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Perspective: The 10 suggestions I offer parents of gender-questioning teens as a therapist

With so many messages today about identity and gender, here are 10 suggestions to help parents and their gender-questioning teens

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Frank Rumpenhorst, Associated Press

As a therapist who frequently works with parents of gender-questioning children, I am concerned about the unique challenges that come with raising kids today. Complex and often confusing messages about identity abound on social media, in entertainment, in school settings, and elsewhere. And while popular culture has long cast parents as out of touch, it’s not uncommon today for parents to be called toxic or even abusive if they don’t align with their children’s opinions, particularly on issues related to gender and sexuality.

Certainly there are abusive parents; many therapists see evidence of this regularly, and genuine abuse should never be minimized or dismissed. But, by and large, most parents love and care for their children as no one else can.

If you are the parent of a gender-questioning teen, what can you do to provide the appropriate support your child needs?

1. Try to foster open, loving communication. Invite your child to share his or her experiences and thoughts. Give your child the experience of being heard, while remembering that hearing does not necessarily mean agreeing. Keep in mind that being rigid, preachy or argumentative in your approach will likely lead your child to feel more defensive and protective. You likely won’t be able to help your child gain a new or enlarged perspective through reason and logic alone. 

But you might also discuss with your child how to recognize what information is reliable and what is not, and how this applies to what your child might learn at school, on social media and elsewhere. And, at the same time, do not feel you have to be silent about your understanding of sex and gender. Share reliable information about the reality and purpose of the sex binary

As you keep all of this in mind, don’t focus primarily on gender in your relationship with your child. Recognize and build on your child’s strengths in all facets of life. Be aware of your other children’s experience too. What messages are they receiving from your parenting? Are they also being heard and supported? Are you participating in activities as a family? Having regular family dinners can be an especially important way to connect and to strengthen relationships.

2. Be aware of what research does and does not say. Much of the research into this topic is grounded more in ideology than science, as are the recommendations of most major medical and mental health organizations in the United States. For example, recommendations supporting the medical transition of minors stand in stark contrast with the positions of a growing number of politically progressive European countries including England, Sweden, Finland and Denmark, all of which have noted insufficient data supporting treatments and the potential risk of harm. Studies claiming to demonstrate that medical transition improves mental health and reduces suicidality have been plagued with methodological problems, such as relying on convenience samples without a control group and omitting important data. And because transgender identities have exploded over just the past decade or so, particularly among teenage girls and young women, there are no long-term studies on this emerging population. In short, many outcomes of social and medical transition are still unknown.

3. Seek to understand what a particular gender identity might symbolize for your child. Your child may be experiencing considerable distress, whether due to mental disorders, neurodevelopmental conditions such as autism, a trauma history, family disruption, social difficulties or other challenges. Many youth view a new gender identity as both an explanation and a solution for their struggles. Identifying as trans or nonbinary might also be an attempt to find a sense of worth, connection with others and meaning. It might be a way to try to create a new, better version of themselves, and leave their old self behind. Or it might be an attempt to escape from the difficulties they associate with their sex or to prolong childhood and avoid adulthood. 

As a young person growing up today, your child is likely unwittingly steeped in a worldview that suggests that her most important task is to be her “authentic self” as guided by her feelings, particularly feelings associated with sexuality and gender. According to this worldview, true wisdom is to be found by gazing inward rather than outward or upward. This worldview might be quite different from your own. Understanding where your child is coming from can help you identify and address unexpressed needs. 

4. Remember the importance of your parental role. You might have been told that children can understand their identity at a young age — that, as one renowned gender expert put it, even toddlers ripping barrettes out of their hair or babies unsnapping a onesie to “make a dress” are sending “gender messages.” Furthermore, you might have been encouraged to disregard what used to be widely understood about child development: that trying on different identities is a normal part of growing up and that body discomfort, especially when puberty looms, is also normal.

Perhaps you feel intimidated by the amount of information your child has gleaned from social media, other online resources or peers regarding gender issues. You might also be confronted by vocabulary and definitions that seem entirely new. And you might have heard the jarring question “Would you rather have a dead daughter or a living son?” 

