Transcending Uncertainty: How Parents Can Make a Huge Difference for Transgender Youth

When you become a parent, you sign up for all of the twists and turns along the way. Although many of these challenges follow an expected flow (the trials of toddlerhood, the tribulations of teenagedom) you also sign up for not always knowing exactly what your child will experience. We grew up in a different world than the one to which our kids belong; we watched the internet emerge in a time before ubiquitous cell phones and social media, and experienced cultural shifts around anti-racism, feminism and LGBTQ+ rights. Our children now have much more insight and information available about themselves and their identities than we ever had. (Even many parents — myself included — are still exploring their own gender identity.) Closing this gap between our personal experiences and exposures as parents and those of our kids can feel insurmountable. And in the current political climate, LGBTQ+ kids — and trans kids more particularly — are facing intense backlash for being themselves, making it even more difficult for parents to really see, validate and support them through all the misinformation.

A survey from queer and transgender youth suicide prevention nonprofit, The Trevor Project, found that 90% of LGBTQ+ youth surveyed in Oregon expressed that recent politics have harmed their well-being. And 54% of trans and nonbinary youth here have seriously considered suicide. These numbers illustrate bluntly what parents need to understand: how to support trans children, the facts about gender-affirming care, and the state of trans rights in Oregon and in the greater U.S. Here’s what to know and how to best help your child — or any trans child in your life.

Step 1: Where to Start

So, your child has come out to you as transgender — now what? 


“Who knows (your child) better than themselves,” says Karin Selva, M.D., who heads the gender clinic at Randall Children’s Hospital, and sees a wide range of children, teens and families.

When your child comes out to you, “your time to learn has begun,” says Jenn Burleton, the director of TransActive Gender Project at Lewis & Clark College, which provides holistic support to transgender and gender-expansive youth and their families. This isn’t the time to question or debate, she says. “This is something that your kiddo has thought about for a very, very long time … probably for such a long time that the amount of time they’ve thought about it and have not felt safe talking to you about it will pain you,” says Burleton.

So, follow your child’s lead when it comes to their name and pronouns. “You’re not going to get it right 100% of the time, but it really just takes practice,” says Theo, an 18-year-old trans man, who asked that PDX Parent use only his first name. 

Everyone interviewed for this piece echoed that using a child’s preferred name and pronouns is number one on the list of ways parents can support their trans children. And that support is more than lip service — it can be lifesaving. Consider the CDC’s most recently reported data that while 36.7% of all high school students experience symptoms of depression, the rate for LGBTQ+ students is 66.3%. The numbers on suicidal ideation are even more staggering: 18.8% of high school students expressed having seriously considered suicide in the past year, but this shoots up to almost 50% of LGBTQ+ students. Thankfully, recent research reveals that when young trans people are able to use their chosen name and pronouns in all areas of their life, this can decrease symptoms of severe depression by 71%, thoughts of suicide by 34%, and suicide attempts by 65%. And even having one space in which their name and pronouns are honored can decrease suicidal thoughts by 29%. However, less than 1 in 3 trans or nonbinary kids report an affirming home, according to The Trevor Project. 

And it’s important to note that being supportive does not require your full understanding. “It (can be) really difficult to understand at times,” says Theo, “but the best thing people can do right after someone comes out to them is just to accept, whether or not you understand.”


Beyond using their correct name and pronouns, helping your child move forward with expressing their gender is huge. This doesn’t have to mean medical intervention (see “What Is Gender-affirming Care?” on this page); it can be as simple as taking them shopping for a few new outfits or getting a new haircut. Burleton wants parents to know that being trans or gender diverse doesn’t always necessitate mental health treatment — start with a peer group, like the ones TransActive runs, and listen to your child as they express what kind of support they need. Before discussing medication or surgical procedures, Burleton emphasizes that parents should first get a sense of stability in understanding which aspects of gender diversity do and don’t apply to their child. “It’s very easy to get overwhelmed, to second-guess, to have doubts, [or] to question the professional recommendations,” she says, especially if a parent hasn’t done their own work and research. 

Step 2: Embrace uncertainty.

Still, no matter how much learning (or unlearning!) you have done, get used to embracing uncertainty. Many parents may have questions about the permanency of their child’s gender identity, see it as a “phase,” or classify their child’s experience as “experimentation.” 

