In a sign of growing acceptance for transgender children, a new survey conducted online by Harris Poll on behalf of the American Osteopathic Association finds 53% of American adults would support their teenage child’s request to transition to another gender.
Early intervention and family support are shown to improve mental, physical and emotional outcomes for children with gender dysphoria, broadly defined as a conflict between a person’s anatomy and the gender with which they identify.
The importance of family
“Parents have a significant role in raising transgender kids,” says Laura Arrowsmith, DO, who practices at a transgender clinic in Oklahoma. “Once they get on board—often after stages of denial, rejection, condemnation and grief—they become powerful advocates at school and with extended family. This is crucial to the child’s well-being.”
Historically, transgender youth and adults experience higher rates of homelessness, substance abuse, HIV infection, depression, anxiety, self-harm and thoughts of suicide than the general population. Rejection by family and community are considered the main catalysts for these issues.
“Watch your child for eating disorders, self-harm, substance abuse and suicidal tendencies,” says Dr. Arrowsmith. “A mental health counselor who is familiar with transgender people and local support groups can make all the difference.”
Transgender and gender-expansive children do best when their family helps them cope with social pressure and bullying while affirming their journey. Simple actions can ensure a child feels safe and loved. In many cases, patience, support and careful listening are the best ‘medicine’.
What parents need to know
“Trans children are living in a body that doesn’t match how they view themselves,” says Dr. Arrowsmith. “To address the dysphoria, some may wish to transition socially or to medically transition through gender-confirmation surgery and/or hormone treatment.”
For children who have not reached puberty, gender transition consists solely of social changes like name, pronoun and gender expression.
The clinical protocol for children indicates that when a child who has socially transitioned is “consistently” and “persistently insisting” they are transgender, they can be placed on puberty-blocking medications to postpone physical traits.
These medications prevent the child from developing the secondary sex characteristics of their birth gender, such as breasts for females or facial hair for males. Stopping the onset of puberty is reversible and makes medical treatment simpler if the patient decides to fully transition. On average, adolescents stay on the puberty-blocking medications from one to three years.
“We know that if a child persists through puberty in identifying as the sex not assigned to them at birth, then it’s pretty certain that they are transgender,” says Dr. Arrowsmith. “Should they decide to change course and stop the puberty-blocking medications, they will simply go through a delayed puberty of their birth gender.”
What parents can do
Parents should understand that early intervention eases transition. A young patient may choose to delay the onset of puberty through puberty blockers, which prevent biological changes and allow additional time to consider transitioning—or not. Adolescents who initiate hormone therapy prior to puberty do not require the same level of medical care as a fully developed adult. Females transitioning to males take testosterone while males transitioning to females receive estrogen with an androgen inhibitor. Unlike social transitioning and puberty suppression, hormone therapy is only partially reversible after puberty.
Parents first need to educate themselves on gender dysphoria, gender identity and the complexities of living transgender. Often, support groups are the turning point for families who are struggling with accepting their transgender children, says Dr. Arrowsmith. Once they meet other parents and see children who have transitioned, they are more likely to be supportive.
Support is available to guide families and children through gender transition. Depending on the person’s age and individual needs, the steps may include medical, social, surgical and legal changes. For more information, speak with your physician. Additional resources are available online, including the Human Rights Campaign’s detailed reference guide Supporting & Caring for Transgender Children.
This survey was conducted online within the United States by Harris Poll on behalf of American Osteopathic Association from June 20-22, 2017 among 2,192 adults ages 18 and older. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete survey methodology, including weighting variables, please contact Jessica Bardoulas.