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Supporting trans and non-binary youth

Updated: Jul 15, 2022

The most common question I receive from parents regarding their child’s gender identity is, “Is this a phase?” And the answer is, “maybe.” To help understand what your child is experiencing, consider these key factors:

· Persistence, insistence, and consistency in how they convey their gender identity

· Using declarative statements such as “I am a boy (or girl)” rather than “I want to be (wish I were) a boy (or girl)”

· Significant distress about their body, leading to great distress when either undergoing pubertal changes in the “wrong” gender or when forced to present themselves as a gender that does not align with their internal sense of self

“A young gender-expansive child may outgrow the feeling, but for children whose gender-expansive identity has remained stable and unchanged beyond this age insistently, persistently, and consistently this will more than likely continue throughout life. Regardless of the eventual outcome, the self-esteem, mental wellbeing, and overall health of a gender-expansive or transgender child relies heavily on family acceptance; receiving love, support, and compassion from guardians is crucial.” (Human Rights Campaign, 2012)

Gender identity typically develops in stages

· Around age 2: Basic gender identity

Children become conscious of the physical differences between boys and girls.

· By age 3: Most children can easily label themselves as either a boy or a girl.

· By age 4 or 5: Gender stability

Understand that their gender is stable over time, but do not yet understand that it is not changeable for others.

· By age 6 or 7: Gender constancy

Realize gender is stable across situation and time, see separation between genders occurring (e.g. preferred friendships).

· Puberty/Adolescence

Usually consolidated gender identity.

Family Support Matters. Let me say this one again. FAMILY. SUPPORT. MATTERS. Big time.

Transgender youths who are supported by their parents have similar rates of mental health comorbidities to cisgender age matched peers (Busa, Janssen, Lakhman, 2018). In contrast, LGBTQ+ youth who come from highly rejecting families are 8.4 times as likely to have attempted suicide as LGBTQ+ peers who reported no or low levels of family rejection (Family Acceptance Project, 2009). Review the graphic below provided by TSER.

Fostering gender-affirming homes

• Follow your child’s lead

Listen and respond rather than guide, enforce, or force

• Be supportive and positive about your child’s gender identity and expression

Use affirming name and pronoun

Support other changes in gender expression (hair, makeup, clothing)

Praise the child in a genuine manner

• Ask frequently about the child’s experiences

• Provide unconditional support around their suffering

• Have a sense of humor

• Continue to set age-appropriate limits

• Provide accurate information and clarify unrealistic expectations

• Protect your child from harm

No tolerance for transphobia in your home

Asking the right questions

When supporting someone who is transgender or non-binary, don’t make assumptions. Instead, ask questions like:

• What name/pronouns would you like me to use when addressing you?

• What can I do to better support or help you at this time?

• If someone asks me about your gender identity or gender expression, how would you like me to respond?

• Do you have support from other friends and family members?

• Is there anything that you’ve seen or read that you would like me to see or read?

What about non-binary people???

• You don’t have to understand what it means for someone to be non-binary to respect them. Some people haven’t heard a lot about non-binary genders or have trouble understanding them, and that’s okay. But identities that some people don’t understand still deserve respect.

• Use the name a person asks you to use. This is one of the most critical aspects of being respectful of a non-binary person, as the name you may have been using may not reflect their gender identity. Don’t ask someone what their old name was.

• Try not to make any assumptions about people’s gender. You can’t tell if someone is non-binary simply by looking at them, just like how you can’t tell if someone is transgender just by how they look.

• If you’re not sure what pronouns someone uses, ask.

• Advocate for non-binary friendly policies.

• Understand that, for many non-binary people, figuring out which bathroom to use can be challenging. For many non-binary people, using either the women’s or the men’s room might feel unsafe, because others may verbally harass them or even physically attack them. Non-binary people should be supported by being able to use the restroom that they believe they will be safest in.

Gender-affirming care and the role of psychotherapy

• Exploring gender identity, role, and expression

• Provide psychoeducation

• Addressing the negative impact of gender dysphoria and stigma on mental health

• Facilitating a coming out process

• Alleviating internalized transphobia

• Enhancing social and peer support

• Improving body image; or promoting resilience

• Treating co-existing mental health concerns

When searching for a therapist to support your child, consider asking some of these questions before scheduling the appointment

• What clinical experience do you have with trans/NB youth?

• What percentage of your clients are trans/NB?

• How often are you focusing your Continuing Education on trans/NB health?

• Do you work within an informed consent model of transgender healthcare?

Hormone Replacement Therapy can seem scary and permanent. Hormone Blockers can be a safe alternative for HRT if started early

If all of this information has you feeling overwhelmed, confused, or anxious, that's OK. Take a deep breath. Now take a second deep breath and remember the beginning of this post.


Listen to your child, express your support, and work together through this transitional developmental stage. Make an appointment with a therapist if they ask and find a therapist for yourself if you need support too.

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