Transgender and Gender-Diverse Youth | Adolescent Medicine | JAMA Pediatrics | JAMA Network
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JAMA Pediatrics Patient Page
May 28, 2021

Transgender and Gender-Diverse Youth

Author Affiliations
  • 1Seattle Children’s Hospital, Division of Adolescent Medicine, Seattle, Washington
  • 2Department of Pediatrics, University of Florida, Gainesville
JAMA Pediatr. Published online May 28, 2021. doi:10.1001/jamapediatrics.2021.1014

Gender identity is a person’s internal sense of being a boy, a girl, some of both, or neither and typically develops early in childhood.

Every individual’s gender identity is unique and they are the only person who can define it. For some people, their gender identity differs from their sex (typically based on genital appearance at birth or chromosomes). For others, their gender identity and sex are the same. Gender identity is different than a person’s sexual orientation (the types of people someone is attracted to).

Common Gender Identity–Related Terms

Transgender or gender diverse are words used to describe people whose gender identity does not match their sex. Cisgender describes a person whose gender identity does match their sex. Someone may use terms such as transgender boy or trans boy to describe their gender identity if they identify as a boy but were assigned female at birth. Likewise, transgender girl or trans girl may be used by someone who identifies as a girl but was assigned male at birth to describe their gender identity. Nonbinary may be used by someone whose gender identity is beyond the traditional categories of girl or boy. In addition to these terms, there are many other words youth may use to describe their gender identity.

What Can Parents Do To Support Transgender or Gender-Diverse Children?

Transgender and gender-diverse youth thrive when they are supported and affirmed by their families, communities, and health care professionals. As a parent, the most important thing you can do is support your child and remind them that you will always love and care for them. If your child is exploring their gender identity, it is important to listen to them and follow their lead. Ask your child what name, pronouns, and words to use (for example, son, daughter, or child) when describing them and use those consistently. Also ask your child if they want help talking with other adults in their life to create affirming environments for them at home, school, and in health care settings. Support your child in taking steps to align their physical appearance (clothing, hairstyle, etc) and their gender identity in ways that feel right for them. Ask your child if they are interested in receiving additional support from a medical or mental health professional, and if so, help your child find a clinician who is knowledgeable and gender affirming. Talk more with your child’s primary care physician about medications that can support transgender and gender-diverse youth in affirming their gender identity. Establish a network of support for yourself by connecting with other parents and caregivers of transgender and gender-diverse youth.

Some transgender youth experience mental health concerns such as depression and anxiety, but these often improve when youth are supported and affirmed in their identity. Schools and communities should welcome all children and be allies to families as they support their transgender and gender-diverse children.

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Article Information

Published Online: May 28, 2021. doi:10.1001/jamapediatrics.2021.1014

Conflict of Interest Disclosures: Dr Sequeira reports grants from Agency for Healthcare Research and Quality and Seattle Children’s Research Institute during the conduct of the study. No other disclosures were reported.

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