The AusPATH [Australian Professional Association for Trans Health] Position Statement on "Rapid Onset Gender Dysphoria" (ROGD)

Published September 30, 2019. Shared here in its’ entirety.

“The Australian Professional Association for Trans Health (AusPATH) was established in 2009 and is Australia’s peak body for professionals involved in the health, rights and well-being of trans, including gender diverse and non-binary (TGDNB), people. The AusPATH membership comprises approximately 250 experienced professionals working across Australia.

“The term “Rapid Onset Gender Dysphoria (ROGD)” is not a diagnosis or health condition recognised by any major professional association, nor is it listed as a subtype or classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD). Therefore, “ROGD” is an acronym describing a proposed phenomenon, with insufficient peer-reviewed scientific evidence to support its implementation and/or use within clinical, community, social and legal settings1.

“AusPATH affirms the rigorous processes by which diagnoses are developed and applied. These academic and clinical processes operate within professional medical organisations, and are developed by expert working groups of  scientists, clinicians, and stakeholders over long periods of time, with high levels of scientific scrutiny of the evidence-based literature. “ROGD” does not meet this standard, and therefore is not recognised by AusPATH.

“Whilst many have a clear picture of their gender from a very early age, for others the journey towards understanding their gender is more prolonged. The timing of when an individual discloses their gender to others is a separate consideration and does not necessarily reflect the development of their experienced gender. Many do not disclose their identity, rather hiding it for fear of negative reactions from others, including family rejection, discrimination, stigmatisation and social exclusion. The term “Rapid Onset Gender Dysphoria” is not, and has never been, a diagnosis or health condition but has been used in a single report describing parental perception of their adolescent’s gender identity without exploration of the gender identity and experiences of the adolescents themselves.

“AusPATH encourages continued scientific exploration within a culture of academic freedom, not censorship. All TGDNB people are deserving of gender-affirmative, evidence-based care that is underpinned by contemporary, adequately endorsed and community engaged standards of care and clinical guidelines.

“AusPATH recognises the harms caused by conversion, reparative and aversion treatments and opposes any such efforts to invalidate an individual’s experienced gender. AusPATH supports affirmative responses to young people whereby self-reported gender is respected, and young people are able to safely explore their gender and expression without judgment, pathologisation or predetermined outcome. AusPATH urges caution in the use of any term that has the potential to invalidate a person’s gender.

  1. WPATH (World Professional Association for Transgender Health) position on “Rapid-Onset Gender Dysphoria (ROGD)”4 September 2018

A Viral Fake News Story Linked Trans Health Care to 'Thousands' of Deaths

A Viral Fake News Story Linked Trans Health Care to ‘Thousands’ of Deaths

Hormone blockers used by some transgender people have multiple uses, including treating prostate cancer in terminally ill patients.

To be clear: Lupron has been widely used in thousands of trans youth, and members of the Gender Dysphoria Affirmative Working Group are NOT AWARE OF ANY DEATHS attributable to Lupron use in trans and gender noxnbinary youth.

As people may have already seen, an ultra conservative Catholic website (Lifesite News) spread misleading news that some 6,300 deaths over 40 years were attributed to leuprolide acetate (Lupron), a medication also used as a puberty blocker in trans youth. Articles and other information released about this issue minimized or did not mention that Lupron is commonly used in palliative care for long-term and terminally ill cancer patients, and instead implied that this medication has been widely killing transgender youth. Multiple conservative outlets further distributed this story (including Breitbart and Daily Wire). We have become aware that parent groups have reported this article (and similar ones reflecting the same misinformation) being sent by "well meaning" relatives to parents of trans youth. We also are concerned that this issue will be used as a ‘talking point’ in other venues like school board meetings and such by those opposed to policies supporting trans youth.

Thus far only one article in mainstream journalism outlet has debunked this misleading press. The "good" article is linked below.

Sadly, we all may be obligated to push back against the further discrimination, hatred, and transphobia only encouraged by these stories. We encourage you to remember that affirmative care - including puberty blockers such as Lupron - have been demonstrated to have vastly improved outcomes for trans youth including dramatic decreases in depression, anxiety, substance use, school dropout, obesity, smoking rates, suicidal ideation and gestures.

“A recent article published by Catholic news outlet LifeSiteNews alleged that the drugs used to treat gender dysphoria in some transgender children are linked to “thousands” of deaths.

“The story went viral on right-wing news websites such as the Christian Postand the Daily Wire. According to CrowdTangle, a social media metric platform, these posts — including shares by Daily Wire founder Ben Shapiroand commentator Matt Walsh— are currently some of the top performing LGBTQ-related content on Facebook and Twitter.

