Trans Children Research Articles

Lived experiences of empowerment in parents of trans children and adolescents.

The construct of empowerment is associated with beneficial outcomes in numerous populations with well-being across multiple domains. Within families, empowerment has been found to be related to both parent and child well-being. As such, empowerment appears to be a promising concept to support parents of young (< 18 years) trans and gender diverse children and adolescents; however, what empowerment means for parents of trans children and adolescents is not known. This study aimed to characterize empowerment for parents of trans and gender diverse children and adolescents from their lived experiences. To accomplish this, a qualitative design was implemented using reflexive thematic analysis to describe what the lived experience of empowerment is for N = 18 (12 mothers and six fathers) Australian parents of trans children and adolescents under 18 years of age. Four primary themes best described the accounts offered by the participants, with empowerment consisting of (1) having knowledge and information, (2) advocating for their child or adolescent, (3) experiencing a sense of belonging to an accepting community, and (4) experiencing support and help from professionals and systems. These findings support establishing high-quality, easy-to-access, and understandable informational resources for parents and better education and training of professionals and organizations to enhance the empowerment of parents of trans children and adolescents. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The parent empowerment scale: development and psychometric properties

Background Parents of trans and gender diverse (herein ‘trans’) children experience additional challenges in their parenting role relative to parents of cisgender children. Understanding and enhancing parents’ empowerment is a promising approach to support both parents and children. We aimed to develop an empowerment scale specific to parents of trans children, grounded in parents’ lived experiences. Methods Based on a previous qualitative investigation of empowerment in parents of trans children, 32 items were created and iteratively reviewed by a parent advisory group to ensure understanding, respectfulness, and comprehensiveness. Parents and caregivers of trans children 5–17 years old living in Australia, New Zealand, Canada, The Netherlands and the United Kingdom completed the scale (N = 270), as well as additional measures of parenting self-efficacy (Me as a Parent Scale – Short Form) and parent self-esteem (Rosenberg Self-Esteem Scale), to assess the scale’s validity. Results Exploratory factor analysis showed a five-factor solution consisting of Acceptance and Inclusion (α = .91), Supportive Health Services (α = .95), Organizations Support the Child (α = .65), School Supports the Parents (α = .93) and Parent Supports and Advocates for their Child (α = .81). The final 22 item Parent Empowerment Scale (PES) demonstrated convergent, concurrent, and incremental validity. Conclusion This Parent Empowerment Scale is a novel measure grounded in lived experience that can be used in both clinical and research contexts to understand, assess and promote empowerment in parents of trans children.

Hypervisibility and erasure: parents’ accounts of transgender children in early childhood education and care and primary schools

ABSTRACT While much is known about transgender students’ experiences of high school, less research has explored their experiences in primary/pre-schooling settings. This paper presents an analysis of parents’ (N = 15) recounts of their transgender children’s (N = 12) experiences in Australian early childhood education and care (ECEC) and primary schools. The research is situated in a trans-emancipatory theoretical framework that recognises the impact of cisnormativity in educational spaces. We find that the early years play-based approach contrasts with primary school settings, where children are regularly organized by binary gender categories. Whilst early childhood settings are child centred and often celebrate transgender children’s individuality using a trans-accommodative approach, they can simultaneously reinforce cisnormativity through enforcing binary gendered norms. Binary norms erase transgender identities while, paradoxically, making the transgender child hypervisible. Findings can inform a whole-of-school approach to the inclusion of transgender identities and the wellbeing of trans children in ECEC and primary schools.

Unpacking Assumptions About Disproportionate System Involvement Among LGBTQ+ Youth of Color

ABSTRACT Over the course of the last decade, data has reflected that LGBTQ+ youth are disproportionately represented in the child welfare system. In many jurisdictions, the majority of LGBTQ+ youth disproportionately represented are also youth of color. The precise mechanisms of these intersecting forms of disproportionality are underexplored; however, a flattened single narrative of family rejection is often presumed to be the driving force behind LGBTQ+ youth of color’s disproportionate representation. This assumption is, in part, informed by a biased and hyperbolic notion that communities of color are less tolerant of queer and trans children and lends itself to practical responses that may be punitive toward families and disinhibit familial engagement. Moreover, this assumption fails to acknowledge the historical role that the child welfare system has played in regulating, surveilling, and fracturing families of color and in criminalizing youth and parents of color alike. In this paper, we argue for a more nuanced understanding of the roles played by structural and institutional forms of racism, homophobia, and transphobia in understanding LGBTQ+ youth of color’s disproportionate representation.

