My Kid Came Out to Me as Trans/Nonbinary—Now What? Gender Affirming Care and Therapy 101 for Youth and Teens

So you're child or teen recently came out as transgender and/or nonbinary. Learn about gender affirming care options and therapy for youth with FOLX Health.

January 17, 2023
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If you're a parent of a transgender, gender diverse, and/or nonbinary child, teen, or adult, FOLX offers parental consults through our Virtual Healthcare visits where you can get information on how to support your child through questioning, social affirmation, legal affirmation, medical affirmation, surgical affirmation. Schedule a VHC visit with a FOLX clinician today to learn more about gender affirming care options for your child, teen, or adult. Additionally, stay tuned for our parental support groups, soon to be available in our community content platform- the FOLX Community Platform.

We published an article about How to Support Your Transgender Child. Consider this article to be part two. Now, we’ll be tackling the evidence-based gender affirmation model of care for nonbinary and transgender youth. We’ll also provide you with the educational guidance to better understand what gender affirming care looks like for your child or teenager, even if they haven’t yet decided to medically transition.

Inform yourself early on

When it comes to understanding transgender and nonbinary identities, it helps to frame this in the context of general human development and identity formation. The ultimate goal of childhood and adolescence is for someone to grow into their true and authentic selves. Identity development includes identity in being part of a family, friends, and school; it also includes a growing sense of understanding regarding one’s gender and their sexuality. Forming your identity is a significant part of growing up!

It might help to familiarize yourself with the gender affirmation model of care. This framework, which is supported by the American Academy of Pediatrics and other similar professional medical organizations, provides guidance on navigating gender affirming care for those who don’t fully identify with their gender identified at birth. This model supports careful listening to your child/teen and offers additional professional support as well as highlights the importance of parent and family support. While not all trans and/or nonbinary youth are interested in medical transition, it’s helpful for them to know and explore their options, especially with the guidance of a supportive caregiver.

Parental support is key to providing an overall safe, respectful, and accepting home environment that is critical to all children growing up healthy and happy. Parents who help their children explore their gender—whether their identity fits with what is on their birth certificate or not—offer that sort of safe and loving space to grow into adulthood. Just talking and learning more with a gender affirming care clinician is helpful, even if ultimately a child or teen decides not to go through with pursuing gender affirming care. While listening to your child share their experience about a gender diverse experience is important, there is value in talking about what gender means to cisgender children as well. Gender impacts all our lives. 

The gender affirmation model of care supports providing gender affirming care for transgender and/or nonbinary people, including youth and adolescents. The American Academy of Pediatricians offers specific clinical guidelines on navigating gender affirming care for LGBTQ+ patients and their families.There are actually many studies out there that support this model. It’s no way experimental but in medicine we always want to continue to study and evaluate care so we can continue to improve care over time. 

This framework isn’t about pathologizing transgender and nonbinary children and teens, nor does it rely on a firm medical diagnosis in order to treat gender dysphoria. Instead, it’s all about promoting healthy human development and gender diversity. Likewise, whether your child or teen is questioning or completely certain of their trans and/or nonbinary identity, it’s critical to allow them the time and space to experiment.

This model of care recognizes some children are extremely clear about their cisgender or transgender identity early on. Other children don’t think about gender until around the time of puberty. For some, gender is more fluid or complicated than just identifying as a boy or a girl. The Gender Book is a fun way to think about and talk more about gender.

An illustration of a parent with their transgender kid smiling

Options for gender affirming care

Children who talk with parents about their gender experience and gender diverse identity early on seem to have short and longer term improved health outcomes. Getting information and support earlier, rather than ignoring this or waiting to puberty, may be linked to lower rates of depression and anxiety.

Adults who report knowing they had options for care report being less suicidal, even in their adult years. Getting connected with the right provider is an important part of creating this health conversation and an important person to have on your child’s or teen’s support team, even if they aren’t actively pursuing gender affirming medications.

FOLX offers Virtual Healthcare consultation services for parents of trans and nonbinary youth, teens, and adult children looking to learn more about gender affirming care. Book an appointment with an LGBTQ+ specialized clinician today!

The informed consent model

When seeking providers, it’s critical for parents to understand the importance of the informed consent model of care versus the gatekeep model of care.

Historically, talk therapy has been weaponized against trans and nonbinary people, prior to the rising popularity of the informed consent model of transgender care. Previously, it was a common legal requirement to see a therapist or similar mental health professional for a period of time before actually receiving gender affirming care. Unfortunately, depending on where you live and what services are available to you, this may still be a requirement. 

Conversely, the informed consent model, as described in a 2017 paper published in the Journal of Humanistic Psychology, “allows for clients who are transgender to access hormone treatments and surgical interventions without undergoing mental health evaluation or referral from a mental health specialist.” Likewise, the informed consent model enables nonbinary patients to collaborate with their clinicians for a more customizable approach to care, such as with low dose hormone replacement therapy (HRT).

Children as young as eight years old can discuss care options and assent to care with parent and provider support. Teenagers likewise have an increasing ability to provide input into who they are, what they think is right, and contribute to making decisions in their medical care. This is recognized by pediatric providers as an important aspect of teaching and supporting children into taking more ownership and responsibility with their health over time and as they continue to mature. 

FOLX believes and uses the informed consent model in our approach to gender affirming care. To learn more, read more about our testosterone and estrogen HRT services.

Talk therapy for kids/teens plus families/adults

Therapy can be incredibly beneficial for trans and nonbinary youth, especially when geared towards helping them better understand themselves and their gender journey. It can be helpful for parents and families to better understand and support their child. Therapy can help youth learn more about themselves as well as serve as a safe space to explore their own personal growth.

While we recommend you seek out an LGBTQ+ competent therapist for your child or teen, be sure to actively initiate a conversation about talk therapy with your child or teen along the way. Therapy is most effective when it’s collaborative, voluntary, and desirable. Additionally, it’s important to note that conversion therapy is never recommended as it has been proven harmful to persons of all ages; it’s also not recommended by any medical society and is illegal in some states.

Lastly, it might be helpful to consider group therapy for the whole family, since creating an affirming home is a family process. Even social aspects of affirming such as using the child’s asserted name or pronoun can have important contributions on a child’s well being and safety.


FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include virtual primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, preventive care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, or nonbinary, you can find LGBTQIA+-specialized health care that helps you meet your wellness goals. FOLX Health is health care that's queer all year. Get all the benefits of becoming a FOLX member and sign up today!