Gender variance (non-conforming gender behaviour or presentation) is an inclusive term that captures those (in this case children) whose non-conforming gender behaviour or presentation is observable and causes a level of consternation in those that care for them. Gender variance, therefore, may also apply to children whose behaviour indicates a diagnosis of Gender Identity Disorder in Childhood (GIDC) (Zucker and Wood 2011). For the purposes of this paper, gender variant refers to non-conforming gendered behaviour in children and transgender is an umbrella term that includes all adults from those with gender-variant expression or behaviour to transsexuals (Bockting 1999; Green 1994; Lev 2004). Historically, resources for gender-variant children and their parents have been lacking as non-conforming gendered behaviour has been considered abnormal, and significant cultural and ethnic differences exist in pressures to conform (Bullough and Bullough 1998). More recently, however, there is recognition that pressuring children to conform to gender stereotypes creates suffering not only in their childhood, but also through adolescence and into adulthood (Grant et al. 2010; Gray, Carter, and Levitt 2012; Grossman and D’Augelli 2006; Institute of Medicine 2011; Plöderl and Fartacek 2009; Toomey et al. 2010; Whittle, Turner, and Al-Alami 2007). Moreover, a number of studies have found that supportive family responses to gender variance contribute to improved mental health and psychosocial resilience in childhood, adolescence and adulthood (Bowes et al. 2010; Rutter 1985; Ryan et al. 2009; Wyman et al. 2000). Also, it is unknown which gender-variant children are likely to become transgender adults. The study described here aimed to identify the needs of gender-variant children (aged 12 or less) and their parents, and to provide research-based evidence to enhance programmes, training and policies that support gender-variant children and their parents.

The literature review for this study was generated through systematic searches of the electronic databases PsycINFO via OvidSP (1806-present), Ovid MEDLINE and Scopus for the past 10 years, using combinations of the words and terms ‘child’, ‘parent’, ‘gender variant’, ‘transgender’, ‘transsexual’, ‘gender identity’, ‘gender atypical’, ‘cross dress’, gender confusion’, ‘gender non-conforming’, ‘gender orientation’, ‘gender dysphoria’ and ‘gender identity disorder’. Through this search, a number of ‘needs’ studies related to the psychological, emotional and medical health of transgender individuals were found, although the focus of these studies was the needs of transgender adults. The limited discussion of the needs of gender-variant children and their parents in the literature is based on clinical practice (Brill and Pepper 2008; Di Ceglie 1998; Di Ceglie et al. 2002; Hill et al. 2010; Mallon 1999, 2006; Rosenberg 2002), support groups organised for parents (Crawford 2003; Di Ceglie and Coates Thummel 2006; Menvielle and Tuerk 2002), life stories of transgendered identifying individuals or their parents (Boenke 2003; Costa and Matzner 2007) and research examining parents’ attitudes and acceptance of their gender-variant children (Hegedus 2009; Hill and Menvielle 2009). Gender-variant children’s needs identified from the above-mentioned authors are for unconditional love, a safe place to discuss their feelings and for the proper use of pronouns. Parents’ needs are for professional intervention, information, peer contact, help in setting boundaries for their child’s behaviour and access to informed professionals.


Following the above-mentioned work, a series of Internet surveys were designed to investigate and understand the experiences of people who have the requisite experience and knowledge to determine the needs of gender-variant children and their parents. Using an online survey system called Zoomerang (MarketTools 2011), three groups of participants were chosen and surveyed: parents with gender-variant children aged 12 or under, transgender adults and clinical professionals with experience of working with the transgender community. The survey development team included clinicians, researchers and academics experienced with transgendered presentations as well as transgender individuals who were consulted for input and feedback. Ethics approval was granted in August 2008 by the Human Research Ethics Committee at the University of Sydney. Participants were recruited via advertising in newspapers (e.g. Sydney Star Observer, Sydney Morning Herald, Sun Herald), magazines (e.g. Sydney’s Child, Polare), radio programmes (e.g. Life Matters - Radio National, Transmission time - Joy 94.9), websites (e.g. University of Sydney, The Gender Centre, Joy) and via the Listserve and conference proceedings of the World Professional Association for Transgender Health.

Purposeful and strategic sampling (Charmaz 2006; Patton 2002) was employed to capitalise on the knowledge and experience of these three groups. A snowball sampling technique was employed whereby participants were invited to refer others within the target populations who might like to take part in the survey. International participants were also sought to elicit a broad range of views and to provide a sufficient number of participants for the study.