20,000 Species of Bees: Fictional film as a tool for queer pedagogies

Films on trans children often portray transgenderism as a disorder with a tragic ending for the protagonists, thereby ignoring the existing research on children being capable of expressing their own gender. In this article, we perform a close reading of the feature film 20,000 Species of Bees from a queer and feminist perspective. We focus on the potential of the film as a tool for educational practice as part of queer pedagogies. This coming-of-age movie portrays a family in which both daughter and mother undergo an identity crisis, challenging the traditional (gender) norms in the Basque society in which they are embedded. We argue that, unlike some of the recent films featuring trans children, 20,000 Species of Bees breaks with the conventional structures of mediated trans identities as problematic and opens a new perspective on the pedagogical use of the media, particularly cinema, as a space for imagining a ‘future to become’.

Biological and psychosocial evidence in the Cass Review: a critical commentary

Background In 2020, the UK’s National Health Services (NHS) commissioned an independent review to provide recommendations for the appropriate treatment for trans children and young people in its children’s gender services. This review, named the Cass Review, was published in 2024 and aimed to provide such recommendations based on, among other sources, the current available literature and an independent research program. Aim This commentary seeks to investigate the robustness of the biological and psychosocial evidence the Review—and the independent research programme through it—provides for its recommendations. Results Several issues with the scientific substantiation are highlighted, calling into question the robustness of the evidence the Review bases its claims on. Discussion As a result, this also calls into question whether the Review is able to provide the evidence to substantiate its recommendations to deviate from the international standard of care for trans children and young people.

Good GP care for transgender children: The parents’ perspectives

Background As more general practitioners (GPs) are consulted to navigate inclusive care for transgender and gender diverse (trans) children and young people, the experiences of families seeking care for trans children can inform GP practice. Aims The aims of this study were to understand the experiences of parents of trans children in their interactions with GPs when seeking care for their children; to inform GPs about families’ experiences of good care; and to complement existing guidelines and resources for GPs on affirmative trans healthcare for children. Methods This was a nation-wide, qualitative, constructivist study using semi-structured in-depth interviews, which was nested in a larger study on experiences of parents with a trans child across a range of Australian services and agencies. Eighteen parents of trans children in Australia were interviewed, recruited from online support and advocacy networks for parents of trans children. Results We found that although parents valued ongoing care from their family GP, some had to seek a new GP because they had or feared a negative reaction from their regular GP, or their regular GP did not have the knowledge to support their family. Parents sought GPs who would validate their child and affirm their child’s gender. Parents expected practical care from GPs such as referrals to gender-affirming specialists and other health practitioners, routine clinical procedures, and letters of support to services and agencies. Qualities that parents valued in a GP were a respectful manner, listening, putting the child first, asking appropriate questions, and being willing to learn. Discussion GPs that understand trans healthcare for children across a range of health areas and can respond positively in a respectful and matter of fact way to families are in short supply. Parent knowledge can inform GPs to support trans children in line with the Australian Standards of Care.

The good transsexual? The Buck Angel dilemmas

ABSTRACT The often-told Buck Angel bio is that of a female-to-male transsexual who became a ground-breaking and award-winning porn star, documentary producer, sex educator, commentator, dating site host, and entrepreneur. Such a bio is tantalizing and inevitably explains ongoing cultural fascination: Angel has a high public profile and strong following on social media. More interesting than the facts of his bio, however, are his contributions to understanding sexual cultures. Drawing on Angel’s own remarks as well as the many thousand words spilled analyzing them, I explore the relationship between Angel and trans discourse, as well as, more broadly, with contemporary gender and sexuality debates. I begin with a brief discussion of Angel as an ‘expert’, and as a man, and then examine his ‘man with a pussy’ brand. I discuss his contributions to creating the genre of transmasculine porn, and I examine the ways that his bodily display has been interpreted. I explore debates that Angel has become embroiled in, including those around language, biology, and trans children, and I end with a discussion of the tensions around his desire to be an elder to a community which he often exhibits disdain for.

Children's attitudes about transgender identity disclosure and concealment.

Supportive peers are crucial for transgender children's well-being. Transgender children who live in their affirmed gender face decisions surrounding concealment and disclosure of their transgender identity. We sought to understand how cisgender (N = 115) and gender-diverse children (N = 127), and siblings of gender-diverse children (N = 63) think about transition disclosure and concealment. All groups viewed transition disclosure and concealment positively. However, gender-diverse children showed greater acceptance of transition concealment and had stronger liking of transition concealers (relative to non-transition concealers). Additionally, children generally expected transgender peers to be selective about who they disclose to, valuing trustworthiness and diverse friend groups in such decisions. Our findings suggest that regardless of gender identity, children are sensitive to the potential costs of disclosure and may support trans children however they choose to navigate these decisions.

