Getting Expert Support and Care for Gender-Expansive Children
When a child shows signs of distress about their gender, or a family feels they could use more support in raising a gender-expansive child, it's a good idea to connect with a mental health or medical provider who is experienced at working with gender-expansive children.
Mental health and medical providers usually work together on this issue, so you can contact whichever type of expert you're more comfortable with. An experienced medical provider can refer you to mental health providers, and vice versa.
When Should I Look for an Expert?
Consulting with childhood gender identity experts is helpful for many families. It's particularly important when some of the following signs are present:
- A child has severe sex- and gender-related distress
- The distress lasts for a long period of time
- The child expresses disgust about their body, especially their genitals, and may even harm these body parts
- The distress gets worse as the child gets older, particularly as puberty begins
- The child asserts that they are a boy (if they are assigned female) or girl (if assigned male) insistently, consistently, and persistently, with little or no ambivalence
- The child requests a meeting with someone who knows about "gender stuff"
How do I Choose an Expert?
When seeking out medical or mental health providers, ask questions to ensure the provider is both competent and affirming. You may want to ask:
- How much expertise do you have with gender dysphoria? With transgender children in this age group?
- What is your treatment approach with gender-expansive children?
- Are there other professionals whom you consult or collaborate with when you see transgender patients?
- Do you attend conferences on transgender health?
- Are you a member of any professional associations related to transgender health?
Many types of medical and mental health professionals work with gender-expansive children. The type of provider you choose is less important than their approach or amount of experience in this area.
For medical care, the Interactive Map on HRC's Transgender Children and Youth page may help you find a clinic in your area. Local LGBTQ groups, especially those focused on transgender people or family members, also have recommendations.
Signs of a Good Fit
It's important to find healthcare providers that you and your child feel comfortable with. The following are some signs to look for:
Most important signs of a good fit
- The provider takes time to listen to your concerns and answer your questions
- The provider has a positive attitude towards how your child expresses their gender, and makes the child feel good about who they are
- The provider does not suggest ways to make the child change how they express their gender. (This is different than suggesting changes based on what the child wants, such as allowing them to wear clothing they feel comfortable with.)
Other positive signs
- The provider has relationships with other local healthcare providers who work with gender-expansive children or transgender adults. For instance, they might work as part of a group, or offer to refer you to additional services.
- The provider has good relationships with local groups serving the lesbian, gay, bisexual, transgender and queer community
Areas with Fewer Providers
While high-quality care for gender-expansive kids is becoming more and more accessible, certain cities and many rural areas still lack a comprehensive pediatric gender identity clinic. Some families travel to clinics elsewhere in the region. Clinics in your state or region may also help you find a provider closer to home.
Like all kinds of healthcare, some families are concerned about how they will pay for care for their gender-expansive child. There are a few important facts to know:
- If your child has health insurance, including Medicaid or CHIP, it will usually pay for visiting a medical provider about gender concerns. This may be true even if your insurance says they don't cover services for transgender people.
- Many mental health providers also take insurance. In some cases, you might have to pay the provider yourself and be reimbursed by the insurance company.
- Some mental health providers have a "sliding scale" with reduced fees for patients who don't have insurance.
In each case, it's important to ask the provider's office about your child's insurance (or other ways of paying) when you schedule your appointment.