Your child is questioning their gender. What should you do?

What does it mean when a child is questioning their gender?

This might feel scary, but exploring gender identity is a very normal part of development. Some kids just happen to fit into the prescribed boxes, so we don’t always notice it. But experts at the American Academy of Pediatrics state that by age four, kids have a sense of their internal gender identity.

Young children start to discover that boys and girls are separate categories and that boys and girls wear and play with different things. They start to explore what that means and where they fit into those gendered categories. As they grow up, they integrate more into their concept of gender and their relationship to it.

Kids can start to question their gender at any age. Puberty is a particularly common time because that’s when they’re trying to define themselves in relationship to their peers. But even toddler-age children can experience a clash between what they are told their gender is and how they understand it.

Of course, gender exploration looks drastically different at four years old than it does at 14 years old. Here’s what questioning their gender might look like at various ages and stages:

• Toddlers/Pre-schoolers (2-5 years): Kids this age may have very strong feelings about their gender and insist “I’m a boy!” or “I’m a girl!” This is the age where it’s most likely that they will stand firm and argue with adults or other kids who misgender them. Depending on how safe they feel, they’ll tell you what they want to wear, how they want their hair to look, and maybe even what they want their name to be. They are unlikely to understand why other people don’t understand their gender the way they do.
• School age (6-12 years): By this age, other people’s understanding of their gender will have had an effect, and after hearing “no honey, you’re not a girl” or “boys don’t wear pink” enough times, they’ll start to internalize their feelings. Kids this age are more likely to be quiet about their gender and struggle in gendered settings. Spaces and activities that are split into boys/girls become fraught and they may become angry, anxious, or depressed. They might drop out of sports or want to stay home from school more often.
• Teens (13-18 years): Teens also experience those same complicated moods and may start dealing with significant physical gender dysphoria. Body or facial hair growth, breast growth, voice deepening, menstruation, and other puberty changes can all cause significant distress. Depression can become severe.

What your child needs from you

You might be wondering: What if it’s just a phase? What if this is just a kid who is confused and exploring?

Here’s the thing: You don’t need to know if your kid is trans or not in order to support them. Research in the Journal of Adolescent Health shows that positive family support for transgender youth leads to fewer mental health concerns, whereas negative family support is associated with higher levels of suicidal ideation. Social and familial support can be truly life saving.

Whether or not your child is exploring an identity that is temporary or permanent, listening to and supporting them teaches them that you are trustworthy and that you will be by their side when things feel complicated. They will trust that you are someone they can talk to no matter what comes up.

Here’s what supporting them might look like:

If they show signs of wanting to socially transition, let them.

Let them explore. Let them grow their hair out or get a haircut. Let them wear a dress or go by the name “Benji.” Let them use they/them pronouns. Social transition is extremely low stakes and hair, clothes, and words are all very easy to change.

If it seems like these changes are things they want to do all the time, then you’ll likely need to advocate for them. You don’t need to have all the answers, but you can tell their school and their grandparents that they’re exploring and you support them.

Sometimes parents try to discourage their child’s exploration for fear they’ll get bullied, but all that teaches your child is that they should hide their feelings from you. Instead of trying to discourage their exploration, it’s more helpful to talk to them and let them know that some people might not understand what they’re doing or how they’re presenting, but you support them.

If they say they want to medically transition, start doing some research.

A pre-teen or teen who is experiencing gender dysphoria may be interested in medically transitioning. Once again, don’t panic. This will take some effort and research, but it’s important.

Access to trans-affirming care has become much more limited in recent years. Many transgender youth programs at major hospitals have shut down or are at risk of shutting down, and there are fewer resources than there used to be. But there are still options, and it’s extremely important that a teen experiencing gender dysphoria isn’t forced to wait until they turn 18 to access care. Research in the journal Pediatrics found that 90% of transgender adults who wanted trans-affirming medical care during puberty but didn’t receive it reported suicidal ideation at some point in their life.

As a first step, check to see if any major hospital in your area has a transgender youth program. If there isn’t one, you may have to get more creative in finding trans youth-affirming medical providers. You can do this by connecting with other LGBTQ+-affirming providers or parents. A trans-affirming therapist will likely know the closest doctors who do this work. You can also connect with your local PFLAG group or ask in a transgender specific Facebook group (like the Transgender Parenting group)

If medical transition is something that is determined to be appropriate between your child and their care team, the next steps will depend on their age and what stage of puberty they’re in. In the early stages of puberty, it’s possible to go on puberty blockers, which do exactly what you would assume they do: push the pause button and prevent further puberty changes, which allows more time to determine the next best steps without their dysphoria worsening.

Gender exploration doesn’t always mean someone is transgender or will want to socially or medically transition, but it is a possibility. And despite a lot of fear-mongering, social and medical transitions are safe and effective. The American Academy of Pediatrics published a comprehensive policy statement in 2018 (reaffirmed in 2023) confirming that conversion therapy (therapy that’s meant to change someone’s sexuality or gender identity) is ineffective and dangerous, whereas a gender-affirmative care model leads to fewer mental health concerns, whether or not they ultimately identify as transgender.

If they seem distressed by their gender, consider finding them a trans-affirming therapist.

Being transgender itself doesn’t lead to distress or mental health issues, but experiencing bullying and bigotry can be very hard on a child. Dealing with gender dysphoria and trying to navigate relationships with friends and family while transitioning can be overwhelming. If these issues are becoming too difficult to navigate on your own, then it may be time to bring in professional help.

Look for someone with expertise working with transgender individuals and considers themselves trans-affirming. Thriveworks lets you filter by therapists who specialize in LGBTQIA+ issues, while Psychology Today’s therapist finder gives you similar options. You may also want to ask the local PFLAG group for personal referrals. If there is no one in your direct area, you can find someone licensed in your state to provide telehealth.

Even if it turns out your child isn’t trans, this is someone who has experience working with all of the possibilities. I know sometimes people are afraid that a trans-affirming doctor or therapist will make their child transgender, but I promise you we don’t have that power. The same way you don’t have the power to make your child do anything they don’t want to do.

Navigating your feelings as a parent

You don’t have to feel perfectly confident in order to be there for them. It’s OK to support them through your fear and your uncertainty. They’re also experiencing fear and uncertainty, so you both have that in common.

It’s also OK to be afraid about how the world is going to treat them. It’s never been easy to be trans or gender nonconforming, and the current political climate makes it very difficult to exist outside the norm. There are very real threats as a trans and gender nonconforming person, which is why they need you on their team, and as a consistent support.

You’re also likely going to experience some grief. Whether you realized it or not, when your child was born, you had an image of what their life would look like. Maybe it wasn’t so specific as assuming they’d grow up to be a doctor or a lawyer or an athlete, but you may have still assumed certain things about them. Like when the doctor said “it’s a boy,” you assumed that your child would grow up to be a man someday. So this may bring up a lot of feelings as you adjust.

There is nothing wrong with experiencing the grief of their life looking different than you expected. That said, it’s important that you don’t grieve your child’s identity with them or in front of them. Instead, look for opportunities to process these feelings with your support system or a mental health provider. Your child likely wants you to be a part of this big experience. Celebrate, support, and protect them. They need you more than ever.

This article is a very brief overview, and I can’t tell you if your child is trans or what they specifically need in this moment. You will have countless more questions, and it may help your family to speak to a trans-affirming doctor or therapist together.
Explore this with an open mind, try to listen to your child with as few preconceived notions as possible, and you will be just fine. Your child is welcoming you into their authentic experience and that is a gift.