“The problem is: the “thousands” of people who die while taking these drugs are likely the terminally ill cancer patients who receive hormone blockers to fight hormone-sensitive cancers, like prostate cancer, according to experts.”

OUT Health and Wellness Transgender 'conversion therapy' associated with 'severe psychological distress'

Transgender 'conversion therapy' associated with 'severe psychological distress'

A study in JAMA Psychiatry is one of the first to highlight the psychological impact of efforts to change a trans person’s gender identity.

A new large-scale study linking conversion therapy - an approach founded on disaffirming a person’s self-identified gender or sexual orientation - is directly link to a sharp increase in suicidal ideation and attempts.

Find more about the benefits of affirmative care, and the risks of disaffirming approaches, at our website:

And follow us on Facebook for regular updates:


“Exposure to "conversion therapy" — efforts by a secular or religious professional to change a transgender person’s gender identity — is associated with thoughts of and attempts at suicide, according to a study published Wednesday in the journal JAMA Psychiatry…”

“…But this was novel, he said, because of its large sample size — over 27,000 transgender people responded to the survey — and its broad approach to identifying past efforts to change participants’ gender identity...”

“…Turban said that previous reports showing the negative effects of conversion therapy, also known as “ex-gay therapy” or “reparative therapy,” have focused on efforts to change a person’s sexual orientation…”

“But this was novel, he said, because of its large sample size — over 27,000 transgender people responded to the survey — and its broad approach to identifying past efforts to change participants’ gender identity...”

“"The term 'conversion therapy' is a misnomer,” Keuroghlian noted. “It suggests that conversion efforts are a legitimate therapeutic practice, even though we are finding that this practice is associated with significantly increased risk of harm, including serious psychological distress and potentially fatal suicide attempts.””

Presentation by the WPATH Standards of Care 8 Child Chapter Working Group

On September 7, 2019, members of the Standards of Care Version 8 - Child Chapter Working Group delivered a presentation at the US Professional Association of Transgender Health conference in Washington DC. This presentation outlined a significant move toward far more affirming philosophies of care, which will appear in the upcoming SOC V8.

Find more information on Affirmative Care for transgender and gender noxnbinary youth and adolescents at our website:

And follow us on Facebook for regular updates: @gdaffirmative

As reported by community rapporteur Lotus Đào, and Dr. Asa Radix, Co-Chair of the SOC8 Review Committee, member of the Board of Directors of the World Professional Association of Transgender Health and the US Professional Association of Transgender Health:

On September 7th, 2019, members of the WPATH Standards of Care 8.0 Child Chapter Working Group presented on "Prepubescent Gender Diversity: Complexities and Recommendations." Presenters opened by sharing the working group's process and naming the complexity of working within a global context in an specialty with few expertise. Following a brief research summary, presenters established a foundation of child gender diversity as an expected aspect of general human diversity, rather than a pathology.

Furthermore, gender identity should not be conflated with gender expression. In fact, research indicates that many young children exhibiting extensive gender expansive behavior while feeling cohesive with their gender identity are likely to evolve to be gay or queer by adolescence, not transgender. In addition, gender identity is sometimes static, and sometimes fluid. Some children know from a very young age who they are and their gender identity is static throughout their lifetime. For other children, their gender identity may change over time. Presenters encouraged providers and community members to practice respect and sensitivity in honoring children where they are at and releasing the cultured need to predict a child's gender identity and presentation. In regards to the mental health provider's role in working with gender expansive children, presenters emphasized that gender expansive children should not be required to be in therapy. However, guidance from mental health providers are often helpful, especially if there are external stressors (family, school, region) or the child is interested in medical treatment.

The presenters provided recommendations for providers around advocacy, including educating and supporting gender diversity is expected and not pathological; acknowledging and addressing privilege and frequent intentional and/or unintentional negating of gender diverse experience; working in partnership with schools and childcare programs to sensitive educational providers to importance of gender affirmative practices to promote curricula; and more.

Presenters shared a much anticipated report of the SOC 8 Core Competency Recommendations, which are not finalized, including compenents on Training/Credentials, Gender Development, Child/Family Mental Health, Assessment, Therapuetic Interventions, Autism and Gender, Research Knowledge and Continuing Education. Ultimately, presenters urged attendees to promote gender literacy with gender expansive children, including identifying oppressive and violent environmental messaging around gender and critically examine whether or not it is authentic. Furthermore, presenters recommended providers to not fixate on pathology or force "transgender" onto gender expansive children, but to incorporate "play" and "fun" as important aspects of working with children.