Dr. Selva says that of the over 2,000 kids she’s treated at her clinic since 2009, fewer than 15 later changed their minds. Of those who’ve stopped treatment, she says, “They’ve said, ‘This is what I needed to do at the time, it saved my life at the time, and this is the level of care that I need now.’” Consider that much of parenting is doing our best with what we know right now. “Kids are experimenting with all aspects of their identity … that’s just the nature of being an adolescent,” adds Theo. You don’t have to have all of the answers about how your child will identify over the course of their life — and neither do they! — for you to be able to support their journey and follow their lead of where they are now. 

Step 3: Advocate with intention, awareness and consent.

You may also find yourself needing to advocate for your child at school or with family and friends. “Be your kid’s protector,” Dr. Selva says. TransActive offers support to help attorneys navigate situations regarding custody or public schools, to help everyone involved understand what kind of supports state law requires. 

When advocating for your child, first ensure you have their consent. You may find yourself wanting to announce to the world that you are the proud parent of a trans child, but you should never share about your child’s transition without asking them for their input first. Sometimes, privacy equals safety. “People using my deadname and she/her pronouns … was kind of a necessity,” says 18-year-old Theo. (His deadname is the name he was given at birth that he no longer uses.) “People who meant well would use my correct pronouns, but it can definitely be endangering.” 

Debra Porta, the executive director of Pride NW — the organization behind Portland’s Pride month and local activism — adds that beyond supporting your individual child, take your advocacy one step further. “Support the organizations that are supporting our kids — in word and purse and deed,” she says. Show how much you care about and value your child by investing in the wider trans and LGBTQ+ community. 

And while you can appreciate the safety and comfort your child might enjoy by way of living here in Portland, Burleton emphasizes that we have to keep pushing to layer more protections for trans kids and cultivate more resources. “Our job is not to be complacent and assume that Portland and Eugene will always keep Oregon [safe for trans kids] — because complacency is deadly,” she says.   

Step 4: Find your own support!

Transitioning as a young person can be overwhelming, scary, intense and emotional — and these words might also describe your experience as their parent. While all those interviewed acknowledged the difficulties parents might face regarding their child’s transition, like a sense of loss, confusion or anger, Theo says this shouldn’t be something that you and your child are dealing with together. “There are some things that need to be processed outside of the relationship you have [with your child],” he says.

Burleton agrees, adding that for most cis/straight parents, having a trans kid can be a big shock. “Suddenly, parents have a kid who very courageously and very terrifyingly is pointing out that we’ve been doing it wrong the whole time,” she says. To help process your experience as a parent, while making space for your child to also do so, she recommends joining a peer support group like TransActive or PFLAG.

What is gender-affirming care?

Now that you and your child have opened dialogue on their journey as a trans youth, and how best to educate yourself, while simultaneously supporting them, the topic of gender-affirming medical intervention might arise. The first clinical guidelines for treating transgender patients with gender-affirming care, such as puberty blockers and hormones, were released in the United States. 

Of course, gender-affirming care is so much more than medical intervention. “The first step depends on the age of the kid, and where they are on their journey,”  says Selva. Patients below the age of 7 (less than pubertal age) receive no medical intervention. Rather, they might get support with socially transitioning and a referral to TransActive for peer support or a mental health provider. If a patient is approaching puberty and feeling distressed, that becomes more urgent in terms of medical treatment. 

Dr. Selva says there is no singular treatment protocol applied to every patient. Jenn Burleton echoes this sentiment: “It’s not about putting them on a path — it’s about opening up and listening to them as their path evolves.”

Another element of gender-affirming care is the expectation and need for all medical providers — whether they are connected to a gender clinic or not — to be knowledgeable and inclusive of trans patients. Porta describes the demeaning experience trans patients are subject to when providers don’t use their correct pronouns or ask invasive questions. This can lead to patients avoiding or halting necessary medical care. 

It’s also key for parents to understand the impacts that gender-affirming care has on trans young people’s mental health. Receiving gender-affirming care can decrease symptoms of depression by 60%, and suicidal thoughts by 73%, according to researchers from the University of Washington, Seattle and the Seattle Children’s Hospital. Everyone interviewed for this piece shared a sentiment similar to Burleton’s thoughts on the subject: “Gender affirming health care is lifesaving, safe and effective, and it should never be denied to any child or youth whose life could be made better [by it].”

