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Gender Non-Conforming & Transgender Children

​​​​Some children have a gender identity that is different from their sex assigned at birth, and many have interests and hobbies that may align with the other gender. Some children, however, do not identify with either gender. They may feel like they are somewhere in between or have no gender. It is natural for parents to ask if it is "just a phase." But, there is no easy answer.  

For some young children, expressing a wish to be or identifying as another gender may be temporary; for others, it is not. Only time will tell. Some children who are gender non-conforming in early childhood grow up to become transgender adults (persistently identifying with a gender that is different from their birth sex), and others do not. Many gender non-conforming children grow up to identify with a gay, lesbian, or bisexual sexual orientation (i.e. attracted to the same or both genders as opposed to feeling they are a different gender).

Parenting a Gender Non-Conforming Child

There is no way to predict how a child will end up identifying him or herself later in life. This uncertainty is one of the hardest things about parenting a gender non-conforming child. It is important for parents to make their home a place where their child feels safe and loved unconditionally. Research suggests that gender is something we are born with; it can't be changed by any interventions. It is critically important that children feel loved and accepted for who they are.

Will my child grow up to be transgender?

Research suggest that children who are persistent, consistent, and insistent about their gender identity are the ones who are most likely to become transgender adults. It is important support and follow the lead of the child. This may mean you will not have an answer for quite a long time, which can be very difficult for parents. Here are some examples:

  • If your teenager has identified as a different gender since early childhood, it is unlikely he or she will change his or her mind. A 12-year-old male who has consistently asserted, "I am a girl," since the age of three, will most likely remain transgender throughout life.
  • Sometimes a young child who strongly identifies with another gender does change. The most common time for this to occur is about 9 or 10-years-old. There is not enough research to know if this change means the child has learned to hide his or her true self due to social pressures, or if it was indeed "just a childhood phase."
  • Puberty is another time when a child's gender identify can come into question. Sometimes teens who never exhibited anything outside the norm in their gender expression or identity, may start feeling differently as their bodies change.  Finding out your teen is transgender can be very confusing for p​arents who "didn't see this coming." Many are unsure if it is just a "teenage phase" or their child is really transgender. It may be helpful to allow your teen to explore their gender identity with support from a counselor or therapist who has experience supporting transgender youth.

What caused my child to identify with a different gender?

While we do not understand why some children identify with a gender different from their birth sex, the cause is likely both biological and social. There is no evidence that parenting is responsible for a child having a gender identity that is not in line with his or her biological sex. Experiencing childhood trauma will not cause a child to become gender non-conforming, transgender, or homosexual. There is nothing "wrong" with your child. However, children perceived as "different" may suffer from teasing or bullying. If this is happening, speak with the child's teacher and the school to create a plan to prevent bullying. The most important thing to remember is to support, love, and accept your child as he or she is. 

Will my child choose to transition? What's like process like?

At some point, a child who is persistently gender non-conforming may choose to "transition", or begin to live as his or her self-identified gender instead of the gender assigned at birth. The transitioning process is different for everyone, and is often initiated by the child.

  • Some children make a transition early in childhood by wearing the clothing for their identified gender and changing their name or pronoun.
  • Medical treatment is available to block the signs of puberty associated with the biological sex during early adolescence. These are sometimes called "puberty blockers;" they prevent the secondary characteristics associated with puberty from occurring (e.g. voice deepening, facial hair, and height in males; breast development in females). These medications allow more time for the young teen and his or her family to make a decision about next steps in transitioning.  The effects of these medications mimic those of a natural hormone found in the body and are completely reversible when the medications are stopped.
  • Later in adolescence, teens can choose to use medication or hormones to transition and go through the puberty of the gender consistent with their identity.
  • Some adults choose to have surgeries, and some do not. If a young person has taken puberty blockers prior transitioning, they will not require some surgeries to reverse the effects of puberty (i.e. breast removal or facial feminization).

