Surviving a Gender Variant Childhood: The Views of Transgender Adults on the Needs of Gender Variant Children and Their Parents

Published in: Journal of Sex & Marital Therapy. 2012. Authors: Elizabeth Anne Riley, Lindy Clemson, Gomathi Sitharthan, Milton Diamond.

“… the needs of children that emerged were most notably, for parents, school staff and other authority figures to be educated so that children do not need to ‘hide’ themselves and their gender expression for fear of adversity. The participants also expressed their need as children to be able to speak about their feelings, to have their gender expression accepted, to be recognised, to be protected, to be given the opportunity to know others with similar feelings and for their parents to be open-minded, able and willing to accept their gender variant children. This study identified that the participants’ parents primarily needed access to information and educated professionals, particularly in schools, counselling and medical contexts. Exposure to successful transgender people and access to parent support groups was also seen as a need to help parents become more accepting of their children's diversity. The need for family and wider support was mentioned as a need for both the gender variant children and the parents as some participants felt that even though support of their parents was necessary, it was not enough for them to live happily and safely within the broader society.”

“The need for ‘health literacy’ was highlighted as tool to empower individuals, in this case, parents, to respond effectively in addressing the issues with regard to their gender variant children. In particular, allowing confidence to approach professionals for support with their own and their child's emotional, physical and social well-being….”

“… it appears that living in a society where punishment is customary for lack of conformity to gender stereotypes creates a lifelong struggle and sometimes ‘withdrawal’ that caused some participants great distress and impacts on their self-esteem and ability to thrive.”

The Needs of Gender-Variant Children and Their Parents: A Parent Survey

The Needs of Gender-Variant Children and Their Parents: A Parent Survey

Published in: International Journal of Sexual Health. 2011. Authors: Elizabeth Anne Riley, Gomathi Sitharthan, Lindy Clemson, Milton Diamond.

“The results of this study support the development of affirmative approaches in supporting gender-variant children and their parents. This is particularly evidenced by the parents’ own approaches to supporting their children where parents experimented with different ways of responding to various scenarios and realized that acceptance of their child was the only option as they learned that their child’s need for expression was not changed by their attitude or management of the behavior.”

Mental Health and Self-Worth in Socially Transitioned Transgender Youth

Socially transitioned youth do better than those who do not transition, and do not show higher level of depression or anxiety than their peers or siblings.

Published in the Journal of the American Academy of Child and Adolescent Psychiatry. February 10, 2017. Authors: Lily Durwood, Katie A. McLaughlin, Kristina R. Olson.

“We found remarkably good mental health outcomes in socially transitioned transgender children in the present study. Transgender children reported normative rates of depression and slightly increased rates of anxiety. Rates of depression in transgender children did not differ significantly from those in siblings of transgender children or from those in age- and gender-matched controls, although rates of anxiety were marginally higher. Parents’ reports of their children’s depression and anxiety largely mirrored the children’s reports, although parents of transgender children reported slightly higher anxiety in their children than the children did…”

“Our findings of normative levels of depression, slightly higher rates of anxiety, and high self-worth in socially transitioned transgender children stand in marked contrast with previous work with gender-nonconforming children who had not socially transitioned. Those studies overwhelmingly reported markedly higher rates of anxiety and depression and lower self-worth, with disproportionate numbers of children in the clinical range.”

High School Gay-Straight Alliances (GSAs) and Young Adult Well-Being: An Examination of GSA Presence, Participation, and Perceived Effectiveness

Yet one more study outlining the importance of LGBTQ+ youth having the opportunity to associate with each other. Rather than making youth LGBTQ+ through ‘social contagion’, contact with other LGBTQ+ youth is protective and aids with development and health.

Published in: Applied Developmental Science. 2011. Authors: Russell B. Toomey, Caitlin Ryan, Rafael M. Diaz & Stephen T. Russell.

