For adolescents, coming out as transgender can be an enormous relief. But it can also be scary and challenging. Research shows that transgender teens may be more likely to struggle with depression and suicidal thoughts due to discrimination, bullying, and family rejection.
Parents of transgender teens need information and resources to help them support their children. To begin with, they need to understand what it means to be transgender and why trans youth are at risk for mental health issues and suicide attempts.
Key Takeaways
- Being trans is NOT a mental health condition, any more than being cisgender is. (Cisgender refers to people who identify with the gender they were assigned at birth.)
- Bullying, discrimination, and rejection by family members can leave trans youth vulnerable to depression, trauma, and other mental health issues.
- Trans teens who feel accepted by their families experience better mental health, self-esteem, and social support.
- A mental health professional can provide tools for navigating the stressors that all adolescents experience, and that are often magnified for trans teens.
What Does Transgender Mean?
According to the American Psychological Association, the term “transgender” describes people whose gender identity, gender expression, or behavior does not conform to that typically associated with their biological sex, also known as the gender they were assigned at birth. Transgender is sometimes shortened to trans, or trans male/trans female.
What does it feel like to be trans? Children or teens born with the biological and physical traits of a male may know without a doubt that they are actually female. Or those assigned female at birth may know that their true gender is male. Or they may be nonbinary—meaning their gender identity isn’t exclusively male or female.
Gender Identity vs. Sexual Orientation
People often confuse gender identity with sexual orientation. However, the two are not the same.
- Sexual orientation refers to our physical, romantic, and/or emotional attraction to another person.
- Gender identity refers to one’s internal sense of being male, female, or something else, such as nonbinary or genderfluid.
A transgender teenager may be straight, lesbian, gay, bisexual, or asexual—just like a cisgender teen. (The term “cisgender” refers to those whose gender identity matches the gender they were assigned at birth.)
The terms gender nonconforming and gender diverse refer to how a person shows their gender on the outside: They may not conform in appearance or behavior to typical expectations around gender.
Identity Development in Transgender Teenagers
Many transgender people say that they knew they were transgender when they were very young. For others, the transgender identity development process lasts into their teens or adulthood.
Some transgender teens experience what might be called a transgender identity crisis—a period of confusion and anxiety around their gender identity. Sometimes children or teens know they are trans but are afraid to come out. They might be concerned about rejection, stigma, or bullying. As a result, transgender teens may come out as gay, lesbian, or bisexual before coming out as transgender.
In most cases, the initial confusion and anxiety evolves into experimentation, gradual acceptance, and eventually integration and expression of one’s identity. Studies on transgender identity development find that being able to fully express one’s gender and having a sense of self is essential, no matter how the participants expressed their gender identity. Moreover, having a safe space to experiment with their gender presentation was instrumental in their process of identity development. These studies indicate that transgender people who don’t have this safe space would benefit from working with a mental healthcare professional who understands transgender issues.
Physical and Social Transitioning for Transgender Teens
Not all transgender people transition into living as the gender they identify with. If they do transition, transgender people express their gender identities in different ways. Some people take hormones and/or have surgery so their body matches their gender identity. Some change the way they dress and/or their behavior without making major physical changes.
Transgender teens and children may begin social transitioning at any age. Ways to transition socially include the following:
- Coming out to friends and family as transgender
- Using pronouns (she/her, he/him, they/them) that match one’s gender identity, and asking others to use them as well
- Going by a different name
- Dressing and grooming to match your gender identity
Suicide and Mental Health Risks for Transgender Teens
Being transgender in itself is not a mental health condition, any more than being cisgender is. However, being transgender can present specific challenges that increase the likelihood of they will experience depression, anxiety, and other mental health conditions. Nearly three-quarters of nonbinary and trans youth experience symptoms of anxiety and 3 in 5 struggle with depression, according to a 2023 Trevor Project survey of 34,000 LGBTQ youth.
As a result, transgender teens are also at greater risk of suicide than their peers. The Trevor Project survey found that about half of trans youth considered suicide during the past year. And 23 percent of trans males and 16 percent of trans females actually made a suicide attempt. That rate is almost four times higher than the rate of suicide attempts among LGBQ youth who identify as cisgender.
Why do trans teens have higher rates of mental health issues, on average, than their cisgender peers? Here are some of the reasons.
Gender Dysphoria
Transgender teens and children often experience a conflict between their assigned or biological gender and what they know and feel to be their actual gender. As a result, they may suffer from what’s known as gender dysphoria.
Gender dysphoria refers to distress, depression, and/or anxiety as a result of this conflict. Experts diagnose gender dysphoria when individuals experience significant distress or impairment in major areas of life. Hence, it disrupts daily functioning, including school, relationships, work, and social activities.
Family Rejection
For transgender teens, rejection by family members is the worst possible result of coming out. Familial rejection is one of the biggest threats to the mental health and safety of trans teens.
In extreme cases, rejection by loved ones can result in homelessness. In fact, 40 percent of homeless youth are LGBT teens who have been kicked out of the house, or who left home due to negative relationships with family members.
Bullying, Violence, and Discrimination
But even when families are supportive, the mental health of a transgender teen can be negatively impacted by bullying and cyberbullying, stigma, prejudice, and violence. Close to 1 in every 5 hate crimes is motivated by anti-LGBTQ+ bias, according to FBI data.
The Trevor Project survey found that 64 percent of trans and nonbinary young people have felt discriminated against in the past year due to their gender identity. And 27 percent of trans and nonbinary youth reported that they had been physically threatened or harmed in the past year as a result of their gender identity.
