In 2016, I posted a short blog that gave general guidance for parents with teens who had recently come out as transgender. In the intervening months, I have spoken with a number of families whose teen identified as trans for some period of time, and subsequently desisted, often as a result of parental support for finding alternative ways of managing the feelings that led the young person to identify as trans. This post summarizes what I have learned from speaking with these families.
As background, I have spoken with dozens of parents looking to help their child deal with gender dysphoria without resorting to transition. In virtually every case, these parents were motivated by a desire to help their child avoid unnecessary medical intervention that could compromise fertility and expose their child to potentially serious side effects. These parents were not motivated by transphobia, bigotry, or right wing ideological beliefs. Many consider themselves politically liberal. In quite a few cases, the young person came out as gay or lesbian to full parental support and acceptance before going on to later come out as trans.
If the distress of gender dysphoria can be managed well with less invasive interventions, this is preferable to transitioning. This is because medical transition damages the body, and can lead to lifelong dependence on synthetic hormones. Teens ought to be guided to make choices that are most adaptive – that will leave them able to have loving relationships and community, meaningful work, and long-term mental and physical well-being.
I have spoken with many families who initially supported their child at least partially toward a social transition. They may have allowed changes in names and pronouns, or purchased a binder or new clothing. These families report that they noticed their child’s mental health symptoms worsening after such a transition. It is worth noting that there may be many families who noticed an improvement in their teen’s symptoms after supporting a social transition, but these families are unlikely to seek me out, so of course my experience is limited in this regard and may not be representative. However, my observations are supported by recent research published in the February, 2017 Journal of Adolescent Health that noted that mental well-being and parent child relationship tended to get worse in the majority of cases after an adolescent came out as trans. This is one of the many areas where further research would be helpful.
Who Tends to Desist?
Teens with rapid onset gender dysphoria who have desisted from a trans identity seem to share at least a few of the following traits or experiences:
- They were younger teens when they came out.
- Their parents received early support not to affirm their child’s transgender identity.
- The teens were never fully affirmed at school.
- They were never fully affirmed by another adult authority figure such as a gender therapist.
- Their online time was limited.
- Their overall mental health was relatively stable.
Parents who meet a child’s initial announcement with loving support but without affirmation were more likely to see their child desist in my experience. It appears that the more teens are supported in a belief that they are a member of the opposite sex, the more entrenched this belief becomes, making later desistance more complicated.
Outcomes
Although my sample is small and my observations anecdotal, teens who have stepped away from a trans identity appear to be happier, less anxious, and more flexible in their choices than during the period of time they identified as trans, according to parent report.
Ignoring versus Challenging
When a child identifies as trans, the topic of gender becomes extremely invested with energy, emotion, and significance. If a parent begins to argue with a child on this topic or to police fine points of the young person’s appearance or behavior, gender will only increase in importance as it becomes the battleground on which normal parent-child skirmishes around separation, independence, and control are fought. In general, therefore, ignoring the topic of gender is helpful in de-escalating the situation. Parents can focus instead on other ways to connect, finding enjoyable ways to spend time together, or discussing neutral topics of interest to the teen.
As with every rule, there are some exceptions. Most parents who have had a child who desisted challenged their child’s belief that they were born in the wrong body. This can obviously be a difficult thing to do, and comes with risks. In general, the more entrenched a person is in a trans identification, the more difficult it will be to engage him or her in a discussion about alternative ways to interpret feelings. If a child is particularly fragile or firmly invested in a transgender identity, even gentle questions may lead a child to feel unsupported. Teens and young adults may decide to cut off contact with a parent who expresses anything other than full support. The decision of whether to engage the teen in a discussion that questions his belief clearly needs to be handled with extreme care. Parents know their children best, and ought to be supported in following their instincts in this regard.
If a child has only recently come out as trans, it can be very effective for parents to share their opposing views. Questioning a teen’s self-diagnoses as transgender does appear to be an important intervention that helps lead to desistance. Challenging a child’s beliefs should always be done without anger. As much as possible, it ought to be done respectfully and with genuine empathy for the child’s suffering. Some parents have had good success with carefully timed, short reality-based statements, delivered with authority but not anger. An example might be a well-placed statement such as “liking video games doesn’t make you a boy.” Since the point is to avoid power struggles, there is no need to engage in an argument. Simply make the statement, and then move on.
