How to come to terms with being transgender as a teen

Parental support for transgender teens truly matters.

Posted December 14, 2017

THE BASICS

I have worked with parents and adolescents through the process of gender disclosure. Some parents brought their adolescent in for care because the adolescent had disclosed their gender and the parents wanted to support their adolescent psychologically and or medically. Some adolescents asked their parents to come to a meeting with their therapist. In this meeting, the adolescents disclosed their gender and would ask for support with me by their side. Unfortunately, the majority of the transgender and nonbinary teens I have worked with wanted their parents support, but were uncertain about disclosing their gender to their parents. They feared being rejected, kicked out of the house, threatened, or worse.

How to come to terms with being transgender as a teen

In the research, we see evidence of staggeringly high rates of depressive symptoms, self-harm and suicidal ideation among transgender youth. For example, a 2017 study found the two-thirds of transgender adolescents (in 9th to 11th grades) had thought about suicide. A 2016 study of transgender youth found that 65 percent 14- to 18-year-olds in their study had seriously considered suicide. This is a high number all together, and is particularly stark when compared to average suicidal ideation (13 percent) in same-aged teens.

Providers who work with transgender and nonbinary teens can tell you that the outcomes for teens with supportive parents are dramatically different from the teens who have unsupportive or rejecting parents. Research supports the existence of these differences as well.

See a 2012 study demonstrating differences in outcomes based on presence or absence of parent support. In this study, adolescents aged 16 to 24 were asked about positive outcomes (self-esteem, life satisfaction, housing and mental health) as well as negative outcomes (depression and suicide attempt in the past year). These outcomes were compared for the groups who reported supportive parents versus unsupportive parents. The results reflected a remarkable story about the importance of support.

For positive outcomes, there were significant differences between supported and unsupported adolescents:

  • Life satisfaction (72 percent compared to 33 percent)
  • Self-esteem (64 percent compared to 13 percent)
  • Excellent mental health (70 percent compared to 15 percent)
  • Adequate housing (100 percent compared to 45 percent)

For negative outcomes, the results were also overwhelmingly better for supported adolescents compared to their unsupported peers:

  • Depressive symptoms (23 percent compared to 75 percent)
  • Suicide attempts in the past year (4 percent compared to 57 percent)

Scientific and anecdotal evidence clearly underscores importance of parental support. Therefore, the question of exactly how parents can demonstrate support for their transgender or nonbinary adolescent bears asking.

How to come to terms with being transgender as a teen

Coming out about gender can be a challenging experience for adolescents. They are disclosing an important and incredible part of their self. It leaves the adolescent vulnerable and in a place to be rejected for a part of their core sense of self. Some ways to affirm a transgender or nonbinary adolescent in this process and after include:

  • Affirming their gender through use of appropriate pronouns and name.
  • Assisting their adolescent in exploring and enacting a social transition when they are ready.
  • Working with schools to ensure access to bathrooms and affirming classroom practices, such as affirming name and pronouns on school materials.
  • Working to prevent bullying, and to address it when it happens.
  • Creating access to gender affirming medical and therapeutic services.
  • Preventing and addressing cruelty and harm.
  • Allowing them to be free to show you who they are and then loving that person fully.

THE BASICS

For parents, the disclosure of gender can involve complex and emotional process of understanding their own sense of loss, addressing family and community relationships, experiencing challenges to beliefs about gender, as well as upheaval of privilege. Parents must also face the increased risk for their adolescent in the world. Parents may also begin to wonder about medical interventions to support their adolescent’s gender process. These can include puberty blockers and hormone replacement therapy (HRT) as well as any other medical interventions that the family may consider. As a parent, it is essential to remain affirming and supportive of your adolescent while you work to process your own experience, and to explore the options available to you and your adolescent.

How to come to terms with being transgender as a teen

It can certainly help to seek therapy for the family, the parent, and the adolescent. When looking for a therapist, it is of utmost importance to find knowledgeable and experienced medical and mental health providers to help in answering questions about interventions. (Note that there is no support for conversion therapies for sexual orientation. They are demonstrated to do more harm than good. These therapies should not be used for gender identity either.)

