What You Need To Know About Transgender And Gender Non-Conforming Youth

Posted by Margie Nichols on Sunday, March 24, 2013

At the Institute for Personal Growth, a counseling and psychotherapy firm where I am a practicing therapist and Executive Director, we offer supportive counseling groups for gender variant and transgender youth, as well as their families.  There is a lot of dangerous misinformation circulating about these young people, so we came up with a list of facts that we hope will combat the stereotypes and falsehoods, something that will hopefully enable communities to embrace these young people for who they are.

1. It's Not a Binary, It's a Spectrum.

We're used to thinking of gender as existing in two (possibly three) categories: male, female, maybe transgender. But lots of people, particularly young people, fight against these limited labels because they simply don't fit. Many kids are GENDER NONCONFORMING, GENDER VARIANT, or GENDER ATYPICAL. An example would be a boy who likes wearing dresses. Books like 'Princess Boy' depict the experiences of children like this who defy gender norms.

2. It's 'Minority Stress,' Not Dysphoria

The psychiatric term for what we are calling gender nonconforming/variant/atypical and transgender kids will be called 'Gender Dysphoria' in the new DSM, the 'psychiatric Bible.'
‘Dysphoria’ is therapist lingo for mildly to moderately depressed.
You'd be dysphoric too if, like research on trans and gender non-conforming youth shows, you were the most likely of your peers to be bullied, rejected and/or abused by your parents, and become homeless. Dysphoria is NORMAL in these situations. Dysphoria only becomes a greater problem if the kid is pressured to conform to gender norms or expectations. The worst thing a parent can do – and the worst thing an expert can advise- is to tell the kid to ‘act like a boy/girl’.

3. Nobody Is Sterilizing Children

Some of the more sensational news stories about gender variant and trans youth claim that gender affirming medical interventions make these young people sterile. First, medical intervention isn’t even considered until the beginning of adolescence.  Second, puberty blockers given early in adolescence are fully reversible. Cross-gender hormones, never given until age 16, have mixed effects, some reversible, some not. Some trans men (assigned female at birth, true gender male) have been able to go off androgens and have children.
Furthermore, alternative methods of having children exist.

Most importantly, if a child reaches adolescence and still identifies as trans, the hormones ALLEVIATE DISTRESS.  They prevent suicidality and self-injurious or reckless behavior. Hormones play an instrumental role in allowing many teens to lead normal, fulfilling lives.

4. Statistics Are (Unsurprisingly) Misleading.

The media will tell you that 'most' gender nonconforming kids don't grow up to identify as trans. This isn't exactly true. That research was done on children brought to clinics, not kids in the general population. Furthermore, many of these young people remain somewhere on the gender non-conforming spectrum even if they don't fully transition. What IS true is that young people who identify as transgender at puberty don't usually change their minds.

5.  Gender Variant Does Not Necessarily Equal Transgender

Some young people are gender non-conforming but retain the gender identity assigned at birth; also more and more GV youth are identifying as "genderqueer." Remember how we said back in #1 that there are more categories than male, female, and transgender? Most are encompassed in that term. Young people can identify as mixed gender, fluid, two-spirit and some can be pretty pissed if you call them male or female.

6. The choice may not be between waiting for hormones/transitioning and not waiting

You’ll hear some ‘experts’ call for ‘caution,’ providing parents and medical professional with a ‘wait and see’ model in considering hormone treatment. But one Los Angeles M.D. who works with these kids says bluntly: "The choice may be between a transgender kid and a dead kid." It's truly that serious.

7. How Will Other Kids Handle Another Kid's Transition? Better Than You Think

Gender non-conforming kids tend to be bullied or harassed by other children more BEFORE they engage in any medical interventions, particularly boys. Our sexist society permits 'tomboy' girl behavior to a certain extent before they become teens, but it really punishes males perceived to be 'feminine.'  Ironically, post-transition, the child no longer violates gender norms, and they are less likely to experience bullying.

Also (hopefully demonstrating an important shift), young people tend to be a great deal more accepting of sex and gender variance than people over 35. There are literally thousands of Gay Straight Alliance groups in high schools throughout the U.S. At IPG we've been pleasantly surprised by the supportive reactions most schools, students included, have had towards our young transitioning clients.

8. Adolescence Is The Key Time

Many gender variant kids don't express a desire to live as a gender different than what they were assigned when they are young; this may be due to the fact that children's bodies aren't that different except for the genitals. When pubertal hormones hit and secondary sex characteristics begin to develop (breast buds for girls, changes in testicles for boys, body hair for both), some gender variant kids are undisturbed. Others, however, have severe emotional reactions. This is the time when puberty blocking hormones can 1) alleviate distress and
2) give the young person some time to explore identity. For those assigned female at birth, these blockers may need to be used as young as age 9.

9. Puberty Blocking Hormones Aren't Toxic OR Irreversible

The once gender variant child who now identifies as a transgender tween is at most risk for mental health problems, unless you give them puberty blocking drugs, which are fully reversible. Then they experience relief and can live for a while in their affirmed gender before starting cross-gender hormones 2-4 years later. If the young person changes their mind? Just stop them. If a young person is given puberty blocking hormones at the right time, they will never develop unwanted characteristics of their assigned sex like breasts or a deep throat. The U.S. Endocrine Society and World Professional Association for Transgender Health endorses their use. It's a no-brainer.

10. Transgender Teens Who Transition Lead Normal Lives Afterwards

Remember how we talked about greater stress, more abuse, and more mental health problems among gender variant youth? Most of that goes away if 1) their family and community support them; 2) they aren't forced to conform to gender norms; 3) they receive the medical treatments they need. Peggy Cohen-Kettenis, who has studied these young people for twenty years in the Netherlands, says that post-transition they are 'indistinguishable' from other teens and young adults.


Margie Nichols, Ph.D. is a licensed psychologist, sex therapist, and Executive Director of the Institute for Personal Growth, a counseling/psychotherapy center serving the LGBTQ community since 1983.

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