Information For Parents and Carers Of Gender-Variant and Transgender Children
- Pre-Puberty
Young children enjoy role-play and dressing-up during childhood, this exploration is normal and healthy. Exploring different roles helps children learn about the world, relate to other people and understand themselves better. For some children this exploration goes further and they question the gender they have been born into and the expectations this places on them. As a parent or carer it can be worrying and confusing when a child prefers playing with toys associated with the opposite gender or dressing in the other gender’s clothes. Some children may request the use of a different name or insist that they aren’t a boy/girl but the opposite.
Mermaids aims to inform and support families of children and young people who question their gender and express it differently. We understand the emotions involved in supporting a gender-variant child, and the confusion over where to turn for help. We offer families the benefit of our experience in dealing with transgender issues, and provide access to the support and knowledge of others in similar situations.
Some useful terms to understand when finding out more about gender identity:
Transgender ~ someone who identifies as a different gender to the one assigned at birth.
Transition ~ process of changing clothes, name etc to live as the gender someone identifies with.
MTF ~ Male to Female (someone who is biologically male but identifies as female)
FTM ~ Female to Male (someone who is biologically female but identifies as male)
Is my child transgender?
For the majority of children, the gender they are born into fits them - that is, the sex assigned at birth (based on their genitals) matches how they feel about themselves. A boy grows up feeling male, and becomes a man; a girl is comfortable in her femininity, and becomes a woman. For some children this isn’t the case, and their feelings inside don’t match their bodies or what is expected of them in terms of behaviour and dress. This is sometimes referred to as gender variance. Gender variant children express themselves in different ways; for example, their behaviour and preferences may not seem usual for their gender, or they may express a wish to be the opposite gender. Some may insist that they have the wrong body.
Nobody can tell you for certain at a young age whether your child’s gender variance will continue beyond puberty and into adulthood. Some children express gender issues as young as 2-3yrs old, while others may experience confusion but not express it until they are older. It isn’t unusual for some girls to prefer toys and clothes that are more associated with boys, and these ‘tomboys’ are generally accepted, but there isn’t a commonly understood alternative for boys. Yet, some young boys do enjoy ‘female’ clothes and toys and this may be for a variety of reasons, not simply that
they are transgender. The changes that puberty brings with the influx of hormones and visible body development can see gender variance increase in some children but resolve itself in others.
This is why the process of assessing children for gender issues can be a lengthy one. You may feel as a parent that things are changing fast, but the process is a long and steady one that allows for development and changes. Many young children expressing gender variance will grow to be comfortable in their birth gender, others may go on to identify as a one of a range of identities and some will go on to become transgender. Looking ahead can be daunting and uncertain, so supporting your child in their identity now and seeking help is a more certain way to ensure the best outcome.
You may find it helpful to read further about gender variance here:
http://www.apa.org/monitor/sep03/children.aspx
http://www.nhs.uk/conditions/Gender-dysphoria/Pages/Introduction.aspx
http://www.nhs.uk/Livewell/Transhealth/Pages/Transparentalworries.aspx
This leaflet is also very good - "If you are concerned about your child's gender behaviors"
http://childrensnational.org/~/media/cnhs-site/files/departments/gender-and-sexuality-development-program/gvparentbrochure.ashx?la=en
What can I do?
You’ve already taken an important first step in looking for help and support by contacting Mermaids. We’re aware that you may be experiencing a range of emotions, from fear to grief, and possibly the relief of things beginning to make sense. It’s important to give yourself time to experience the emotions you feel, this will enable you to support your child best. You may feel confused or pressured to tell family, friends or school, but initially it is fine to take time to inform yourself and decide on the way forward. The key thing you can do as a parent/carer is listen to your child and allow them to express themselves to you. Some children find this easier than others, but having some idea of how your child feels will make it easier to take the next step.
For lots of gender variant children there is no real distress about their body until they approach puberty, but for others there can be discomfort from a young age so it is important to seek help sooner rather than later. The assessment process for gender dysphoria can take a long time and leave your child much closer to puberty before they’re offered help. The first step is to speak to your GP and request a referral to the Tavistock Clinic which runs the only Gender Identity Development Service for children in the UK. The Tavistock have clinic bases in London, Leeds and Exeter where they see patients from all over the country. You can read more about the Tavistock’s services here: http://www.tavistockandportman.nhs.uk/care-and-treatment/information-parents-and-carers
Your GP may refer you to your local CAMHS (Child and Adolescent Mental Health Service) instead. The Tavistock encourage this, as it means your child has local support wherever you live. Mermaids is aware that many CAMHS services have lengthy waiting lists (as does the Tavistock) so you may want to request that your GP refers to both services at the same time. This will ensure your child gets help as soon as possible. If your GP is not happy to refer to Tavistock in
the first instance, don’t worry. CAMHS can also refer your child to the Tavistock once they have seen them. Mermaids are able to supply a referral form for the Tavistock for you to take to your GP.
These online resources can be very useful. The first is to be used by all the professionals who care for young people, as well as by their families. The second is aimed directly at GPs:
www.nlmscontent.nesc.nhs.uk/sabp/gv
www.elearning.rcgp.org.uk/gendervariance (from early 2015)
What happens next?
