As a parent of a young adult I empathize with parents who often have had only a few days’ notice of their teen’s gender dysphoria. At the same time, your teenager is ‘coming out’ after months or even years of discomfort about their bodily sex not fitting their mental, internal sense of their gender.
Adolescents are usually extremely anxious to begin cross-sex hormone therapy in order to feel better and prevent further maturation into the “wrong” body. I respect parents’ need for answers to their concerns before they agree to their child taking hormones.
I see parents of transgender adolescents, young adults and older adults to support you and answer your questions. I explain the “best practices” established as Standards of Care by the World Professional Association for Transgender Health (WPATH), of which I am a member. WPATH is an international group of gender dysphoria researchers and health providers in areas as diverse as child development, sexuality, endocrinology, pediatric psychiatry, psychology and clinical social work, as well as surgeons, mental health therapists and allied health professionals. WPATH publishes the scholarly Journal of Transgender Health based on contributions from these fields, and hosts bi-ennial symposia to share knowledge about gender dysphoria. The Standards of Care (SOC) are clear regarding careful steps in treating gender dysphoric children and teens. Please click WPATH.org to view the Standards of Care, Version 7.
For Parents of Adolescents considering hormone treatment for gender dysphoria
Parents, take the Family Fertility Questionnaire, and have your teen take it too (separately is best: your child can view their own questionnaire on the Youth page. Teens, take it and tell your parents to find their own questionnaire on the Parents page. You can send your results to Laura Thor to talk about at a future session. It is ideal if you as family sit down to talk about your separate resulting opinions.
FAQ I am asked by parents, and answers from the SOC and other resources:
What is ‘gender dysphoria”?
“Gender dysphoria refers to discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics).” SOC
My (born male) child never played with dolls or dressed as a girl. So how can he be transgender?
“…many adolescents and adults presenting with gender dysphoria do not report a history of childhood gender nonconforming behaviors. Therefore, it may come as a surprise to others when a youth’s gender dysphoria first becomes evident in adolescence.” SOC
How do you make sure my child is transgender and needs hormones?
There is no psychological or chromosome test that proves how a person feels their mental gender. Although children with intersex conditions can be examined with sonograms or have their chromosomes checked, most transgender people do not have these conditions. Trained therapists specializing in gender dysphoria use assessment skills and tools to rule out other possible but highly unlikely factors such as psychosis, using interview questions and parents’ developmental history of their child.
Hormone therapy is only one aspect of transition that includes medical, social and internal changes.
What else does my child need?
Assessment shifts into individual and/or therapy or support groups to ensure clients gain realistic expectations about living as another gender, what hormones will and will not achieve (and medical risks) and how much “passing” matters to them and is achievable. “Passing” is slang for the ability to live undetected in one’s identified gender in society. Most of my clients aim for this goal, but some must aim to develop self-esteem to tolerate being ‘read’. While a client is preparing for hormone therapy, parents can help by letting their young person begin these important tasks:
- Beard removal for male-to-female (MTF) teens with laser or electrolysis (see Resources)
- Voice training or vocal cord surgery if needed, for MTF (see Resources)
- Call them by their preferred name and pronouns at home, whether or not they are dressing as that gender, and always in public when they are. At home, you are showing acceptance of your child’s intentions to become outwardly who they already are psychologically and emotionally. In public, the goal is to protect your child’s safety from being “outed.” Confusing? The best guideline is to ask your child in private anytime you are unsure.
- Recognize that gender is variant, not binary, meaning many people who identify as transgender feel their gender as a range of feminine/masculine expressions. The best word of late is “gender non-conforming.”
Most important is to refrain from expecting your MTF child to suddenly dress in girls’ clothing and makeup and to practice a feminine voice in your presence. FTM (female-to-male) or “transboys”/”transmen” will not suddenly act in stereotypically masculine ways, but they may appreciate being asked to come help Dad or join in healthy male-bonding activities. Older teens are faced with another kind of “puberty,” emotionally and physically, with all the self-consciousness you recall from your own puberty years. Avoid pressuring your child to meet your expectations: how you expect boys and girls to behave and look is going to get in your way. Let yourself be uncomfortable, and know that this signals readiness to adapt to change. Talk to other parents—see the Resource page.
Take care of yourself!
You will feel conflicting feelings like: grief, relief, hope, fear, even joy. This means you are a loving, attentive parent. Join PFLAG in your community for support to help you vent concerns and gain perspective. Read books and websites and see films (see my Resource page) to find more positive ways to ‘come out’ as a family, and advocate at school if needed. Learn about health insurance and which ones cover expenses related to transition. You’ll do your best parenting of your transgender teen with knowledge and support.