Setting Limits
In a similar manner, when setting limits around a child’s behavior related to gender, parents ought to be clear, compassionate, and consistent. Rules work best if they are sensible and safety-based. Such limits might include forbidding a child from binding; using male restrooms (for a natal female); having unlimited internet access; routinely staying up late into the night (develops poor sleep hygiene); avoiding physical activity; and becoming isolated. All of these activities pose real health, mental health, or safety risks for teens.
Once these rules have been communicated to the child, parents are advised to enforce them consistently, but not obsessively. This is of course the best way to enforce any limit we set with children. We expect them to step over the line at times. Doing so ought to carry a reasonable consequence, but if we become overly activated when they trespass, we once again invest the action with too much power. A matter of fact response is usually best.
We cannot and should not expect to control every aspect of our child’s life. Experimentation with identity – friends, hairstyles, clothing, belief systems, etc. – is an important and natural part of adolescence, and our kids need some room to do this in a safe and healthy way. Creating safety-based limits that parents feel comfortable with and will be able to enforce, and then ignoring behavior we may not like can be a good way of ensuring our kids stay safe and have some room to explore, and while minimizing conflict and power struggles.
How Do We Know It’s Working?
Encouraging a child to consider other ways of understanding her feelings of distress is often a marathon, not a sprint, especially if the child is in an affirming environment at school. Compassionately refusing to give in to demands for puberty blockers or hormones may bring dramatic displays of anger and upset. When does our child’s distress signal that not affirming is indeed harming our child?
It’s important to remember that adolescence is nearly always a time of increased conflict between parents and children. It is normal for teenagers to experience some degree of distress. The majority of teen girls feel some degree of displeasure or even hatred of their bodies. Limit testing is also a typical feature of the teen years. When we see our dysphoric teenager become angry or upset when we impose a limit around transition, it might help us to place her reaction within the context of normal teen behavior. Just because they express unhappiness does not mean that we ought to give in to their every demand.
It can be helpful to separate the concepts of gender dysphoria from transition. Gender dysphoria is a mental health diagnosis and can result in real suffering, for which we can offer compassion, support, and treatment. Detransitioners are writing and vlogging about alternative ways of managing dysphoria. Asking your teen to wait until adulthood to consider transitioning does not mean that you won’t offer support and care for their dysphoria.
Don’t expect a teenager to tell you that you are right, that they are happy you are imposing limits, or that they are grateful to for you slowing things down. That would be like a toddler waking up and thanking you for making him take a nap! However, you can feel reasonably reassured that things are moving in the right direction if you observe any of the following:
- When you set a limit or refuse to accede to a demand, your teen becomes angry and upset, but recovers quickly. She moves on after a short period of distress and reconnects with you.
- The trans identification becomes more important during periods of stress, such as final exams. Parents have described their daughter’s frequency of binder use as a reliable indicator of academic pressure. When your teen is less tense, she seems generally more content and less interested in asserting a trans identification.
- Although your teen may have periods of significant distress, he also has times where he seems generally content and functions adequately socially and academically. He can participate as part of the family at least some of the time.
If, however, a child disappears into prolonged depression or isolation, it may be a sign that more serious intervention is needed.
What About Suicide?
Any mention of suicidal feelings needs to be taken extremely seriously. Teenagers are highly suggestible, and suicide has long been known to be socially contagious. The transgender narrative that teens learn online tells them that they will become suicidal if they don’t transition, and it is my guess that this belief might have contributed to a number of suicides among teens who were fully supported in their transition.
Regardless of the etiology of suicidal thoughts, such ideation must be addressed with professional support. Teens expressing suicidality ought to be shown support and compassion for their distress. They also ought to be treated for depression and suicidality. In the mental health field, suicidality is treated with therapy, medication, and hospitalization when necessary. Provisions are made to ensure the person’s immediate safety while helping them find more adaptive ways of managing feelings.
Parents Don’t Need to Be Perfect
Although it is important for parents to avoid being overly reactive, parents ought not to berate themselves if they can’t respond with perfect equanimity at all times. Having a child come out as transgender out of the blue can be stressful and frightening, and there are limited supports for families in this situation who would like to explore alternative methods of supporting their dysphoric child. It is important for parents to cultivate compassion for themselves, including forgiving themselves when they lose their temper or otherwise become reactive.
Get Support for Yourself
Parents I spoke with recommended finding something absorbing to do as a way of channeling energy and anxiety. This helps interactions with your child to be less pressured. Finding supportive friends or family members in whom you can confide is also crucial. Parent support can be found online.
