My child says they're trans: a guide for parents

Your child just told you something enormous. Perhaps they did it with courage, perhaps in tears, perhaps through a written message because they couldn’t bring themselves to say it out loud. And right now, you’re probably feeling overwhelmed: confused, scared, perhaps mourning something you can’t yet define, perhaps full of questions you don’t even know how to begin answering.

All of this is normal. You’re not a bad parent because you need time to process. You’re not at fault if you don’t understand everything right away.

This guide is written for you: to help you understand what’s happening, what the science says, what you can do right now, and where you can find help in Italy. You won’t find pre-packaged answers, because every family and every child is different. What you will find is real data and concrete steps.

What it means when your child says they’re trans

When a young person declares they are transgender, they are saying that their gender identity — the deep, inner sense of oneself as male, female, or something else — does not match the sex assigned at birth.

This is not about confusion, nor a trend, nor a response to something that went wrong in the family. Gender identity is a stable component of personality that emerges in the earliest years of life, independent of upbringing.

Some basic terms that can help you get oriented:

• Transgender (or trans): someone whose gender identity differs from the sex assigned at birth.
• Cisgender: someone who identifies with the sex assigned at birth (the majority of people).
• Gender dysphoria: the clinically significant distress that can arise from the discrepancy between one’s experienced gender identity and one’s body or assigned gender role. Not all trans youth experience dysphoria in the same way — some describe it as acute anguish, others as a more subtle discomfort.
• Gender incongruence: the term used by the WHO (ICD-11 classification) to describe the condition itself, without necessarily implying suffering.
• Non-binary: someone who does not identify exclusively as male or female. Some trans people identify as non-binary.
• Social transition: changing name, pronouns, clothing, and presentation in daily life, without medical interventions.

Your child might use just one term, or none, or a mix. It’s not essential that you master the vocabulary right away. What is essential is that you listen.

Is it just a phase? What the research says

This is probably the question you ask yourself most often. The scientific answer is nuanced: it depends on age, on how the identity is expressed, and on whether a social transition has already occurred.

Preschool and school-age children

Historical studies on children with gender incongruence — conducted before social transition became common — showed relatively high rates of “desistance” (i.e., not remaining trans into adulthood), as high as 70-80% of cases. However, these studies have important limitations: they involved children with highly variable degrees of incongruence, many of whom did not identify as trans but simply did not conform to the gender expectations of their sex.

Children who have already socially transitioned

For children who have explicitly affirmed their gender identity and undergone a social transition, the data are very different. The most robust study on this topic was published in Pediatrics in 2022 by the TransYouth Project research group led by Kristina R. Olson (University of Washington): out of 317 children with a social transition (average age 8 at onset), after five years, 94% still identified as transgender or non-binary. Only 2.5% had detransitioned and identified with the sex assigned at birth [2].

These numbers say something clear: in children who express their identity in a persistent, consistent, and insistent way — and who have already taken a conscious step like social transition — the identity tends to persist over time.

Adolescents

In adolescents, especially when dysphoria emerges or intensifies with puberty, persistence is even higher. According to the guidelines of the Italian Society of Pediatrics (2024), if gender dysphoria persists beyond the onset of puberty, it is rarely transient [9]. Puberty is often the moment when an identity that has been present for a long time becomes impossible to ignore, both for the young person and for the family.

The question “is it just a phase” is understandable, but it can become an obstacle. If your child is waiting for you to believe their identity is real before they can receive your support, the wait itself can cause harm. Science shows that early parental support has measurable effects on mental health, regardless of how the journey develops over time.

What to do in the first weeks

You don’t need to have all the answers. You don’t need to understand everything immediately. But some things, done or avoided in the days following the revelation, make an enormous difference.

What to do

Listen first. Ask open-ended questions: “How are you feeling?”, “How long have you been thinking about this?”, “What would help you right now?“. Don’t interpret, don’t correct, don’t minimize.

Tell them you love them. It might seem obvious, but it isn’t for a young person who has just done the most courageous thing of their life. The words “I love you no matter what” can literally save a life.

Take time for yourself. Seeking information, talking with other parents in the same situation, possibly consulting a professional yourself — these aren’t acts of weakness. They’re responsible acts.

