Is Being a Transgender Child Traumatic?

Does being a transgender child entail being doomed to a life of posttraumatic stress and misery? At first glance it doesn’t look so good. Let’s start with the 41% attempted suicide rate. Yes, 41% – nearly half of transgender individuals have tried to kill themselves. Other research indicates that compared to cisgender children, transgender children have substantially higher rates of anxiety and depression (a fair estimate of post-traumatic stress when the latter is not directly assessed).

The obvious question is whether the transgender child’s terrible fate is somehow inherent to being transgender, or rather the result of the shaming, bullying, and discrimination that has been visited upon the child. Fortunately, the answer, as per a recent landmark study, is the latter.

For the first time, many transgender children are living openly as such, and enjoying social acceptance and support in their identities, so these “socially transitioned” transgender children can now be studied. Olsen and colleagues (2016) compared 73 socially transitioned transgender children (ages 3-12) to 73 matched controls and 49 cisgender siblings. Parents completed depression and anxiety measures regarding their children. The primary finding: “Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group.”

I observed this dynamic in action with a child I know well, “Andy.” From age two or so he insisted on wearing dresses – “He wants to be like his older sister,” the parents explained to me. But the dress-wearing persisted into preschool. And he played “family” with the other girls, rather than playing cars with the boys. At age three he persistently said he was she, and to call her Ariel (presumably after the character in the Disney movie). Finally the parents got it: “We thought we had a boy, but we have a girl. At least for now, maybe it’ll change again, maybe not. But for now, we’ll respect and support her as a girl.”

Ariel did not like going to “school” where several of the children routinely challenged her identity. “You’re really a boy, right?” Finally Ariel’s mother met with the preschool teacher and gave her several books about boys who wear dresses and/or who say they are girls. The teacher started reading these books aloud to Ariel’s class, and guided the post-book discussions. The conclusion was that people get to say who they are, themselves. The children ran with this. One child proclaimed, “I’m Superman!” Another shouted, “Call me French Fry!” And Ariel got to be Ariel without further challenge.

Within days, Ariel’s parents noticed a dramatic change. She no longer protested going to school. In school, she went from being quiet and withdrawn to talkative and social. And at home she became happy – not every minute, but generally – for the first time in many months.

As time went on, Ariel’s community accepted her gender identity as a fact, and her parents’ concerns more closely matched other parents’ concerns about their children: “Does she have enough friends? How can we help her learn to tolerate frustration better?” Ariel’s transgender status was also a focus; for example, they made an effort to socialize with a couple of other families who also had a transgender child, to further normalize Ariel’s experience.

One day in Ariel’s fourth year, she announced that she didn’t want to be Ariel anymore; she wanted to be Andy again. Still a girl, but with her own name. Apparently she no longer needed that other girl name to establish that she was a girl. Following some discussion with her parents, though, the new spelling was Andie.

At this writing, Andie is four and a half, and basically a “normal kid” with various interests, strengths and challenges. She wears dresses often, because they’re pretty, and wears pants sometimes but not as often as her older sister. She has friends, mostly girls. Recently when an older cousin (who should have known better) said that Andie was really a boy, she became deflated: sad, quiet, withdrawn, for the rest of the day. Other times she is able to stand up for herself and correct the person without any apparent negative impact.

The clear conclusion is that the anxiety, depression, and suicidality that has long been associated with a child being transgender (previously called gender identity disorder) is not inherent, but rather is the result of bullying, rejection, disrespect, and discrimination. When the maltreatment is not present, transgender children have about the same range of mental health issues as other children. The slightly elevated anxiety may reflect the extra challenges associated with being a transgender child, that can persist even in a supportive environment.

Note: Andie’s name and details have been altered for confidentiality, despite the fact that Andie and her parents requested that her real name and details be used. My rationale is that Andie is not old enough to make a choice that could impact her as a teen and adult. As a socially transitioned transgender child, her preference for openness is appropriate. Even so, in an only partially transitioned society, I chose to exercise caution on her behalf. When she is older, she can write her own blog posts if she wants to.

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20 Responses

  1. A wonderful post, centered around a wonderful anecdote. “Andie”‘s story is compelling. If more people had contact with such narratives, a lot of ignorance would be dispelled, prejudice corrected, and hurtfulness prevented.

    1. Thanks, Tom. I think more people are getting contact with such narratives. A few years ago I didn’t know any transgender people — or at least, as far as I was aware. Now I know several. Hopefully it continues to get easier and less punishing to “come out.

  2. I agree wholeheartedly and kudos to Andie’s parents and teacher! I work with several socially transitioned trans students who are just kids and who just want to be kids. As with many issues, it is as much or more the reaction which causes trauma rather than the issue itself. Unfortunately not all parents and schools are as accepting and that is the root of the traumatic experiences that occur.

