People who identify as transgender feel like their gender identity differs from their physical body. Gender identity is one’s psychological sense of being male, female, some of both or neither. Children may identify as transgender at a young age or may not identify as transgender until after puberty. Sometimes, though, children who are transgender may not come to this realization until after puberty. 

Many children have gender “atypical” behavior. The amount of this behavior varies. Some individuals also experience their sense of being male or female as different from their sex assigned at birth. Some children experience significant distress about not being able to live and act the way that they feel. For many children who experience these feelings before puberty, it is a phase.

If the child is insistent, consistent, and persistent, we initially discuss living in this gender outside of the house. When a child who is insistent, consistent, and persistent begins puberty, we discuss delaying puberty.

We work with patients and families to determine if the transgender identity is “real.” Sometimes it can take a while. We offer support to patients and families the whole time.

Family acceptance is important. Children’s mental and physical health are affected when they feel that their family rejects their transgender identity. Transgender children who feel rejected by their family are more likely to attempt suicide, develop depression, use illegal drugs, and contract HIV and other sexually transmitted diseases.

The information below is from the Family Acceptance Project.

What can you do to help make your child feel accepted?

• Talk openly with your child and other family members about your child’s transgender identity.  
• Show your child affection when he or she tells you about his or her transgender identity.
• Bring your child to lesbian, gay, bisexual, transgender, queer or questioning and more (LGBTQ+) events or organizations.
• Connect your child with a transgender adult role model to show options for the future.
• Stand up for your child when he or she is mistreated by someone else because of his or her transgender identity. 

These behaviors can make your child feel rejected. Avoid:

• Hitting, slapping, or physically hurting your child. Parents should never do this for any reason, but especially not because of their child’s LGBTQ+ identity.
• Name-calling because of your child’s transgender identity.
• Excluding your child from family activities.
• Blocking your child’s access to other transgender children and adults.
• Making your child keep his or her transgender identity a secret. 

The Transgender Clinic has resources to help families with this issue. Families often talk about this issue in our support group and in our private Facebook group. This may look different for each family, and there is no right or wrong way. Helpful resources are from the Human Rights Campaign (HRC) and the Family Acceptance Project:

• HRC - Transgender Visibility: A Guide to Being You

• HRC - Resource Guide to Coming Out

• Family Acceptance Project Publication – Supportive Families, Healthy Children

We will see your child on a regular basis to assess how things are going. We will talk to your child and you to determine the best plan for each individual child.
A resource that talks about this important question is:

• The Human Rights Campaign

 

Cincinnati Children’s follows Ohio Law in regard to care of Transgender patients. We are unable to provide these services.

Every insurance plan is different. Cincinnati Children’s Financial Counseling Department can help patients and their families figure out the answers to these questions. Call 513-636-0201.

It is important to remember that for insurance to cover our services, the patient’s legal name in the Cincinnati Children’s system needs to match the name on the insurance card. If the patient’s legal name has changed, it should be updated in our records.

Cincinnati Children’s Transgender Clinic is dedicated to meeting families where they are. We know that patients and their families have diverse values and beliefs.

We work with patients and their families to make sure the patient has the correct diagnosis, to educate them, and to provide them with the support and resources that they need.

At Cincinnati Children’s, we are unable to provide hormones to minors due to Ohio law.

We work with patients and families to determine if patients meet the American Psychiatric Association’s criteria for gender dysphoria, which requires symptoms must be present for at least 6 months.

“Gender dysphoria” includes many factors. Gender dysphoria means someone is uncomfortable with their sex assigned at birth. We know that genetics plays a part in gender identity. We also know that there are some physical differences in transgender individuals. In research studies, transgender people have areas of the brain that are different sizes than cisgender people. “Cisgender” means that a person thinks their gender identity matches their gender at birth.

In the Transgender Clinic at Cincinnati Children’s we do a complete history and physical exam, and the child is seen by both a physician or nurse practitioner, and a social worker. We make referrals to specialists if any other concerns are found.