Don’t promise things you can’t keep yet. You don’t need to promise right away that you’ll use the new name or that you’ll immediately start the clinical pathway. But it is necessary not to close the door.

What to avoid

Don’t try to “convince” them they’re wrong. It doesn’t work and it causes harm. Studies on conversion practices show that attempting to change a person’s gender identity significantly increases the risk of depression and suicide attempts [8].

Don’t tell others without their permission. The coming out is theirs, not yours. Deciding when and to whom to tell is one of the few things your child can still control.

Don’t isolate yourself. Many parents face this phase alone out of fear of judgment. There are parent associations of people who are going through, or have gone through, exactly the same situation as you — see the Resources section below.

Who to turn to in Italy

Specialized centers in the public health system

In Italy, public centers deal with gender identity in children and adolescents, affiliated with the ONIG (National Observatory on Gender Identity). Among the main ones [12][13]:

• Rome — SAIFIP (Service for the Alignment between Physical Identity and Psychic Identity), San Camillo-Forlanini Hospital. One of the historic centers in Italy, also active for minors with a dedicated psychological pathway.
• Turin — CIDIGem (Interdepartmental Center for Gender Dysphoria), AOU Citta della Salute e della Scienza, Molinette campus.
• Florence — Outpatient Clinic for Atypical Gender Identities in Children and Adolescents, SOD Sexual Medicine and Andrology, Careggi Hospital.
• Bologna — Service for Children and Adolescents with Atypical Gender Identity Development, in collaboration with the MIT consultancy. Contact: evolutiva.bologna@onig.it
• Milan — Gender Adjustment Service, Niguarda Ca Grande Hospital.
• Naples — Center for Andrology and Reproductive Medicine, AOU Federico II.

Waiting times vary from center to center and from region to region. In some facilities, you may wait many months for the first appointment. It’s worth contacting the nearest center and in the meantime seeking local psychological support.

Family support associations

AGEDO Nazionale (agedonazionale.org) is the Italian association of parents, relatives, and friends of LGBTQIA+ people. Founded in 1992, it has over twenty branches throughout Italy. It offers mutual self-help groups for parents, listening and information desks. Many of the volunteers are parents who have lived through your same experience [10].

GenderLens (genderlens.org) is an association created specifically for families of young trans people. It offers three free online psychological orientation sessions to help families understand the services available in their area. It organizes monthly online meetings for parents. Their approach is affirmative: they do not consider gender variance a pathology [11].

Both can be contacted even just for an initial conversation with someone who understands.

The clinical pathway in Italy: how it really works

Many parents imagine the clinical pathway as something rapid and irreversible. In reality, it is structured, gradual, and designed to support both the minor and the family.

The psychological assessment

The first step, in nearly all Italian centers, is a psychological assessment conducted by professionals specialized in gender identity. This phase includes:

• Individual sessions with the minor, generally weekly or biweekly.
• Sessions with the parental couple or single parent.
• Possible administration of standardized psychodiagnostic tests.
• In some centers, sessions with a psychiatrist.

The assessment typically lasts 6 to 12 months, sometimes longer, depending on the center and individual complexity. Its purpose is not to verify whether the person is “trans enough”: its purpose is to ensure adequate support and to rule out conditions that might require independent treatment (such as untreated active psychosis).

The presence of depression, anxiety, or other psychological difficulties — very common in trans youth due to the stress of not feeling accepted — is not a contraindication to the pathway [14].

The role of the family

The clinical pathway in Italy necessarily involves the family. For minors, parental informed consent is required for every medical step. This means your role is not that of a spectator: you are an active part of the pathway. Family sessions also serve to support you, to help you process your emotions and understand how to accompany your child in the most helpful way.

Puberty blockers

If the psychological pathway confirms the presence of gender incongruence and the minor is at the threshold of puberty (Tanner stages 2-3), the center may propose the use of GnRH analogues (commonly called puberty blockers). These medications temporarily suspend pubertal development, giving the young person and the family time to explore options without the body changing in ways that are difficult to reverse.

These are medications that have been used for over 40 years in pediatrics to treat precocious puberty. When discontinued, puberty resumes its course. The major international scientific societies — WPATH, Endocrine Society, American Academy of Pediatrics — consider them an appropriate option under medical supervision [14].

