As a parent, there’s nothing you wouldn’t do for your child. If they get sick, you take them to see a doctor. If they express interest in a particular activity, you help them find ways to get involved.
So what if your child tells you they’re not actually the gender they were assigned at birth? That’s the question facing parents of gender-diverse youth, a broad term used to describe a wide range of gender identities including transgender and nonbinary people.
While the best way to support your gender-diverse child is different for every family, rest assured, there are simple ways you can do this and resources available to help you.
“Just as you educate yourself about parenting, you can also educate yourself about gender identity and sexual identity, so it’s not such a foreign topic if it comes up,” says Dr. David Inwards-Breland, an associate professor of adolescent medicine and pediatrics at the University of Washington School of Medicine and medical director of Seattle Children’s Gender Clinic.
What it means to be transgender or nonbinary
Part of that self-education process is learning what it means to be gender-diverse.
Traditionally, gender used to be thought of as two distinct categories based on your anatomy at birth: male or female. There are also intersex individuals whose anatomy or sex chromosomes don’t conform to either traditional gender stereotype. Now we understand that gender is actually a spectrum and isn’t determined by your reproductive system.
For someone who is transgender (trans for short), their gender identity — aka their internal sense of gender — doesn’t match the sex they were assigned at birth. This is different from cisgender individuals whose gender identity matches their assigned gender.
For example, if you have “female” listed on your birth certificate and feel comfortable with this as your gender identity, you’re a cisgender person. But if your child was born with “boy” on their birth certificate and now identifies as female, she’s a transgender girl.
According to a recent report, 1.4 million adults in the United States and about 150,000 youth between the ages of 13 and 17 identify as transgender. In Washington, those numbers are around 57,000 adults and 4,500 high schoolers.
There are also individuals who feel like they don’t belong to either traditional gender category and may describe themselves in a number of ways, such as nonbinary, genderqueer, agender or bigender.
No matter where someone falls on the gender spectrum, it’s important to take note of and use that person’s preferred gender pronouns. A transgender girl may want to be called “she” while a nonbinary youth might ask to be addressed by a gender-neutral pronoun like “they.” It’s up to them, so pay attention and respect their request.
Being transgender or nonbinary is not a “phase”
Let’s be honest: You probably didn’t expect your child to come out as gender-diverse. Despite your surprise, though, it’s crucial not to be dismissive of this as just a passing thought.
“A huge misconception is that it’s a phase or something trendy that kids want to be,” Inwards-Breland says. “Parents should understand that this is something that they need to take seriously and understand where their kid is coming from.”
The key, he explains, is to understand the difference between a young child who is still discovering who they are from a child who is trying to tell you a deep, personal truth about themselves.
One way you can do this is to watch out for consistent, persistent and insistent messages from your child. In essence, if your child is regularly and emphatically telling you that they’re a certain gender identity, it’s important to listen up.
Your kid or teen may not tell you outright either, so pay attention to other ways their gender can manifest like how they choose to dress, conversations they’re having with their peers or pronouns they’re asking to go by.
“Parents wonder, ‘What if they change their mind?’” Inwards-Breland says. “There’s not a lot of evidence where this happens. And if it does, there are very few who do. If you look at research, most gender-diverse adults knew when they were a kid or a teenager or even younger.”
How to support your transgender or nonbinary child
If your child does come out to you as trans or gender nonconforming, the first step to showing your support is to confirm that you love them. It may seem like a simple thing, but one study shows that trans youth who are supported in their gender identities have better mental health outcomes.
“Tell them that you accept them, then ask them to educate you about it so you can find a way to support them,” Inwards-Breland says.
Hearing how your kid realized their true gender identity allows them to not only share their journey with you but also allows you to understand and learn more about your child. Remember, their being trans or nonbinary isn’t about you or your parenting — it’s about who they are as a person.
You should also seek out additional information from support groups and medical professionals like your child’s pediatrician or family medicine doctor. This lets you hear from trusted individuals who have personal experience raising or treating gender-diverse children.
Aside from showing your acceptance and making an effort to learn more, you can also ask your child how they would like you to support them. Do they want you to be with them while talking to extended family about pronouns? Should you have a conversation with their school? Let your child tell you what they need, so you can figure out how to best be there for them.
Treatment options for gender-diverse youth
After your trans child shares their gender identity with you, they might ask about gender-affirming medical treatments. While anything involving medication or surgery can seem daunting, it’s important to discuss options with your child and your child’s doctor to make an informed decision.
Medication options fall into two main categories: pubertal blockers and cross-sex hormones.
Pubertal blockers are most effective when someone is just starting puberty. These signal to the brain that it’s time to stop producing sex hormones like testosterone or estrogen. Usually, they’re given as a regular shot every three months or an implant that can last up to a year.
Cross-sex hormones are doses of testosterone or estrogen that can help patients who have already been through puberty. These are commonly administered as injections, a patch, pill or gel.
Then there’s gender-affirming surgery, procedures that physically align anatomy with that person’s gender identity. As with any medical procedures, Inwards-Breland notes, patients usually must be the age of consent or have permission from their parent or guardian. It’s also important for you to consider potential risks as well as long-term benefits before making a decision with your child.
“If you look at those who are transitioning, there’s evidence that shows that they have better mental health outcomes and better quality of life,” he says. “Ultimately as a parent, you love your child, so find a way to understand what’s going on and figure out what’s best for them.”
Family Acceptance Project
Human Rights Campaign
King County Trans Resource & Referral Guide
National Center for Transgender Equality
TransFamily Support Services
The Trevor Project
UW Medicine Transgender and Gender Non-Binary Care