Statement from Brown University School of Public Health Faculty Members Committed to LGBTQI Affirmative Health Research

We at the Gender Dysphoria Affirmative Working Group wish to thank these distinguished faculty from Brown University School of Public Health for openly and directly speaking out to the Rapid Onset Gender Dysphoria ‘controversy’. We respect and appreciate their commitments to scientific honesty and rigor, to creating an environment of compassion and openness, to the necessity to include members of the trans and gender nonbinary community in all work done about the trans and nonbinary community, and to the health and wellbeing of trans and gender nonbinary people worldwide.

A few notable quotes:

“… [W]e write this letter as individual scientists and educators—who benefit from academic freedom—to publicly acknowledge the health-related harms and consequences of a lobby that seeks to undermine the legitimacy of transgender experiences. We also write this letter to state and underscore our commitment to uplift transgender and gender diverse communities through our research, scholarship, teaching, and service.”

“…The ROGD lobby has worked to undermine the experiences and identities of transgender and gender diverse individuals, with the potential for dire health consequences.”

“The ROGD lobby is also threatening transgender individuals’ rights via healthcare practice and public policy.”

“It is well-documented that being affirmed in one’s gender identity yields mental health benefits. Thus, we are committed to creating a safe and gender-affirming educational space for our students, staff, and fellow faculty of all genders, gender expressions, and sexual orientations.” 

“We also recognize that research is best conducted withnot onmembers of the population of interest. Thus, we are committed to carrying out our research in accordance with best practices for community-engaged research.”

“We also recognize the importance of having research agendas developed and implemented bytransgender and gender diverse communities. Thus, we are committed to building a pipeline of transgender students, fostering an environment where transgender and gender diverse students can thrive, and mentoring and training future generations of transgender and gender diverse researchers.

“Finally, an essential responsibility of learned communities is to contribute to social good by amplifying the voices of vulnerable populations. Thus, we affirm our unwavering commitment to transgender and gender diverse communities and the highest standards of ethical, rigorous, and affirming research and practice.”

We encourage the Brown University School of Public Health and Brown University as a whole to issue similar statements in the near future. 

Counterpoint: Pediatric gender care is safe and necessary

While not research, this is a well written piece, concisely outlining the issues and why evidence-based, affirmative care for trans and gender nonbinary youth is safe and effective, and the current standard of care.

Published in: Star Tribune. June 25, 2019. Authors: KATHLEEN MILLER , MARLA EISENBERG , AMY GOWER AND G. NIC RIDER.

"Transgender and nonbinary youths experience persistent and significant distress when forced to conform to the gender they were assigned at birth. They face substantial health disparities, with higher rates of depression, suicide attempts, substance use, bullying and unprotected sexual encounters than their cisgender (i.e., not transgender) peers. However, research shows that these health outcomes are related to stigma, rather than the simple fact of being transgender or nonbinary. This is a subtle, but critical, distinction: Negative health outcomes are not intrinsic to being trans and nonbinary. Rather, daily experiences of discrimination and harassment lead to poor health outcomes..."

"The medical and research community supports gender affirming medical care as a powerful tool to improve the lives of children and adolescents who are transgender or nonbinary. There is ample and growing evidence that children and adolescents have better health outcomes when they are supported in their gender, which includes access to medical interventions when appropriate. As clinicians and pediatric researchers, we firmly support expanding access to gender affirming care for youth."

Don Cheadle Makes Powerful Fashion Statements On ‘SNL’

The Gender Dysphoria Affirmative Working Group would like to thank Saturday Night Live and actor Don Cheadle for their clear and visible statement in support of trans and gender nonbinary youth... some of the most vulnerable in our world today.

Don Cheadle Makes Powerful Fashion Statements On ‘SNL’

The award-winning actor offers support for transgender kids and takes a slap at Donald Trump.


By Carla Baranauckas

“Award-winning actor Don Cheadle had more than laughs on his mind when he hosted “Saturday Night Live” this weekend. And he made that clear with some of his wardrobe choices.”

“When he introduced Gary Clark Jr., the show’s musical guest, Cheadle wore a T-shirt that said, “Protect Trans Kids.” “

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

The 2018 Australian SOC for Trans and Gender Diverse Children and Adults... a very strongly affirming document based on the latest research making clear that affirmative treatment approaches - in which the youth's identity is respected and supported, where the youth are provided the freedom and safety to explore their gender without judgment - yield much happier and better adjusted youth and young adults. It also makes clear that disaffirming approaches are unethical and may cause harm.

