Op-Ed: How to raise happy, healthy transgender kids


John, if you ask him, is 8 and 3/4 years old. He plays baseball, argues with his little brother and loves quesadillas. He was a vampire for Halloween. If you saw him at school, he wouldn’t stick out.

Unlike the other boys in his class, however, when John was born his parents and his doctors said he was a girl. But John (which is not his real name) spent years insisting otherwise. His parents tried to point out that, in fact, girls could wear or do anything boys could. They tried to explain the difference between being a tomboy and an actual boy. John persisted. He was certain, even if his parents weren’t, that he was a boy.

After more than three years, which entailed many discussions with their family, a psychologist and a gender specialist, John’s parents came to support that identity. They let him to go to school and everywhere else as a boy — what is called a “social transition.”


A transgender childhood need not be plagued by mental health problems.

John’s is not the commonly told transgender story. The dominant narrative is that transgender people’s lives are characterized by trauma, victimization, mental health problems and unhappiness. This grows out of sobering statistics: Transgender teens and adults suffer high rates of depression, homelessness and substance abuse. Underscoring these statistics are the devastating stories of suicides by teens Leelah Alcorn in Ohio in 2014 and Skylar Lee in Wisconsin last fall. Media reports suggest they both struggled to gain parental acceptance of their identities.

But there are more hopeful stories, and we have seen them first-hand. Our TransYouth Project is the first large-scale, longitudinal study of American transgender children, and we’re finding that there is a group of silly, friendly, thoughtful and all-around quite average children who also happen to be transgender.

To date we’ve studied more than 180 children whose parents allowed them to “socially transition” — that is, to live publicly as the gender they insist that they are. This typically involves a name change, shifting pronouns, growing or cutting hair, and letting kids dress as they please. Because the children in our study have yet to reach puberty, no medical interventions such as hormones or surgery are involved.

Our findings — just published in the journal Pediatrics — suggest that transgender children who socially transition with the support of their families, on average, are doing quite well.

For instance, we compared a group of 73 such kids to two control groups: 49 of their siblings and 73 unrelated and non-transgender children the same age. We used normed scales of anxiety and depression on which the average score for American children is 50. Scores above 63 would represent “clinical” levels of anxiety or depression.


The transgender children in our study had an average depression score of 50.1, and an average anxiety score of 54.1 — levels statistically indistinguishable from our two control groups.

These outcomes are strikingly different than earlier studies, which found average depression and anxiety level scores of 60 to 64 among gender-nonconforming children.

Why the big difference? Previous studies included many children who’d been brought to a clinic to “fix” them (or at least align their gender with their sex). The children in our study, by contrast, were recruited specifically because their parents accepted their new gender identity.

Such parents were virtually unheard of a decade ago and are still quite rare. Those who’d agreed to a social transition for their child often told us their decision was a long time coming. Only after trying other solutions to no avail — and learning about the poor health outcomes among alienated transgender teens and adults — did most of them opt for this route.

It’s also important to note that, although the families in our study are from all educational and socioeconomic backgrounds, the parents tend to be more educated and wealthier than the average American family. This gave them access to resources such as child psychologists, support groups and camps and conferences for families like theirs. In some cases, families moved so their child could enroll in a new school where no one knew his or her birth sex — a luxury clearly not available to all families.

That’s why we see our findings not as evidence of what’s probable but what is possible: a transgender childhood need not be plagued by mental health problems.


What will happen when these children face puberty? It will be more difficult to outwardly maintain their gender identity without medical intervention. In the teen years, how will they deal with dating, or bullying? We will be following them and hundreds of other gender pioneers to see. We suspect that their uncommon experiences will shed light on how concepts of gender shape everybody’s lives.

Already these kids have challenged prevailing ideas about the prospects of young transgender people today. As society becomes more aware of transgender children, as support networks grow, and as parents and schools grow more accepting, we believe the situation will continue to improve for transgender people of all ages.

Yes, some clinics still counsel families to “guide” children to become satisfied as their biological sex. High rates of anxiety, depression and suicidal behavior persist among transgendered youth. Yet we see in our young research participants a clear sign that unhappiness and tragedy are not inevitable.

Indeed, some of these children are growing up just like John, going about their lives with only the routine worries of any 8-and-3/4-year- old. We are optimistic about their futures.

Kristina R. Olson is an associate professor of psychology and director of the TransYouth Project at the University of Washington. Katie A. McLaughlin is an assistant professor of psychology and director of the Stress and Development Lab at the University of Washington.

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