Don’t be swayed by alarmist language like this and allow your child or others to make decisions that will permanently affect your child’s life. Instead, slow down and be thoughtful and careful, remembering that you have much more than simply a legal stewardship as a parent. Therapists, doctors, and teachers may come and go, but no one is better positioned than you to understand what is in your child’s best interests. 

Listen to your child’s perspective, but remember that it is ultimately your responsibility to decide what rules govern your home and what language you will use. Set boundaries both lovingly and firmly, ensuring that you are keeping the long view while focusing on what you can do in the present that will be most helpful.

5. Give your child room for growing autonomy. If your child feels overly managed or controlled, he or she will push back harder. Seek appropriate areas of compromise — for example, one mother described helping her trans-identifying daughter find a sports bra that deemphasized her chest rather than wearing a chest binder that might cause pain or breathing problems. Allow your child room to make some decisions, even if you don’t entirely agree, so that your relationship isn’t defined by power struggles. Let your child know you are on her team and that you want to face the complexities of life together.  

6. Encourage your child to engage regularly in real-life activities away from screens. Activities that involve serving others, being in nature and using the body in healthy ways can be especially helpful. Service-related activities can help expand your child’s awareness and put situations into perspective. Nature can be rejuvenating and inspiring, while also helping to anchor your child to reality. And activities involving the body — such as hiking, yoga, sports and dance — can reduce feelings of disconnection from the body and help your child appreciate what her or his body is capable of. 

Participate in some of these activities with your child, while also encouraging individual participation. In doing so, encourage your child to step outside her comfort zone and to experience the growth that can come from this. 

Consider taking family road trips, where you can expose your child to different environments and experiences. You might choose to listen to podcasts on the drive that foster critical thinking or exposure to various viewpoints on subjects unrelated to gender, so that your child can recognize the value of different perspectives, particularly as you discuss this together.

7. Modify online activity. You would not send your minor children alone and unsupervised to an unfamiliar city, where they could fall prey to individuals who do not have their best interests in mind. Similarly, you need to be familiar with and monitor what sites your child accesses online, as many websites and social media influencers share information that is inaccurate, misleading and sometimes dangerous. 

Furthermore, an accumulating body of research shows that social media in general can be damaging to mental health, particularly for girls. Limit screen time, and do not allow your child to have electronic devices in the bedroom at night.

8. Ensure that serious mental health issues are appropriately addressed. If your child does not have serious mental health issues, a therapist may not be needed. But if such issues are present, be cautious when selecting a therapist. Good therapy can be invaluable, but a bad therapist is worse than no therapist. 

Interview the prospective therapist first. Ask if the therapist takes a comprehensive approach and does not make quick assumptions about gender. Ensure that he or she supports your role as the parent and involves you in the process. 

Be particularly cautious when selecting therapists who work only with this population. Ask what the therapist’s perspective is on children socially or medically transitioning and whether he or she is familiar with the weaknesses in the relevant research. Also, see what you can learn from the therapist’s presence on social media and elsewhere. 

9. If you are married, nurture your relationship with your spouse. You and your spouse can be each other’s best support when dealing with difficult identity issues. Build on areas of agreement in parenting your child. Go on regular dates, if possible, where you don’t talk about family concerns. Do what you can to foster a loving environment in your home. 

10.  Model a healthy, meaningful life for your child. Don’t forget some of the basics: Are you taking care of yourself and showing that you appreciate your own body and mental health? Have you clearly identified what your values are, and are you aligning your choices and behaviors with those values? Is there anything in your relationships with others that needs attention? Focus on what you can control, and practice acceptance of what you cannot control. Demonstrate what it means to embrace being a woman or man, husband or wife, mother or father.  

It can be a wrenching task to parent a gender-questioning child when your perspectives do not align. Remember that your child needs your love, even if you can’t always see that right now. Continue to keep the long view, knowing that you are seeing only one part of your child’s pathway and that you have not yet arrived at the end of the story. And please be compassionate toward yourself, allowing yourself to grieve the very real losses you have experienced. Do what you can to find support as well as giving yourself moments to reclaim hope and to focus on what brings you peace. 

Rebecca Taylor is a psychotherapist practicing in Sandy, Utah.