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Children, adolescents, and young adults need parents and caregivers to show their support as much as they can. Therefore, parents must challenge themselves to do the hard work of processing this disclosure, while doing their best to affirm their adolescent in the meantime.

Has your child come out as transgender or nonbinary? What have you been able to do to affirm their gender and support them? What challenges have you had and how are you facing them?

Perez-Brumer, A., Day, J. K., Russell, S. T., & Hatzenbuehler, M. L. (2017). Prevalence and correlates of suicidal ideation among transgender youth in California: findings from a representative, population-based sample of high school students. Journal of the American Academy of Child & Adolescent Psychiatry, 56(9), 739-746.

Eisenberg, M. E., Gower, A. L., McMorris, B. J., Rider, G. N., Shea, G., & Coleman, E. (2017). Risk and protective factors in the lives of transgender/gender nonconforming adolescents. Journal of Adolescent Health, 61(4), 521-526.

A new study of social contagion raises important clinical and ethical questions.

THE BASICS

Transgender identity* is characterized by experiencing distress with, or an inability to identify with one’s biological sex, usually prompting a desire to live one’s life as the opposite sex.

In the DSM-5, the standard classification of mental disorders used by mental health professionals, this condition is known as “gender dysphoria.” Note that classifying gender dysphoria as a disorder does not—indeed, should not—imply a moral judgment of transgender individuals. Depending on the degree of social stigma associated with it, transgender identity can be accompanied by very significant distress. The point of the mental-health outlook is to help reduce stigma and assist transgender individuals in leading good lives. The role of social norms in this picture, however, remains unclear and hotly debated.

The historical and cross-cultural record indicates that conditions akin to what we now call “transgender identity” have been known to occur in all societies, with varying degrees of acceptance, suppression, or even encouragement. The widespread acceptance of individuals who were born males and dress and live as females, such as the hijra in India, katoey in Thailand, bakla in the Philippines, and travesti in Brazil, for example, long predates the current transgender movement in the West. Despite a longstanding recognition of their existence, transgender individuals in those countries continue to face some discrimination. Among the Kuna (also known as Guna) of the San Blas Islands in Panama, transgender identity appears to have been fully accepted since precolonial times. As a rare example of a matriarchal and matrilineal society, names and properties are typically passed on from female to female among the Kuna, leading to a cultural preference for having girl children. In this context, male children were sometimes raised as girls, thereby conferring families with a distinct social advantage. This gave rise to a rare example of absence of cultural stigma around transgender identities.

These examples are telling because they point to the importance of different social norms in mediating gendered preferences and behavior. They also introduce another piece in our puzzle: all the culturally recognized incidences of pre-modern transgender individuals mentioned above involve natal males who transition to female. In the DSM-5, prevalence rates of gender dysphoria are estimated at 0.005 percent to 0.014 percent of the population for natal males, and 0.002 percent to 0.003 percent for natal females. The higher prevalence of males exhibiting the condition is likely related to a higher percentage of male homosexuals worldwide (3 to 4 percent) as compared to lesbians (1 to 2 percent). While these rates are the subject of debate, the higher ratio of male homosexuals as compared to women is a consistent finding across surveys.

As attested by current controversies, rates of transgender identity appear to be on the rise, particularly among young people. Increased social acceptance of a previously stigmatized condition likely plays a role in this process, but other findings are clearly puzzling: Transgender identity is now reported among young natal females at rates that clearly exceed all known statistics to date.

In a recent survey of 250 families whose children developed symptoms of gender dysphoria during or right after puberty, Lisa Littman, a physician and professor of behavioral science at Brown University, found that over 80 percent of the youth in her sample were female at birth. Littman’s study reported many other surprising findings. To meet the diagnostic criteria for gender dysphoria, a child typically needs to have shown observable characteristics of the condition prior to puberty, such as “a strong rejection of typically feminine or masculine toys,” or “a strong resistance to wearing typically feminine or masculine clothes.” Again, 80 percent of the parents in the study reported observing none of these early signs in their children.