The surveys

All surveys included closed- and open-ended questions. To ensure that responses to all questions were voluntary, the survey was structured to allow participants to skip questions. The closed-ended questions were used to gather demographic data while the open-ended questions were used to obtain reflective elaborated responses in which participants could articulate their experiences, behaviours, feelings, knowledge and opinions, and which would allow the researchers to develop an appreciation of the extent and depth of the participants’ experiences (Huberman and Miles 2002; Patton 2002).

Open-ended questions directed at the parent cohort enquired about their challenges, experiences, needs and concerns for themselves and their children. The transgender adults were asked about their experiences of gender variance as a child, their families’ responses and their own and their parents’ needs at that time. The professionals were asked about their general understanding of the issues faced by gender-variant children and their parents, and then specifically about the needs of these two groups.

To ensure that the analysed data were representative of the participants represented in the demographics, analysis was conducted only on data in which participants responded to at least one of the open-ended questions. In addition, with respect to the parent and transgender adult respondents, results were excluded where gender variance had been identified after the age of 12 years. However, it is acknowledged that some children do reach puberty before the age of 12 and that at puberty, the needs of gender-variant children are likely to change as adolescent factors significantly affect their circumstances (Cohen-Kettenis, Delemarre-van de Waal, and Gooren 2008; de Vries et al. 2011; de Vries, Cohen-Kettenis, and Delemarre-van de Waal 2007; Olsen, Forbes, and Belzer 2011). No limitation was placed on the professionals’ responses as the research team believed that the needs of gender-variant children and their parents could potentially be gleaned from any focussed work with transgender people. From the total of 244 participants who responded to the survey, 170 were finally included in the data analysis. The participant numbers are presented in Table 1.

Table 1. Participants who entered the survey

Survey participants
Number of participants who responded to the survey Number of participants who did not meet the inclusion criteriaa Number of participants included in the data analysis
46 17 29
50 19 31
Transgender adults
148 38 110
244 74 170
a Either identified the age of gender variance after the age of 12 or did not respond to any open-ended questions.

The number of responses from all participants to the open-ended questions was high (97.3%), as shown in Table 2.

Table 2. Number of responses to open-ended questions.

Number of responses
Professionals Parents Adults Total
All possible responses
261 527 1870 2658
Missing answers
14 (12 from 2) 9 (5 from 1) 49 (43 from 6) 72
Total responses
247 (94.6%) 518 (98.3%) 1821 (97.4%) 2586 (97.3%)

In the parent group, out of a possible 537 responses from 17 open-ended questions, only nine responses were left blank and five of these were from one participant. In the transgender adult group, out of a possible 1870 responses from the 17 open-ended questions, 1821 answers were received. Of the missing answers, 43 were from six people. In the professional cohort, from a possible 261 answers to 9 open-ended questions, 247 responses were obtained. Of the 14 missing responses, 12 were from two participants.

Data analysis

The qualitative data were analysed using grounded theory and content/thematic analysis (Charmaz 2006; Grbich 2009; Spradley 1980) which involved an ongoing reflective-interpretive process (Moustakas 1994; van Manen 1997). Responses were considered separately with respect to each question, each participant and each group of participants, and then summarised as a whole. Coding followed Buckingham and Saunders’ (2007, 142) rules of: (a) ‘discrete categories’ where codes are unique for each category; (b) ‘exhaustive categories’ where all responses are represented; and (c) ‘discriminatory categories’ where variations are initially coded separately for later group identification. Although Weft Qualitative Data Analysis (Fenton 2006) was initially used to organise and code the data, this was quickly replaced with a manual method that more readily provided a logical trail of thinking using colour coding as well as full access to all previous steps and saved versions of the analysis.

The findings were first derived from the responses of participants in the three groups: parents raising children with gender variance, transgender adults and professionals working with the community. Six sets of needs (i.e. the child’s needs and the parents’ needs as identified by each group) were then compiled to create two sets of needs: one for the children and one for the parents.


Study findings are described first via a summary of needs as identified across the three groups. Then, the needs of gender-variant children and those of their parents are each focused upon in more detail.

