topic that requires careful consideration and empathy. A prevalent misconception is that children who express a gender identity different from their “true gender” (misunderstood term when describing gender assigned at birth are) merely going through a phase. However, research and lived experiences indicate that gender identity is often a deep-seated, enduring aspect of a person’s identity.
Differentiating Exploration from Affirmed Identity: Childhood is a time of exploration and discovery, and it’s normal for children to explore various aspects of their identity, including gender. However, there is a clear distinction between this exploration and a persistent, consistent identification with a gender different from the one assigned at birth. For many children, this consistent identification is not a phase but a central part of their identity (Children’s Minnesota & Goepferd, 2019).
Research on Gender Identity: Research tells us that gender diverse children who transition have a strong and persistent sense of their true identity (Brooks, 2018). This sense of identity often remains stable over time, reinforcing the understanding that being transgender is not a transient phase but a fundamental aspect of a person’s identity.
Recognizing and Supporting a Child’s Gender Identity: It’s important for parents and caregivers to recognize and support a child’s gender identity. Dismissing it as a phase can lead to feelings of misunderstanding, isolation, and distress in children. Acceptance and support, on the other hand, contribute significantly to the child’s mental health and overall well-being.
Resources for Understanding Gender Identity: For parents seeking to understand this better, GenderGP offers insightful articles, including discussions on differentiating a phase from a transgender identity, available in their section on Transgender Phase (Gender GP, n.d.).These resources provide valuable perspectives and guidance for families navigating these experiences.
Part 6: Resources and Support for Families and Transgender Children
Navigating the journey of understanding and supporting a transgender child can be challenging, but families are not alone in this process. A wealth of resources are available to provide support, advice, and community for parents, caregivers, and transgender children. It is best for families to work through their biases, losses and/or struggles in community. Here are a few resources to consider:
Parent Experiences: Understanding the experiences of other parents can be incredibly valuable. Publications like The New York Times feature articles and personal accounts from parents of transgender children, offering insights, advice, and shared experiences (Hassouri, 2020).
Community and Advocacy Groups: Organizations dedicated to LGBTQ+ rights offer a wealth of resources. For example, The Human Rights Campaign provides not only educational materials about transgender people but also support networks and advocacy tools for transgender children and their families. These resources can be instrumental in helping families navigate legal, medical, and social challenges.
Online Forums and Support Groups: The internet hosts numerous forums and online communities where parents and caregivers of transgender children can find support, ask questions, and share experiences. These platforms offer a space for connection and understanding with others who are on similar paths. At Sentier, we have a parent support group for parents of trans and nonbinary kids/adults, ages 11+. 
Professional Counseling and Support Services: Seeking professional help from counselors or therapists who specialize in gender identity can be beneficial for both the child and the family. These professionals can offer tailored advice, therapy sessions, and coping strategies to navigate the challenges that may arise, as well as the loss that parents often feel.
Conclusion
Understanding and supporting a child’s gender identity is indeed a profound journey, one that encompasses love, empathy, challenges, and continual learning. It’s a path that requires patience, open-mindedness, and a deep commitment to the well-being and happiness of the child. As parents and caregivers embark on this journey, they become vital allies in their child’s exploration and acceptance of their true self.
The role of parents and caregivers in this process cannot be overstated. By staying informed about the nuances of gender identity, actively seeking professional guidance, and offering unconditional support and love, parents can attend to the root of children’s well-being. It’s through this support that children find the courage to express their true selves and navigate the complexities of their gender identity with confidence.
Blog written by Sentier therapist Lily Ferreira, MSW, LICSW.
References
Brooks, J. (2018, August 26). Is Three Too Young for Children to Know They’re a Different Gender? Transgender Researchers Disagree. KQED. Retrieved January 23, 2024, from https://www.kqed.org/futureofyou/440851/can-you-really-know-that-a-3-year-old-is-transgender
Children’s Minnesota & Goepferd, A. K. (2019). Support without Steering [How to Talk to Kids and Families about Gender Identity].
Gender GP. (n.d.). GenderGP: Online Transgender Clinic | Worldwide Gender Clinic. Retrieved January 23, 2024, from https://www.gendergp.com/
Hassouri, P. (2020, September 8). What I Learned as a Parent of a Transgender Child (Published 2020). The New York Times. Retrieved January 23, 2024, from https://www.nytimes.com/2020/09/08/well/family/transgender-child-parenting.html
Mayo Clinic Staff. (n.d.). Children and gender identity: Supporting your child. Mayo Clinic. Retrieved January 23, 2024, from https://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/children-and-gender-identity/art-20266811
Polaris Teen Center. (2018, December 28). How to Know If Your Child Is Transgender. Polaris Teen Center. Retrieved January 23, 2024, from https://polaristeen.com/articles/signs-of-transgender-child/
Schmidt, S. (2022, February 25). Transgender kids, gender dysphoria and puberty blockers: Your questions, answered. Washington Post. Retrieved January 23, 2024, from https://www.washingtonpost.com/dc-md-va/2021/04/22/transgender-child-sports-treatments/
