“Insistent, persistent, and consistent.”

Parents of trans kids are typically familiar with this trinity of words; they’ve been considered the guiding principals in determining whether a child is actually transgender, or just going through some sort of phase. When parents rush to the internet, often frantically, searching for resources because their child is showing or telling them that they are different from their sex assigned at birth, the “insistent, persistent, and consistent” mantra shows up more often than not. Those words are the foremost, foundational concept that research regarding trans youth has built upon (considering not much research on trans youth – specifically, the Gender Affirmative Model – really became more available until around 2013).

What this phrase means is that transgender youth are insistent (unwavering); persistent (continuing firmly, in spite of difficulty or opposition); and consistent (unchanging in nature over a period of time), in their assertions that they are the opposite binary gender, or some other gender altogether. Anyone who’s not transgender is cisgender (or “cis,” for short), meaning their sex assigned at birth, their gender identity (one’s deeply held, internal sense of gender), and usually, their gender expression (how they present or show their gender to the world) – to some degree – are all in alignment.

Trans children sometimes say and do things we don’t usually hear and see in cis children. Trans children may say things like, “I was born in the wrong body,” “God made a mistake,” or, “I’m really a boy (or girl) in my brain and in my heart.” They may say these things at extremely early ages, often catching parents off-guard. Sometimes, they express severe discomfort with their anatomy, and may go as far as expressing a desire (or even trying) to self-mutilate their genitals. 

But what about trans kids who never say or do those things? My almost 12-year-old trans child only said once, at just under 3 years old, “Mommy, you know I’m only a boy because of my parts, right?” and never said anything that assertive about gender again, until age 9. Until then, I was certain my child wasn’t insistent, persistent, and consistent in communicating “I’m not a boy,” and therefore, was not transgender. However, I now can see clearly in retrospect that my child very thoroughly showed me, through insistent, persistent, and consistent actions and behaviors, that the “boy” gender and “boy” label was for (him, then) very much incorrect. 

This leads to the first important thing that parents of trans children need to know:

1.) All behavior is communication. 

This is one of the most useful phrases I’ve learned: “all behavior is communication.” It is through this lens that we must understand that even though young children may lack the vocabulary or verbal maturity to tell us with words that they are something other than their sex assigned at birth, they may be very adept at showing us through their behavior, actions, and preferences. Unfortunately, as parents (like me, who didn’t grow up with an understanding of this whole gender spectrum thing), we don’t always get the hint or “hear” what these kids are trying so hard to show us.  

I’ll use parts of my story from a parent’s perspective as an example. Let’s say you have a child who’s assigned male at birth, but is actually trans. (Typically this would be trans female, but could also be trans non-binary, meaning neither male nor female, but some combination of both, neither, or something else altogether, kind of like Native American Two-Spirits). For the sake of ease, I’ll use the example of a child assigned male at birth who is actually trans female. This child may begin from a very young age (sometimes as early as the child can express wants and needs, around ages 2-3) exhibiting traditional “girls” preferences for toys, characters, colors, playmates, clothing, accessories, hair styles, shoes, stories, etc. This child may simultaneously reject any and everything traditionally “boy” related.

That part was my child. Couldn’t get enough of Disney princess movies, princess costumes, play makeup, plastic high heels, My Little Ponies, jewelry, baby dolls, Barbies, Polly Pockets– basically anything sparkly, glittery, pink, purple, pouffy, or otherwise screaming “GIRL!” But if you gave this same child a brand new, shiny red fire truck with all the bells and whistles, or even a basic Lego set in primary colors, it would never even make it out of the box. Everything, including friends, had to be in the “girl” category to be of any interest whatsoever, and my child began exhibiting this preference and behavior before age 3. (Now, my child is nearly 12, still expresses female, and prefers they/them pronouns, but will also use she/her pronouns. I have no idea where they will ultimately end up, or if it will be a fluid, lifelong journey). 

Perhaps even more importantly, though, this child who was assigned male at birth was always very gentle, sensitive, anxious, and delicate in nature. This child moved with grace and poise, and spoke with expression and a soft lilt. It was as hard-wired into this child’s genetic makeup as was my older son’s proclivity to be mature, responsible and academically gifted, and my older daughter’s penchant for being daring, whimsical and artistically gifted. And though my youngest, third child was ridiculously intuitive, verbal, and wise beyond their years, they were also very immature, socially and emotionally speaking.

Tantrums. Drama. Overreactions. Loud crying jags. Encopresis. Panic attacks. A never-ending stream of awful, negative self-talk and self-deprecation. Lashing out unfairly at others. Anxiety, worsening every year, that often presented as moodiness or rudeness. Unable to have successful friendships with other males, but a leader among students for the special ed students; a child who sought out and intentionally befriended the kids no one else would interact with. Perhaps because my child knew what it felt like to be “othered.” 

