Hi everyone, I’m Nora. My title at QueerDoc is “Facilitator Unicorn.” I do free introductory visits and care navigation visits, some administrative tasks, and coordinate the blog. I’m also a nonbinary parent to a nonbinary young adult. This month, the blog has been focused on youth and teens. Today, I want to talk about supporting trans teens and some of the things I’ve learned parenting a trans teen over the last several years (almost a decade now!) I’d like to thank Tess Kilwein, PhD for chatting with me as I pondered this blog and helping me to clarify some thoughts, and to thank my now thriving young adult for the honor of being a parent to them.
First and foremost, supporting your child can save their life. This is that important.
Adolescence and puberty are a rough time for almost everyone. It can be exponentially harder for gender diverse tweens and teens – they’re navigating changes in their bodies, which may or may not be emotionally devastating, at the same time they have new expectations and pressures put upon them from their parents, teachers, peers, media, and community. Many of these expectations are gendered, and may make things even harder for gender diverse younth.
Perhaps the most important lesson I’ve learned over the last several years is that we can’t control the future. We can’t even control the right now. Gender is different for everyone, and for some people, their sense of gender can change over time. That’s okay. I have worried – and I have met so many other parents who have worried – about doing the wrong thing while our kids are still developing. We worry if supporting them now – if allowing medical changes now – will hurt them in the future. That is irrelevant.
Some of our kids won’t have a future if we don’t support them now.
My goal as a parent is to help my kiddo develop tools to navigate the future, whatever the future may hold. Maybe my kid’s gender identity now isn’t what their gender identity will be in the future. I can’t predict that. But I can support them in exploring their gender(s) and support their well-being as best I can. If that includes interventions like blockers and/or hormones that reduce their right now risks, that’s what I am going to do.
Part of supporting trans teens is very practical:
Change their name in your phone and in your email contacts as soon as they ask you to use a new one. Practice saying their name and using their pronoun(s) when they’re not around. Know that you’ll probably slip up. Cry with them on the kitchen floor if they need to, and cry on your best friend’s kitchen floor if you need to. Do the best you can.
Here are some of the other things I’ve learned about gender, child development, the risks that trans youth face, and what I could do help my child navigate the route to adulthood. With support, trans teens are just as likely as cis teens to become happy and healthy adults. Without support, their chances are much bleaker.
Early Knowledge of Gender vs. Discovery at Puberty
Some people know their gender from their earliest memories. Theories of childhood development place gender awareness between two and four:
At about age two, children know about physical differences between the sexes.
A consistent sense of gender identity – the who am I of gender – often develops between two and four.
At the same time, children are learning about gender roles and what the outside world is telling them about how genders are expected to act, and they use play to explore those roles.
We are learning that gender diverse children’s identities are just as consistent and known as cis children’s identities.
They may not have the words to say (or feel the need to say) “I am/am not a girl/boy” but they do have a solid sense of who they are.
The freedom to explore gender, play with gendered expectations, and try on gendered roles often abruptly ends at puberty when bodies start to develop secondary sexual characteristics. Suddenly, gender may be a source of pain and possibly confusion – and may be a significant reason why so many transgender people realize something is wrong in their teens. As bodies develop, it becomes harder to just be when your body doesn’t match your interior sense of self.
If your teen comes out, it is a gift. They are sharing their truth.
Mental Health
Adolescence can also be a tumultuous time for mental health. From the World Health Organization:
One in six people are aged 10-19 years. Adolescence is a unique and formative time. Physical, emotional and social changes, including exposure to poverty, abuse, or violence, can make adolescents vulnerable to mental health problems. Protecting adolescents from adversity, promoting socio-emotional learning and psychological well-being, and ensuring access to mental health care are critical for their health and well-being during adolescence and adulthood.
Globally, it is estimated that 1 in 7 (14%) 10-19 year-olds experience mental health conditions(1), yet these remain largely unrecognized and untreated.
Adolescents with mental health conditions are particularly vulnerable to social exclusion, discrimination, stigma (affecting readiness to seek help), educational difficulties, risk-taking behaviours, physical ill-health and human rights violations.
One in seven youth, worldwide, struggle with their mental health.
According to the Trevor National Survey of LGBTQ Youth (USA youth,)
72% of LGBTQ youth reported symptoms of generalized anxiety disorder in the past two weeks, including more than 3 in 4 transgender and nonbinary youth.
62% of LGBTQ youth reported symptoms of major depressive disorder in the past two weeks, including more than 2 in 3 transgender and nonbinary youth
Rates of poor mental health skyrocket in LGBTQ teens, and especially in gender diverse teens.
