Supporting Transitions: Insights from a Study on Trans Youth

• A new study shows that affirmative approaches to supporting trans children—validating their gender identity through social transitions—significantly improve their mental health and well-being.
• The research highlights the crucial role of family support, particularly maternal support, in fostering the well-being of trans children.
• The study underscores the emotional journey for both trans youth and their parents, highlighting the phases of confusion, denial, acceptance, and ultimately joy as they navigate the child’s transition together.

---

Background

The visibility of trans children and youths has increased significantly in recent years, though they have always existed. Historically, society failed to recognize their presence, but the emergence of organizations supporting families of trans children has brought their experiences to light. These networks play a crucial role by providing parents with the necessary knowledge, resources, and confidence to support and advocate for their children.

Despite the growing awareness and support from family networks, there remains no consensus on the best ways to support trans children. Research on their experiences is relatively recent. Earlier approaches, like the watchful waiting model, suggested delaying any form of transition based on the belief that most children would desist from their gender identity by puberty. However, these data are now discredited. Recent studies show that detransition is rare, and affirmative approaches, which support children in their gender identity without imposing age limits or future predictions, are gaining acceptance.

Affirmative approaches have shifted the support of trans children, focusing on social transitions during childhood:

• Social transition involves recognizing a child’s gender identity and making necessary changes, such as names, pronouns, appearance, and clothing.
• Studies have shown that social transition, along with family acceptance and support, positively impacts the mental health of trans children and adolescents.

Parents of trans children often face challenges during their children’s social transition. Lack of knowledge is a significant barrier, with many parents initially believing their child’s gender expression was a temporary phase or related to sexual orientation. However, the internet and LGBTQ+ communities provide valuable information and support for these families.

Research consistently highlights the importance of parental support, especially maternal support, in fostering the well-being of trans children. Family support is a critical factor, as mental health issues in trans children are often linked to external factors rather than their gender identity.

In Spain, where González-Mendiondo et al. conducted their research, the recognition and support for trans children and adolescents have evolved significantly:

• The creation of family organizations in 2013 brought media attention and greater recognition of gender diversity.
• Healthcare for trans individuals has also progressed, with the establishment of multidisciplinary gender identity units across Spain. These units offer specialized care, including psychiatry, psychology, and endocrinology services.
• Legislative progress culminated in the 2023 “Trans Law,” which allows gender self-determination from the age of 14, among other rights.
• Recent changes in response to activists’ demands have moved away from a psychiatry-centered model to a more holistic approach, involving primary care services.

Given the limited research in Spain and the vital role of family support, González-Mendiondo et al. aimed to explore the experiences of trans children and their families. Their study focused on children and adolescents who clearly identified as a gender different from their assigned sex at birth and who had undergone a full binary social transition.

The study examined social, legal, and medical transitions:

• Social transition involves changes in name, pronouns, and appearance.
• Legal transition includes changing names and/or sex on official documents.
• Medical transition involves endocrinological treatments for pubescent children and adolescents.

The study aimed to understand how these transitions impacted the quality of life for trans children and adolescents and their families. By analyzing parents’ reports, the research sought to shed light on the experiences before, during, and after social transition, providing valuable insights into the benefits and challenges of the affirmative approach.

• This research is grounded in the concept of substantive sexology, which values human diversity and rejects the notion of pathologizing gender differences.
• It also adopts a trans-emancipatory framework, recognizing the harmful effects of cisnormativity and the need for structural change.
• The study’s goal is to describe and understand the experiences of trans children, emphasizing that gender diversity is not problematic but a natural aspect of human identity.

Methods

This study utilized a narrative approach to understand the experiences of families with trans children:

• A narrative approach allows researchers to document and analyze personal stories to uncover themes and understand how people communicate their experiences (Mertens, 2005).
• By using this method, the study performed a thematic data analysis, where themes emerged directly from the participants’ narratives.
• The researchers’ own knowledge and perspectives were considered valuable, promoting a reflective engagement with the data (Braun et al., 2019).

The researchers’ positionality was integral to the analysis, influenced by their life histories and values (Lorusso & Albanesi, 2021; Singh et al., 2013).

