How to help teenager with gender identity

Gender identity and your child

Gender identity is your child’s sense of who they are – male, female, both or neither.

Your child might identify as cisgender. This is when your child’s gender identity is male or female, and it’s the same as the sex your child was given at birth.

Or your child might identify as gender diverse, which includes:

• transgender – your child’s gender identity doesn’t match the sex given at birth
• non-binary – your child’s gender identity is neither male nor female, or it’s a blend of male and female
• gender fluid – your child moves between gender identities
• agender – your child doesn’t identify with any gender.

Or your child might use another term to identify their gender. And your child might discover or understand more about their gender identity over time. This might mean they express this identity in new or different ways.

Most children grow up thinking of themselves as a girl or a boy and don’t question their gender. But some children and teenagers in all cultures identify as a gender that’s different from the sex they were assigned at birth.

How children and teenagers express gender

Gender expression is how your child shows their gender. This might be through their name, clothes, behaviour, hairstyle or voice.

Almost all children begin expressing their gender identity at around 2-3 years old. They do this in the way they talk about themselves and through the clothes they choose. Children can be very firm about their gender from an early age. For example, toddlers often proclaim ‘I’m a boy!’ or ‘I’m a girl!’

Many gender-diverse children also express their gender identity at around 2-3 years old. They can be firm about their gender too. For example, a child might get angry when people call them a boy or girl, refuse to wear particular clothes or say that they’re a different gender.

Other gender-diverse children might start to talk about their gender identity being different when they’re at primary school. For some, this happens after puberty, and some might not know or express this until they’re well into adulthood.

It’s normal for all children and teenagers to experiment with gender. For example, your daughter might refuse to wear skirts or dresses, or your son might want to play ‘mum’.

For most children and teenagers, experimenting with gender doesn’t mean that they’re gender diverse or transgender. Most children go on to feel comfortable with the gender they were given at birth.

Gender dysphoria is when your child feels distressed because their gender identity differs from the sex they were given at birth. This distress might affect their school or home life.

Not all gender-diverse children have gender dysphoria. Some children are comfortable identifying as a gender that’s different from what they were assigned at birth. And being gender diverse or experimenting with gender expression isn’t a problem unless your child seems upset or distressed about their gender.

But some children do experience gender dysphoria, especially if they experience bullying, stigma or discrimination at school or other places.

Young children: signs of gender dysphoria

If you think your young child has gender dysphoria, there are some signs you can look out for.

Your child might:

• insist they’re a different gender – for example, they might say ‘I’m a girl, not a boy’
• get upset or angry if they’re called a boy or girl, or brother or sister, or anything else that’s gender specific
• show signs of childhood anxiety like not doing as well as usual at school, having tantrums, or not wanting to take part in usual activities. These signs might be more obvious in settings that are gendered, like school or sports activities
• go to the toilet in a way that’s associated with a different gender – for example, your gender-diverse child who was assigned as female at birth might stand up to urinate
• ask you to call them by a different name and use a different pronoun like ‘he’, ‘she’ or ‘they’
• ask questions about their gender – for example, ‘Will my vagina turn into a penis?’ or ‘Can I be a daddy instead of a mummy when I grow up?’
• not like the physical signs of their sex or want those that match a different gender – for example, your child might say, ‘Can the doctor take my penis off?’ or ‘I don’t want to grow breasts when I grow up’.

Teenagers: signs of gender dysphoria

If you think your teenage child has gender dysphoria, there are some signs you can look out for.

Your child might:

• feel strongly that their gender identity differs from the sex they were given at birth or tell you that they feel unsure about their gender
• ask you to call them by a different name and use a different pronoun like ‘he’, ‘she’ or ‘they’
• want to get rid of the physical signs of their sex or have those of a different sex – for example, your child might say they want to use medication to become more masculine or feminine, or they might start wearing clothes that hide their body
• show signs of teenage anxiety, especially in social situations
• show signs of depression – for example, not wanting to take part in activities, particularly activities that are gendered, like sport
• self-harm – for example, by scratching, cutting or biting themselves.

You can support your child with gender dysphoria by showing that you love and accept them as they are and know themselves to be. It’s also good to talk with them about what they’re experiencing.

Children and teenagers who want or need to affirm a gender that differs from sex at birth

If your child identifies as a gender that’s different from the sex they were given at birth, your child might want or need to affirm their gender identity.

For many gender-diverse children and young people, affirming their gender identity is about openly acknowledging a gender that they already feel themselves to be.

If this sounds like your child’s situation, or you’re worried that your child has gender dysphoria, going to your GP is a good first step. The GP can give you information and a referral to a psychologist or specialist gender service if there’s one in your area.

Your GP or psychologist might not be familiar with the needs of children who want to affirm their gender identity or who have gender dysphoria. Or they might not be supportive of your child’s situation. In this case, it’s OK to seek a second opinion.

Treatment for children who want to affirm their gender identity or who have gender dysphoria depends on children’s individual needs. It will focus on your child’s physical and psychological wellbeing and aim to support them as they affirm their gender identity.

If your child hasn’t reached puberty, the professionals supporting your child might:

• work with your family to help you understand your child’s experience and support your child
• support your child to understand their gender identity
• support your child to affirm their gender, where appropriate.

Once puberty has started, treatment options include:

• psychological support like psychotherapy to help your child explore their gender identity
• family therapy to help you understand your child’s experience
• support to help your child affirm their gender, where appropriate
• voice coaching and speech therapy to help your child communicate in a way that’s consistent with their gender identity.

Children who want to affirm their gender identity need to have a comprehensive medical and mental health assessment before any medical treatment can be recommended. For some teenagers, medical treatment can help reduce the distress associated with physical aspects of their bodies.

There are two stages of medical treatment for children who want to transition medically:

• Stage 1 is medication to put puberty on hold so your child has time to decide about future treatment. This treatment is mostly used in early puberty. It stops the physical changes of puberty and can be reversed.
• Stage 2 is hormone treatment to change your child’s body to be more consistent with your child’s gender identity. It’s appropriate for some older teenagers.

A person’s gender identity is different from their sexual orientation, which is to do with romantic or sexual attraction. It’s also different from being intersex, which is when people are born with variations in the parts of the body associated with sex and reproductive development.

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