Advice for Parents of Trans Kids

Listen to your kid, not to me

Time rolls on, people age, and in addition to anguished messages that start with “am I trans?” I’ve started to get anguished messages that start with “my kid just came out to me.” So I have decided to write up my thoughts on the matter.

I’ll probably get around to doing a full evidence review at some point, but for now let me say: there’s not a lot of good data on it. This post is based on anecdotes I’ve heard and personal observation.

Help! My kid just came out as trans. What do I do?

Take a deep breath, calm down, and listen. Ask them questions about their experiences. Don’t jump to conclusions based on what “trans” means to you. Especially if you don’t know many trans people, you’ve probably picked up a lot of inaccurate ideas about trans people from the media.

It’s also very tempting to research and learn everything about what trans people need, want, and believe. But you aren’t a parent of All Trans Children Everywhere. You’re a parent of one trans child. Your child’s experiences are unique. Absolutely nothing substitutes for listening and trying to understand.

A child coming out as trans can be very worrying for a parent. Are they going to face transphobia? Did you miss the signs and wind up hurting your kid by misgendering them? Are they going to take hormones and get surgery with various scary risks and side effects?

It is important to remember that, for the vast majority of trans teenagers, we are not talking about permanent changes. (See “what about biomedical transition?” below.) Pronouns and names can be easily changed, and just as easily changed back. Hair can be cut or can grow out. Clothes can be replaced. These are not irreversible decisions. You may need to close your eyes and repeat to yourself “it’s just hair” until your heart isn’t racing so much.

If my kid identifies as trans now, are they going to be trans forever?

Nearly all trans people remember feeling gender dysphoria when they were adolescents. There’s a natural and very easy narrative that anyone who identifies as trans is “really” trans, and that teenagers who come out as trans or nonbinary never end up deciding that they’re actually cis.

Identity exploration is a normal part of adolescence. One of the key developmental tasks teenagers need to work on is figuring out who they are in the world. Part of that—especially as trans people have become more prominent in the popular culture—is figuring out their relationship to gender. It’s exactly what we ought to expect that some teenagers try on a trans identity—and that many of these teenagers ultimately end up identifying as cis.

There are a range of possible outcomes. Some teenagers will come to a cisgender identity (often a cisgender queer identity). Some teenagers will continue to identify as nonbinary, but will not biomedically transition and will come to terms with living in their assigned gender. Some teenagers will end up seeking out biomedical transition and/or will live out their lives as a different gender.

As this natural process of gender exploration plays out, the absolute worst thing you can do is get really invested in your child not being trans. If your child feels like they’re not being taken seriously, or like you don’t want them to figure out who they really are, or like there’s a particular way they’re supposed to be and you’re disappointed that they’re not fitting the mold, they’re likely to cling more closely to their trans identity. And, of course, if your child is actually trans, your rejection will cause them an enormous amount of psychological pain (I discuss this more in the suicide question).

I am invested in my child being gender-conforming. When my child stops with this “trans” thing, will they stop being weird and embarrassing me? Will I be able to get manicures with my daughter or play football with my son like I always dreamed of?

Almost certainly not.

With the exception of a small number of teens who spent too much time on the wrong corners of trans TikTok—most of whom, left alone, will detransition six months later with no harm done other than embarrassment—people try out trans identification because they experience a deep alienation from their assigned gender. If someone tries on the trans identity, it is because it speaks to something important about their experiences of gender.

Of course, many cis people also feel deeply alienated from their assigned gender. It’s very common for lesbians or gay men to pass through an “am I trans?” stage. Even today, our understanding of “man” and “woman” are fundamentally shaped by heteronormativity: men fall in love with women and not men; women fall in love with men and not women. Many cis queer teenagers feel like they don’t fit in with these expectations.

Many autistic people also wonder if they’re trans. Autistic people often feel like they’re space aliens or robots rather than humans, or like they’re in a play and they’re the only one who didn’t get the script. Gendered norms can be particularly difficult: other boys or girls can feel like strange, incomprehensible creatures whose experiences are entirely unrelated to the autistic person’s; gendered expectations and norms seem arbitrary to the point of being nonsensical. Many autistic teenagers identify as trans because they are in fact not like other girls/boys.

Those are two common reasons that people feel alienated from their assigned gender, but there are dozens more—including people who are just pretty gender-non-conforming and who feel more comfortable around people of a different gender.

