See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/324467668

Supporting families of transgender children/youth: Parents speak on their

experiences, identity, and views

Article in International Journal of Transgenderism · April 2018

DOI: 10.1080/15532739.2018.1450798

CITATIONS READS

95 3,131

1 author:

Christine Aramburu Alegría

University of Nevada, Reno
9 PUBLICATIONS 624 CITATIONS

SEE PROFILE

All content following this page was uploaded by Christine Aramburu Alegría on 30 July 2018.

The user has requested enhancement of the downloaded file.

 International Journal of Transgenderism

ISSN: 1553-2739 (Print) 1434-4599 (Online) Journal homepage: http://www.tandfonline.com/loi/wijt20

Supporting families of transgender children/youth:

Parents speak on their experiences, identity, and
views

Christine Aramburu Alegría

To cite this article: Christine Aramburu Alegría (2018) Supporting families of transgender
children/youth: Parents speak on their experiences, identity, and views, International Journal of
Transgenderism, 19:2, 132-143, DOI: 10.1080/15532739.2018.1450798

To link to this article: https://doi.org/10.1080/15532739.2018.1450798

Published online: 11 Apr 2018.

Submit your article to this journal

Article views: 116

View Crossmark data

Citing articles: 1 View citing articles

Full Terms & Conditions of access and use can be found at

http://www.tandfonline.com/action/journalInformation?journalCode=wijt20
INTERNATIONAL JOURNAL OF TRANSGENDERISM
2018, VOL. 19, NO. 2, 132–143
https://doi.org/10.1080/15532739.2018.1450798

Supporting families of transgender children/youth: Parents speak on their

experiences, identity, and views
Christine Aramburu Alegrıa
Orvis School of Nursing, University of Nevada, Reno, Nevada, USA

ABSTRACT KEYWORDS
Background: Transgender children/youth demonstrate the best possibility for resilience and positive Children; families; identity;
mental health when they are part of an affirming and supportive family. To optimize families in parents; resilience;
supporting transgender children/youth, parents/caregivers need to be supported. Transgender transgender
children/youth and their families regularly navigate a myriad of challenges through society.
Aims: Within the extant literature on transgender children and youth, relatively little attention is
focused on the experiences of parents/caregivers and how their close family relationships are
affected. The present qualitative study addresses this gap in knowledge through its exploration of
the experiences, identities, and views of parents/caregivers of transgender children/youth.
Method: The study is longitudinal and this article represents the first wave. Fourteen parents of 12
transgender children/youth, aged 6–17, participated in in-depth semistructured interviews.
Participants were recruited via social media and at an on-site conference for transgender youth and
their families. All children/youth had socially transitioned. Those who were eligible for puberty
suppression and/or hormone therapy were receiving those. The interviews were inductively coded
for themes by two coders using the constant comparative method.
Results: Participants’ reports on their experiences yielded three themes: (1) transgender issues as the
family’s focus; (2) proactivity, child-focused: preemptive actions to prevent adverse consequences;
and (3) self-care. These themes included subthemes on effective coping strategies to mitigate
struggles. Three themes related to participants’ identity and views emerged: (1) identity
reformation, (2) self-evaluation, and (3) views of future. These themes included subthemes that
reflected how participants viewed themselves, their child, and the future.
Discussion: A transgender identity in one family member affects all household members. Parents/
guardians may experience guilt and self-doubt over decisions. Factors that may improve outcomes
with extended family and schools include families’ preemptive dissemination of information on
transgender identities and explicating expectations of respect and nonintrusion. Ingrained
traditions may force life-altering decisions.

