Appropriate support and treatment for trans kids is widely misrepresented. The reality is most gender-affirming care for kids is social support and time to explore. The World Professional Association for Transgender Health (WPATH) publishes the WPATH Standards of Care for the Health of Transgender and Gender Diverse People. This document outlines the best consensus of medical and mental health professionals regarding gender-affirming care for all ages.
When a pre-pubescent child expresses questions about their gender, or even certainty that they are not the gender they were assigned at birth, this is how we provide gender-affirming care:
Set the child up with a trained therapist who can help them reflect, explore, learn, and grow in their understanding of their gender identity using evidence-based therapies. Depending on the age, this might be play therapy with a younger child or talk therapy with an older child. In any case, it proceeds at the child’s pace and follows the child’s lead. The therapist facilitates the child’s exploration rather than directing it.
Provide the child and their caregivers information about the risks and benefits of exploring gender identity through social transition. There are real risks to consider: we live in a world with a lot of transphobia, and that’s not a reason to deny trans kids gender-affirming care, but it is a serious issue parents, caregivers, and healthcare providers need to acknowledge.
Begin family therapy to help the family understand their trans child/sibling better, communicate more effectively, and support one another through change.
Permit the child to try new types of clothes, hairstyles, and other forms of self-expression congruent with their authentic gender. This can be something that happens at home, in therapy, at school, and/or in the community.
Permit the child to go by a different name, nickname, and/or pronouns at home, in therapy, at school, and/or in the community.
Include the child in activities congruent with their felt gender, such as Girl Scouts.
Encourage the child to participate in groups and activities for gender diverse kids, such as a support group or summer camp.
Provide the child and their family with medically accurate information about options for delaying puberty and for future medical transition, including pros and cons to pursuing such interventions and options for preserving fertility.
When appropriate, and with informed consent by the parents/guardians and child, under the guidance and monitoring of a physician or clinic specializing in gender-affirming pediatric care, begin puberty blocking medication when the child begins to demonstrate signs of early puberty. This medication was originally developed for cisgender children experiencing precocious puberty. It has minimal side effects (mainly: potential loss of bone density, which can be mitigated with dietary supplements) and, if the medication is discontinued without further intervention, natural puberty will proceed.
When anti-trans politicians and activists make false and misleading statements about what gender-affirming care is and how it is provided, they count on people not knowing these facts. They want to leverage parents’ natural concern for their kids’ safety and make gender-affirming care seem dangerous. In reality, gender-affirming care gives kids the space, time, support, and resources to explore who they are; and gives parents and caregivers the information and support they need to help their kids thrive.