In any case, those desiring to make a medical transition need to have a relationship with a counselor or therapist who has experience supporting transgender youth. The child will also need to see a pediatric endocrinologist or a doctor who specializes in hormone therapy for young people, ideally just before the start of puberty.

Sexual Orientation vs. Gender Identity

Sexual orientation refers to the person someone falls in love with or is attracted to. Sexual orientation becomes evident later childhood, while gender identity refers to the way one identifies him or herself in early childhood. While sexual orientation and gender identity are quite distinct tracks of development, children who are gender non-conforming often grow up to identify as gay or bisexual, and many gay or bisexual adults recall gender non-conforming behavior in childhood. Like gender identity, an individual's physical and emotional attraction to a member of the same or the opposite sex cannot be changed.

Your Child's Mental Health

All gender non-conforming children (regardless of whether they later identify as straight, gay, lesbian, bisexual, or transgender), are at risk for bullying and mental health problems

A large proportion of teenage suicide attempts are linked to issues of gender and sexuality, and many gay, lesbian, bisexual, and transgender youth attempt suicide. As a parent, your most important role is to offer understanding, respect, and support to your child. A non-judgemental approach will gain your child's trust and put you in a better position to help him or her through difficult times. You need to be supportive and helpful, no matter what your child's gender identity or sexual orientation may be.  Research has shown that supportive families greatly reduce a teen's risk of suicide.

What parents can do:

  • When your child discloses his or her identity to you, respond in an affirming, supportive way. Understand that although gender identity and sexuality are not able to be changed, the way people identify their sexual orientation or gender identity may change over time as they discover more about themselves.
  • Accept and love your child as they are. They will need your support and validation to develop into healthy teens and adults. 
  • Stand up for your child when he or she is mistreated. Do not minimize the social pressure or bullying your child may be facing. See How You Can Help Your Child Avoid & Address Bullying.  
  • Make it clear that slurs or jokes based on gender, gender identity, or sexual orientation are not tolerated. Express your disapproval of these types of jokes or slurs when you encounter them in the community or media. 
  • Be on the look out for signs of a​nxiety, insecurity, depression, and low self-es​teem. Some children who do not have a supportive family or friend group may struggle with these emotional problems. See Mental Health and Teens: Watch for Dangers Signs.
  • Connect your child with LGBTQ organizations, resources, and events. It is important for them to know they are not alone.
  • Celebrate diversity in all forms. Provide access to a variety of books, movies, and materials—including those that positively represent same-sex relationships. Point out LGBTQ celebrities, role models who stand up for the LGBTQ community, and people who demonstrate bravery in the face of social stigma.
  • Support your child's self-expression through choices of clothing, jew​​elry, hairstyle, fri​ends, and room decoration.
  • Reach out for education, resources, and support if you feel the need to deepen your own understanding of LGBTQ youth experiences.

Support for Families

Having a gender non-conforming child can be very stressful for parents and caregivers, as they deal with uncertainty and navigate schools, extended families, sibling relationships, and the world around them. There are several national and international organizations that support families with gender non-conforming children (see resources below), as well as excellent books. Many parents and siblings also find it helpful to meet with a mental health care professional or other families in a support group setting.

When to Talk to Your Child's Pediatrician:

If your child persistently identifies as another gender, rather than just showing a mix of behaviors, talk to your pediatrician. Your child may need help from a mental health professional to sort out his or her feelings regarding gender or sexuality, or to help cope with being different.

Children who are gender-nonconforming are more likely to suffer from anxiety and depression due to bullying, discrimination, and non-acceptance. It is important to talk to your child's pediatrician or mental health professional if you are concerned that your child may be suffering from any mental health problems. 

For more information or help finding a support group for yourself or your child, please talk to your child's pediatrician.

Additional Information & Resources: 

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Last Updated
6/4/2015
Source
Section on Lesbian, Gay, Bisexual, Transgender, Health and Wellness (SOLGBTHW) (Copyright © 2015 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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