Lack of Access to Gender-Affirming Care
Whether or not a teen receives gender-affirming care can have a huge effect on their well-being, even if it’s just affirming someone’s (asserted) name. Consequently, not having access to gender-affirming care has the potential to drastically increase the likelihood that a trans teen will experience depression and suicidality. A new poll found that policies banning gender-affirming care leave transgender and nonbinary youth feeling angry, stressed, sad, hopeless, scared, and helpless.
7 Ways to Support Transgender Teenagers
Parental support can buffer against the challenges that transgender teens face. When trans teens feel accepted by their families, their health, self-esteem, and social support improve. Moreover, they are less vulnerable to depression, substance abuse, and suicidal ideation. Hence, the most important aspect of supporting a transgender teenager is providing unconditional love and support.
“If they have a supportive family from the beginning, children who are transgender don’t experience higher rates of anxiety, depression, suicidal ideation, or suicide compared with cisgender peers. Without family support, all those mental health risks increase substantially.”
Tandy Aye, MD, researcher on trans adolescent-parent relationships and associate professor of pediatrics at Stanford Medicine
Here are seven guidelines for parenting a transgender teenager.
- Don’t misgender trans teens: Always use your teen’s preferred gender pronouns and preferred names. This may seem like a small thing, but it’s extremely important to the mental health of transgender youth. According to the Trevor Project, transgender and nonbinary youth whose pronouns are respected by the people they live with are half as likely to attempt suicide as those whose pronouns were not respected.
- Get the information you need. Educate yourself about the issues that transgender teenagers face now and will face as adults, by reading, attending conferences, and consulting with experts. Look for resources for parents of transgender youth, like those provided by the Trevor Project.
- Let them take the lead. Don’t make assumptions about a transgender teen’s sexual orientation, or their plans for transitioning. Encourage them to explore their gender identity and expression. If your teen son says she feels like a girl inside, support a different hairstyle, different name, and/or a new way of dressing. Let them know you’ll be there for them no matter what.
- Keep the lines of communication open. Make sure to have a meaningful connection with your teenager every day, no matter how busy you both are. Parents should also perform regular mental health temperature checks. If your teen feels more comfortable speaking with someone outside the family, help them connect with a mental health provider, school guidance counselor, or local LGBTQ community leader.
- Do your own work. It’s natural and understandable for parents of trans teens to need some time to get used to this change. Parents might be grieving the loss of their expectations for their child. Or they may have fears about how their child will be treated in the world. Process any reactions you have to your teen’s transition with a counselor or a parent support group, not with your teen. Look for parents of trans youth support groups, either local or virtual.
- Be an activist. Parenting a transgender teenager means standing up for them in the larger world. Learn more about transgender rights and policies, and support policies and politicians that protect transgender people from discrimination. Advocate for trans teens by calling out transphobia and asking others to respect their identity.
- Access professional support. Make sure you and your teen have a team of professionals to support next steps in the transitional process. That team should include medical experts, mental health providers, and school professionals, as well as LGBTQ community groups.
Culturally Competent and Gender-Responsive Treatment at Newport Academy
We understand the specific challenges that trans and nonbinary teens navigate as they come of age. Our treatment takes into account the unique needs of LGBTQ+ adolescents and provides them with tools for navigating the world, building self-worth, and forming strong relationships with peers, mentors, and their larger community.
Our clinical experts and care staff have expertise and experience in addressing the mental health challenges that LGBTQ+ youth face. Newport has partnered with the Trevor Project, the nation’s foremost LGBTQ+ advocacy and research organization, to provide specialized training for our staff.
Newport Academy’s Admissions experts and Clinical Outreach Specialists can help parents of transgender teens get the support they need. Contact us today.
Frequently Asked Questions
Listen to your child’s words and observe their behavior. Do they make clear statements about being in the wrong body, or being the opposite gender than they were assigned at birth? Do they prefer underwear and clothes typically worn by their preferred gender? Experts often refer to the idea of insistence, consistency, and persistence in terms of gauging whether a child is trans or is just experimenting or going through a phase.
Gender dysphoria is the conflict a teen may feel if their “assigned” or biological gender is not the same as what they know and feel to be their actual gender. Being transgender is not a mental health condition. Nor is it the result of a mental health condition or a traumatic experience. However, it is important to protect a trans teen from trauma resulting from bullying, societal stigma, or lack of acceptance from family members.
Offer unconditional love and support, and make sure they have the professional medical and mental health support they need. Allow them to express themselves in their appearance, choice of clothing, and activites. In addition, always use your teen’s preferred gender pronouns and preferred names. According to a survey by the Trevor Project, trans youth whose pronouns are respected by the people they live with are half as likely to attempt suicide as those whose pronouns were not respected.
Feelings of gender dysphoria may begin at a very early age, or a person may not realize they are trans until they are a teen, young adult, or even an older adult. No matter when a person transitions, they deserve respect, access to gender-affirming care, and all the same rights as cisgender people enjoy.
Puberty can be difficult for a trans teen because the development of their secondary sex characteristics is not aligned with their gender identity. In other words, a trans boy who is developing breasts or a trans girl who begins to have facial hair may feel more uncomfortable in their body than they did as a child. And they are more likely to be misgendered due to their appearance. Parents and trans teens should work with a healthcare provider to determine a path forward in regard to puberty blockers and other hormonal treatments.
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