My Adolescent Came Out as Transgender, What's Next?

I have worked with parents and adolescents through the process of gender disclosure. Some parents brought their adolescent in for care because the adolescent had disclosed their gender and the parents wanted to support their adolescent psychologically and or medically. Some adolescents asked their parents to come to a meeting with their therapist. In this meeting, the adolescents disclosed their gender and would ask for support with me by their side. Unfortunately, the majority of the transgender and nonbinary teens I have worked with wanted their parents support, but were uncertain about disclosing their gender to their parents. They feared being rejected, kicked out of the house, threatened, or worse.

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In the research, we see evidence of staggeringly high rates of depressive symptoms, self-harm and suicidal ideation among transgender youth. For example, a 2017 study found the two-thirds of transgender adolescents (in 9th to 11th grades) had thought about suicide. A 2016 study of transgender youth found that 65 percent 14- to 18-year-olds in their study had seriously considered suicide. This is a high number all together, and is particularly stark when compared to average suicidal ideation (13 percent) in same-aged teens.

Providers who work with transgender and nonbinary teens can tell you that the outcomes for teens with supportive parents are dramatically different from the teens who have unsupportive or rejecting parents. Research supports the existence of these differences as well.

See a 2012 study demonstrating differences in outcomes based on presence or absence of parent support. In this study, adolescents aged 16 to 24 were asked about positive outcomes (self-esteem, life satisfaction, housing and mental health) as well as negative outcomes (depression and suicide attempt in the past year). These outcomes were compared for the groups who reported supportive parents versus unsupportive parents. The results reflected a remarkable story about the importance of support.

For positive outcomes, there were significant differences between supported and unsupported adolescents:

• Life satisfaction (72 percent compared to 33 percent)
• Self-esteem (64 percent compared to 13 percent)
• Excellent mental health (70 percent compared to 15 percent)
• Adequate housing (100 percent compared to 45 percent)

For negative outcomes, the results were also overwhelmingly better for supported adolescents compared to their unsupported peers:

• Depressive symptoms (23 percent compared to 75 percent)
• Suicide attempts in the past year (4 percent compared to 57 percent)

Scientific and anecdotal evidence clearly underscores importance of parental support. Therefore, the question of exactly how parents can demonstrate support for their transgender or nonbinary adolescent bears asking.

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Coming out about gender can be a challenging experience for adolescents. They are disclosing an important and incredible part of their self. It leaves the adolescent vulnerable and in a place to be rejected for a part of their core sense of self. Some ways to affirm a transgender or nonbinary adolescent in this process and after include:

• Affirming their gender through use of appropriate pronouns and name.
• Assisting their adolescent in exploring and enacting a social transition when they are ready.
• Working with schools to ensure access to bathrooms and affirming classroom practices, such as affirming name and pronouns on school materials.
• Working to prevent bullying, and to address it when it happens.
• Creating access to gender affirming medical and therapeutic services.
• Preventing and addressing cruelty and harm.
• Allowing them to be free to show you who they are and then loving that person fully.

For parents, the disclosure of gender can involve complex and emotional process of understanding their own sense of loss, addressing family and community relationships, experiencing challenges to beliefs about gender, as well as upheaval of privilege. Parents must also face the increased risk for their adolescent in the world. Parents may also begin to wonder about medical interventions to support their adolescent’s gender process. These can include puberty blockers and hormone replacement therapy (HRT) as well as any other medical interventions that the family may consider. As a parent, it is essential to remain affirming and supportive of your adolescent while you work to process your own experience, and to explore the options available to you and your adolescent.

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It can certainly help to seek therapy for the family, the parent, and the adolescent. When looking for a therapist, it is of utmost importance to find knowledgeable and experienced medical and mental health providers to help in answering questions about interventions. (Note that there is no support for conversion therapies for sexual orientation. They are demonstrated to do more harm than good. These therapies should not be used for gender identity either.)

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Children, adolescents, and young adults need parents and caregivers to show their support as much as they can. Therefore, parents must challenge themselves to do the hard work of processing this disclosure, while doing their best to affirm their adolescent in the meantime.

Has your child come out as transgender or nonbinary? What have you been able to do to affirm their gender and support them? What challenges have you had and how are you facing them?