    1. That’s it: kids just want to be kids, and don’t need people freaking out about them. What is so interesting (and encouraging) is that other kids are fine with it, once they’re given some guidance.

  3. I’ve worked with *trans and gender non-conforming adults and teens for many years as a mental health provider and as a Board member of a local LGBT support group for youth. Thanks for your post, Ricky, I’ll share it with clients with your permission. It has been my experience that PTSD-like symptoms are greatly alleviated with participation in local support groups and when client’s spend time with other *trans individuals and families attend PFLAG or other family support groups.

    1. Carrie, you’re welcome to share the post. I would love for this to be shared widely. I also want to express my appreciation for you and Christa and so many others who have worked for years to make this world more welcoming to all people. That pioneering work has made all the difference for Andie and others.

  4. Thanks, Ricky, for an inspirational account of how caring parents and teachers can make a crucial difference in the life of a transgender child.

  5. As a mom of an openly gay child, I can say: “the struggle is real” : ) I find myself grateful almost daily for the support and acceptance of teachers, family members, excellent therapist, friends…… but mostly, for the amazing spirit of my child and all he has taught me. But I never, ever forget the (sometimes daily) hurdles he faces.

  6. What is sounds like to me is that this child feels more comfortable with the socialized gender stereotypes of the opposite sex. The issue isn’t necessarily a transgender child, but a personality which is deemed unacceptable for male children. Perhaps if male children were allowed to wear dresses and love Barbie dolls and “playing family”, we wouldn’t have to pretend they were the opposite sex. Girls are not born loving tutus and baby dolls. That’s how we socialize them.

    My son was this child. Now he is a happy, healthy 24 year old gay man. When I see stories like this, my first thought is conversion therapy; instead of accepting a “feminine” boy, we call him a girl. My heart aches for these children.

    1. Christina, I can assure you that this child was readily accepted as a boy who wore dresses. She was not socialized, as a boy, to be into “boy” things. Even so, she was clear that she was a girl. Your son’s path is not the only possibility. And for children like this, so-called conversion therapy is a prime example of the harm that should be avoided.

    2. The CHILD may believe that liking what they like makes them a girl. Has anyone asked the child, “what is it about girls that makes you feel like one?” My son described stereotypes, to which I responded, “Oh! Well boys do that too, it’s just less common because we teach them differently, which we shouldn’t because anyone can like anything.” And if he had said he simply *felt* like a girl for no particular reason, I may have responded in a similar way with different reasons.

      Eventually, armed with knowledge that he is in fact male, he desisted. Had I allowed transition I would have been practicing conversion therapy on a gay child. Most children desist, but I suspect this will become harder after living socially as the opposite sex, and today’s parents are increasingly ok with deluding their children because it’s expected that they be “tolerant” and supportive, even if it’s not in the child’s best interest. The road ahead is filled with potentially harmful chemical intervention and surgeries, as well as additional life difficulties. I think we should be using more caution when transitioning kids. I read stereotypes in the story above. I’m alarmed.

    3. Parents in this situation do not readily accept a child as transgender without considerable negotiation as well as passage of time. However, I see no point in providing further detail about how Andie’s parents handled this. Your critique will persist. Every child is unique, and I hope that what you did with yours was good for him. Regardless, how Andie’s parents and teachers managed this situation is consistent with what the research is now telling us is good for children.

  7. Ok, I hope you can indulge a little Transgender 101 from a trans social worker and advocate. Words matter, especially in this community.

    Great info, except for “…child transgenderism (previously called gender identity disorder)”

    True, it used to be called Gender Identity Disorder because that was how it was listed in the DSM, but in DSM 5 it was updated to Gender Dysphoria, which is more accurate. Not “transgenderism.” While it may be technically correct, it may be offensive (it kind of is to me) and should be avoided. Just stick with Gender Dysphoria as the diagnosis and you’ll be good.

    Also, please never use the plural “transgenders” to refer to 2 or more people. Say “transgender people” or “people who are transgender” instead, using person-first language.

    Using the word “Transgendered” is even more inappropriate and offensive and should never be used under any circumstances.

    I hope this helps and didn’t come off as preachy. If I can ever answer any questions you might have, please contact me at caitlynxpress at gmail dot com or check out my advocacy organization’s facebook page at

    Have a great day!! 🙂

    1. Caitlyn,

      Thanks very much for the language lesson.

      And also for including your web address. We’re working on upgrading the web site to include the web addresses of commenters, but meanwhile putting it into the text of the comment is a good solution.

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