For parents of transgender and gender expansive youth

Thanks for caring about the health and happiness of your child! Unconditional love is so important. I served on the board of TYFA, a national group dedicated to helping families with gender diverse children, so I have worked with many families with gender diverse children and adolescents.

More and more young people are identifying as gender diverse due to greater acceptance and less bullying in schools. A 2016 survey of Minnesota adolescents found that about 3% identified as transgender or gender nonconforming:

Data came from the 2016 Minnesota Student Survey, which consisted of 80 929 students in ninth and 11th grade (n = 2168 TGNC, 2.7%). Students self-reported gender identity, perceived gender expression, 4 health status measures, and 3 care utilization measures. 

Rider (2018)

In other words, almost 1 in 30 young people surveyed identified as gender diverse.

What does it all mean?

I created the chart below to help families and guardians understand issues around minors and gender.

Not all gender diverse young people make a gender transition. Many just want to express their gender creatively in ways that are not traditional for their assigned gender:

  • Clothes
  • Grooming
  • Activities and interests
  • Friends

Experts now agree that affirming these young people and letting them be creative is a healthy part of development.

Within this group of gender diverse minors, some do not identify with their assigned gender. For young people whose gender identity is complex or causing them distress, may also benefit from:

  • Therapy (age 3 and up)

Working with a therapist who specializes in gender issues for children and adolescents can help them understand their feelings and have tools to be happier.

Some may transition socially:

  • New names and/or pronouns
  • They may switch back and forth

Some make legal changes on passport or birth certificate with or without medical care:

  • Legal name change
  • Legal gender change

Medical options are only for those who are:

  • Persistent, consistent, & insistent and/or distressed
  • Allowed by experts and family after steps above

The most common medical option:

  • Puberty blockers (usually age 8 and up)

For those who adjust well to all the steps above, adolescents are sometimes approved later for:

  • Hormones (usually age 12 and up)

In rare cases, late adolescents are approved for:

  • Surgery (usually age 15 and up)

Some of the young people


Gender Spectrum (

  • The most comprehensive English-language site.

Healthy Children (

TransYouth Family Allies (

  • Archived resource for parents of trans youth.

TransKids Purple Rainbow Foundation (

  • Advocacy group by parents of transgender children.

Children’s National Health System (

Lynn Conway (


Trans Kids (2018) by Tey Meadow


Love What Matters (

  • Great podcast by parent of a trans child.


Rider GN, McMorris BJ, Gower AL, Coleman E, Marla E.Eisenberg ME (2018). Health and Care Utilization of Transgender and Gender Nonconforming Youth: A Population-Based Study. Pediatrics, Mar 2018, 141 (3) e20171683;