The needs of gender-variant children

In the parent data, children with gender variance emerged as having the following needs: being able to discuss gender issues with parents; having access to information; knowing that having gender variance is valid and okay; being loved unconditionally; being accepted and respected; having their issues and well-being made a priority; being permitted to make their own choices in friends, clothes and activities; being referred to by the pronoun of their choice; not having to conform to society’s gender expectations; having peer support and learning the skills to create friendships and cope with bullying; having supportive counselling; having acceptance and support from school authorities; and being safe. The need to not be blamed or punished for their gender differences, the need to not be anxious and in fear of others’ reactions to them and the need to not be cast out and isolated by others were also included (Riley et al. 2011a).

The transgender adults data identified the following needs for gender-variant children based on their experience: the need for education and information about gender variance; the need for parental love and support; the need for permission to express their gender; the need for knowledge about similar others; the need for recognition as having gender variance and for support; the need for parents to overcome their negative biases and influences; the need for society to be more tolerant and accepting of gender differences; the need to have an understanding and supportive school environment; the need to have access to other transgender persons; the need to have medical intervention where suitable; and the need to be protected from abuse and violence (Riley et al. 2013).

Professionals who work with transgender individuals and their families identified the needs of gender-variant children as the following: to be loved; to be listened to; to be respected and accepted; to be offered general, school and professional support; to be free to express their true gender; to have gender-variant friends; to be safe and have the same opportunities as other children; and to have access to a delayed puberty where indicated (Riley et al. 2011b).

In summary, the needs of gender-variant children as identified by parents, transgender adults and professionals can be represented by the acronym H-A-P-P-I-N-E-S-S. These needs are: to be Heard; to be Accepted; to have Professional access and support; to have Peer contact; to have access to current Information; Not to be bullied, blamed, punished or otherwise discriminated against; to have freedom of Expression; to feel Safe; and to have Support. Although some of the needs identified by the three groups of participants were given similar names, further investigation revealed that the reasons behind these needs were sometimes different. Where relevant, these differences are explained below.

To be heard

This need encompasses children being given permission to discuss gender with their parents; to have their parents listen to them and provide them with a safe and comfortable environment for the interaction. Transgender adults described their suffering due to being unable to share their concerns and feelings about their gender in various ways, as reflected in the following comments from the data: ‘I thought if I told anyone they might put me away in some mental institution. I dared not even tell my parents’; ‘I promptly came out to my family [and] received a forceful message that what I was doing was wrong’- and:

I tried to talk with my mother about my ‘problem’ but it was too difficult for her. I was sent to a private all-boys school. As if that would ‘cure’ me ... [It was] the only time I have endured beatings ... I was definitely not cross-dressing at school. Somehow people just knew ... I will never get over that.

To be accepted

The need for acceptance involves being valued, respected and loved unconditionally by parents and being referred to in the preferred gender. This need includes both family acceptance and acceptance beyond the family, for instance, the tolerance of diversity at schools and in the wider community. A lack of acceptance was particularly noted in the responses of transgender adults. Several participants related the following:

As a teen I told my mum I was gay and was forced to leave home.

[Even though] I’d have been killed quite literally, if I transitioned where I grew up, either way, feeling loved and valued, no matter what, by those who cared for me is what would have helped me the most.

Participants also suggested that parents need a better understanding of sex and gender to help them accept their children’s expression of gender variance. They stressed that children ought to be accepted as they are and be given adequate time to determine their unique gender. Gender differences should not be merely tolerated, but respected, embraced and valued.

To have access to professional support

Access to professionals includes access to counselling and medical practitioners with the knowledge and expertise to recognise gender variance and provide intervention and referrals (where indicated) for children anxious about their developing bodies. Access to knowledgeable school counsellors, general practitioners and community groups was also highlighted as it was noted that children also need options for support beyond their immediate families. Transgender participants expressed their dismay at the lack of local support services available to them as children and described instead how they were subjected to reparative therapies. Professionals mentioned the need for their colleagues to be able to recognise gender identity issues and offer sensitive and friendly support in a positive environment.

To have peer contact

The need for connection with peers includes opportunities to meet similar others and to have access to support groups, either face-to-face or online, to alleviate feelings of isolation, to learn about different ways of coping and to make friends. Transgender adults also stressed the importance of having access to transgender role models and described how they, as children, needed to know that gender variance is a naturally occurring phenomenon and to see how transgender people are treated. They noted that this would have helped them to situate their experience in the wider world and to see a future for themselves.