The plot thickens again: First, many of the youth in the survey had been directly exposed to one or more peers who had recently “come out” as trans. Next, 63.5 percent of the parents reported that in the time just before announcing they were trans, their child had exhibited a marked increase in Internet and social media consumption. Following popular YouTubers who discussed their transition thus emerged as a common factor in many of the cases. After the youth came out, an increase in distress, conflict with parents, and voiced antagonism toward heterosexual people and non-transgender people (known as “cis” or “cisgender”) was also frequently reported. This animosity was also described as extending to “males, white people, gay and lesbian (non-transgender) people.” The view adopted by trans youth, as summed up by one parent, seemed to be that:

“In general, cis-gendered people are considered evil and unsupportive, regardless of their actual views on the topic. To be heterosexual, comfortable with the gender you were assigned at birth, and non-minority places you in the ‘most evil’ of categories with this group of friends. Statement of opinions by the evil cis-gendered population are consider phobic and discriminatory and are generally discounted as unenlightened.”

THE BASICS

Parents further reported being derogatorily called “breeders” by their children, or being routinely harassed by children who played “pronoun-police.” The observation that they no longer recognized their child’s voice came up time and again in parental reports. In turn, the eerie similarity between the youth’s discourse and trans-positive online content was repeatedly emphasized. Youth were described as “sounding scripted,” “reading from a script,” “wooden,” “like a form letter,” “verbatim,” “word for word,” or “practically copy and paste.”

Littman raises cautions about encouraging young people’s desire to transition in all instances. From the cases reviewed in her study, she concluded that what she terms “rapid-onset gender dysphoria” (ROGD) appears to be a novel condition that emerges from cohort and contagion effects and novel social pressures. From this perspective, ROSD likely exhibits an aetiology and epidemiology that is distinct from the “classical” cases of gender dysphoria documented in the DSM.

How to come to terms with being transgender as a teen

“Your son is transgender? I never would have known. He looks so much like a boy!”

It’s one of the well-meaning comments San Diego mom Kathie Moehlig heard over and over from strangers after her son, Sam, transitioned from female to male when he was a teenager.

“I’m like, of course he looks like a boy, because he is,” Moehlig tells NBC News BETTER.

Transgender youth and their families are often bombarded with unsolicited comments from strangers, family, and friends related to the teen’s gender identity. These comments range from well-meaning advice to intrusive questions and even accusations of child abuse, according to Diane Ehrensaft, the director of mental health at a gender clinic in San Francisco and the author of “The Gender Creative Child.”

“All of a sudden, because you have a child who says ‘I’m transgender,’ now people look at you funny and wonder ‘Why are you letting your child do that?’” Ehrensaft says.

In the United States, 0.7 percent of youth between ages 13 and 17 identify as transgender, according to a recent report from the Williams Institute UCLA School of Law. More and more of America’s youth are identifying outside the male-female binary: 56 percent of Generation Z kids know someone who uses gender-neutral pronouns, one survey found, and New York City joined four states in allowing gender-neutral birth certificates.

For many people, adjusting to a young person who is transitioning or using new pronouns may seem challenging. Experts who work with these individuals and their families say there are a number of do’s and don’t’s to keep in mind when interacting with these youth and their families. The first step, these experts say, is to not question the young person’s identity.

“Some of the recent literature that’s coming out is demonstrating that all the ills that we have known to be associated with transgender youth and adults as in anxiety, depression, self harm, even suicidal thoughts, drug and alcohol addiction in later life, risky sexual behaviors, go way down when there is social support for a person to be a gender that feels authentic to them,” says Ehrensaft.

Here are some of the most common misconceptions about sex, gender, and gender identity, according to experts and parents interviewed for this story.

Misconception #1: Sex and gender are the same

People often conflate “gender” with “sex,” but they are not the same, according to Ehrensaft.

Whereas “sex” refers to a person’s reproductive system, “gender” refers to one’s personal sense of oneself as a man or woman, she explains.

“Your gender lies not between your legs but between your ears,” Ehrensaft says.

The term “cisgender” refers to anyone who identifies with the gender assigned to them at birth.

How to come to terms with being transgender as a teen

What’s going on in your brain plays a large role in determining the gender you identify with — and researchers working with transgender people are just starting to understand how.

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Being transgender has nothing to do with sexual identity. As one doctor puts it, “Sexuality is about who you’re attracted to. Gender is about who you are.”