• The research team consisted of three sexologists from public universities in Spain—two cisgender women and one cisgender man. All shared a trans-affirming approach.
• Notably, one researcher who collected the data is the father of a trans girl and a member of the family organization that participated in the study. This connection helped build trust and encouraged participants to share their stories openly.

The study used purposive and convenience sampling for participant recruitment. An announcement was made by the collaborating organization for families of trans children, informing its members about the study’s goals and procedures. To participate, members needed to be part of the organization and have a child who had socially transitioned. The organization focuses on increasing visibility for trans issues and providing mutual support.

Volunteering families were instructed to write detailed stories about their trans child’s life and the family’s experiences from birth to the present. They were asked to include:

• The child’s experiences (e.g., verbal and non-verbal expressions, clothing, games, emotions, conflicts).
• Parental experiences (e.g., fears, crises, acceptance).
• Sibling, grandparent, and overall family experiences.
• Interactions at home, with neighbors, friends, health services, and administrative bodies.
• Specific anecdotes and significant scenarios, including literal expressions and dialogues.

Families did not need to address every aspect but were encouraged to cover the most significant issues in about eight pages (Times New Roman, size 12, single-spaced). Completed stories were emailed to a researcher who pseudonymized them before sharing them with the team.

All stories were written in Spanish, with analysis and discussions conducted in the same language. The final translation into English followed an interpretative-communicative method to maintain the original text’s intent and style for an international audience.

Twenty-two stories were collected from parents of trans children and adolescents aged 4 to 18 years, all members of the BLINDED Organization in BLINDED, Spain. This organization supports families with trans children, aiming to provide support, increase visibility, offer training, and advocate for children’s rights. Most participants were Spanish, except for one French parent. All were heterosexual, and except for one case, parents were living together during the child’s social transition.

Table 1 in the original study provides details about who wrote each story (mother, father, or both), along with data on the parents’ age and educational level. It also includes information about the children, such as pseudonym, gender, age at social transition, current age, and any medical transitions involving puberty blockers or cross-sex hormones.

To ensure anonymity, stories were pseudonymized, removing any identifying information before sharing with the research team. Informed consent was obtained by mail, with no compensation provided. The University of BLINDED’s Research Ethics Committee approved the study.

The study involved a thematic analysis of 22 detailed family stories, ranging from 1,665 to 5,551 words, using the MAXQDA 22 software. Two researchers independently coded the data until no new themes emerged, ensuring thorough coverage and saturation of the data.

Results

Gender transition can be a complex journey, not only for the individuals transitioning but also for their families. The transition process was categorized into three stages:

1. Before Social Transition: This stage involves the child’s early expressions of gender identity, often through non-verbal cues and behaviors that diverge from their assigned gender.
2. During Social Transition: This phase begins with the explicit disclosure of their gender identity and includes the initial steps of living according to their affirmed gender.
3. After Social Transition: In this stage, the child fully integrates into their new gender role, with ongoing adjustments and experiences post-transition.

Before Social Transition

• Early Signs: Children often exhibited behaviors and preferences that did not align with their assigned gender, such as preferences for clothing, toys, and activities typically associated with the opposite gender.
• Emotional Struggles: Many children experienced significant distress, anxiety, and even suicidal thoughts due to the mismatch between their gender identity and assigned gender. Parents reported observing their children’s discomfort and unhappiness from a very young age.
• Grammatical Gender Usage: Some children used language that aligned with their gender identity early on, even before they fully grasped the concept of gender.

During Social Transition

• Disclosure and Name Change: Explicit disclosure of gender identity, often to the mother first, marked the beginning of social transition. Choosing a new name was a significant and affirming step for many children.
• Positive Changes: Once the transition began, children typically showed increased happiness and well-being, although the process was accompanied by urgency and anxiety, especially in adolescents.
• Role of Internet and Social Networks: For older children, finding similar experiences online helped them understand and articulate their feelings.