This is what I mean by “behavior,” and it was all interconnected like a tightly wound ball of string – all related to the underlying, internalized feelings of being a square peg trying to fit into a round hole. As we learned later through our gender therapist, we had to think of our child not as a 10-year-old boy, but more like a 7-year-old girl, because that’s where they were. Behavior is valuable in communicating not only the child’s likes and dislikes, strengths and weaknesses, knowledge and deficits, but also, something about the child’s internal sense of gender.

Diane Ehrensaft, Ph.D., a prominent child psychologist, author, associate professor of pediatrics at UCSF, founding member of The Child and Adolescent Gender Center, and expert in the field of gender and gender identity states that “parents should pay very close attention to persistent cues from their children, take those cues seriously, and not try to forcefully alter the direction a child seems to be going in.” That is because all behavior is communication. 

2.) Don’t try to change them.

As parents, letting go of our children is one of the hardest things to do, especially when letting go means letting go of our own expectations of what their lives should look like, or letting go of our own wants and desires for them, especially as it relates to their gender. When we’re given the awesome blessing of raising children, however, we are not charged with making clones of ourselves. Instilling them with values, teaching what’s morally right and wrong, legal and illegal in society? Absolutely. But we are supposed to let them make mistakes and find their own identity; we are supposed to hope that they are not just like us, but even better than us. 

I’ll be the first to admit that letting go of gender expectations is painfully difficult. As parents, our instinct is to protect them from hurt and bullying, so we often discourage our children from exploring or expressing outside of their assigned genders. At some point we tell “gentle” boys they’ve gotten too old for princess costumes, that “pink is for girls,” and they should “Man up!” because “boys don’t cry.” At some point we don’t find our “tomboys” so cute anymore, and we find ourselves forcing them into training bras at younger ages than probably necessary. We badger them with “You’re too pretty to dress like that,” and “you shouldn’t hide those gorgeous eyes under that baseball cap all the time” because “don’t you want a boyfriend one day?” 

Letting go of the gender expectations is critical, though. There’s enough research concluded now (and decades of individual, personal anecdotes) to know that factors like family rejection of transgender people, and attempts to change an individual’s authentic self, (via conversion therapy, reparative therapy, and other means) are not only considered outdated, dangerous, discredited, and abusive practices, but are also known to have a direction correlation with depression, anxiety, drug use, homelessness, and suicide.

This is especially true with regard to children and gender identity – so much so, that the AAP (American Academy of Pediatricians) issued a statement in July, 2017 (shortly after Trump tried to implement, via tweet, a transgender military ban) clarifying their position of support for trans children and trans people in general. The AAP, the largest, most well-respected and prominent organization of pediatricians in the country, who are committed to the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults, condemns attempts to stigmatize or marginalize trans youth, and supports policies that are gender-affirming for children. 

All experts in the field agree that at some point, all children will engage in behavior associated with the opposite binary gender. This is developmentally appropriate, especially at younger ages: Girls will play with trucks, boys will play with dolls, girls will hate wearing dresses and boys will insist on wearing them, and gender nonconforming behavior does not necessarily mean that a child is transgender. That said, sometimes it does, with some children identifying as another gender than the one they were assigned at birth, sometimes from very young ages. On that note…

3.) Children are not “too young to know.” 

Perhaps because the “T” (transgender) is included with the “LGB” portion of the LGBT acronym, and “L” (lesbian), “G” (gay), and “B” (bisexual) all have to do sexual orientations, people conflate sexual orientation with being transgender. With the “T” already being vastly misunderstood, it seems that some people assume because the “L,” “G,” and “B” are sexual orientations, so then, must be the “T.” Further, it seems people assume that the “T” must be some sort of fantasy cross-dressing or drag, or fetish of the sexual kink nature, and certainly, that children are too young to have discovered this part of themselves. But nothing could be further from the truth. Being transgender has nothing to do with sexual orientation.

We all have certain components that make up our whole person. Included are:

• gender identity (our internal, deeply held sense of being male, female, or other) 
• gender expression (how we present, or show our gender to the world)
• sex assigned at birth (male, female, or intersex, as determined by a doctor’s quick glance at external sex organs)
• sexual (and/or) romantic orientation (who we’re attracted to, whether male, female, both, other, all, or none)

Anyone can be any mix of these four components. If the stars line up perfectly, you are cisgender, heterosexual, and you are part of the large majority who won’t have to fear discrimination in the world because of your gender identity or who you’re attracted to. But if you happen to be trans, you’ll spend the majority of your life facing rejection, isolation, intrusive questions, microaggressions (like being misgendered, often on purpose), and the fear of being killed just for walking out your front door, dressed and presenting as yourself. If you happen to also be black, that fear quadruples, as black trans women are statistically the most likely group of marginalized people to be brutally murdered. 

Aside from the fact that gender is not the same as sexual orientation, and therefore children are not too young to know it, it’s difficult to explain how else children just know. The amazingly awesome organization Gender Spectrum recommends asking cis people, when attempting to understand trans people, to consider their own gender journey. Ask a female, “at what point did you know you were female?” Ask a male, “when did you first realize you were a boy?” 