The Role of Healthcare Professionals in the Transition Process: A Qualitative Study of Families of Trans Children and Adolescents.

The aim of this study was to explore the role that healthcare professionals, such as pediatricians, psychologists, psychiatrists and sexologists, play in supporting trans children and adolescents in their transition processes. To this end, 22 life stories written by parents of trans children and adolescents who had undergone social transition were collected, and a qualitative analysis was carried out using MAXQDA software. For this purpose, three key periods were considered in the stories: before, during and after the transition. Among other aspects, the stories highlight a major lack of understanding on the part of the professionals who should support trans children and adolescents, and their families, in their transition processes. Parents described the attitude of those professionals who actively listened to their children's needs and were cooperative as positive, even if they do not have the necessary training. The need for specific training in diversity is one of the main conclusions of this study.

Let Our Stories Be Told: Conducting Narrative Inquiry with Trans Youth

ABSTRACT Today’s trans youth are being spoken at and/or for, while adults and legislators are debating and deciding how they must live their day-to-day existence. However, to best understand today’s trans youth, counselor scholars and practitioners need to hear directly from trans youth. This article provides a foundational understanding of why conducting narrative inquiry with trans youth is ethical, affirming, and a best practice. Additionally, it provides a base of understanding of what narrative inquiry’s purpose and intention is, as well as considerations for creating a rigorous, trustworthy, and credible narrative inquiry. Finally, the author addresses research biases that may exist within the process of narrative inquiry that are necessary to evaluate. Additionally, there is an increased risk to safety with minor participants who identify as transgender. There are biases within research regarding gender identity development; therefore, using a case example, the author attempts to address these concerns as elements to address throughout the entire research cycle, specifically with narrative inquiry with trans children and adolescents.

Research priorities in trans health: a Delphi-study.

Progress has been made in understanding trans health needs, but research priorities are often set by policy or healthcare professionals without trans input, which may not reflect public needs. Our study sought to identify trans health research priorities in France from both researchers and the trans community. Expert stakeholders (health and social sciences professionals, trans individuals, and their families) answered a three-round Delphi survey on trans health research priorities. The first round involved an open-ended questionnaire, analyzed qualitatively. In the second round, participants ranked research propositions from round one using a Likert scale. The study's second phase involved a two-hour workshop with experts and trans individuals. 53 participants (32% trans individuals/relatives, 60% health professionals) contributed 217 responses to open-ended questions, leading to 44 research priorities. After the two voting rounds, a total of five proposals reached a strong consensus cut-off and were considered as the main research priorities: evaluation of the effect of puberty blocker use in trans children and adolescents (95%), evaluation of the effect of supporting trans children and adolescents (92%), study of the support systems available for trans youth and their parents (86%), persistence of trans identity around puberty (prevalence, persistent persons characteristics) (86%), and needs assessment survey of the support for adolescents and their families (83%). Thirteen other proposals were considered moderate priorities. The main consensus in our French study concerned research on trans-youth care and support needs. Our results may guide further trans-health research that meets the public's needs and desires.

“I Don’t Want to be a Girl. I Am a Girl!” Experiences Before, During and After Transition in Families with Trans Children and Adolescents

Families often have little knowledge and skills to support their trans children. Therefore, our aim was to learn more about the experiences of parents of trans children and adolescents and how the transition process is experienced. Using a qualitative approach, we analyzed 22 life stories written by parents of trans children and adolescents. The data were analyzed with MAXQDA. Three key periods were considered: (1) before, (2) during, and (3) after social transition. The themes most frequently reported by parents were: children’s not expected gender expressions and negative attitudes and feelings, and parents’ negative feelings, denial and repression attitudes, confussion and search of information, before transition; children’s explicit disclosure, name selection and more positive attitudes, followed by parental understanding, acceptance and support, during transition; and both parents’ and children’s positive attitudes and feelings, as well as concern about pubertal development and expectations and fears about the future, after transition. In general, the stories reflect children’s negative emotions before social transition and parents’ doubts and lack of knowledge, which were followed by acceptance and more positive emotions once the social transition had taken place. Concerns and problems were reported by most of the families throughout the three time periods. Our findings emphasize the need to facilitate social transition and to design specific approaches to better support transitioning children and adolescents, and their families.