Your child may end up identifying as cis. But if your child has come out to you as trans, I think it is wise to come to terms with the fact that your child will probably not ever be a “normal” boy/girl—even if the way that it manifests isn’t quite set yet.

I’d also like to caution that you shouldn’t go “my child was assigned female at birth and is only attracted to women, they’re not really trans” or “my child is autistic, they’re not really trans.” Both autistic people and people who are attracted to people of the same assigned gender as them are vastly more likely to be trans than the general population. As you’d perhaps expect, most traits that cause people to be deeply alienated from their gender are correlated with a stable, lifelong identification as trans.

So my kid may or may not identify as trans forever. What should I do with this knowledge?

Your child coming out as trans can be scary, but in reality it’s no different than any number of big decisions that a teenager winds up making—ones you’ve thought about in more detail as a parent. Think about transness the way that you’d think about your teenager deciding that they love playing basketball, or want to be a roboticist, or are aiming for a particular college, or are in love with their girlfriend, or have converted to Wicca.

What do you do when your kid makes this kind of decision? You try to understand where they’re coming from. You support them. You don’t say disdainful or insulting things, even if you don’t understand what they get out of whatever they’re doing. You ask them questions about it, because you love your child, and the things that are important to them are important to you, because you love them. You go to basketball games and cheer them on, or invite the girlfriend over to dinner, or help them set up the altar in their bedroom.

At the same time, you know your child. If your child’s room is littered with knitting needles, cheese-making supplies, expensive cameras, and a guitar, from previous hobbies quickly adopted and as quickly abandoned, perhaps it’s a bad idea to spring for a six-month commitment to expensive basketball lessons. Still, that’s no reason to be dismissive or invalidating. The interest is not any less real for being short-lived. And you do want to keep in mind that this might be the hobby that they stay with for a lifetime.

On the other hand, a lot of teenagers are sensible people who know their own minds. If your child has always been thoughtful and careful and self-aware, not impulsive or quick to draw conclusions, then it would be absurd to go “except basketball, they don’t know whether they like basketball.”

My kid didn’t seem trans before they came out. What happened?

You might not have noticed. It’s easy to round off gender-non-conforming behavior to “that’s just what my kid is like”—especially if you’re an anti-sexist parent. Sometimes people reflect on it and discover that their child has actually always been quite gender-non-conforming. And some manifestations of gender dysphoria, such as an aversion to mirrors or any sexuality-related symptoms, aren’t going to be obvious to parents.

Some people (including me) became gender dysphoric at puberty. That rush of hormones can have major effects. This hasn’t been studied, but it’s a common anecdote.

Some people just sort of go along with their assigned gender. Everyone seems to be expecting them to do pink and Disney princess movies, so they do that—even if identifying in a more gender-non-conforming way would make them happier. In particular, some autistic people try to learn and follow the rules of their assigned gender, without necessarily paying attention to whether they want to do that.

Some people cope with gender dysphoria by repressing their feelings and behaving in a hyper-gender-conforming way. They might think “if I am really good at being a girl/guy, I will stop feeling this way.”

A number of factors play into people’s gendered behavior. Some traits, such as aggression and propensity to cry, seem to be related to hormones. If everyone has treated you in a particular way and expected particular things of you, you might act like other people who are treated that way and have those things expected of them—even if you identify differently. Many trans people experience early transition as a process of “learning the rules” of their identified gender—it doesn’t come naturally to everyone. Sometimes people pick up the gender socialization of their identified gender before they socially transition, but it is hardly universal.

And, finally, some people just happen to have a personality more similar to that of their assigned gender. If you think about it, there’s no reason that wanting a flat chest should necessarily mean you punch people on the playground.

I heard that 41% of trans children commit suicide and I’m scared.

That statistic is commonly misquoted. In fact, the Williams Institute study that that statistic came from is talking about attempted suicides. The study used broad questions that tend to elicit a high rate of suicide attempts: for example, people might say that they attempted suicide if they got very close but stopped before actually harming themselves in any way, while other studies might only count something as a suicide attempt if the attempter had to seek medical attention.

I recommend reading the full report to get the statistic in context. One of the most important protective factors for trans people is acceptance. Trans people who were accepted by their families of origin are half as likely to have attempted suicide in the past year than trans people who weren’t. Experiencing discrimination, conversion therapy, or rejection by loved ones increases the risk of suicidality. Your love, acceptance, and support are the most important suicide-prevention methods.