Much of this is because of societal stigma. If you’ve been reading our blogs, you’ll recognize the term “minority stress.” It’s a theory that describes the additional burdens on health and well-being of minority populations because of stigma, discrimination, prejudice, and unequal laws. Some of it is because of physical changes as discussed above. Some of it is because adolescence is already hard, but existing support systems are designed for cis teens.
Our kids experience Minority Stress.
It may be because of school bathrooms. It may be because they can no longer play on the same sports teams – or even the same sports. It may be because of media and marketing pressures. It may be because lawmakers and important people in the community openly denigrate LGBTQ people and try to discriminate against them. It may be because of bullies at school, in their families, or in their clubs and communities.
We can counteract those stressors.
What is the key to supporting trans teens?
Accepting and supporting our kids as they are.
One single person can improve a transgender teen’s chance of survival to adulthood, and chances of a happy and healthy adulthood. The impact of many people is even greater.
You can save your kid’s life, and that is everything.
Names and Pronouns
If they ask you to use a different name or pronoun, use it. Access to clothing, makeup, and/or other gender expression resources? Yes! We discuss some of the ways to create an affirming home here.
Again, according to the Trevor Surveys of LGBTQ Youth in 2020 and 2021:
Only 1 in 3 LGBTQ youth found their home to be LGBTQ-affirming.
LGBTQ youth who had access to spaces that affirmed their sexual orientation and gender identity reported lower rates of attempting suicide than those who did not.
In Schools:
As parents, we can demand safer schools for our children. We can pressure our schools to provide affirming curriculums, to allow equal bathroom access, to sponsor GSA clubs, to allow name and pronoun changes before they’re legal, to codify and implement non-discrimination policies.
In Our Communities:
We can join support groups, and encourage our youth to find and join peer support groups. We can speak out about inclusion in all of our community spaces, we can ask our employers to add gender affirming care to our insurance policies. We can lobby for societal justice and change. We can locate and support other people, families, and organizations. We can grow communities.
Note: small changes are just as important as big changes. The families who testify at state legislatures are brave and necessary, but the individuals who talk amongst other parents or who volunteer to make cookies for the GSA or send an email to the town council are just as impactful and necessary. Sometimes, my favorite Saturday morning activity is reporting transphobic tweets.
In Ourselves:
Search out and join support groups just for parents. It’s normal and okay to have mixed feelings about your child transitioning, but it is vital that you process this away from your child. (We love TransFamilies.org, TransFamily Support Services, and Gender Spectrum as places to start finding groups and resources.) I personally help admin a Facebook group for moms (including femme nonbinary parents) of transmasculine teens and young adults. If that description fits you and you want to know more, feel free to contact me through QueerDoc.com.
Learn about gender – and explore your own gender!
I know plenty of parents (myself included!) whose sense of gender changed as they learned more *about gender* through parenting. I was never particularly comfortable with “being a woman” before being the parent of a trans kiddo, but the journey helped me understand and name how and why “woman” didn’t fit. Your gender might not change, but you may understand it more.
Challenge your own internalized transphobia and/or homophobia.
We live in a world where a lot of prejudice about LGBTQ people is taken for granted. If you have negative thoughts about your child being transgender, nonbinary, questioning, gender diverse, or other, it’s important to take time to investigate what may have influenced you to think that way and if the root of it is true.
When in doubt, believe your kid.
Yes, teens push boundaries. Yes, they may lie sometimes – it’s part of appropriate development. But, they generally don’t lie about who they are unless they don’t feel safe telling the truth. Create spaces for them to fully be themselves, without fear.
Learn – everything you can.
Here’s another place where support groups are invaluable. There is so much community knowledge available, and parents who have been there are great resources.
At QueerDoc, we are happy to provide links to educational resources through our Resources pages, but there are so many other ways to gain knowledge. Ask your kid who they follow on Insta or TikTok. Learn the lingo at Trans Language Primer. Check out the resources pages of the groups we mention, or the resources we listed last week in our blog. If your schools, churches, doctor’s offices, and friends are affirming, ask them for resources. Does your company have an LGBTQ affinity group or a diversity team? They might be able to point you in good directions. This is an area where taking on the labor is important – if you already have transgender friends, they can be a great resource, but ask them if they have the interest and ability to be a teacher before asking them to teach you.
Do you live in a socially conservative area? Your local PFLAG (Parents and Friends of Lesbians And Gays) group may be of help. Or, search for and reach out to the closest Pride group/festival/march in your area.
Learn about affirming healthcare.
At QueerDoc, we don’t believe that there is one way to be trans. Some patients want or need to change their bodies. Some don’t. For tweens and teens, especially, that need may include preventing changes that would happen without intervention.
Puberty Blockers
Puberty Blockers may benefit your child.
(We discuss puberty blockers at length here and here.)
Puberty blockers are safe.
