Parenting Your Gender Expansive ChildMedical Considerations
As with any relationship with a medical professional, it is important to be an active participant in your child’s care and monitor relationships with health professionals on an ongoing basis

Choosing Medical Professionals

It is important to find a medical professional who understands children and gender, or who is at least willing to educate themselves. Interview potential medical providers and find out about their experience in working with gender-expansive or transgender children. Ask about how they see their role in your child’s gender journey, and make sure they won’t be another adult trying to put your child into a gender box. See more in our tips for choosing professionals.

Tips for Choosing Professionals

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Unfortunately, many physicians are intimidated by this relatively new area of practice, or disagree with treating transgender children. Sometimes, families end up having to travel to established gender clinics in order to receive treatment for their child.  If no one in your area is qualified, try to find someone who is willing to learn. We can help connect them to experienced physicians who can consult with them about the process. 

Need some help finding a medical professional? Gender Spectrum has connections to many professionals who are committed to affirmative care and support of gender diverse youth. If you need referrals for medical, mental health, legal or educational support, contact us and we will connect you to professionals who can help you find appropriate referrals.

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Children’s Emotions Around Medical Care

For many kids, going to the doctor can be traumatic. For gender-expansive or transgender kids, physical examinations of their bodies can feel especially invasive because if forces them to face a body they want to be different. Or, it can feel hard to explain their gender expression to a doctor who doesn’t understand.

Changing Bodies to Match Gender identity

Gender-expansive and transgender kids do not have to change their bodies in order to change their gender expression or identity. Some choose to make no changes to their bodies at all, while others know that they must change their bodies to feel complete. One of our roles as parents is to help our children figure out what road is right for them.

Introduce your children to the ideas of different body choices, so they know there are a variety of paths. Just as each child knows their own gender expression and identity, they also know how they feel about their bodies. Some may experience no body dysphoria at all. Some may choose to take hormones but never have surgery. Some may choose to have some surgeries but not others, and many other combinations of choices. Discuss with your child and doctor which treatments are permanent and irreversible and which are not. Physicians work in conjunction with a team, including the child, parent, and therapist to help determine if body changes are appropriate for any given child or teen.

Approaching Puberty

Sometimes when a young child is consistent and persistent in their transgender identity, they will experience great dread and anxiety as puberty approaches. Parents of pre-pubertal transgender children are aware of this oncoming physical betrayal. They are fearful of the potential depression their child may experience, and the consequences of this depression. 

Rightfully so, many parents are worried their child may experience suicidal feelings if forced to experience the pubertal changes not in alignment with their identity. However, parents are often in the dark about the consequences of acting to delay puberty or to offer cross hormones, but there is information available to help you make these decisions with your child. 

Medical intervention can be a more difficult decision when your pre-teen or teen suddenly announces they are transgender. This news is almost always shocking and difficult to integrate. We want to protect our children and have them make healthy decisions, yet the changes your child may request can be dramatically life-changing and permanent.

Parents who are just discovering their teen’s gender identity may be more than a little confused regarding appropriate medical options for their child. Your teen, on the other hand, may know exactly what they want to do. Take time to let your child know that you support them. Take any non-permanent steps that you can to show your support—name and pronoun changes, clothing and haircuts, etc. You may even consider hormone “blockers” to pause puberty to give you and your child more time. It is OK for you to take the time you need to catch up and do your research.

If your child is going down the road of physical transition, you may be referred to an endocrinologist. But endocrinologists are not the only physicians who can help you -- any physician, including your pediatrician or family practitioner, can help a child start their physical transition with hormone “blockers” and/or cross-hormones.

Keep the lines of communication open and explore options together. Discussing what you learn together can work to make the whole family better informed as well as allow for ample adjustment time. However, keep in mind that a parent and child may have very different ideas of an appropriate timetable. Don’t feel rushed into making decisions about permanent changes, but also keep in mind that your child may feel rejected by you if these critical life decisions are delayed indefinitely.