Disclaimer: This blog post is not meant to take the place of psychotherapeutic treatment.
Thank you so much for publishing a follow up. My 11yo daughter is exhibiting sudden onset transgender and we have found that when we confront her with facts she becomes more entrenched in the identity. We are not allowing her to use a male name or male pronouns at home and will not allow it at school. We are also closely monitoring her Internet activity. I’m hoping that the ignore approach combined with lots of love and therapy will allow her to become more comfortable with her body. She entered puberty early and I think her brain is having problems coping with looking like a 16 year old. Our society sends mixed messages of hypersexuality that many young girls cannot cope with and then offers a solution, “become a boy”! Thank you for giving me tools and some hope that we will move out of this phase at some point.
This is the best article I have read. My 18 year-old son just came out saying he is transgender about 2 months ago with no prior signs. We took him to an excellent psychothetapist who told him he needed months of therapy before even considering hormone therapy. Well, he went to Planned Parenthood and a Nurse Practitioner prescribed hormones on his first visit with no therapy! We are appalled that they did this to our son! We cancelled the Prescription and he is having a fit! We are trying to convince him to continue with therapy. This is a nightmare! He has threatened to leave the house but we are not putting up with his threats.
It is much harder when I child reaches 18. Their attitude is I am an adult and can do what I want. I found out through snooping through my daughter’s phone that she considers herself transgender (that was about a year and a half ago). She is now 20. She wears a binder, dresses as a male, no longer shaves and has short hair. I still address her as her given name and sex. The name she prefers is a nickname that actually goes with her given name but she spells it in a masculine way. I told her as long as she is under my roof and living with me she can not take testosterone or have any kind of surgeries. She suffers from Aspergers, severe depression and an unspecified anxiety disorder. She never expressed any desire to be male while growing up and never she in no way shape or form has a personality you would expect from a masculine male. It is all so confusing for me. When she hit middle school she no longer wanted to wear dresses but I was the same way. My Mother is 70+ and she still will only wear a dress when absolutely needed to so that is not odd. Personally I just think she is a nonconforming female. There is nothing wrong with that but I don’t know how to make her see it. Therapists seem to automatically be like express your reality. Do what makes you happy. What they don’t do is take into account the reaction the family will have and how that will affect the child. All of us have struggled with her decision (me, my parents and her 2 sisters). My middle child refuses to talk about it. She still calls her by her given name but I think is more comfortable with the situation in general than some of the rest of us. My youngest is totally confused. She doesn’t understand why. She has asked “Why does Sissy want to be a boy when she doesn’t act like one?” I can’t answer that. I feel the same way.
I’m so sorry you are going through this. To my mind, it is not clear at all that blindly affirming young people is best for their mental health.
Thank you for this follow up and for your initial article. Sometimes I feel like my husband and I are the only ones that are not willing to affirm our son’s sudden “realization” that he is trans. It is hands down the most emotionally and mentally taxing situation we’ve ever been through. The fact that it came out of nowhere and we (b/c we know him so well) see major red flags makes this even harder. It’s like feeling that we need to protect him from himself. He suffers from anxiety which we are addressing. I made an account at the gender critical resources site. We have seen therapists but had NO idea that it would be virtually impossible to find someone that would NOT affirm his new found identity. Why does everyone want to celebrate this “epiphany” and be willing to help him “come out”? If he were gay then I would accept that. It would definitely be difficult but this sudden urge to want to be a girl seems like an extremely slippery slope and one that could cause long term serious medical and mental health issues. Thank you again. I hope you know that you are helping some of us hang on to our sanity.
My daughter exactly, 18, Aspergers, Major Depressive disorder. She hasn t told us she s trans. Just read it in her sketch book. Dresses as a boy , short hair, and binds. Goes by a boys name on line or in psychiatric hospital. We also will not allow hormones or surgery. We haven t told her. She won t talk to us about it. Asking to see a gender therapist!
how do I find a therapist in Arizona to help me understand my daughter and her sudden onset gender confusion?
For starters, make an anonymous account here: https://gendercriticalresources.com/Support/index.php. You can connect with other parents who are going through the same thing.
Cheryl…goodness why are we all up connecting in the wee hours?! I have the same question but for a resource in Denver. Lisa, I did create an account on the website you suggested. Its possible 4am is not my best self, but I’m not seeing where parents are sharing info on finding a therapist. Any other suggestions?