Where does gender originate?

In the birthing process, a medical professional will declare your baby a boy or a girl based on their sexual organs — but does this determine their gender?

“We’re trying to change the understanding of gender,” says psychiatrist Murat Altinay, MD. “That’s one of my big goals. The main question I’m asking is, ‘Where is the gender?’”

We know that as an embryo forms, the genitalia specializes into either male or female. But what about development in the brain?

“The brain and the body can go in different directions,” Dr. Altinay says. “Gender is not only in our genitalia; there’s something in the brain that determines gender.”

Male, female and transgender brains

“The male and female brain have structural differences,” he says. Men and women tend to have different volumes in certain areas of the brain.

“When we look at the transgender brain, we see that the brain resembles the gender that the person identifies as,” Dr. Altinay says. For example, a person who is born with a penis but ends up identifying as a female often actually has some of the structural characteristics of a “female” brain.

And the brain similarities aren’t only structural.

“We’re also finding some functional similarities between the transgender brain and its identified gender,” Dr. Altinay says.

In studies that use MRIs to take images of the brain as people perform tasks, the brain activity of transgender people tends to look like that of the gender they identify with.

“Research in these areas is extremely limited, and more research needs to be done to find conclusive results,” Dr. Altinay notes. “But we’re already seeing definite trends.”

Though these differences in brain structure and function are important markers for gender determination, it isn’t always as simple as male or female.

Some research shows the brains of transgender people are somewhere in between, sharing characteristics of both male and female brains, Dr. Altinay says.

This is consistent with the growing understanding that gender exists on a spectrum, with people identifying not only as male or female but also as genderqueer, genderfluid or nonbinary. These terms refer to gender identities that incorporate a variety of gender characteristics.

Understanding gender dysphoria

In a world that still misunderstands, discriminates against and victimizes transgender people, research demonstrating that gender develops in the brain could have important implications for transgender people, Dr. Altinay says.

There’s also hope that this research will give us a new understanding of gender dysphoria — the psychological distress that many transgender people experience because their assigned gender doesn’t match the way they see themselves, he says.

“If we can define gender dysphoria better, we can tailor treatments for it,” he says.

Those treatments involve taking steps to help a transgender person live as the gender they identify with. This may include medical transition — with hormones or surgery in some cases — as well as with therapy.

“A lot of transgender people who are diagnosed with bipolar disorder or depression or anxiety are actually suffering from gender dysphoria,” Dr. Altinay says. “The hope is that we’ll be able to properly diagnose these people and treat them appropriately so they don’t develop depression and anxiety.”

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Transgender people have a range of experiences with transitioning. Some may transition socially, legally, and medically, some may transition only socially, and some may not do any of these.

What does it mean to transition?

Transitioning is the process of changing the way you look and how people see and treat you so that you become the gender you feel on the inside. Transitioning can means lots of different things. It can involve medical treatment and hormones. It can involve changing your name and preferred pronouns. It can involve changing your appearance and dress. It can involve coming out to your friends and family. It can be a long and ongoing process. Or it can be something that happens over a short period of time.

How do transgender people transition?

There are two different types of transition, or ways to affirm your gender: social transition and medical transition.

Social transitioning may include:

coming out to your friends and family as transgender

asking people to use pronouns (she/her, he/him, they/them) that match your gender identity

going by a different name

dressing/grooming in ways that match your gender identity

For trans men and some non-binary people medical transition may include any of the following:

hormone therapy (to create masculine characteristics such as a deeper voice, facial hair growth, muscle growth, redistribution of body fat away from hips and breasts, not getting a period, etc.)

male chest reconstruction, or “top surgery” (removal of breasts and breast tissue)

hysterectomy (removal of internal female reproductive organs such as the ovaries and uterus)

phalloplasty (construction of a penis using skin from other parts of your body)

metoidioplasty (surgery that causes your clitoris to work more like a penis, along with hormone treatment to make your clitoris grow larger)

For trans women and some non-binary people medical transition may include any of the following:

hormone therapy (to create feminine characteristics such as less body hair, breasts, redistribution of body fat toward hips and breasts, etc.)

breast augmentation (implants)

orchiectomy (removal of testes)

laser hair removal (to remove hair from your face or other parts of your body)

tracheal shave (making your Adam’s apple smaller)

facial feminization surgery (create smaller, more feminine facial features)

penile inversion vaginoplasty (creation of a vagina by inverting penile skin)

Does everyone who is transgender decide to transition?

