FFFTransgender and Gender Diverse Youth

No. 122; May 2020

As children grow up, they develop a sense of who they are. This sense is sometimes called their identity. Gender is an important part of identity. Gender identity refers to an internal sense of being male, female, a combination of both, or neither. Gender identity is different from sex anatomy, also called someone's sexual body parts, and is different from sexual orientation, which refers to sexual or romantic attraction. Gender expression refers to how a person displays their gender, for example through play, dress pronoun use, and the name they use. Assigned gender is the gender that was originally on a child's birth certificate. Affirmed gender is the gender by which one wishes to be known.

Starting around age 2, children begin to think about and express their gender. Some of a child's behavior and interests may match traditional gender roles and some may not. For example, a boy may be more interested in traditionally female activities like playing with princess dolls, or a girl may be more interested in traditionally male activities like playing with trucks. These examples do not mean the child has a gender identity different from their assigned gender. Exploration of different gender expressions is a common part of development.

Having a child whose affirmed gender identity differs from the gender on their birth certificate can be confusing for families. Parents may not understand why their child's behavior and interests differ from their siblings or peers. Parents may worry about their child's future or what friends or relatives will think or say. Children and adolescents may also have trouble asking questions or expressing their feelings. When a child's gender identity consistently differs from their assigned gender, it may cause them a great deal of sadness and distress. This is referred to as gender dysphoria.

It can be very helpful to try to understand how your child describes their gender identity. Some terms that describe gender variations include:

  • Gender diversity, expansiveness, creativity, or nonconformity, referring to behaviors and appearances that do not match a society's traditional ideas about gender
  • Transgender, meaning that a person consistently identifies with a different gender than their gender assigned at birth
  • Gender neutral, genderqueer, gender fluid, and agender, describing other gender variations

Research suggests that accepting a child's affirmed gender identity and expression can decrease the risk of future psychiatric problems such as depression, anxiety, and suicidal behavior. There are many ways a parent can do this:

  • Talk about gender with your child in an open and understanding way
  • Use the name and gender pronouns (e.g. “he/she/they”) your child prefers
  • Allow your child to play with toys and dress in clothes they choose
  • Stand up for your child if you notice other people acting disrespectfully
  • Help your child prepare for teasing or bullying, including identifying trusted adults
  • Learn about school policies and laws that address gender issues. Advocate for changing them if they negatively impact your child
  • Help your child make decisions about telling others about their gender identity
  • Connect with other parents raising gender diverse or transgender children
  • Seek out guidance early on from medical and mental health professionals who have experience with these issues

Sometimes children take steps to transition from their assigned gender to their affirmed gender. This is called transitioning. Social transitioning refers to a change of gender roles, expressions, name, and pronouns. Medical transitioning refers to the use of medication to help their body better match their gender identity. Medications can pause some of the physical changes that happen with puberty. Surgical transitioning refers to the use of surgery to match one's body and gender identity. Surgery is not an option until late adolescence and adulthood. If transitioning is something your child is wondering about, you can explore options with a medical professional who is knowledgeable in this area. These treatments are different from conversion therapy which attempts to force gender identity to match assigned gender. Conversion therapy is not based on evidence and is harmful to the child and their relationship with their parents.

Raising a gender diverse or transgender child can lead to many questions and concerns. Consult with your primary doctor who may recommend speaking to a qualified mental health professional or another expert in the field. With patience and support, both children and parents can adjust, improve understanding of each other's concerns, and lead a happy and productive life. Most importantly, reassure your child they will always have your love and support.

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