To have access to information

Information and education for children was a key component of gender-variant children’s needs and was emphasised by all groups. It was recommended that resources and education programmes related to gender variance be freely available in libraries, schools, doctors’ surgeries and other public places. This suggestion also includes implementing strategies for dealing with bullying referrals, for making available suitable websites and for offering face-to-face assistance. The onset of puberty was identified as a crucial time when children need to have access to reliable and age-appropriate resources. This availability of resources was also considered to be a way for children to ‘better understand who they are and what might help them to become more comfortable’ and to know that ‘gender is not sex and not binary’. From the parents’ perspective, knowing that appropriate and correct information regarding sex and gender was available to their children would have reduced the burden they felt in needing to know, but not knowing, about gender variance.

Not to be bullied, blamed, punished or otherwise discriminated against

This need advocates for gender-variant children’s rights to be treated equally without fear and anxiety and not to be pressured to conform to gender stereotypes; to have their diversity affirmed; to be offered the same opportunities as other children; and to have the potential for a satisfying and successful future.

To have freedom of expression

The need for freedom of expression involves allowing gender-variant children to make choices regarding their presentation, selection of clothes, and friends and activities, with the flexibility to have a blended or fluid gender expression. Participants commented that children need permission to explore their gender identity without pressure, judgement or restriction, and to know that gender variance is okay. Joan wrote:

Basically I felt like my life was pretty much an act in which I walked around in a vehicle that wasn’t quite right, whereby no one could really see me or know me and [where] I couldn’t be authentic. I was depressed, anxious, desperate, alienated, but managed to act nearly all the time as if everything was fine.

To feel safe

Safety and protection from abuse and violence was identified as a priority for gender-variant children. Participants noted that safety could only be established in schools and communities where there is suitable education and advocacy in conjunction with punishment for offenders and resources for children to cope with bullying and harassment. Parents highlighted their concerns for the safety of their gender-variant children specifically with respect to the lack of support from schools and community in their (the parents’) absence. Transgender adults described the fear and anxiety that a lack of protection generated for them as children and the ongoing impact of living with bullying and violence. Helen wrote of how ‘the constant fear of being beaten’ affected their choices and impacted their self-confidence. Many described how these kinds of experiences continue to impede their progress as adults.

To have support

The need for support includes the need for proactive intervention comprising emotional and physical support from parents, professionals, schools, community and religious groups, and society generally. Culture, tradition and religion were seen as imposing such strict rules on behaviour that some transgender adults were convinced that their parents would have been incapable of accepting their gender variance. Participants expressed the need for children to be supported in expressing their authentic selves (instead of being punished). They felt that gender stereotyping in schools and society in general severely limits the amount of support, safety and protection that is available to gender-variant children and furthermore, that most schools lack the understanding, strategies and resources for positioning the gender-variant child’s behaviour within their established frameworks.

Parents’ needs

The parents identified their own needs as being for specific and correct information about gender variance in children as derived from books, guidelines, research and the media; information about parenting strategies, sharing of stories with other parents, peer support and contact with members of the transgender community; skills to counteract bullying and negativity towards themselves and their children; access to competent medical and counselling professionals; school policies, special needs and disability support; community education and government assistance to support them and their children; and the ability to tolerate the uncertainty of not knowing the future outcomes for their child. Parents also appealed for financial and legal aid, political advocacy and lobbying to gain support for themselves and their children (Riley et al. 2011a).

The needs for parents as described by the transgender adults in the study encompassed needs for information; the opportunity to meet other similar parents; trained professionals who can advocate for gender-variant children; access to counselling; familiarity with role models of successful transgender people; legal and financial support; and social and religious groups that are aware and supportive of gender variance (Riley et al. 2013).

Parents’ needs, as seen by the professionals, were for information and emotional support from families, friends, local communities and society in general; professionals who are knowledgeable and competent in dealing with gender-variance issues; the prioritisation of the child’s well-being; contact with other similar parents; schools that are accepting and supportive of their children; and access to the latest research regarding gender variance.

The needs of the parents of gender-variant children in this study are for information; education; support from family and friends; support from schools; counselling and professional support; peer and community support; contact with transgender people; and financial, legal and government support. These are described in detail below.


Participants suggested that information could be provided in the form of books and stories about gender-variant children and their families; up-to-date research published in the media; and guidelines and strategies for parenting. Information should be available not just online but in doctors’ waiting rooms, in libraries and on television and radio programmes. Requested guidelines and strategies were related to setting limits on their child’s behaviour, handling negativity towards their child and advice on choosing schools sympathetic to diversity in gender expression. Professional participants noted that a lack of correct information feeds into parents’ fears. Parents commented that their uncertainty about what to do or who to turn to was a major contributor to their inability to support their children.