No, not all transgender people transition. For those who do, not all transition in the same way. Some may transition socially and not medically. Some may transition medically by doing one or only a few of the procedures listed above. Some may take hormones and decide not to have any surgeries, or just choose one kind of surgery and none of the others.

There are many reasons for the differences in how people transition. These medical procedures can be very expensive, which means that not everyone can afford them. Some transgender people may have health insurance that covers transition-related procedures, and some may not. And finally, but most importantly — not all trans people want all of the available medical procedures.

Regardless of whether a transgender person chooses to transition and how they choose to do it, they’re no more “real” than other trans people who don’t transition. Someone’s gender identity should always be respected no matter how they decide to transition socially or medically.

How to come to terms with being transgender as a teen

Family acceptance is still a major issue for many transgender people. Your support could make all the difference to a young trans, nonbinary, or gender-questioning person in your life.

How to come to terms with being transgender as a teen

Share on Pinterest Illustration by Brittany England

We strive to share insights based on diverse experiences without stigma or shame. This is a powerful voice.

Trans visibility has never been higher than it is today. Yet trans people, in particular trans children and youth, are also facing severe, renewed efforts to criminalize and suppress their identities and regulate their bodies.

A record 82 anti-transgender bills have appeared in the U.S. state legislature in 2021 alone. These bills seek to create bans and restrictions surrounding trans people’s access to bathrooms, athletics, and healthcare, among other arenas.

Many of these proposed bills — and the hateful rhetoric surrounding them — are based on inaccurate information and use negative, fear-baiting stereotypes around trans people.

At such a high-stakes moment for trans rights, the participation of families and other allies continues to be of tantamount importance. Keeping trans youth and their families together, and fostering a healthy dynamic between them, is one of the most dire imperatives of contemporary trans activism.

I came out as a trans boy in 2011, when national visibility around trans and nonbinary identities was still very low, and no one in my life had ever hear the word “transgender.”

Living in an all-girls dorm at my boarding high school, I grappled with my gender identity and dysphoria in relative isolation, with no trans role models or resources tailored for me.

For years after my coming out, my mother, Mary, a creative writing professor, and I faced semi-estrangement and conflict; she was filled with anger, grief, and confusion, and struggled to comprehend the perceived loss of her “only daughter.”

While I began to find a support network of friends, educators, and healthcare professionals, my mom found little available for her as a conflicted parent.

After nearly 5 years of hard conversations and healing, we wrote a book incorporating both our perspectives in the hopes of beginning to bridge that divide, sharing our story in hopes it might help other families.

Many — though not all — parents initially experience the same anger, grief, and confusion around their child coming out as trans that my mother did.

This article aims to guide family and friends of trans people through key terms and definitions, and supply gold-standard resources.

Rather than become overwhelmed or discouraged by new terms and concepts, instead consider the ways transness and engagement with gender identity exemplify the complexity and variety of human identity.

Both families of trans youth and young trans people themselves stand to remember: You are not alone, and we are rooting for you!

How to come to terms with being transgender as a teen

Fact #1: Being transgender is hard.

Fact #2: Transgender stress is common

It is no surprise that transgender individuals experience a kind of stress that cisgender (those who identify with the gender they were assigned at birth) individuals do not. People who identify as transgender can and often do experience stigma, discrimination, violence, and internalized homophobia/transphobia. People who are transgender also are at higher risks for “loss pileups.” Family, friends, and romantic partners may not understand the transition and not be able to provide the needed support. There is also a danger of job loss or financial loss, especially for transgender women. Some researchers believe this discrepancy is related to the greater difficulty transgender women have passing, as opposed to transgender men, as well as greater male privilege for transgender men.

There are many ways of dealing with the challenges that come with transitioning and living as a transgender individual, some healthier than others.

How do you deal with transgender stress?

