A social transition is, of course, completely reversible, and not inherently dangerous.Įarly studies have shown that transgender youth who are allowed to socially transition have mental health nearly indistinguishable from their cisgender peers (a stark contrast to past studies of transgender youth who weren’t allowed to socially transition who had high levels of anxiety and depression). Mostly, it means not placing restrictions on how your child wants to express their gender. “Embracing a child when they come out as transgender can be a matter of life and death”Ī social transition may involve the child taking on a new name or new pronouns, or wearing stereotypical gendered clothing. What a psychologist or psychiatrist might recommend is allowing the child to “socially transition” if the child so desires. Medical guidelines advise that prepubescent children not be offered any hormonal interventions. Luckily, the interventions that doctors would recommend for kids this young are completely safe and reversible. It’s possible that many prepubescent transgender children will, in fact, change their minds about transitioning medically. Parents should not panic about reversible interventions for transgender youth They also, by definition, have not yet started puberty, and thus there is no puberty to block and no need for hormone therapy. For this reason, they are not offered hormone therapies. There is more debate around how likely prepubescent children are to later not identify as transgender. A large study of transgender adolescents from the Netherlands found that only 1.9 percent of those who hit puberty and start puberty blockers decide to stop treatment like Alex did. The answer depends on if their child has hit puberty.įor adolescents who have reached the earliest stages of puberty, the odds are very low. How likely is your transgender child to change their mind?īefore parents let their children start hormone therapies, they often want to know how likely their child is to later change their mind about transitioning. Sometimes “de-transitioning” is just part of a person’s healthy psychological development. For the very small percentage who do, like Alex, this isn’t the horrible outcome that conservative media outlets lead people to believe. The vast majority of transgender kids who begin hormonal treatments do not change their minds about medically transitioning. The reality could not be further from the truth.
This comes in the midst of a flurry of media stories about transgender youth who choose to stop hormone therapies, ranging from a cover story in the Atlantic to more heavy-handed pieces from conservative writers and pundits who have painted a picture of crazed liberal doctors irreversibly “mutilating” the bodies of confused children. (Their name was changed to protect their privacy.)Īs a doctor and researcher who studies the mental health of transgender youth, I was alarmed to learn that the Trump administration is planning to invalidate the experiences of transgender people by defining gender based on a person’s genitalia at birth. Though the hormones left Alex with some cosmetic changes - redistribution of body hair and fat - Alex says they were necessary to fully solidify their gender identity. At this point, they also stopped the medications and went through male puberty.Īlex, whose case I described recently in the journal JAMA Pediatrics with two other Harvard physicians, has no regrets about taking the hormones. She was prescribed estrogen pills about a year later to help her go through female puberty.Īfter four months on the hormonal medications, she decided she did not identify as female but rather as gender nonbinary (neither male nor female) and would use the gender-neutral pronouns they, them, and theirs. At 15, she asked to transition, and her parents, though reluctant, brought her to the Boston Children’s Hospital Gender Management Service, where she started a puberty-blocking medication. She started going to a therapist, who diagnosed her with gender dysphoria. In ninth grade, she took on a female name and came out as transgender to her friends at boarding school.
She started dressing in gender-neutral clothing and wearing makeup, and was happy when strangers perceived her as a girl. When she hit puberty, she became anxious and depressed about how her body was becoming more masculine.
She grew up knowing she was “supposed to be a boy,” but as a young child, she never felt like that gender fit.