Transgender kids—like all children—deserve to feel at home in their bodies and be respected for who they are.
Gender-affirming healthcare can aid in those goals, easing the psychological pain (gender dysphoria) caused by a mismatch between the gender they were assigned at birth and their true identity. Social acceptance is also essential. Transgender youth who aren't supported by their families are at three times greater risk of attempting suicide, according to the Centers for Disease Control and Prevention, and face much more anxiety and depression.
Too many, though, have to navigate their development without any of these supports. And a growing tide of state legislation, panic and disinformation targeting their care has made life even harder for vulnerable children and teens.
Dr. Paria Hassouri, who leads Cedars-Sinai's Pediatric and Adolescent Gender Wellness Clinic, combats some of the misconceptions here.
Gender identity isn't a choice
You can't make a cisgender child become transgender by talking to them about the gender spectrum, Dr. Hassouri stresses. Nor can teachers or books.
About half of kids know very young; one Cedars-Sinai study of transgender adults found most felt uneasy with their gender by 7 years old. There's also a spike in dysphoria around puberty when preteens start to feel uncomfortable with how their body is changing.
Supportive care includes a range of tailored physical and mental health and social services
Gender-affirming care is, ultimately, accepting someone for who they tell you they are on the inside and taking steps to recognize that.
Young children typically transition socially, with changes such as name, pronouns, hairstyle and clothes, while preteens can take puberty-blocking medications to postpone the process as they explore. A doctor might later prescribe hormones to affirm older teens, including testosterone for transmasculine youth or estrogen and pregosterone for transfeminine youth.
Pediatricians follow strict clinical guidelines—a child won't be prescribed medical care on a whim or just because they are questioning, Dr. Hassouri emphasizes.
Affirming surgeries are not conducted before puberty—and overwhelmingly on adults.
Pediatric gender-affirming treatments work
Major healthcare organizations all back gender-affirming care for gender-diverse youth.
Earlier treatment can reduce dysphoria and puberty effects such as breast development and vocal changes that would require more invasive surgeries later.
And repeated studies show their life-saving mental health benefits in transgender and nonbinary youth, including one finding that a combination of puberty blockers and hormones lowered the chances of moderate or severe depression by 60% and suicide by 73%.
The vast majority of youth who transition maintain their identity after five years.
The Cedars-Sinai blog has more on how gender-affirming care can help gender-diverse kids and teens live as their most authentic selves.