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Worried about your gender identity? Advice for teenagers

If you feel confused about your gender identity, you're not alone.

Many teenagers question their gender, whether they feel female, male, non-binary or any of the other terms used on the gender spectrum.

Some people believe that society has become more accepting of differences in gender identity.

Although most people do not question their gender, for some young people their gender identity is more complex.

You may question your gender if your interests and social life do not fit with society's expectations of the gender you were assigned at birth.

You may feel:

  • that you cannot identify with being just male or female
  • that you identify with multiple genders
  • that you have no gender (agender)
  • that you are non-binary

Or, you may have a strong sense of being a gender that is different to the sex you were assigned at birth and may feel that this has affected the way you feel about your body.

For young people who feel distressed about their gender, puberty can be a very difficult and stressful time.

Puberty is a time of physical changes to your body, such as the growth of breasts or facial hair.

Does it make me gay, lesbian or bisexual?

Gender identity and sexual orientation are separate things.

You may identify as straight, gay, lesbian, bisexual, polysexual, pansexual or asexual.

Or, you may want to describe your sexuality and gender identity as being fluid – that is, they change over time.

How does gender discomfort affect you?

If you experience discomfort with your gender identity, you may feel unhappy, lonely or isolated from other teenagers.

Gender identity issues are not a mental health disorder or disease. However, if you feel as though you are struggling with your mental health you can seek help for this.

You may feel social pressure from your friends, classmates or family to behave in a certain way, or you may face bullying and harassment for being different. This may be affecting your self-esteem and performance at school.

All these difficulties can affect your emotional and psychological wellbeing. In some cases the distress can be considerable. Depression is very common among young people with gender discomfort.

Who can help me?

If you're experiencing discomfort or uncertainty about your gender identity, and it's causing you distress, it's important to talk to an adult you can trust.

You might want to talk to a parent or family member, or someone at your school or college.

Schools and colleges are now much more aware of trans and gender identity issues, are keen to support young people, and have a duty to support you.

If you do not feel able to talk to someone you already know, there are charities and local gender support groups you can talk to. Many have trained counsellors you can speak to in confidence.

You can find charities and support groups on the Tranzwiki page on the Gender Identity Research & Education website.

What help is available on the NHS?

If you have strong and continuing feelings of distress because of a mismatch between your sex assigned at birth and your gender identity, there are options available.

These include talking therapy, hormone treatment and, after 18 years of age, surgery if appropriate.

Your GP, other health professional, school or a gender support group may refer you to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust.

This NHS service specialises in helping young people up to the age of 18 with gender identity issues. It takes referrals from anywhere in England. Its main clinics are in London and Leeds.

What can I expect from the service?

The team at GIDS considers the individual needs of each young person, including their age and their stage of development.

The GIDS will support you, involving your family as appropriate, your school and any other services that may be involved.

All sessions are confidential and information about you will only be shared with your consent (unless there is a concern that you are at serious risk of harm).

Assessment

The first stage is an assessment, which will usually involve between 3 to 6 appointments over a period of time (usually up to 6 months).

You will have a key worker who will co-ordinate your care. 1 or 2 members of the clinical team will oversee your assessment, such as a clinical psychologist, child psychotherapist, child and adolescent psychiatrist, family therapist or social worker.

The assessment will include exploring your past and current gender identity, your relationships with family and friends, your emotional and psychological wellbeing and your physical health.

For more serious emotional issues, the GIDS team may refer you to your local child and young people's mental health service if you are not already in touch with them, where mental health specialists will support you.

Continued support

After you have been assessed by the GIDS, you and your family will be offered support for as long as you need it (up to the age of 18). You may find that this support is enough to help you live in the gender role with which you identify.

Hormone therapy

If you have lasting signs of gender dysphoria and you meet strict criteria, you may be referred to a hormone specialist (consultant endocrinologist) to see if you can take hormone blockers as you reach puberty. This is in addition to psychological support.

Hormone or puberty blockers allow a young person to consider their options while exploring their gender identity.

GIDS advises that blockers are physically reversible when treatment is stopped. However it is not known what all the psychological effects may be. The decision to have any kind of healthcare treatment always involves weighing up the different benefits and risks involved.

Fertility

Gender-affirming hormones may affect your future fertility, so it’s important to consider this before choosing to move on to hormones.

The GIDS team will help you to consider your options and recommend you seek further specialist advice via your GP regarding gamete storage. This is the harvesting and storing of eggs or sperm for your future use.

Gamete storage is sometimes available on the NHS.

Find out more information for trans and non-binary people seeking fertility treatment on the HFEA website

What next?

Through the help and support of the GIDS, many young people become at ease with how they express their gender identity.

Once you are aged 17 years, you can ask for a referral to NHS adult gender identity services if you wish to explore your gender identity further.

Information:

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 how services are delivered for children and young people.

Page last reviewed: 12 November 2021
Next review due: 12 November 2024