Education was identified as a need for counsellors and medical professionals, for school staff, for parents and for community programmes. The aim of education is to increase knowledge and general awareness about gender variance. Education across the various sectors was identified as a way to increase acceptance of gender variance and counter assumptions that biological sex is always in alignment with gender expression and/or identity. Parents, in particular, commented that the ignorance and fear of other people contributed significantly to the difficulties they faced and due to this they felt misunderstood, blamed and judged for supporting their child. Parents also cited the need for the education of ‘special needs’ and disability staff.

Support from family and friends

Participants suggested that an accepting and caring environment, for instance, respect, compassion, help and encouragement from family and friends, allows parents to manage their child’s needs. Professionals noted that this kind of support builds parents’ confidence and helps them to advocate for their children in public.


Counselling was identified as being a foundation to providing reassurance, understanding and guidance for parents as well as for other family members. Counselling helps parents with decision-making and provides a context within which they can discuss their values, fears and concerns without fear of judgement. Professionals emphasised parents need to know that they are not at fault, that it is okay to advocate for their child and that there are other families dealing with similar issues.

Support from professionals

Professionals need to be informed and be aware of the issues for transgender individuals, trained and caring. Parents voiced the need for a diagnosis and treatment pathway for their children as they enter puberty; professionals’ prioritisation of their child’s well-being and speaking publicly about the needs of gender-variant children. Transgender participants noted that support from knowledgeable professionals would have improved their own parents’ ability to cope and thereby reduce the pressure on them as children. Competent professionals would respect parents’ reactions and give them the time to adjust their approach to raising their gender-variant child.

Peer support

Contact with other parents of gender-variant children and access to support groups, both face-to-face and online, were identified as being necessary to help parents understand that they are not alone. Meeting other families would provide parents with emotional support and give them the opportunity to learn about issues that other parents had dealt with. This would also allow parents to create a network of support to draw on in times of distress.

Community support

The need for support from local and wider community networks includes assistance and acceptance from religious groups, local clubs and schools, and more tolerance of gender variance in society generally. A supportive culture and society that do not impose and enforce stereotypes were seen as critical in ensuring consistent support for their child. It was also recommended that school counsellors liaise with gender specialists to provide a broader support base for parents.

Access to transgender people

The need for access to transgender people includes the visibility and positive portrayals of transgender individuals and communities. Some participants noted that parents would benefit from ongoing social contact with transgender persons.

Financial support

Financial support was considered to be necessary to ensure that parents could afford the costs of counselling and other professional expenses likely to be required to meet the child’s needs.

Legal and government support

Politicians and leaders with an awareness of the issues faced by parents of gender-variant children were identified as being important for recognising the rights of parents and their children. This type of support included lobbying and legal protections. Although legal and government support was identified as a need by all groups, it was the parents in particular who would like leaders and politicians to demonstrate leadership and direction for the wider community by legitimising their concerns.

Although this study focussed on children under the age of 12, parents, professionals and transgender adults all identified the need for puberty-delaying hormones to be available for children as they enter puberty. Parents of older children felt that the lack of access to puberty blockers significantly increased their child’s suffering. Transgender adults described the misery they felt during puberty and the ongoing issues that not having had access to puberty- delaying hormones had created for them as adults. Professionals, as witnesses to the distress of adolescents with extreme gender dysphoria, described the need for adherence to best- practice guidelines for adolescents in need of puberty-delaying hormones.’


The various sets of needs described above provide more insight into the experiences and requirements of gender-variant children in their day-to-day lives. The literature has rarely discussed the needs of gender-variant children, while those needs that have been identified tend to be the by-products of support programmes organised in support of gender-variant children. Mallon (1999) in ‘Practice with Transgendered Children’, for example, put forward a framework which can be used by clinicians who work with gender-variant children and their families. He recognised gender-variant children’s needs for information; acceptance and unconditional love; support; and advocacy. Brill and Pepper (2008), in their guidelines for trans-positive support of gender-variant children, discuss gender- variant children’s need to discuss their situation, be actively loved and supported by their parents and be allowed to make their own choices regarding clothes, activities and toys. Although Wyss (2004) identified several safety needs for gender-variant school children, their information was related to teenagers only.