There are two primary coping styles that people use to deal with difficult things in life: Emotion-focused and problem-focused, also known as facilitative and avoidant, respectively. These are fancy terms for a simple concept.

Simply put, avoidant coping is when you…(drumroll please)….avoid the problem. It occurs when you avoid dealing with the emotions and thoughts that come up when you experience discrimination or loss by:

Minimizing the issue: “I’m sure he didn’t mean it.”

Becoming emotionally detached: “Whatever. I don’t even care.

Over-intellectualizing: telling your friends how the socially constructed discourse of gender and the rigid constructions of gender stereotypes are contributing to an unfriendly work environment and not adding, “It really hurt that my boss passed me over for a promotion after I started the transition from male to female.

Using food, drugs, or alcohol to dull your emotions or thoughts

Isolating yourself from social support

Ironically, the more you try to avoid a problem, feeling, or thought, the bigger and more anxiety-provoking it becomes.

How to develop better coping skills for transgender stress

As you can probably guess, facilitative coping is the style we are recommending. Facilitative coping is all about adaptation. It is taking whatever we are given in life and transforming ourselves or the situation to deal with it in a positive manner. Some ways to develop facilitative coping include:

Seeking Social and Professional Support

Seeking out social and professional support is the number one factor in decreasing anxiety and depression in transgender individuals. Discovering friends and family that are supportive of your transition, locating a local (or virtual if you live in a rural area) support group, and finding a transgender-affirmative therapist can make a massive positive impact on your experience.

Self-efficacy

As cliché as it sounds, believe in yourself! Early in the transition process, many transgender individuals experience a sense of hopelessness about the future, believing that transitioning is an impossible, daunting task. As people move further along in the transition process, these feelings begin to change as they realize they do, in fact, have the power to follow through with their transition.

Reframing is looking at your situation in a new light. For example, reframing the difficulty one experiences while transitioning as a source of personal strength and resilience.

Acting “As if”

No one feels confident all the time. However, if you walk out the door with a smile on your face, putting out the confident air that you don’t necessarily feel in the moment, your emotions will often eventually catch up with your actions.

Learning a new skill or hobby (or reviving interest in an old one)

Cognitively challenging yourself by learning a new skill, such as a language or instrument, has been shown to decrease anxiety and depression. Additionally, it provides an opportunity to expand your social network and find a new passion. In the same way, reviving an interest in an old hobby can be immensely fulfilling.

Education and Advocacy

Many transgender individuals find great joy and meaning in doing education and advocacy work for the transgender community. Someone further along in the transition process can find a new source of meaning in helping someone new to the process talk through the initial anxiety and offer them hope for the future.

Being transgender is hard. AND it was the best decision I ever made.

All of this talk about the difficulties of being transgender can begin to sound a little bleak. It is important to note, in that studies cited, every individual expressed that they did not regret transitioning and felt like they were finally living as their true self. They also expressed that all of the hardship was worth the payoff and that the best times in their life were being honest about who they were through their gender transition.

Budge, S. L., Adelson, J. L., & Howard, K. S. (2013). Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. Journal Of Consulting And Clinical Psychology, 81(3), 545-557. doi:10.1037/a0031774

Budge, S. L., Katz-Wise, S. L., Tebbe, E. N., Howard, K. S., Schneider, C. L., & Rodriguez, A. (2013). Transgender emotional and coping processes: Facilitative and avoidant coping throughout gender transitioning. The Counseling Psychologist, 41(4), 601-647. doi:10.1177/0011000011432753

IntraSpectrum Counseling Our therapists are specialized in supporting the full spectrum of LGBTQIA identities and committed to helping you become more you. A validating and supportive environment can help you discover your authentic self and free expression. We offer individual, couples, family, and group counseling, and are conveniently located in the heart of both downtown Chicago and Andersonville. Contact Us with any questions you may have about our therapy services. To set up an appointment with one of our therapists, please visit Get Support.

Rena McDaniel, MEd is the Director of Outreach and Operations and a Staff Therapist for IntraSpectrum Counseling, a group private practice in Chicago that specializes in the LGBTQI community. Follow IntraSpectrum Counseling on Twitter and Facebook.

What social stresses might transgender youth face?