What parents know: Informing a wider landscape of support for trans and gender diverse children and adolescents

The childhood and adolescence of transgender and gender diverse children and young people (trans children) is contested in many areas, such as media, education, health, and increasingly in the political sphere. Parents and carers of trans children navigate services and societal relations in their journey to affirm their children, from happy childhood to trans adults. This paper reports on the accounts of parents of trans children in Australia. Semi-structured interviews with 18 parents of 15 trans children in four states were analysed to understand the journey holistically, and interactions with services and institutions on this journey. Children ranged in current age from 8 to 21 years, and were 2 to 16 years when they first expressed their trans identity. These journeys highlight moments of gender euphoria, and points of both positive and negative interactions with a range of services such as GPs, specialist healthcare, trans healthcare, schools, foster care, government records, and sporting environments. This research demonstrates that parents have a collective body of knowledge on supporting and affirming trans children that should be drawn on to inform child and youth services.

The Cass Review: Cis-supremacy in the UK’s approach to healthcare for trans children

Background Since 2016 trans people in the UK, and particularly trans children, have experienced a sustained and escalating campaign to roll back trans freedoms, rights and access to healthcare. A series of legislative, politicized and media-driven campaigns have resulted in the year-by-year worsening of access to affirmative healthcare for trans children in the UK. Aim This study examines publications from the NHS-commissioned ‘Cass Review’ into children’s gender services, seeking to better understand what is happening in trans children’s healthcare in the UK. Methods Inductive and deductive reflexive thematic analysis was applied to a collection of Cass Review publications related to trans children’s healthcare published between January 2020 and May 2023. Results Four concerns are presented and explored: (1) prejudice; (2) cisnormative bias; (3) pathologization; and (4) inconsistent standards of evidence. Each of these concerns impacts the Cass Review’s approach to trans children’s healthcare, with negative repercussions for trans children’s healthcare rights and well-being. Discussion The Cass Review itself can be understood as an example of cis-supremacy, within a cis-dominant healthcare system lacking accountability to trans communities. These findings draw attention to systemic barriers to effective healthcare policy, with relevance for trans healthcare across and beyond the UK.

… Trans … Forming … M/othering …

Finding inspiration in embodied life writing methodologies, the essay explores the fraught slow intimacies of mothering a trans child, now a young adult. The essay engages an experiential familial, in the sense of ‘family’ relations, but in seeking to process the uneasy forms of m/othering through trans allyship, the paper turns to a range of intellectual repertoires, both old familiars and newer strangers, hoping to shape ways of responding that re-home family gender troubles within wider communities of scholarly and creative thought, and reading. Wanting comfort in ideas, the author grapples and drifts, trying deliberately to open her heartmind to unbecoming methods and messy, queerying adjacencies that elude polarities, even push me aside, and admit to never completely representing the subject. Alongside conflicted negations/negotiations of mastery, then, the essay tries muted moves into intimate geographies of mutter, martyr, mater, matter, meta, all in a lived struggle ‘to look for a way out of the usual traps and impasses of binary formulations’ (Halberstam, 2011: 2) in search of deliberately fugitive, blurred intimations that place m/othering in difficult, witnessing relation with a transmasculine life lived at assertive gender variance.

The Positive Aspects of Being the Parent of a Trans Child: Findings from Trans Pathways

The existing literature exploring the experiences of parenting a trans child tends toward reporting the challenging aspects of the parental journey. Studies also reference positive experiences such as enhanced parent-child connectedness and affirmation of personal values. Limited dedicated research focused on the positive aspects of parenting a trans child exists. We aimed to better understand positive parental experiences accordingly. Using data from a large cross-sectional survey, we explored parental responses (N = 134) to a single open-text question asking what parents had experienced as positive about parenting their trans child. We used the general inductive approach (GIA) to analyze data and report on common themes. Almost all parents identified at least one positive aspect; most cited multiple benefits. Five major themes emerged from the data: 1) Personal growth; 2) experiencing the strengths of the child; 3) improved aspects of the parent-child relationship; 4) positive change in the child; 5) experiencing social connection and support. Findings provide a nuanced addition to the literature on parental experiences and have clinical implications for those working with parents of trans children. A better understanding of positive parental experiences can aid clinicians in increasing parental support and acceptance for young people within an affirmative framework.