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

Authors: M.M. Telfer, M.A. Tollit, C.C. Pace, & K.C. Pang.   2018.  

“Being trans or gender diverse is now largely viewed as part of the natural spectrum of human diversity. It is, however, frequently accompanied by significant gender dysphoria (GD), which is characterised by the distress that arises from incongruence between a person’s gender identity and their sex assigned at birth. It is well recognised that trans and gender diverse individuals are at increased risk of harm because of discrimination, social exclusion, bullying, physical assault and even homicide. Serious psychiatric morbidity is seen in children and adolescents. A study of the mental health of trans young people living in Australia found very high rates of ever being diagnosed with depression (74.6%), anxiety (72.2%), post-traumatic stress disorder (25.1%), a personality disorder (20.1%), psychosis (16.2%) or an eating disorder (22.7%). Furthermore 79.7% reported ever self-harming and 48.1% ever attempting suicide.”


“Increasing evidence demonstrates that with supportive, gender affirming care during childhood and adolescence, harms can be ameliorated and mental health and wellbeing outcomes can be significantly improved.”


“Understanding and using a person’s preferred name and pronouns is vital to the provision of affirming and respectful care of trans children and adolescents.  Providing an environment that demonstrates inclusiveness and respect for diversity is essential... Some children or adolescents may request use of a preferred name or pronoun only in certain circumstances, such as when their parents are, or are not, present in the room. This is important to respect and enact to enable optimal patient-clinician engagement, and ensure confidentiality and patient safety.”


“Avoiding harm is an important ethical consideration for health professionals when considering different options for medical and surgical intervention. Withholding of gender affirming treatment is not considered a neutral option, and may exacerbate distress in a number of ways including increasing depression, anxiety and suicidality, social withdrawal, as well as possibly increasing chances of young people illegally accessing medications.” 


“In the past, psychological practices attempting to change a person’s gender identity to be more aligned with their sex assigned at birth were used.  Such practices, typically known as conversion or reparative therapies, lack efficacy, are considered unethical and may cause lasting damage to a child or adolescent’s social and emotional health and wellbeing.”


Young Trans Children Know Who They Are

Young Trans Children Know Who They Are: A new study shows that gender-nonconforming kids who go on to transition already have a strong sense of their true identity—one that differs from their assigned gender.

Published in: The Atlantic. January 15, 2019. Author: Ed Yong

“This study provides further credence to guidance that practitioners and other professionals should affirm—rather than question—a child’s assertion of their gender, particularly for those who more strongly identify with their gender,” says Russell Toomey from the University of Arizona, who studies LGBTQ youth and is himself transgender…”

““When the 85 gender-nonconforming children first enrolled in Olson’s study, her team administered a series of five tests that asked what toys and clothes they preferred; whether they preferred hanging out with girls or boys; how similar they felt to girls or boys; and which genders they felt they currently were or would be. Together, these markers of identity gave the team a way to quantify each kid’s sense of gender.”

“The team, including James Rae, now at the University of Massachusetts Amherst, found that children who showed stronger gender nonconformity at this point were more likely to socially transition. So, for example, assigned boys who had the most extreme feminine identities were most likely to be living as girls two years later. This link couldn’t be explained by other factors, such as how liberal the children’s parents were. Instead, the children’s gender identity predicted their social transitions. “I think this wouldn’t surprise parents of trans kids, and my findings are often ‘duh’ findings for them,” says Olson. “It seems pretty intuitive.””

“…“The findings of this compelling study provide further evidence that decisions to socially transition are driven by a child’s understanding of their own gender,” says Toomey. “This is critically important information given that recent public debates and flawed empirical studies erroneously implicate ‘pushy’ parents, peers, or other sources, like social media, in the rising prevalence of children and adolescents who identify as transgender.””

Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth

Even something as “simple” as using a trans youth’s chosen/preferred/self-identified name can be a very powerful intervention with clear positive outcomes. And don’t we want our youth to have less depression, anxiety, and suicidal ideation?

Published in: Journal of Adolescent Health. October, 2018. Authors: Stephen T. Russell, Amanda M. Pollitt, Gu Li, Arnold H. Grossman.

“Transgender youth whose gender expression and names do not appear to match may be vulnerable to unintended disclosure or “outing,” and to discrimination or victimization, factors that could lead to mental health problems [1]. The purpose of the current study was to examine the relation between chosen name use, as a proxy for youths' gender affirmation in various contexts, and mental health among transgender youth.”