Cis people don’t know how they knew; they just knew. Or maybe they knew when their parents told them early in life, and they felt no discrepancy. Invariably, they just knew. The same is true for transgender people. They just know. Though it may take some until later in life to come to the realization, (or to come out of the closet), most of them will tell you it’s not something they woke up one day and suddenly discovered. All the trans people I’ve ever met have said they felt different or “wrong” their entire lives. Some were better at hiding it than others. Which leads to…

4.) Sometimes, parents never saw it coming. 

Parents are often blindsided by a teen who announces, “Mom, Dad, I think I may be transgender.” Maybe in hindsight, a parent might think, “Well, I guess she always hated wearing dresses and playing with dolls but I just figured she was a tomboy; I had no idea she always felt like a ‘he’…” And it may be that you have a cisgender child who just happens to march to the beat of their own drum and simply refutes gender stereotypes. However, it could be that your child has been masking (pretending to be someone they’re not, typically for the sake of fitting in and feeling accepted within their family, at school, and within the larger community). Or, it may be that puberty brought forth the realization.

Though many trans people know they’re somehow different as early as late toddlerhood, some trans youth may not experience those feelings or debilitating symptoms until the onset of puberty, when their body begins aligning itself physically with their biological sex. When a child enters puberty, in many cases, it is the first time parents hear of their child’s disconnect or discomfort in regard to their changing body. Sometimes, puberty is the very thing that ushers in the seemingly sudden inner conflict between assigned sex at birth, and the gender with which a child identifies. This conflict is referred to as gender dysphoria. 

Gender dysphoria varies greatly among trans people, and it manifests differently. Trans people may be uncomfortable being seen as their assigned gender, or they may be uncomfortable with society’s expected role of their assigned gender. They may experience significant psychological distress, or only mild discomfort. While gender dysphoria renders some youth unable to function at all, others may openly embrace it, expressing their authentic selves regardless of the consequences. Every child is different. 

Lastly, and perhaps most importantly:

5.) There’s no “right” way to be trans. 

Unfortunately, there is no handbook or guide, no “What To Expect When Your Child Is Trans” book. But it’s important that as parents, we stop fighting against what we don’t understand, start listening, and find the bravery to let go of gender expectations. As more and more children and youth begin verbalizing what other trans people have known about themselves forever, but were too afraid to admit, society will evolve even more to better understand this precious and gifted community of people. More research and studies will be conducted, more stories told, more books written. More people will find their bravery to come out of hiding, and that is a good thing. 

Look how much we’ve evolved in just the past decade – or even the past five years: As the parent of a trans child watching it unfold in real time, I’ve seen the DSM-IV replaced by the DSM-V, and with that, the term “gender identity disorder” removed because the APA recognized the need. This act was integral in helping to remove stigma against  transgender people based on false stereotypes about gender identity and expression. It was also important because it removed the word “disorder.” Being trans is not a disorder, just like being cis is not a disorder. 

We also are beginning to realize that “insistent, consistent, and persistent,” while formerly helpful in determining if people were trans or not, may not always be the best gauge. There’s no one ‘right’ way to be trans, no definitive set of guidelines that every trans person will follow. In fact, the word transgender is merely an umbrella term for the much larger gender spectrum, with an infinite number of possible combinations of identities. 

Contrary to popular belief, “transgender” doesn’t mean someone who has had a “sex change” and “transgender children” doesn’t refer to kids who are undergoing “sex changes.” Medical transition is only relevant at and after Tanner Stage II of puberty, and many surgeries related to transitioning are not available until adulthood. Not all trans people elect to have surgery, either. Whether it’s for financial or personal reasons, many trans people never undergo a knife or take hormones.

Some trans children socially transition (they begin living as their authentic gender, which typically involves growing hair long or cutting it short, dressing in the expected clothing of their authentic gender, changing pronouns, and sometimes, changing names). Some trans children live in fear and shame, knowing that coming out as their authentic self would render them helpless among the school bullies, or would tear their family apart. Some trans people come out as gay or lesbian when they’re teens or young adults, because they feel that would be easier for their family to handle than if they were to come out as trans.

Some trans people don’t feel safe enough to come out until they’re in their late adulthood, or after divorcing or losing a spouse from a heterosexual marriage; they may have been masking, or they may have really been in love – it doesn’t change the fact that they’re trans, since sexual orientation is not the same thing as gender and gender identity. And still others don’t connect all the dots and realize they’re trans until their twilight years. Nothing is off the table. 

Of course, it’s not always the case that these subtle or even obvious cues all add up and mean someone is definitively transgender. There are plenty of males and females who are not trans or gender nonconforming, but by nature just seem to buck traditional or expected gender norms (I’m one of those). Still, it’s always important for parents to pay attention from early-on, follow the child’s lead, remain open to possibilities, and not make a big deal out of it. The more we understand that, the more we can move toward seeing the word “transgender” free of stigma and for what it actually is: a beautiful spectrum of endless possibilities.