Once your child has been referred to the Tavistock clinic you will begin a process of assessment. Initially, this will consist of lots of talking with you and your child. This enables the specialists to build a picture of your child’s gender identity and the history of their feelings. The gender clinic will not encourage your child in any direction but will look at supporting you all while observing how your child’s gender issues present themselves. They will offer help to cope with any distress and practical support relating to schools. The service will offer this support until the gender issues resolve and if necessary may offer hormone blockers during puberty.
The thought of medical intervention at young age can be intimidating for many parents. However, the hormone blockers offered are reversible and are not offered before a child reaches a certain level of adolescent development, Tanner Stage 2 at the earliest (http://en.wikipedia.org/wiki/Tanner_scale). The blockers do not change your child’s body, but they do pause puberty to give them time to explore their gender further without the adolescent physical changes that can bring great distress. If a young person decides that they are happy in their birth gender then they can stop the treatment. A normal puberty will begin, allowing their body to develop in the expected way. However, if a young person continues to identify as a different gender, the blockers will minimize the development of physical characteristics of their birth gender. This can reduce the need for corrective surgery at a later date, and allow them to present more clearly as their chosen gender.
This treatment path, followed by cross-sex hormones at a later stage, has been shown to be very successful in The Netherlands where they have been treating gender variant children and young people for a long time. Findings indicate that blockers allow young people to fit in more easily, suffer less psychological stress, and have more confidence in their identity. There is a book called 'Inside Out' by Sarah Wong, which features photographs of some of these young people. You can view some of the pictures here: http://www.sarahwong.com/independent
Looking further ahead, a young person may opt for cross-sex hormones where they receive the hormones of the gender they identify with. This helps their body develop in-line with their brain
and will see them go through puberty albeit at a later age. Some may then opt for surgery, but others may not - nobody can say for certain what any individual will do so far ahead. The important thing is to focus on your child now, and support them at the stage they’re at.
What can Mermaids do?
Mermaids is a charity staffed entirely by DBS checked volunteers, all of whom have experience of gender variance, either as the parent of a transgender child or as a transgender adult themselves. We offer support, advice and information, as well as a community of families dealing with gender issues. Our online forum for parents is a secure and confidential space where you can share your feelings and experiences with others, and gain friendship, practical advice and moral support. The forum is also the place to find out about any meetings or social events happening around the
country. To join, follow this link - http://groups.yahoo.com/group/Mermaids-UK-parents/ Keeping our members safe is important, so we will send you an email when you apply - please reply to this ASAP so that we can approve your membership and give you access to the board.
Mermaids also has a helpline which you are welcome to call with any queries or for a friendly ear – we recognize that it can be difficult to find someone to confide in but we’re here to listen and talk things through. Alternatively, if you’d rather email then please contact us at for information and support. We have experience in dealing with a range of organisations and have supported families in discussions with schools and other services.
What about school?
For many parents the issue of school is an understandable worry when they have a gender variant child. Bullying can be common and some schools are not prepared or informed enough to welcome transgender children. As a reassurance there are many young trans children and teens in education in the UK and there are some very supportive and welcoming schools. We receive requests for information and advice from teachers and school support staff on a very regular basis. Awareness of gender variant children is increasing and many schools are willing to embrace this and provide support. If you encounter a school that doesn’t fit this description then you’re not alone and Mermaids can supply information and guidance for both you and the school staff.
It’s important to remember that the school has a duty of care towards your child and this is covered in the Equality Act 2010, which has the protected characteristic of 'gender reassignment'. This may sound odd when talking about a young child, but it actually means anyone who is outside the accepted gender norms i.e. someone who acts as though they may one day change gender (even if they eventually don’t), or anyone has had or will have gender reassignment. This means that the school must take steps to integrate gender variant children and to alleviate any discomfort they may feel. This may mean educating their peers to accept those that are a little bit 'different' and even extending this learning to parents. Many schools with gender variant pupils hold assemblies to talk about individual difference and look at
educating the whole school including staff. It is not illegal to make special allowances for trans or gender variant young people, as they have certain special needs. The following link provides useful information: https://www.gov.uk/discrimination-your-rights.
There is a very good toolkit available for schools focused around transgender inclusion, Mermaids can supply copies of this along with another resource created by Lancashire council which is also very useful. Local education authorities/councils often also have their own guidance. The Rainbow teaching website (http://rainbowteaching.co.uk/) is also recommended - their aims are to provide free support and guidance to teachers and school staff, to challenge anti-LGBT+ bigotry in schools and to provide guidance on an LGBT+ inclusive curriculum.
Where can I find more information?
There is a lot of information available at www.gires.org.uk including explanations of gender issues and information on treatment, bullying and legal rights.
This link takes you to a comprehensive directory of the groups campaigning for, supporting or assisting transgender people and their families across the UK
http://www.gires.org.uk/tranzwiki/index.php/Main_Page
This link takes you to a comprehensive directory of the groups campaigning for, supporting or assisting transgender people and their families across the UK