Puberty blockers are reversible – they don’t change the body, they stop the physical changes associated with puberty from progressing.
Puberty blockers are a pause button for physical changes associated with puberty:
- Blockers don’t block cognitive development, just the hormone precursors that tell the body to make estrogen and testosterone. They give your child extra time to explore identity and/or accessibility to age-restricted medical treatments.
- Blockers prevent bodily changes that can be difficult to reverse in the future.
- Blockers give time for social transition.
- Like supportive family and community, blockers reduce suicide risk and gender dysphoria, and improve psychological well-being.
You can learn about professional standards of gender affirming care via WPATH, the American Association of Family Physicians, and the American Academy of Pediatrics – although you may find the reading dry, or even too conservative for your child’s needs. But, you can also use this knowledge to push back against people who are arguing against supporting transgender youth.
Be your kid’s safe place, as best you can. Help your kid find other safe places.
Finally, I’d like to leave you with some words from my kiddo (err, young adult) who I am so very proud of. We weren’t always sure we’d get here.
My name is Cody (they, them, he) and I am a femme presenting, transmasc nonbinary person. My gender is complicated, and it took me years to figure it out. I was a teenage boy once. *wink* As a trans adult, who has a wonderfully unique experience powered by the support and love I received from my family, I am very lucky to be able to share what I’ve learned with others.
I didn’t understand what it meant to be nonbinary until I was almost 18. This was purely due to a lack of information in the educational spaces for queer youth that I had access to. I was already openly queer by my freshman year of highschool, so I already participated in queer spaces at school. Most of them used “nonbinary” interchangeably with “agender,” which didn’t describe me. Agender, as I understand it, is something more specific, referring to a full detachment from either femme or masc, a lack of gender, among a few other variations. I didn’t know that I could be nonbinary and not agender, so I didn’t think nonbinary described me, either.
Turns out, agender isn’t the only way to be nonbinary. There’s lots of ways to be nonbinary! That’s the wonderful thing about it – it simply refers to being outside the binary of male or female.
Experiencing dysphoria as a nonbinary person who didn’t have enough resources to understand what I was feeling led me to believe I was male – I wasn’t a girl, I felt masculine at heart – so that was the path I believed was correct to take. I went to therapy (lifesaving), started taking testosterone (lifesaving), and generally felt better presenting and experiencing society as masculine.
This would not have been possible if not for Nora and my dad, who supported and loved and affirmed me through this process, providing access to everything I needed to pull myself out of the emotional pit of despair I had fallen into when dysphoria hit me full force.
Therapy, support groups, doctors, hormones, pronouns, a legal name change (Huge!), a sex marker change on a new birth certificate (Huuuge!), and more than anything, they believed me at every turn. That meant everything to me. It still does.
And it set me up to figure out what it really meant to be me. After about 2 years of testosterone, my lowered voice sounded like how I sounded inside of my head. My broadened shoulders and other effects of masculine puberty looked right and how I feel I’m supposed to. I stopped T when it felt right. At 22, I have a few more years of brain development, and it feels right to do that without added testosterone. This sort of puberty experience feels very unique to me and has left me with a body and a mind that is truly mine. I really can’t express how valuable that is.
Being perceived as feminine was and can still be painful for me – it took a long time for me to revisit presenting femme, and it can be hard (and sometimes traumatic) for me, even though I also enjoy and feel comfortable presenting femme. It remains true that I’m not a girl, and sometimes looking more femme than not is scary and uncomfortable. But, it is still a part of me, and I’m so thankful that I have the space to keep exploring it. Being who I am, authentically, gets easier with time and experience, and most importantly, support.
Support and safety was everything for me. It was lifesaving, it gave me unique and valuable insights, and created and strengthened bonds with my family.
A safe space to be yourself, to try things out, shake out new names, new pronouns, have a meltdown, wear a dress, wear pants instead, dye your hair, cut your hair – anything and everything until it all settles around the true self that will be embraced and loved for however that may be or may become – that is truly the most valuable thing you as a parent could offer.
Tess Kilwein, PhD, is a psychologist specializing in trauma/PTSD, addictions, sports psychology, and trans* care. | WY, CO, ND
Kai (he, they) is a gender diverse young artist.
Cody provides email wrangling support by day, and spends the rest of their time creatively, chasing their fuzzybutt cat, or posting on Twitter about art & neurodiversity. @Sake_bunbun
Citations
The Trevor Project. (2020). 2020 National Survey on LGBTQ Youth Mental Health. New York, New York: The Trevor Project. For additional information please contact: Research@TheTrevorProject.org
The Trevor Project. (2021). 2021 National Survey on LGBTQ Youth Mental Health. West Hollywood, California: The Trevor Project.
For additional information please contact: Research@TheTrevorProject.org
https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