“… there appear to be positive associations between GSAs and well-being and educational attainment. Our finding that students who were in schools with GSAs were more likely to obtain a college education underscores the potential impact on educational achievement and socioeconomic and occupational status as an adult. In addition, given the heightened attention to suicides of young males who were known or perceived to be gay and bisexual that have been linked to anti-gay harassment at school (e.g., Katz, 2010), our findings point to GSAs as a potential context for reducing this risk – at least at low levels of LGBT school victimization - given the significant interaction between GSA participation and LGBT school victimization on lifetime suicide attempts.”

“In sum, our findings suggest that school administrators and personnel should be supportive in helping students to form and facilitate GSAs in schools as a potential source of promoting positive development for this underserved population. “

Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population

Continuing on the theme of the need for peer support: While proponents of “Rapid Onset Gender Dysphoria” might argue that exposure to other youth is what spreads the ‘social contagion’, connections to peers is a key in these youth being resilient.

Published in: American Journal of Public Health. May, 2013. Authors: Walter O. Bokting, PhD, Michael H. Miner, PhD, Rebecca E. Swinburne Romine, PhD, Autumn Hamilton, HSD, and Eli Coleman, PhD.

“… family support, peer support, and identity pride all were negatively associated with psychological distress, confirming that these assets are protective factors. Moreover, peer support significantly moderated the relationship between enacted stigma and psychological distress, thus emerging as a demonstrated factor of resilience in the face of actual experiences of discrimination.”

“Together, these results offer support for the value of transgender individuals connecting with similar others, possibly providing the opportunity to question stigma from the majority culture and reappraise their experiences in a self-affirmative way… This finding is particularly pertinent because previous research found that transgender people have higher levels of depression and lower levels of peer and family support than their gay, lesbian, and bisexual counterparts. These results support a need to promote resilience by facilitating ample peer support.”

Describing Roles that Gay-Straight Alliances Play in Schools

Yet another study making clear the link between supporting LGBT youth and better mental health outcomes...

Published in: Addictive Behaviors. April 2014. Authors: Nicholas Heck, Nicholas Liivngston, Annesa Fletne, Katherine Oost, Brandon Steward, Bryan Cochran

"After controlling for demographic variables and risk factors associated with illicit drug use, the results of 12 logistic regression analyses revealed that LGBT youth attending a high school without a GSA evidenced increased risk for using cocaine... hallucinogens... and marijuana... relative to peers attending a high school with a GSA. Youth without a GSA also evidenced increased risk for the misuse of ADHD medication... and prescription pain medication. The present findings underscore the importance of providing LGBT youth with school-based support groups and highlight the potential damaging effects of not having these resources in our nation's schools."


  • "Assessed association between high school gay-straight alliances (GSA) and illicit drug use."

  • "LGBT youth evidence lower risk for illicit substance use when their school has a GSA."

  • " Inclusive school-based programs may be protective factors for LGBT youth."

"These findings extend the research base related to GSAs and further demonstrate the importance of providing LGBT youth with opportunities for socialization and support within the school setting."

Demographic and Psychosocial Factors Associated With Psychological Distress and Resilience Among Transgender Individuals

Published in: The American Journal of Public Health. October, 2015. Authors: Emily Bariola, BA, Anthony Lyons, PhD, William Leonard, BSc, BA, Marian Pitts, PhD, Paul Badcock, PhD, and Murray Couch, BA.

“The findings indicated that, relative to other sources, family of origin may have the most influence in protecting against psychological distress… our findings support a need to encourage family members to be open and receptive sources of support.”

“…frequent contact with LGBT peers was revealed as a significant [protective] factor… for transgender individuals, frequent peer contact may be particularly important for developing individual resilience, as gender transitioning can be a complex and challenging process and having peers who share similar experiences may provide not only a sense of support and understanding, but also a sense of belonging.”

Why Parents of Trans Kids Are A Special Kind of Tired

Not research, but a really lovely piece on being a parent to a trans or nonbinary youth. Hopefully this helps some of the parents who might need some support.

Why Parents of Trans Kids Are A Special Kind of Tired

Yes. All parents walking the earth are tired.

We are all absolutely in solidarity with that fact.

We could all use about a week on a deserted island without any children, technology, or responsibilities of any kind.

