Think your child might be trans or non-binary?
If your child seems confused about their gender, it's usual for parents to feel puzzled or worried. But there is help available to support you and your child.
It's not unusual for children to show an interest in clothes or toys that society tells us are more often associated with the opposite gender.
With toy stores dedicating whole floors to colour-coded boys' or girls' toys, as just one example, it's not surprising that parents may expect a child to closely match traditional expectations of how male and female genders should behave.
You may be worrying that your child's exploration of different gender preferences and behaviours is not "normal" or you may feel that such explorations are somehow your "fault". However, none of this is the case.
We now believe that gender identity is on a spectrum, with male at one end, female at the other and a "diversity" of gender identities in between. These can include male and female, non-binary or even agender (no gender).
A young child's exploration of different gender identities is quite common and, in most cases, will fade. However, in some, it will continue into later childhood and adolescence.
When should I seek help for my child?
Children develop and change quickly as they grow up. The majority of children who seem confused about their gender identity when young will not continue to feel the same way beyond puberty.
However, you should ask for help if your child is strongly identifying with the opposite gender and this is causing significant distress to them or your family.
Signs of distress in a child can include anxiety, withdrawal, destructive behaviour or depression. It's also likely that such behaviours will have been noticed at school.
You may seek support for your child before puberty starts, which can be as young as age 9 or 10. The physical changes that occur at puberty, such as the development of breasts or facial hair, can increase a young person's feelings of unhappiness about their body or gender.
Who can help?
Your child's GP can refer them to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust. Other NHS professionals, teachers, local support groups and relevant charities, and counsellors can refer them too.
GIDS is the NHS service specialising in providing gender identity development support tailored to the needs of children and young people, and takes referrals from anywhere in England. Its principal clinics are in London and Leeds.
The multidisciplinary team at GIDS works with family members, children and young people to help manage any anxieties and ease emotional, behavioural and relationship troubles associated with gender identity.
After an initial assessment, you and your child are seen by the team at GIDS. The team will help you keep your child safe and reduce any stigma around exploring their gender identity.
The team will also discuss with you the support and consultation they can offer to other agencies and services that may be involved, such as the nursery or school, and local Child and Young People's Mental Health Services (CYPMHS) as appropriate.
If your child continues to be upset or confused about their gender identity and is nearing puberty, you and your child may be seen more often by the team at GIDS.
Each child or young teen will have different needs and goals for how they wish to express their gender.
If your child has lasting signs of gender dysphoria and meets strict criteria, they may be referred to a hormone specialist (consultant endocrinologist) to see if they can take hormone blockers as they reach puberty. This is in addition to psychological support.
GIDS needs to apply to the court for permission to start puberty blockers for children and young people under the age of 16.
This is because a recent court ruling states that it's doubtful children and young people under the age of 16 are able to give informed consent for this treatment.
The court will be asked to consider in each case whether hormone treatment is in the best interests of the young person.
Different arrangements apply for young people aged 16 and 17, as the law presumes they are able to give informed consent.
In these cases, an application to the court will only be necessary if there is any doubt about the young person's capacity to give consent or disagreement about the best interests of the young person.
NHS England has more information on the changes to the current service specification for the Gender Identity Development Service (PDF, 16KB).
Will my child grow up to be trans or non-binary?
In many cases, gender-variant behaviour or feelings disappear as children get older – often as they reach puberty. Many will go on to identify as gay or lesbian.
Children who do continue to feel they are a different gender from the one assigned at birth could develop in different ways.
Some may feel they do not belong to any gender and may identify as non-binary. Others may want to dress in the clothes associated with the opposite gender from time to time or on a regular basis.
A small number of children who have continuing, strong feelings of a different gender identity will go on to live full-time in a gender different from the one assigned at birth.
How can I support my child?
Children sometimes worry that if they tell you how they feel, you won't love them anymore. It's important to accept your child and let them know you love and support them, whatever their preferences are.
If you feel anxious or uncomfortable, you're not alone. You may blame yourself because you think it's your "fault", but it's important to remember gender identity is nobody's "fault".
Many young people and parents find talking to other parents and children who have had similar experiences a great help.
It's also important to remember that you, as a parent, need support too. You may be experiencing feelings of loss at your child wishing to live in another gender, or you may be anxious about their future and the effect on the rest of your family.
The charities listed on the TranzWiki page on the Gender Identity Research & Education Society website are there to help you, too.
You and your GP can find advice and guidance for parents and carers on the GIDS website.
NHS England review of gender identity services
NHS England has commissioned an independent review of gender identity services for children and young people. The review will advise on any changes needed to the services for children and young people in 2021.
Page last reviewed: 4 June 2018
Next review due: 4 June 2021