Protecting Children in 'Gender Critical' Rhetoric and Strategy: Regulating Childhood for Cisgender Outcomes

While academic works on the ‘gender critical’ movement have generally focused on its advocacy and claims regarding womanhood and adult women, the movement also heavily targets children. This article contributes a case study of ‘gender critical’ activism around children in the United Kingdom, which is strongly committed to the belief that children cannot be ‘genuinely’ trans. Building on the argument that anti-trans movements seek to undermine the institutions that allow for trans people’s social existence as trans people, it demonstrates that ‘gender critical’ groups seek to intervene in the institutions that regulate childhood in order to inhibit trans children’s ability to both understand themselves and exist socially as trans children. This requires interventions targeting education, specifically for the removal of trans-inclusive guidance and teaching resources. However, it also requires interventions into the family and the recruitment of parents as ‘gender coaches’ best placed to encourage desistance.

10.O. Round table: Anti-gender movements and their implications for trans-specific healthcare for children in Europe

Abstract Anti-gender movements, which have gained significant momentum in recent years, challenge the validity and existence of gender as a concept, and in turn, gender identity. Anti-gender campaigners are varied, ranging from conservative political actors, religious leaders and institutions, to “gender critical” feminists but they are united in one respect - they have been working consistently to influence public opinion and advocate for legislative and political action against the fundamental human rights of trans and gender diverse people, with clear public health implications. These actors target, among other things, self-determination of gender identity and the provision of care services for trans children and adults. Trans and gender diverse children are especially vulnerable, as their physical and mental healthcare needs are at risk due to the relentless attacks and misinformation campaigns across Europe against the provision of trans-specific healthcare, including puberty blockers. Yet, existing research demonstrates that access to puberty blockers leads to marked improvements in mental health for trans and gender diverse children. Countering anti-trans narratives and protecting trans and gender diverse childrens’ health and human rights requires concerted action on the part of the trans and gender diverse community, with the active participation and support of the public health community. Our aim for this roundtable is to bring together members from the trans and gender diverse community and the public health community to discuss what is required to counter anti-trans narratives in the provision of trans-specific healthcare. Representatives from 1) Transgender Europe, 2) the European Region of the International Lesbian, Gay, Bisexual, Trans and Intersex Association, 3) the International Lesbian, Gay, Bisexual, Transgender, Queer and Intersex Youth &amp; Student Organisation, and 4) the European Professional Association for Transgender Health will be panelists in this round table. We will discuss cases from several European countries, the best interest of the child, informed consent, and what is urgently needed at the regional level to ensure trans and gender diverse children are able to access the healthcare they need. We will also dedicate time for questions from the audience to enable sharing of concerns and diverse personal and regional experiences. Key messages • Anti-gender movements, which have gained significant momentum in recent years, challenge the validity and existence of gender (identity), hindering access to gender-affirming care. • Strong support from the public health community is required to counter anti-trans narratives and protect trans and gender diverse childrens’ health and human rights. Speakers/Panelists Deekshitha Ganesan Transgender Europe, Brussels, Belgium Seb Rowlands Transgender Europe, Brussels, Belgium Cianán Russell ILGA-Europe, Brussels, Belgium Motmans Joz UZ Gent, Gent, Belgium Rú Ávila Rodríguez IGLYO, Brussels, Belgium

The Impact of Gender Affirming Medical Care During Adolescence on Adult Health Outcomes Among Transgender and Gender Diverse Individuals in the United States: The Role of State-Level Policy Stigma.

Purpose: Gender affirming medical care (GAMC) aims to alleviate gender dysphoria by helping people align their physical body more closely with their gender identity. Bills seeking to limit or prohibit GAMC for trans children and adolescents have become a controversial topic. This study aimed to examine whether exposures to GAMC during adolescence are associated with adult psychological and general health outcomes, and to demonstrate the mechanism through which state-level legislation may work to moderate the association. Methods: We conducted analyses using data from the 2015 U.S. Transgender Survey, which surveyed 27,715 transgender and gender diverse (TGD) adults between August and September of 2015. The study compared the health outcomes of those who had GAMC exposures during adolescence with those who did not. Moderation analysis with propensity score matching was used to adjust for potential confounding factors. The general and psychological health outcomes measured were past-month severe psychological distress, past-year suicidal ideation, participant's general health, and past-year health care avoidance due to possible mistreatment. Results: GAMC during adolescence was negatively associated with severe psychological distress in adulthood. When examining past-year health care avoidance due to possible mistreatment, the effect sizes differed significantly between those in a trans-supportive state and those in a trans-unsupportive state. Conclusion: Our work highlights the importance of state-level policy stigma in understanding the association between GAMC and health outcomes. Findings point to the importance of enacting long-term legislative safeguards against TGD discrimination and removing barriers to access the full spectrum of care for adolescents who identify as TGD.