But I feel the need to tell you about the special kind of tired that parents of transgender kids are experiencing.

It’s different than most versions of tired.

And this isn’t to “one-up”. And this certainly isn’t to take away from an LGBTQIA child themselves, their own struggles and hardships. This isn’t to take away from, or distract from… anyone.

This isn’t a competition.

This is just to simply explain and shed light on how we’re feeling, since it’s of my belief that we, the parents of trans youth, are living in our own marginalized community.

Read the rest:

Access to GSAs Yields Happier, Better Adjusted Youth...

Contrary to current research, proponents of “Rapid Onset Gender Dysphoria” have argued that the trans identity in some youth could possibly be due to “social contagion” (ie being around youth who identify as trans and taking on the identity themselves though it is not authentic) and thereby urge parents be cautious when around allowing trans youth access to their peers via friends, GSAs, and online resources, so as to limit their exposure to the “contagion”.

There is extensive literature to document that social supports - these same friends, GSAs, and online resources - actually improve the lives and outcomes for these youth. Below is a piece from the publication of the American Federation of Teachers.

Gay-Straight Alliances

Promoting Student Resilience and Safer School Climates

Published in: American Educator. Winter 2016-2017. Author: V. Paul Poteat.

“Students in schools with GSAs report lower mental and physical health concerns, greater overall well-being, less drug use, less truancy, and greater perceived school safety than students in schools without GSAs. These findings now have been documented across a range of studies at local and national levels. Other studies have recorded feedback from GSA members who attribute instances of personal growth and empowerment, as well as a range of other positive experiences, to their GSA involvement.”

Three Studies for our French Speaking Friends...

« Pour des intervention anti-oppressives auprès des jeunes trans : nécessités sociales, évidences scientifiques et recommendations issues de la pratique».

Médico, D. et Pullen Sansfaçon. (2017) Service social. Volume 63, Numéro 2, 2017, p. 21–34 

"Les pistes d’intervention doivent donc non seulement soutenir les jeunes, mais également leur famille et leur entourage. Elles doivent s’inscrire dans une vision plus structurelle et politique en facilitant les changements nécessaires pour rendre la société plus inclusive.” 

« Parentalité et jeunes transgenres : une exploration des enjeux vécus et des interventions à privilégier »

Pullen Sansfaçon, A. Santé mentale au Québec, 2016, Vol. 40 (3) pp 93-197 

"Bien que certains débats sur ces questions perdurent, on observe que les associations professionnelles, de plus en plus, reconnaissent l’importance des approches transaffirmatives visant l’autodétermination de la personne, d’une part, et le soutien du jeune et de sa famille dans le processus d’acceptation, d’autre part.” 

« L’éthique de la reconnaissance comme posture pour travailler avec les jeunes trans »

Pullen Sansfaçon, A. et Bellot C. (2017). Nouvelles pratiques sociales, Vol 28(2) pp 38- 53 

"L’approche transaffirmative devient alors un cadre d’intervention par lequel les professionnels, et notamment les travailleurs sociaux, pourraient soutenir à la fois l’accompagnement des jeunes dans leur affirmation de genre, soutenir leurs familles et les institutions et milieux qu’ils fréquentent, mais aussi de manière collective, soutenir la lutte pour la reconnaissance de la fluidité des identités de genre, ainsi que les enjeux de tolérance et de respect des individus pour soutenir la promotion d’une société plus juste.” 

Trans Youth: Digging Beneath the Surface: Factors That Facilitate Or Impede Trans Youth Well-being in Quebec

“Quebec has one of the leading identity-affirming clinics for trans kids, the Gender Variance Clinic of the Mon- treal Children’s Hospital. This fact sheet aims at presenting oppressive factors and structures that negatively influence the well-being of trans youth as well as aspects that contribute to it…”

  • “Experiences and Dynamics in the Healthcare System: Healthcare system is a primary contributor to participants’ well-being (gender specific or general care), yet, resources in this system are not trans affirmative. Indeed, because of their gender identity, even when the services they are seeking are not transition-related, barriers to access and fear of negative treatment from healthcare professionals are an issue…”