Hormone therapy

Gender-affirming hormone therapy is generally accessible from age 16 onwards with parental consent, and from age 18 independently. It involves taking estrogen (for those who wish to feminize) or testosterone (for those who wish to masculinize). Through the public health system, medications can be dispensed free of charge (except for co-pays) under the AIFA Determination of 2020.

Surgical interventions

Gender-affirming surgical interventions on minors are extremely rare in Italy and reserved for specific situations, after lengthy pathways and with specialist supervision. They are not part of the standard pathway for children or adolescents.

Young children and gender identity

If your child is between 3 and 10 years old, you might wonder: are they really too young to “know” these things?

The answer from developmental psychology is no. Gender identity — the inner sense of self — consolidates between ages 3 and 5 in nearly all children, trans or cisgender. It is not a conscious process or a choice: it emerges with the same naturalness as identity in general.

The signal to distinguish is this: a child who occasionally wears clothes of the other sex for play, or who prefers toys “of the other gender,” is not necessarily expressing a different gender identity. This is called gender nonconformity and is very common. Gender dysphoria or gender incongruence is something more specific: a persistent, consistent, and insistent declaration of identifying with a gender different from the one assigned, often accompanied by distress when the body or gender role is imposed.

If your young child says “I’m a girl” (when assigned male at birth) not once but repeatedly and firmly, and shows distress when treated as belonging to the other gender, it’s worth consulting a qualified professional — not to “decide” anything, but to understand and support.

At this age, no medical step is necessary or appropriate. The only thing that can be done, and that makes a difference, is to listen and not force.

Adolescents and gender dysphoria

Puberty is often the crisis point. Many trans youth manage to keep their distress at bay during childhood, but when the body begins to change — the voice deepening, breasts developing, body hair, menstruation — the distress can become unbearable.

Signs to look for in an adolescent who might be experiencing gender incongruence:

• Intense distress about pubertal body changes (tries to hide them, experiences discomfort seeing them, refers to them with words expressing rejection).
• Social withdrawal, avoidance of situations where the body is visible (sports, swimming pools, changing rooms).
• Depression, anxiety, irritability that emerge or intensify with puberty.
• Explicit statements about their identity, even if expressed with difficulty or indirectly.
• Requests to be called by a different name or pronouns, even just among friends.

None of these signs, alone, is a diagnosis. Together, and in a context of persistence over time, they signal the need for consultation with specialized professionals.

The thing not to do is to wait for it to “go away on its own.” If your child is suffering, the suffering is real now, regardless of what the future holds.

How to support your child today

You don’t have to wait to understand everything, or to agree with everything, to do the things that matter most. Here are concrete actions with measurable effects on your child’s health.

Chosen name and pronouns

Using your child’s chosen name is the action with the highest cost-benefit ratio that exists. A 2018 study conducted by Stephen T. Russell and colleagues on 129 trans youth measured the effects of using the chosen name in different contexts (school, home, work, friends). The results are clear: those who could use their name in all four contexts showed 71% fewer symptoms of severe depression and 65% fewer suicide attempts compared to those who couldn’t use it in any context. Even being able to use the name in just one context was associated with a 29% reduction in suicidal thoughts [6].

You don’t have to do it perfectly right away. But starting — even just at home, even just you — is a medical act in the most literal sense of the term.

School

If your child attends school, you might consider requesting the alias career: an agreement with the school that allows the use of the chosen name in the register and internal communications, without modifying legal documents. Over 500 Italian schools have adopted it. For minors, the consent of at least one parent is required.

Extended family

Deciding when and how to involve grandparents, aunts, uncles, and siblings is a conversation to have with your child. Some young people want their parents to be the first advocates in communicating it; others prefer to do it themselves when they feel ready. The important thing is not to act without their consent.

When you speak with relatives who might have difficulties, it can be helpful to have clear information and authoritative sources available. The resources from AGEDO and GenderLens are designed for this purpose as well.

Psychological support

A professional specialized in gender identity can be invaluable for both your child and you. Not to “change” anything, but to offer a safe space to process complex emotions, ask questions without judgment, and build practical strategies.

Mental health: real risks and protective factors

Trans youth have higher rates of depression, anxiety, and suicidal ideation compared to cisgender peers. These figures are frightening — and they should be taken seriously. But it is essential to understand where they come from and what reduces them.