Transgender children/youth demonstrate the best pos- supported transgender prepubertal youth with a com-
sibility for resilience and positive mental health when parative control group, Olson, Durwood, DeMeules,
they are part of an affirming and supportive family and McLaughlin (2016) found no greater existence of
and environment (Costa et al., 2015; Olson, Durwood, depression in the transgender youth and only slightly
DeMeules, & McLaughlin, 2015; Simons, Schrager, higher levels of anxiety. Similarly, Durwood,
Clark, Belzer, & Olson, 2013; Wilson, Chen, Arayasiri- McLaughlin, and Olson (2017) found that transgender
kul, Raymond, & McFarland, 2016). Parental support youth did not have significantly higher levels of
increases resilience in transgender youth. Grossman, depression than their siblings or cisgender control
D’Augelli, and Frank (2011) found resilience in trans- groups but they did have slightly higher levels of anxi-
gender youth to include a sense of personal mastery, ety. In youth with gender dysphoria eligible for
positive self-esteem, and perceived social support puberty suppression, psychological well-being further
from family and friends. Further, parental support has improves with the administration of GnRH agonists
been correlated with higher life satisfaction, lower per- (de Vries, Steensma, Doreleijers, & Cohen-Kettenis,
ception of burden, and fewer symptoms of depression 2010). When not supported, transgender youth are at
(Simons et al., 2013). In a study comparing family- particular risk for discrimination, violence, family

CONTACT Christine Aramburu Alegrıa [email protected] Orvis School of Nursing, University of Nevada, Reno, MS 0134, Nevada 89557, USA.
© 2018 Taylor & Francis Group, LLC
 INTERNATIONAL JOURNAL OF TRANSGENDERISM 133

rejection, depression, suicidal ideation, and suicide Unsuccessful attempts to cope with the uncertainties
(Grossman & D’Augelli, 2007). Persons of color may included setting limits on their child’s variant gender
be at particular risk for negative outcomes as family expression and engaging in birth-assigned gender-typ-
and friends have been cited as the greatest influence ical behaviors with them.
on gender identity among African American youth
(Singh, 2012). Current study
To optimize families in supporting transgender
children/youth, parents/caregivers need to be sup- The present study builds upon the limited extant
ported. Gender non-conforming and transgender chil- knowledge on families and transgender children/
dren/youth and their families regularly navigate a youth by further illuminating parents’ experiences and
myriad of challenges through society including bully- views. The realization of a change in one family mem-
ing, discrimination, a lack of adequate healthcare, dis- ber can bring with it a disruption in established
approval from family and community, and an overall norms, and the need for reformation as a new stability
lack of societal understanding (Grossman & D’Augelli, is created. Through an increased understanding of
2007; James et al., 2016; Reisner et al., 2015). Yet, reforming experiences and views, parents/caregivers
within the extant literature on transgender children can be better supported, and consequently, their chil-
and youth, relatively little attention is focused on the dren and the family unit can be as well. The research
experiences of parents/caregivers and how their close questions addressed in this study are:
family relationships are affected. The present study 1. What are the experiences of parents of transgen-
addresses this gap in knowledge through its explora- der children/youth, including in the following
tion of the experiences and views of parents/caregivers areas of: (1) family dynamics, (2) social net-
of transgender children/youth. works, (3) school, and (4) healthcare?
2. How are the views/identity of parents of trans-
gender children/youth affected, including self-
Relationship reformation following disclosure views and views of their child?
As established relationships, families have their own
set of norms and expectations. Family relationships Method
maintain dynamic stability within the expectations
Participants
that have been created through continued interactions
(Baldwin, 1992). When one family member manifests The parents of five trans female children/adolescents,
behavior outside the established norms or comes aged 6–17, and seven trans male children/adolescents,
“out,” relational dynamics are altered and expectations aged 6–17, completed the first wave of interviews.
are destabilized and must be reformed. Previous stud- Two of the interviews, Participants 6 and 7, included
ies demonstrate that parents’ initial reactions to a two parents, interviewed jointly; ten interviews
child’s disclosure of transgender identity include a included one parent, the child’s mother. All partici-
myriad of responses such as confusion, sadness, disbe- pants identify as white; the trans son of one of the par-
lief, and dismissal (Gregor, Hingley-Jones, & David- ticipants is identified as African-American. Among
son, 2015; Malpas, 2011). As understanding and the parents are two same-sex couples. Interviews were
acceptance develops, parents may continue to feel loss conducted either by phone or face-to-face. Partici-
and grief, helplessness about the situation, and anxi- pants were from six States, four on the West coast and
eties about the future, including whether their child two on the East.
will remain transgender and how to proceed (Gregor All of the children/youth are socially transitioned, liv-
et al., 2015; Malpas, 2011). To cope with the situation, ing in their affirmed gender and using their chosen
parents often turn to support groups and self-educa- name and pronouns at home, at school, with extended
tion (Wren, 2002). In their interviews with parents of family, and in society. All key administrative school per-
children with gender-variant behaviors, Hill and Men- sonnel at the childrens’/youths’ knew of the students’
vielle (2009) found that parents’ initial reactions to assigned gender at birth. Although the students partici-
their child’s gender variance included making sense of pated in school in their affirmed gender, generally the
the situation and believing it to be a phase. student’s legal name of record remained the name given
134 C. ARAMBURU ALEGRIA