After Social Transition

• Improved Well-being: Post-transition, children generally exhibited better academic performance, greater social integration, and overall improved mental health. The term “happy” was frequently used to describe the children’s state after transitioning.
• Ongoing Concerns: Despite improvements, fears about social rejection and body development persisted. Adolescents often worried about the changes brought by puberty and sought hormone treatments to align their bodies with their gender identity.
• Family Support: The support from family, especially siblings and grandparents, played a crucial role in the child’s adjustment and acceptance.

Parents’ Experiences

Parents typically went through phases of confusion, denial, and a lack of understanding. Many initially believed their child might be gay or simply defying gender norms.

Over time, parents moved towards acceptance, often guided by support groups, professionals, and online resources. This acceptance significantly improved the family dynamics and the child’s well-being.

Parents experienced a range of emotions, including fear, guilt, and grief for the loss of their perceived child. However, they also felt joy and relief seeing their child’s happiness post-transition.

Family support played a crucial role in the child’s adjustment. Siblings often showed empathy and understanding, quickly accepting the new reality. Grandparents, contrary to some social prejudices, also provided significant support and love, prioritizing their grandchildren’s well-being over their own beliefs.

The study highlighted the importance of societal acceptance and professional support in facilitating a successful transition. Early and affirmative approaches to gender identity were shown to promote resilience and reduce the risk of mental health issues. Professionals working with transgender children and their families must be equipped to provide accurate information, support, and care.

What Can You Do?

This study underscores the transformative impact of acceptance and support on transgender children and their families. It emphasizes the need for early intervention, societal acceptance, and professional guidance to ensure the well-being of transgender youth. By understanding and supporting these families, we can contribute to a more inclusive and empathetic society.

Supporting trans youth in their transitions is crucial for their well-being and mental health. Here are 10 concrete actions you can take to make a positive impact:

1. Educate Yourself and Others: Learn about gender identity, transgender issues, and the experiences of trans youth. Share accurate information with friends, family, and your community to foster understanding and acceptance.
2. Use Correct Names and Pronouns: Respect and use the names and pronouns that trans youth prefer. This simple act of recognition affirms their identity and shows your support.
3. Advocate for Inclusive Policies: Support policies and legislation that protect the rights of trans youth in schools, healthcare, and public spaces. This includes advocating for gender-neutral bathrooms, inclusive curricula, and non-discriminatory healthcare practices.
4. Provide Safe Spaces: Create and support safe, affirming environments where trans youth can express themselves freely. This includes schools, community centers, and online spaces.
5. Support Families: Encourage and assist families of trans youth by connecting them with resources, support groups, and counseling services. Family acceptance is a critical factor in the well-being of trans children.
6. Promote Mental Health Resources: Advocate for and provide access to mental health resources that are inclusive and affirming of trans identities. Support the availability of counselors and therapists who are knowledgeable about transgender issues.
7. Challenge Discrimination and Prejudice: Speak out against transphobia and discrimination whenever you encounter it. Whether in conversations, online, or in public forums, challenging harmful attitudes helps create a more inclusive society.
8. Support Trans-Led Organizations: Donate to and volunteer with organizations that are led by and for trans people. These organizations are often at the forefront of advocacy, support, and education for the trans community.
9. Encourage Peer Support Networks: Help trans youth connect with peer support networks where they can share experiences and find solidarity. Peer groups provide vital emotional support and a sense of belonging.
10. Listen and Validate: Listen to trans youth and validate their experiences and feelings. Providing a non-judgmental, empathetic ear can make a significant difference in their lives.

The experiences of the families in this study highlight the importance of informed and compassionate support from both society and professionals. This knowledge can inform legislative, educational, and healthcare decisions, ultimately improving the quality of life for transgender children and their families.

By taking these actions, you can help create a more inclusive and supportive environment for trans youth, ensuring they have the opportunity to thrive and live authentically.

---

Have you or someone you know navigated a similar journey? Do you have any questions about the transition process for trans youth? Ask away in the comments, and let’s discuss!

Stay informed and inspired! Subscribe to our newsletter, “Society This Week,” and get a free copy of our exclusive report, “Peaceful, Powerful: 225 Nonviolent Tactics for Impactful Activism!”