Transgender is a term we hear all the time now; in the news, on social media, in politics—it is everywhere. But what does it mean to be transgender? Children are assigned a gender at birth based on their genital anatomy or chromosomes (if known prior to birth). Some children identify with a gender that does not correlate with the gender they were assigned at birth. These children and adolescents are referred to as gender-nonconforming, gender-variant, or transgender. It is hard to predict which of these children will grow up to be transgender adults and which will be cis-gendered adults (when a person’s gender identity matches their assigned gender based on their anatomy).
Experts do not know why this happens, but it is not a new trend or phenomenon. There have been documented cases of transgender people—once thought of as a psychiatric disorder, but that type of labeling is no longer considered appropriate—since the 1700s.
What we do know, thanks to many studies, is that adolescents and youth who have questions about their gender and are not supported by family are at higher risk for depression, anxiety, substance abuse, and suicide. Therefore, it is important for all parents to be well-informed of what transgender means and how best to support their children. Children and adolescents are more likely to have a healthy self-image, self-esteem, and general well-being when their parents and families recognize, support, and love them no matter what gender they identify with.
Guidelines for Support
There are some basic guidelines all parents should follow, however, the most important guideline is that each child should have an individualized approach.
All parents should educate themselves on the possibility of gender-nonconforming conditions and how it relates to their children and families. There are many excellent resources and support services that are affordable and convenient.
Follow your child’s lead with respect to gender expression. This could range from experimenting with playing with toys considered more “male” or “female” to a desire of social transition. This could mean wearing clothes or appearing more like the gender your child identifies with, using the bathrooms or locker rooms at school, and asking to be addressed by a different name than what was assigned at birth. The positive well-being of a transgender child is directly correlated with a highly supportive family. If your child desires a social transition, it is wise to work with your child’s school to help the transition and avoid issues such as bullying and name confusion with teachers.
As with any other childhood issue, the role of the parent is to protect and keep their children safe from negative reactions from others. If parents are struggling with understanding how to advocate for their children, it is suggested the parent seek support from a mental health provider who specializes in transgender care or support organizations. There are many parent support groups available to assist and guide parents through this process. Your child may face negative criticism during this process and they will ultimately look to you for comfort and safety.
Medical and Mental Health Care
A consultation with a transgender child and adolescent specialist is recommended to assist in coordinating care for your child and for the family. Each child will have his or her own individualized approach appropriately tailored to his or her needs.
What about hormones and other treatment?
Hormonal interventions to stop puberty and/or to promote development of desired gender characteristics may be warranted in gender-nonconforming youth. There are criteria that medical and mental health providers use to determine whether hormonal therapy is appropriate. In addition, there are guidelines by the Endocrine Society and the World Professional Association for Transgender Health that guide care. There are also medical and mental health providers who can assess and provide hormonal treatments if appropriate.
Hormonal therapy involves close clinical and laboratory monitoring and consent from the parents. It may not be indicated for all, but when gender dysphoria is having a negative impact on the youth’s ability to function, causing anxiety, depression, self-harm, and suicidal thoughts, parents are encouraged to seek consultation with a specialist in transgender care for children and adolescents.
Are there any surgical options?
Surgery is generally not offered to any youth younger than 18. Here, too, there are specialists who can assist you and your child.
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