at birth unless required documentation was submitted. nonconformity, and the trajectory it took. Ques-
Schools varied as to the documentation required. Those tions on their family experiences and those with
youth who were eligible for puberty suppression were extended family, school, healthcare, and community
receiving GnRH agonists, and those who were eligible followed. Participants were then asked about their
for hormone therapy were receiving those. Please see views of themselves, their child, their spouse/part-
Table 1 for age of the child at the time of the interview, ner, and any other members of the household. Par-
and age of the child when they first manifested gender ticipants were also asked about any helpful
nonconformity or transgender identity. strategies they may have discovered in challenging
situations.
Procedure
Analysis
The study was approved by the University of Nevada,
Reno, USA, University Institutional Review board. The author and a second coder, health care pro-
Informed consent was obtained from all individual viders who advocate for improved healthcare for
participants included in the study. The study takes a the transgender population, analyzed the data. The
longitudinal approach. Data is collected via in-depth interviews were inductively coded using the con-
semi-structured interviews with parents/guardians of stant comparative method (Glaser & Strauss,
transgender children/youth on the following schedule: 1967). The author coded all data. The second
(1) initial, (2) 6 months following initial interview, (3) coder coded one-half of the data. The constant
12 months after the second interview, and (4) comparative method is an iterative process in
12 months after the third interview. This article which each interview was first read in its entirety
reports on the first wave of the study. Participants for initial impression. The interview was then
were recruited at a USA conference for families of coded line by line for emergent themes. Compari-
gender nonconforming and transgender children/ sons were made across interviews and as new
youth. Interviews were conducted by the author either themes emerged, interviews were further analyzed
face-to-face or on the phone; interviews were 30– for the newly emerged themes. Themes and sub-
90 minutes in length. The interviews were recorded themes were created. The two coders communi-
and transcribed verbatim. This paper reports on the cated regularly to ensure consistency and
first wave of interviews. consensus in the coding of themes. Member checks
during the interview further contribute to the
study’s validity. During the interview process, the
Interview schedule
interviewer paraphrased and reflected back to the
The initial interview began with a question on the participant their statements. This provided the par-
household composition. This was followed by a ticipant the opportunity to clarify and expand
question on their child’s history with gender upon their statements.

Table 1. Participant, child, gender assigned at birth (GAB), affirmed gender (AG), current age (CA), age at affirmed gender presentation
(AGE-A).
Participant Child Name GAB AG CA AGE-A Comments

1. Betty Elyse M F 8 4
2. Ann Lori M F 17 16 Depression prior to diagnosis
3. Carol Adam F M 13 3 / 12 Initial indication age 3; SA, age 12 – disclosed
4. Stacy Adrian F M 17 4
5. Alisa Jared F M 13 3
6. Kristi & Karl Lily M F 7 3
7. Patty & Paul Roger F M 9 3
8. Kim Tony F M 12 4 / 11 Initial indication age 4; diagnosed age 11 after year of depression
9. Denise Clay F M 15 14 Depression prior to diagnosis
10. Sandy Emily M F 9 4
11. Mary George F M 17 14 SI prior to diagnosis
12. Lynn Alexis M F 9 4 Diagnosis of autism

SA D Suicide attempt/SI D Suicidal ideation.