There are occasional references in the literature to the needs of parents with gender-variant children, mainly in studies of parents’ experiences and parent support groups. For example, a study by Hill and Menvielle (2009) focussed on the experiences of parents with gender-variant children and teens. They identified parents’ needs for education and the setting of limits on their child’s dressing. Parents’ need for peer contact was first recognised by Pleak (1999), who organised a group for parents of boys diagnosed with GIDC. Pleak reported that parents who were able to speak openly about their situation demonstrated greater acceptance and support of their own children. Menvielle and Tuerk (2002) provided a support group for parents of gender non-conforming boys and reported on the benefits for parents in finding support related to the issues of disclosure, grieving, embarrassing situations and the use of humour. Rosenberg (2002) organised a group for parents of children diagnosed with GIDC. The reported outcomes for parents were relief in speaking about their situation and strategies for coping with family members, teachers and neighbours. Mallon (1999) recommended that social workers be aware that parents of gender-variant children need to have resources, family support and strategies for negotiating with their children and other people.

The data in the present study suggest that even when gender-variant children actively endeavour to conform, their efforts are often thwarted by individuals who seek to marginalise and victimise them for their difference. Children therefore suffer from an invisibility and lack of recognition of their needs, on the one hand, and (in some cases) a violation of their personal boundaries that can foster a general anxiety, on the other. The well-documented need of all children for acceptance and affirmation places even moreresponsibility on adults to be compassionate and make provisions for gender-variant children. The cohort of transgender adults in this study provided some evidence of the consequences of reparative therapy and indicated support for alternative approaches that would allow children to either come to terms with, or confidently develop, their own sense of identity in a caring environment.

It is notable that most of the transgender adults who responded to the survey had experienced childhood prior to 1980. Since then, there has been a substantial change in attitudes towards transgender individuals, indicating perhaps that the experiences of individuals in this study were more negative than might be the case today. However, in the first author’s (Elizabeth A. Riley) clinical experience, there are still many children whose parents and families are not accepting of the child’s presentation of gender variance.


Although this exploratory study breaks new ground in understanding the needs of gender-variant children and their parents, several limitations may restrict its impact and significance. Some of these are inherent in the nature of this style of research while others are specific to the study itself.

One limitation of the project is that all data were collected via online surveys. Some participants may have found that having to rely on written text restricted their ability to express themselves. In addition, not only were participants required to express themselves in written text but the surveys also had to be completed in English. Consequently, the online surveys not only excluded those without access to computers or the Internet, but also those who could not express themselves effectively in written text or in English. This use of the Internet also prevented the researcher from a further probing of answers or the use of other cues, such as physical presence, body language or voice, to enhance understanding; although, it has been questioned whether these elements are necessary, distracting or even relevant (Markham 2005). It is also acknowledged that participants may have either minimised or overstated their difficulties or the impact of gender variance on them to match their current beliefs, needs or values.

It was assumed that the context of the professionals who entered the survey would be clinical. This turned out not to be the case as only 76% identified as using a clinical setting for their clients. The other 24% (directors/coordinators, educators, one lawyer and one researcher), however, did appear to have a significant and ongoing association with transgender people as suggested by the thoughtful and significant responses they provided to the survey’s open-ended questions.

Lesbian and gay individuals also have experience of gender-variant childhoods (D’Augelli 2008; Grossman, D’Augelli, and Frank 2011; Toomey et al. 2010). Research focussing on the childhoods of lesbian and gay individuals would enable a more complete study of the needs of gender-variant children.

Finally, this study did not attract those parents who do not accept gender variance in their child. The circumstances and views of these non-accepting parents were only represented in this study through the experiences of transgender adults who reported this attitude in their own parents. Therefore, non-accepting parents were likely to be under-represented in the results.


This study has attempted to understand the needs and experiences of gender-variant children and their parents. There is currently, however, little existing information against which the findings of the study can be easily validated. Specifically, the aims of this study were to identify the support needs of children with gender variance and the support needs of parents raising a gender-variant child. The current and future objectives are to contribute to information, resources and curriculum development in the education of professionals, schools, parents and the community in supporting gender-variant children; to influence the development of evidence-based health and policy in support of gender-variant children and their parents; to invite professionals to advocate for and reduce the stigma of gender variance; and to pave the way for future research.