High Stakes and the Potential for Love and Support 

It’s important to foster spaces that uplift trans joy. Community celebrations of friends receiving gender-affirming care or meeting personal milestones like starting hormones or getting top surgery (see A Helpful Glossary below) can be extremely powerful. 

Even “the little things,” says Theo, with a laugh. “Like, I’ve started getting these little, gross mustache hairs … if I was a cis teenage boy, it wouldn’t feel the same, but when you’re trans and medically transitioning, the smallest things can be a huge victory.” 

Dispelling the disinformation that being trans will mean a difficult, unhappy life for your child, is key for Dr. Selva. “[Trans kids] are lovely, happy children,” she says, sharing the story of her first patient, who blossomed from a withdrawn teenager failing her high school courses to a positive, successful college graduate. 

Your trans child will face challenges that will at times feel insurmountable — and just by reading this, by being willing to learn and stretch and grow, you’re taking a huge step to show your child you’ll be by their side, come what may. But they will also have experiences that will bring them an affirming community, connect them to deep and loving friendships, and unlock their potential to live a fulfilling, authentic life. 

“I really do believe in trans joy over trans dysphoria,” says Theo. “It’s just limitless joy.” 

May we all find this kind of joy — for ourselves and for every trans child. 

Resources for Trans Youth

These national organizations offer helpful resources and support for trans youth and their families:

Portland also has many outstanding resources available:

  • TransActive sets the standard for support groups and advocacy.
  • Pride NW, led by Debra Porta, both organizes Pride month events and engages in year-round activism.
  • Basic Rights Oregon has been running their transgender rights project since 2007.
  • Portland has gender clinics at OHSU and Randall Children’s Hospital at Legacy Emanuel, among others.
  • Many schools have Gay-Straight Alliance clubs, and both PFLAG and GLSEN are active in our community.

A Helpful Glossary

Transgender/trans: Describes people whose gender does not match the one usually associated with the sex they were assigned at birth. 

Cisgender: Describes people whose gender identity matches the sex they were assigned at birth. 

Gender Expression: The external manifestation of gender, expressed through such things as names, pronouns, clothing, haircuts, behavior, voice, body characteristics and more.

Gender Identity: One’s internal, deeply held sense of gender. Unlike gender expression, gender identity is not visible to others. 

Sex: At birth, infants are commonly assigned a sex. This is usually based on the appearance of their external anatomy and is often confused with gender identity or expression. However, a person’s sex is a combination of bodily characteristics including chromosomes, hormones, internal and external reproductive organs, and secondary sex characteristics. As a result, there are many more sexes than just the binary male and female, just as there are many more genders than just male and female. 

Gender-affirming care: Medical care that affirms a person’s gender identity and gender expression. This includes social affirmation, puberty blockers, hormone therapy and/or gender-affirming surgeries.

Deadname: the name that a transgender person was given at birth and no longer uses upon transitioning

Top surgery: a gender-affirming surgery to create male-typical chest shape or enhance breasts.

Bottom surgery: a gender-affirming surgery on genitals or reproductive organs.

The Local State of Gender-Affirming Care and Trans Rights

Although it might not seem as present here in Portland, several lawmakers, school districts and religious leaders have joined the fray against gender-affirming care. However, in general, Oregon is a state with strong protections for trans people, and LGBTQ+ people. It’s one of only 15 states to have its policies rated “high” by the Movement Advancement Project, a nonprofit think tank dedicated to equity. 

Currently, Democrats in the state legislature are championing a bill that would require private insurance to cover gender-affirming care (Oregon Health Plan, OHP, has covered it since 2015) and would also extend protections to patients and providers who may be or have already faced prosecution by laws like the one recently passed in Idaho making providing gender-affirming care a felony.  

Federally, more and more bills have been introduced, and passed, to restrict or outright ban gender-affirming care and to decimate some of the meager protections trans people retain in states like Florida, Texas or Missouri. Some bills focus on keeping young people from accessing this health care, and others focus on criminalizing the medical professionals who provide it. 

“Trans people are terrified right now,” says Jenn Burleton, the director of TransActive Gender Project at Lewis & Clark College. Burleton grew up trans in the 1980s, arguably a much more difficult time to be openly queer in any way, but still, she goes on to say that she’s “never been as fearful for the safety and future of trans people in general, for our trans children” as she is today. 

Robin Lanehurst
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