Kristin, the forum is very new but there are already dozens of parents on there. You will need to go on and post questions. You may need to be active on the forum in order to get the ball rolling. There are also some resources posted there.
Thank you for your follow up- it’s so helpful. Our situation is still intense and our daughter is incredibly entrenched. When I asked her a few months ago what it meant to her to be masculine, she couldn’t give me an answer but responded with “how could you ask me something line that?! This is so important to me!” It obviously didn’t go well.
Still going to therapy and family therapy and still hoping for a positive outcome.
I am so happy I found this site. I just registered at the gender critical forum. This is a relief, but it’s still new and i just noticed today she’s wearing a binder. If you’re a member of the board you can read my story from azreedfamily. I won’t go into it all here. I’m just so happy I’m not the only open minded parent to question the trend.
I am so thankful to find others who do not immediately entertain transitioning without question especially with sudden onset. Maybe if my son had shown signs throughout his childhood I would have eased into the idea he had a genetic predisposition but this sudden interest in becoming a girl is alarming. He doesn’t dress like a girl or act like a girl in anyway. While he has not gravitated towards sports or aggresive behavior, he has neither shown interest in typically feminine activities either. God help me! Is somebody online telling him he must be a girl if he isn’t a typical guy? I’m interested to hear more of what goes through the mind of a 14 year old boy that could bring him to this sort of self diagnosis.
Thank you so much for your piece! If it were a year ago, I would have likely asked you to contribute it to the anthology, FEMALE ERASURE – What You Need To Know About Gender Politics’ War on Women, the Female Sex and Human Rights. There is even a piece that discusses the Pied Piper luring the children! I think that you would find this book a great support to you, your work, and to know that you are certainly not alone in your concerns, questions, and wisdom. Again, my thanks, Ruth Barrett http://www.femaleerasure.com
Thank you for posting this link! This is EXACTLY what I’ve been saying.
Our daughter is 14 (almost 15) adopted from Russia. She is a beautiful person inside and out but as of age 13 started expressing that she is transgender. As many of you have commented, we (my female spouse and I) have been struggling on how to handle her dysphoria. We want to support her and love her as she is obviously struggling with herself in a genuine way. However, we have refused to turn on the FTM switch and affirm that her name change to male. We have compromised with a nickname. She is in counseling and just starting to open up although she speaks indirectly about her being boy-like. She has extreme shame of her breasts so
I am encouraged to see how many of you are coping with this. I agree that we should be extremely cautious and support but not necessarily affirm until many waters have been tested over time. And I appreciate your comments Lisa about how not to confuse typical teenage reactions with dysphoric issues- how true!
I intend to ask her more about how she knows she is a boy as typically she rejects this kind of probing, but I feel that it will be beneficial to her as well as to us to gain insight on what is motivating her to take on such a difficult journey.
I am also a parent in shock that my 17 year old daughter came out a year ago that she was suddenly transgender. We have also been encouraged by therapists to basically blindly accept this and in my gut I just can’t do it. I could see if at birth her genitalia was ambiguous or if she had expressed any feelings of this during her childhood. She is also very bright and has underlying anxiety and depression. We have been struggling for the past year and this blog is the first thing that has affirmed my feelings that I’m not a monster for not wanting to blindly give in to her desire to take hormones and have body altering surgery. Thank you for what you are doing.
This is one of the very few resources I have found for parents in this situation. I have been shunned, threatened with CPS, and called transphobic simply because I will not blindly agree with and allow my child to transition. We are very close and she knows I support her in every other area of her life. I am grateful to have found this blog and look forward to connecting with some of you. I am tired of feeling helpless, alone and ignored.
Hi Lisa, Thank you so much for your article! My 19-yr-old son suddenly told us he is a transgender. I feel like I am going to break down. Thanks for your help. We are willing to go from LA to Philadelphia to see you. How can we do it?
I don’t work with young people, but I am happy to speak with you. You can schedule a free consultation with me here http://www.lisamarchiano.com/appointments/
Also, please consider making an anonymous account on the forum for parents where you can get support advice from others going through this. https://gendercriticalresources.com/Support/index.php
You are a despicable person for the approach you take with young people trying to transition. The closest companion would be a shock the gay away therapist.
I found you trying to seek help in transitioning, not reminding myself people like you still exist in the world.