The various attitudes and biases of the three groups of participants – parents of gender-variant children, transgender adults and professionals working with gender-variant children – were outlined where relevant with reference to the specific needs identified. Across all three groups of participants, the findings indicated a significant shortfall in compassion towards gender-variant children; education available to professionals; support available to parents; awareness of gender variance in schools; and the management of bullying of gender-variant children in the school context.

Parents described their experience of watching their children struggle with the pressure to conform to societal gender expectations and one-third wrote that their children were at times sad, depressed or suicidal. They recounted their struggles in attempting to stem bullying and deal with hostility towards their children and lamented their inability to make the world a safer place for their children as they approached puberty. Parents also conveyed their sensitivity to the fear and anxiety they had observed in their children and their search for strategies to alleviate their discomfort and to help place appropriate boundaries around their children’s presentation in order to prevent negative reactions and hostility from others. They also disclosed their concerns, challenges, needs and fears about making the right parenting decisions and wrote extensively about their need for resources and support.

Transgender adults expressed a finely tuned awareness of the challenges faced by gender-variant children and described their own parents’ ways of coping. They described their anguish at having to ‘perform’ in their assigned gender and the ongoing ramifications of dealing with the anxiety and hostility even when they felt they were conforming. They recommended that children be encouraged to discuss gender rather than keeping their experiences and feelings hidden. They also described what they felt were the unnecessary constraints that had inhibited their parents’ acceptance and support of them as children, and expressed the frustration arising from the lack of resources and support to alleviate their confusion and concerns. They also identified parents’ needs for family counselling, financial support and legal protection, and the need for public advocacy and presentations by clinicians.

Professionals’ views in this study were both compassionate and pragmatic. They proposed mechanisms to help parents cope and make informed decisions that would best serve the interests of their children. The professionals’ responses reflected a broader perspective as the parents’ and children’s stated needs were described as ‘rights’. They offered practical solutions and emphasised that gender-variant children ought to be heard and believed, given choices and loved unconditionally. Some professionals felt that pressure and disapproval from society was the cause of many difficulties and consequences for both the child and the family. They identified needs for general education and for parents to have access to the latest research, for legal support and, notably, for the child to be happy.

The process of identifying the needs of gender-variant children and their parents has generated input for training programmes and recommendations for enhanced roles for government. This study has indicated the need for further research in many areas associated with gender variance in children. First, knowledge of the needs of gender-variant children and their parents in non-Western countries would assist in developing a multicultural approach towards transgender individuals. Second, sourcing the perspectives of lesbian and gay individuals (given the association between gender variance in childhood and a homosexual adulthood) would shed light on the needs of gender-variant children and their parents. Third, the views of teachers would help facilitate the integration of knowledge about gender variance into various aspects of the school curriculum. Fourth, understanding the psychological dynamics of shame and stigma could help in developing therapeutic approaches for working with clients who have been subject to stigmatisation. Fifth, an exploration of the experiences of gender-variant people who have had successful and productive lives would provide a basis to ascertain the elements that may have contributed to their success. Sixth, long-term treatment outcomes (including for those individuals exposed to coercive and reparative approaches) could help determine which approaches are likely to provide the most positive, successful and healthy outcomes for gender-variant children. Seventh, information about the motivations for transphobia and homophobia would provide critical input to anti-bullying programmes in support of gender-variant children. Eighth, identifying the impact of the media on people’s belief systems, values and behaviour would help to identify the power of the media in perpetuating beliefs about gender variance and determine how best to more effectively use the media to promote tolerance and acceptance of diversity.

This study on the needs of parents of gender-variant children has engaged with the voices and insights of three groups of participants. It has incorporated the knowledge and experience of parents of gender-variant children; the understanding and insight of transgender adults who have described their parents’ needs when they themselves were gender-variant children; and insights from professionals who work with members of the transgender community. The combined wisdom of these three groups has delivered a comprehensive understanding of needs that could be used to inform programmes in support of gender-variant children and their parents.

Although children have no choice but to live in the world that is made available to them, society does have a choice about how to treat them. With respect to gender variance, we may ask: can society, professionals and schools facilitate a child’s self-identification instead of policing conformity to gender norms? Can the stigma of gender variance be eliminated so that children whose behaviour harms no one can live in peace while embracing their differences?



1. Although the use of puberty-suppressing medication is considered to be reversible, evidence is required regarding the medium- and long-term effects on adolescents of this treatment.



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