People who have detransitioned at some point are more likely to be suicidal. Given that this is a study of trans people, it’s likely that these were detransitions forced by circumstances and not the healthy process of realizing that transition is not for you. It is important to avoid coercing or pressuring your child into detransition; coerced detransition causes severe psychological distress.

What about biomedical transition?

Which biomedical transition steps to take, and whether to biomedically transition at all, is a difficult question even for adult trans people. For trans teenagers and their parents, it is very, very hard.

Many loving parents, concerned about the effects of biomedical transition, want to take a conservative route and avoid biomedical transition, reasoning that their child can always transition later when they’re sure. However, there’s no neutral approach. Both biomedical transition and allowing natural puberty to happen cause irreversible effects. The question is what set of irreversible effects sets up the child for the best chance at a happy, healthy life.

In many ways, this decision is easier than it could be. I have known many, many adults—both trans and cis—who identified as trans when they were teenagers. Every one I have met felt that they would have been best off doing the thing they actually wanted. People who grow up to identify as cis almost never want to take hormones or get surgery when they’re adolescents.

I have heard anecdotes from some parents who were pressured by their doctors into having their children biomedically transition even though the children don’t want to.

It is astonishing to me, the commitment the medical profession has to being terrible. They’re so inventive!

If your child does not want the effects of hormones, do not put them on hormones. If your child is fine going through their natural puberty, put them through their natural puberty. It’s not like the hormones do secret things! It’s not like if you’re trans and don’t take hormones your legs will fall off!

If your child wants to biomedically transition, the situation is more complicated. Trans healthcare is shamefully understudied, and we don’t actually know the long-term effects of cross-sex hormone replacement therapy. And it is certain that if someone takes puberty blockers and then cross-sex hormones, they will be infertile. There are genuine reasons to be hesitant.

Here are some things I would consider:

• Is your child generally a responsible, thoughtful person who thinks through their decisions? Or are they an impulsive, flighty person who is bad at understanding long-term consequences?

• How bad is your child’s dysphoria right now? Are they crying in the shower every night because of how disgusted they are by their body? Or is their physical dysphoria manageable through dressing appropriately?

• Have they always wanted to be a parent? Have they talked about how they want kids of their own someday? Or do they seem like they hate children and, in your heart of hearts, you suspect they won’t ever have any?

But I can’t decide this for you. You need to talk it over with your child, your child’s doctor, and the child’s other parent or parents, and come to the best decision you can—knowing that anything you choose will have serious, lifelong consequences.

I know you said that you can’t decide for me but I want you to decide for me.

The primary benefit of skipping your natural puberty, other than relief of physical dysphoria, is that you’ll pass better as your identified gender. This is a very real benefit: if you pass well, you’ll be less likely to be misgendered and you’ll face less transphobia (since transphobes won’t necessarily know you’re trans).

After about five years of hormonal transition, trans men basically all pass if they want to, because they can grow beards. No one looks at a bearded guy and goes “this guy is clearly trans, he’s short and round-faced and has a gay-sounding voice.” So if your family has acceptable beard genetics, I would suggest allowing a trans teenager assigned female at birth to go through natural puberty long enough that he can have biological children, then to have him take testosterone. Normally people can still conceive after taking testosterone, even for many years; however, if you have the money, freezing eggs might be wise for peace of mind.

If a person goes through a male puberty, they will have a deeper voice, which requires hundreds of hours of voice therapy to make feminine; even then results are mixed. Trans women don’t have anything that overrides all other gender signifiers the way that a beard does.¹ Transmisogyny tends to be more vicious than transphobia directed at trans men. And, not to be cynical, conventional attractiveness improves the life of a woman far more than it does a man. For these reasons, I would generally suggest that a trans teenager assigned male at birth should skip natural puberty. Unfortunately, if puberty is allowed to continue long enough for her to bank sperm, her voice will already have irreversibly dropped.

If your child wants surgery, they should ideally get it in senior year or the summer after they graduate high school, because then they’ll have a support network which makes postoperative care much easier. This is especially true for bottom surgery.

Again, these are just my general thoughts. By far the most important thing is the experiences, needs, and wishes of your own child. There is no one-size-fits-all transition experience. But I hope that a bit of brutal honesty about the experiences of trans people, from an adult trans person, will inform your decision-making.

1. Trans women’s breasts are often too small to make the matter obvious, and anyway many trans women dress modestly and don’t draw attention to their breasts.