Transgender Children & Youth: Understanding the Basics

One of the most important and difficult tasks that parents face is how to best support their children while also setting the kind of boundaries and structure that helps them grow up to become responsible and successful adults. Sure, children and teens love to test the boundaries that adults set for them. But it is important to make distinctions  between instances where “kids are being kids” and when they’re asserting things about themselves that are critical to their identity and development -- as is the case with gender identity and expression.   

Gender identity and expression are central to the way we see ourselves and engage in the world around us. This is certainly true of transgender and gender-expansive children and teens, for whom family support is absolutely critical.

Studies show that familial rejection can:

  • lead LGBTQ youth to engage in behaviors that put their health at risk,

  • trigger depression and other mental health problems,

  • and – in the worst of cases – result in homelessness or suicide.

Moreover, familial support can act as a buffer against bullying and bias outside the home. As child welfare expert Caitlin Ryan has demonstrated, “Family acceptance predicts greater self-esteem, social support, and general health status,” for LGBTQ youth. “It also protects against depression, substance abuse, and suicidal ideation and behaviors,” issues for which transgender youth are at disproportionate risk.

In other words, for some transgender youth, family support can be the difference between life and death.

Gender Basics

Children are not born knowing what it means to be a boy or a girl; they learn it from their parents, older children and others around them. This learning process begins early. As soon as the doctor announces – based on observing the newborn’s external sex organs – “it’s a boy” or “it’s a girl,” the world around a child begins to teach these lessons. Whether it’s the sorting of blue clothes and pink clothes, “boys’ toys” and “girls’ toys” or telling young girls they’re “pretty” and boys they’re “strong.” It continues into puberty and adulthood as social expectations of masculine and feminine expression and behavior often become more rigid. But gender does not simply exist in those binary terms; gender is more of a spectrum, with all individuals expressing and identifying with varying degrees of both masculinity and femininity. Transgender people identify along this spectrum, but also identify as a gender that is different than the one they were assigned at birth.

Is My Child Transgender...

At some point, all children will engage in behavior associated with different genders – girls will play with trucks, boys will play with dolls, girls will hate wearing dresses and boys will insist on wearing them – and gender nonconforming behavior does not necessarily mean that a child is transgender. That said, sometimes it does – with some children identifying as another gender than the one they were assigned by the time they are toddlers.

The general rule for determining whether a child is transgender (rather than gender nonconforming or gender variant) is if the child is consistent, insistent, and persistent about their transgender identity. In other words, if your 4-year-old son wants to wear a dress or says he wants to be a girl once or twice, he probably is not transgender; but if your child who was assigned male at birth repeatedly insists over the course of several months that she is a girl, then she is probably transgender. Naturally, there are endless variations in the ways that children express themselves, so the best option if you think your child might be transgender is to consult a gender therapist.

...or is my child gay or lesbian?

Gender identity and sexual orientation are two different things. Being transgender is about an individual’s gender identity, while being gay is about an individual’s sexual orientation, which is our sexual or romantic attraction to people of the same gender, different genders, both or neither. While many children who go on to identify as lesbian, gay or bisexual express gender-expansive behaviors, whether they are transgender is about identity rather than attraction. Everyone possesses both a gender identity and a sexual orientation; in other words, a transgender person can also identify as gay, lesbian or bisexual.

What is “gender dysphoria”?

Gender dysphoria is the diagnosis typically given to a person whose assigned birth gender is not the same as the one with which they identify. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), the term – which recently replaced Gender Identity Disorder – “is intended to better characterize the experiences of affected children, adolescents, and adults.” To be clear, transgender identity is not a mental illness that can be cured with treatment. Rather, transgender people often experience a persistent and authentic disconnect between the sex assigned to them at birth and their internal sense of who they are. This disconnect is referred to by medical professionals as “gender dysphoria” because it can cause undue pain and distress in the lives of transgender people.

It isn’t just a phase and it’s not something you can change.

Sure, most children and teens go through “phases” – like only wearing all black, dying their hair, being obsessed with a certain band or asking to go by a nickname – but being transgender is not a phase, and trying to dismiss it as such can be harmful during a time when your child most needs support and validation.

Trying to change your child’s gender identity – either by denial, punishment, reparative therapy or any other tactic – is not only ineffective; it is dangerous and can do permanent damage to your child’s mental health. So-called “reparative” or “conversion” therapies, which are typically faith-based, have been uniformly condemned as psychologically harmful by the American Psychological Association, the American Medical Association, the American Psychiatric Association, and numerous similar professional organizations.

But my teenager just came out, shouldn’t they have known already?

While many transgender people say that they knew they were transgender as soon as they knew what “boys” and “girls” were, for many others, the journey to living openly as their affirmed gender is longer. For some, understanding their gender identity is a more complex process that lasts into their teens or adulthood, even seniors. Stigma, lack of knowledge and fear of rejection by family and peers often keep transgender people from coming out as children or teens. Sometimes a transgender person will come out as gay, lesbian, or bisexual before recognizing their gender identity or coming out as their true gender. No matter when your child comes out, knowing they have your support is critically important.

Simple Ways to Start Supporting Your Transgender Child

  • Always use the child’s preferred gender pronouns and preferred names.

  • Be your child’s advocate – call out transphobia when you see it and ask that others respect your child’s identity.

  • Educate yourself about the concerns facing transgender youth and adults.

  • Encourage your child to stand up for themselves when it is safe to do so.

  • Assure your child that they have your unconditional love and support.


More information about transgender children and youth:

  • The Human Rights Campaign’s Transgender Children and Youth page includes resources for families, community members, school officials and more.

  • Co-published with the American Academy of Pediatrics and the American College of Osteopathic Pediatricians, the Human Rights Campaign Foundation’s “Supporting & Caring for Transgender Children” is a groundbreaking resource that explains how families and healthcare professionals can help transgender and gender-expansive children thrive.

  • HRC Foundation's Welcoming Schools is the nation's premier professional development program providing training and resources to elementary school educators on a range of issues, including how to support transgender and non-binary students.

  • Gender Spectrum offers information and training for families, educators, professionals, and organizations, helping them creating gender-sensitive and inclusive environments for all children and teens.

  • Trans Youth Equality Foundation provides education, advocacy and support for transgender and gender-expansive young people and their families. Programs include support groups, camps and retreats, and a popular Tumblr blog for youth.

More support for families, caregivers and communities:

  • PFLAG is one of the oldest organizations in the country that supports the families, friends and allies of LGBTQ people. PFLAG has local chapters across the United States, including groups specifically for families with transgender children.

More information about affirming parenting:

  • The Family Acceptance Project is a research, intervention, education and policy initiative that works to promote physical and mental health for lesbian, gay, bisexual and transgender children and youth by increasing family acceptance and affirmation in the context of their cultures and faith communities.

  • Gender Spectrum has adapted Family Acceptance Project research for parents and family members of transgender children.