Posted September 7, 2016

THE BASICS

With the recent mandate for schools to make bathrooms transgender-inclusive [1], and the revelations from Caitlyn Jenner [2], public discussions about people who are transgender have exponentially increased. That doesn’t necessarily mean that all parents of transgender teens are feeling better equipped to talk to their teens about what it means to be transgender or about the challenges that transgender youth can face. Parents make a clear and resounding difference. Transgender youth who have supportive parents do better emotionally – they have better mental health and are generally happier than their unsupported peers [3,4].

How to come to terms with being transgender as a teen

So first, just to make sure we’re all clear on what we’re talking about: Gender identity is one’s knowing of themselves as a boy or a girl; or both; or neither. For many people, their gender identity is the same as the sex they were assigned on their birth certificate. For others, it is different. Perhaps their birth certificate says ‘girl’ but they feel inside they are a boy; or vice versa. Not everyone feels one or the other however. Some people are pangender or genderqueer and may feel that this binary definition of girl versus boy does not fit them and their identity. People who have a different gender identity than the sex on their birth certificate, some of whom may identify as transgender and some of whom may not, are together referred to as ‘gender minority.’

Second, about 1 in 33 American teens, which is roughly equivalent to one teen in each classroom, identifies as transgender [5]. So, if your child or another teen you know is gender minority, they are not the only one. Many people identify as transgender.

As a parent, it can be difficult to anticipate what challenges transgender youth might be faced with and how to support them through it. To help provide insight, we looked at data from several studies of transgender youth and identified common stresses. Here’s what we found:

1. Peer harassment and bullying

When victims of bullying are asked why they think that they are targeted, the most common response is that they “didn’t fit in” [6]. As members of a minority group, transgender youth are likely to experience this feeling of not fitting in, and they are much more likely to be bullied, harassed, and sexually harassed than non-transgender youth [7,8]. In fact, 75% of transgender respondents in a national study of youth reported regular verbal abuse, 32% regularly experienced some form of physical harassment (being pushed, shoved), and 17% reported regular episodes of assault (being kicked, punched) [9]. These teens cited their gender nonconformity as the reason for the bullying [9]. In another national study, over 80% of transgender teens reported experiencing sexual harassment—the highest of any group [7].

Bullying can have negative, long-term effects for all youth, including gender minority teens. Gender minority teens who are bullied are more likely to skip school and abandon their educational goals [10-12]. Furthermore, when examining the connection between bullying and substance abuse among transgender youth, we found that bullying can be associated with higher rates of substance use [8].

2. Substance use

Social stress, as a result of bullying, is one contributing factor to substance use among transgender teens. In other words, transgender teens who experience peer harassment may use substances as a coping mechanism. Perhaps understandably, gender minority teens use cigarettes, alcohol, marijuana, and other substances at higher rates than their non-transgender counterparts [8,13]. When approximately 5,500 teens from across the United States were surveyed, 49% of gender minority teens versus 37% of non-gender minority youth had consumed alcohol at least once in the past year [8].

Similar disparities are found for marijuana and other drug use, especially in terms of the recency of use: Among the transgender youth in the national survey, 15% had recently used marijuana, and 10% had used other drugs, compared to 9% and 6%, respectively, among non-gender minority youth [8]. Substance use during adolescence can have lasting negative impacts on social, physical, and mental wellness, as well as long-term development [8].

THE BASICS

These are just two examples of the social stresses that transgender youth experience while growing up in a society that does not often present a welcoming environment for them. So, what can we as parents and other adults who care about teens do to support transgender youth? The biggest thing is to create positive home and community spaces for them [3,4]. This includes school. Transgender teens who attend trans-inclusive, supportive schools experience less bullying [14] and the social stresses that come with it.

Here are some more concrete suggestions if you want to make your local school gender-inclusive:

  • Confirm that your child is able to use the proper bathroom and locker room facilities.
  • Make sure that resources offered and that health, history, and English curricula taught are trans-inclusive as well.
  • If there isn’t an LGBTQ club on campus, such as a Gay-Straight-Alliance, ask your teen if they would like your help starting one.
  • Ask school administrators about their anti-bullying efforts and act to add stronger anti-bullying programs if they do not already exist.