The numbers

A study on American trans adolescents (Youth Risk Behavior Survey) showed that 44% had seriously considered a suicide attempt, compared to 16% of cisgender peers. Mental distress does not arise from being trans: it arises from being trans in a context of non-acceptance, misunderstanding, and lack of support. This is what the literature calls minority stress.

The study by Turban and colleagues (2020), conducted on over 20,000 trans adults, found that those who had access to puberty blockers during adolescence showed a 70% reduction in lifetime odds of suicidal ideation compared to those who had wanted them but not obtained them [3].

The study by Tordoff and colleagues (2022) on trans youth receiving affirmative care found, after six months of treatment, 60% lower odds of depression and 73% lower odds of suicidal ideation compared to those who had not yet started treatment [7].

The most important factor: you

The study by Simons and colleagues (2013) on 66 trans adolescents in care showed that parental support was directly associated with greater life satisfaction, lower perception of the burden of being trans, and fewer depressive symptoms [4].

The study by Ryan and colleagues (2010) from the Family Acceptance Project demonstrated that LGBT youth with high family support were three times less likely to attempt suicide compared to those with low family support [5].

The 2016 study by Olson and colleagues on 73 trans children supported by their families showed that these children had depression levels within the norm — identical to cisgender children of the same age — and only slightly elevated anxiety levels [1].

The most powerful protective factor that exists is not a medication, not a clinical pathway: it’s you.

Resources for parents

Support among parents

AGEDO Nazionale: agedonazionale.org — mutual self-help groups throughout Italy, listening desks, meetings. You can find the nearest branch on the national website.

GenderLens: genderlens.org — three free orientation sessions for families, monthly online meetings on the fourth Saturday of the month and every two weeks in the evening. Contact: info@genderlens.org

Clinical centers

See the “Who to turn to in Italy” section above. To find the nearest center, you can also consult Infotrans.it (institutional portal created by the National Institute of Health and UNAR) and the ONIG map.

If there is a crisis

If your child is going through an acute crisis, active helplines exist:

• Telefono Amico: 02 2327 2327 (every day, various hours)
• Telefono Azzurro: 19696 (active 24 hours, for minors)
• Arcigay LGBTQIA+ helpline: some local branches offer phone desks
• Psychiatric emergency number: 118 in case of immediate danger

Don’t wait for the crisis to pass on its own. Asking for help is the most responsible thing you can do.

FAQ: parents’ questions

Is my child trans because they saw it on social media? Research does not support the idea that exposure to social media “creates” trans identities. The Littman (2018) study that hypothesized “social contagion” was widely criticized for serious methodological problems and was partially retracted. What social media does, if anything, is give trans youth the language to describe something they have always experienced — and often the connection with peer communities that understand. For more detail, see the article on social contagion.

What if my child is wrong and then regrets it? Detransition exists and is a real experience. Current statistics estimate it at around 2% to 8%, with causes that include social and family pressures more often than identity reassessments. The Italian clinical pathway is designed precisely to take the necessary time: the 6-12 month psychological assessment, the reversibility of blockers, the gradual steps, all serve exactly this purpose. To learn more: detransition.

Can I oppose the medical pathway? In Italy, the consent of both parents (or the custodial parent) is required for any medical intervention on a minor. This means you have a say. That said, opposing support does not prevent your child’s suffering: it postpones it, and often intensifies it. A conversation with a professional — for you, for them, for you together — is always the most useful step.

How do I talk about it with other children? Siblings often adapt faster than adults. You can say it simply: “Your brother/sister really feels like a girl/boy, and we want them to be okay.” Answering questions with honesty and calm is more effective than any elaborate explanation. If siblings struggle, psychological support is available for them too.

Is my child trans and gay at the same time? Gender identity and sexual orientation are distinct things. A trans boy (born female, who identifies as male) can be heterosexual, gay, bisexual, or anything else — just like anyone else. Being trans does not define who one is attracted to. Often trans youth themselves take time to understand their own orientation, and that is perfectly fine.

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You don’t need to have everything figured out right now. You don’t have to be perfect. You just have to not let go of your child when they need you most. And if you’re reading this page, you probably won’t.