  • “Other Institutional Spaces: Schools, Child Protection Services, Justice System - Participants feel that those institutions are positive in their lives as long as they are affirming of their identity…”

  • “Family relations and Other Social circles: Family support, in the form of feeling loved, accepted, and supported by immediate and extended family, is a significant resource to help participants cope with difficulties in other spheres of their lives. However, family can also be a source of fear and anxiety (when being rejected, or kicked out). Explicit lack of parental support is detrimental to participants’ well-being…” 

  • “Community spaces: Trans youth identified trans and LGBTQ+ non-governmental organizations (NGOs), support agencies, and other community spaces as an important source of support and information (student unions for example). Online spaces (social medias and web) were also identified as important to affirm their identity…”

Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents.

Published By: The American Academy of Pediatrics. September 17, 2018.

“Supportive involvement of parents and family is associated with better mental and physical health outcomes. Gender affirmation among adolescents with gender dysphoria often reduces the emphasis on gender in their lives, allowing them to attend to other developmental tasks, such as academic success, relationship building, and future-oriented planning. Most protocols for gender-affirming interventions incorporate World Professional Association of Transgender Health and Endocrine Society recommendations and include ≥1 of the following elements:

“Social Affirmation: This is a reversible intervention in which children and adolescents express partially or completely in their asserted gender identity by adapting hairstyle, clothing, pronouns, name, etc. Children who identify as transgender and socially affirm and are supported in their asserted gender show no increase in depression and only minimal (clinically insignificant) increases in anxiety compared with age-matched averages…

“Legal Affirmation: Elements of a social affirmation, such as a name and gender marker, become official on legal documents, such as birth certificates, passports, identification cards, school documents, etc…

“Medical Affirmation: This is the process of using cross-sex hormones to allow adolescents who have initiated puberty to develop secondary sex characteristics of the opposite biological sex…

“Surgical Affirmation: Surgical approaches may be used to feminize or masculinize features… These changes are irreversible. Although current protocols typically reserve surgical interventions for adults, they are occasionally pursued during adolescence on a case-by-case basis, considering the necessity and benefit to the adolescent’s overall health…”…/09/13/peds.2018-2162

Family Rejection as a Predictor of Suicide Attempts and Substance Misuse Among Transgender and Gender Nonconforming Adults

Published in: LGBT Health. May 25, 2016. Authors: Augustus Klein and Sarit Golub.

"42.3% of [transgender adults] reported a suicide attempt and 26.3% reported misusing drugs or alcohol to cope with transgender-related discrimination… family rejection was associated with increased odds of both behaviors. Odds increased significantly with increasing levels of family rejection."

Analysis finds strong consensus on effectiveness of gender transition treatment

Published in: Cornell Chronicle. April 9, 2018

"Of 56 peer-reviewed studies, 52 (93 percent) found that gender transition improves the overall well-being of transgender people. The other 7 percent reported mixed or null findings. None of the reviewed studies showed that gender transition harms well-being."

"The positive outcomes of gender transition and related medical treatments include improved quality of life, greater relationship satisfaction, higher self-esteem and confidence, and reductions in anxiety, depression, suicidal tendencies and substance use."

"The positive impact of gender transition has grown considerably in recent years, as surgical techniques and social support have improved."

"Regrets following gender transition are extremely rare and have become increasingly rarer."

Gender nonconforming youth: current perspectives

"The gender affirmative model is defined as a method of therapeutic care that includes allowing children to speak for themselves about their self-experienced gender identity and expressions and providing support for them to evolve into their authentic gender selves, no matter at what age.”

Published in: Adolescent Health, Medicine and Therapeutics. 2017. Author: Diane Ehrensaft.

Why ‘Rapid-Onset Gender Dysphoria’ is bad science

Published in: March 22, 2018. Authors: Florence Ashley and Alexandre Baril.

“The unfounded idea of rapid-onset gender dysphoria is a poor attempt at manufacturing a new moral panic — based on the same old idea of “contagion” — over children who couldn’t be in safer hands.”