“We asked transgender youth whether they had a preferred name different from the name they were given at birth, and, if yes, asked, ‘are you able to go by your preferred name’ at home (n = 54), at school (n = 57), at work (n = 50), or with friends (n=69).”

“…chosen name use in more contexts predicted fewer depressive symptoms and less suicidal ideation and suicidal behavior. An increase by one context in which a chosen name could be used predicted a 5.37-unit decrease in depressive symptoms, a 29% decrease in suicidal ideation, and a 56% decrease in suicidal behavior. We observed similar results when we individually tested specific contexts for chosen name use (except that chosen name use with friends did not significantly predict mental health after adjusting for demographics and close friend support). Depressive symptoms, suicidal ideation, and suicidal behavior were at the lowest levels when chosen names could be used in all four contexts.”

Recognising the needs of gender variant children and their parents

Recognising the needs of gender variant children and their parents

Published in: Sex Education: Sexuality, Society and Learning.  2013.  Authors: Elizabeth A. Riley, Gomathi Sitharthan, Lindy Clemson & Milton Diamond

“The data in the present study suggest that even when gender-variant children actively endeavour to conform, their efforts are often thwarted by individuals who seek to marginalise and victimise them for their difference. Children therefore suffer from an invisibility and lack of recognition of their needs, on the one hand, and (in some cases) a violation of their personal boundaries that can foster a general anxiety, on the other. The well-documented need of all children for acceptance and affirmation places even more responsibility on adults to be compassionate and make provisions for gender-variant children.”

The Needs of Gender-Variant Children and Their Parents According to Health Professionals

Another article outlining that more supportive, nurturing, and affirming perspectives on a youth’s self-reported gender identity are needed to support both the youth and their parents.


Published in: International Journal of Transgenderism.  March 4, 2013.  Authors: Elizabeth Anne Riley, Gomathi Sitharthan, Lindy Clemson & Milton Diamond

“The issues that gender-variant children face highlight consistent deficits and negativity in the children’s lives and focus our attention to the extraordinary burden placed on gender-variant children in their formative years. A report by Grant et al. (2010) describes in detail the extraordinary levels of harassment, physical assault, and sexual violence experienced by transgender children in years during primary and high school. These issues, if unable to be alleviated, are likely to present ongoing and accumulative difficulties that then impact their lives as adults.”

“… The needs of parents overwhelmingly feature the various types of support that would help parents become informed, be able to cope, and make the best decisions for their child. Societal and community support appear to be crucial factors for parents to comfortably engage with the tasks required of them to support their child.”

“… The needs of gender-variant children identified from the professionals’ responses revealed a lack of respect for the rights of children who experience gender variance. The most frequently mentioned needs were to be accepted and supported; to be heard, respected, and loved; to have professional support and recognition; to be allowed to express their gender; to feel safe and protected; to live a normal life; to have peer contact; to have school support and; to have access to puberty-delaying hormones. The needs of the parents focused primarily on areas of support and professional assistance, namely, the need for emotional support and guidance; education and information; support from society, local community, friends, and family; competent knowledgeable professionals; diagnosis, treatment, and beneficial outcomes for their children; peer support; support, understanding, and acceptance from schools; and research.”

“Together, these findings call for education programs to provide knowledge and exposure to the issues that transgender people face, across such sectors as medicine, mental health, and teaching in schools. The targeted education of medical and counseling professionals, the inclusion of printed materials in doctors’ surgeries, and the distribution of best practice guidelines and training in schools would signal a major change across the professional and community sectors that the needs of transgender children are being taken seriously.”

Social Support Networks for LGBT Young Adults: Low Cost Strategies for Positive Adjustment

A study demonstrating that family support is essential in the wellbeing of LGBTQ+ youth.

Published in: Family Relations.  July, 2015.  Authors: Shannon D. Snapp, Ryan J. Watson, Stephen T. Russell, Rafael M. Diaz, Caitlin Ryan.

“Our study adds to the growing body of evidence that family support, both general and sexuality specific, is a crucial factor in LGBT youth’s health and well-being…”

“Two variables were most relevant in predicting adjustment: (a) the percentage of friends who knew about participants’ sexual or gender identity and (b) support related to being LGBT from friends. The presence of a network of friends to whom youth can be out has been linked to measures of health and well-being…”

“Although friendship support is clearly associated with positive well-being in young adulthood, it appears that family acceptance has a stronger overall influence when other forms of support are considered jointly.”

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.”

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