All names are fictional and therefore pseudonyms.
 INTERNATIONAL JOURNAL OF TRANSGENDERISM 135

Results My husband and I are on the same page when it comes

to Adrian. We talk about medical decisions and day-to-
RQ 1. What are the experiences of parents of trans- day decisions. You have to. Otherwise the family unit
gender children/youth, including in the following will fall apart. (Stacy, mother of 17-year-old transgender
areas of: (1) family dynamics, (2) social networks, (3) son)
school, and (4) healthcare?
Three themes emerged illustrating the experiences
Trans filter
of parenting transgender children/youth and the strat-
With transgender identity being a family focus within
egies they used to meet challenges: (1) transgender
the home, family decisions inevitably were viewed
issues as the family’s focus; (2) proactivity, child-
through a “trans filter,” with the predominant consid-
focused: preemptive actions to prevent adverse conse-
eration being how/if the decision would affect the
quences; and (3) self-care. Each of these themes
trans child.
included subthemes. All names are pseudonyms.
[The trans filter] is constant. There’s no time when the
Trans as family focus trans part/filter isn’t there. Everything we do has to be
filtered through what does it mean from a trans perspec-
A family member’s transgender identity became the tive. That’s just kind of exhausting. I just want to take a
family focus, being ever present on parents’ minds. little vacation where there’s no trans. (Ann)
This category includes two subthemes: Enmeshment Situations triggering the trans filter ranged from the
and trans filter. seemingly prosaic to those with potentially more
impact. Participant 1 illustrates how situations that
Enmeshment may be relatively insignificant for cisgender persons
Participants described relational enmeshment between are anything but for transgender persons:
themselves and their transgender child. Concern for
their child subsumed other concerns, and mutual She wears girls’ bathing suits and stuff and she used to
like to wear the little bikini bathing suit bottoms. And
dependence between parent and child occurred. The
finally we were like “you know these [bathing suit
mood of one depended on the mood of the other. Par- shorts] are girl ones too and you know you are starting
ticipant 2 illustrates: to develop and you’re bigger and you know if you chose
to wear the bikini ones, the bottoms, you know, then
I’m trying to find balance. My anxiety is very specific. If
you can see more.” (Betty, mother of 8-year-old trans-
things are going ok for Lori, I’m ok. If she is stressing
gender daughter)
about something, I just can’t leave it or deal with it. So it
is directly tied to Lori. (Ann, mother of 17-year-old
transgender daughter)
Proactivity child-focused
This was often to the detriment of the parental Participants reported activities designed to optimize
relationship: outcomes and stave off adverse events. There are four
I have kind of put my life, my independent interests and subthemes: (1) independence/self-determination; (2)
my relationship [with my husband] on hold for the last selective disclosure; (3) network, and (4) advocacy.
couple of years. As an adult I was able to be better bal-
anced and prioritize and not be co-dependent type in Independence/self-determination
my relationship and I feel like I have reverted back a lit-
All participants reported following their child’s lead in
tle bit to that behavior with Lori because I have made
her such a focus of everything. (Ann) gender expression and decisions related to social tran-
sition, puberty suppression, and cross-sex hormone
However, participants who did not report activities administration.
indicative of enmeshment often reported that having a
[My partner] and I remind Jared that he’s always got
transgender child had no effect on the parental rela-
choices all along the whole way. The plan is when and if
tionship. These participants reported communication he’s ready to continue on a more masculine path and
and a joint focus on the child as strategies to both start testosterone, then that’s what we’ll do. He will need
serve the child and maintain stability in the family. to make the decision, not us. (Alisa, mother of 13-year-
Participant 4 illustrates: old son)
136 C. ARAMBURU ALEGRIA

Promoting independence and self-determination camaraderie, and resilience. Local and regional sup-
extended to life situations in an effort to equip youth port groups were frequently mentioned, along with
for future challenges. online networks. Establishing a relationship with a
“safe adult,” often a counselor, provided emotional
There’s only so much I can control. He’s going to college
soon. I can’t be there. So we talk about situations at his
strength for participants:
work and school now so that he’ll have a better idea how [My daughter] sees [counselor] Mary so she can have “a
to handle things when I’m not there. (Mary, mother of safe adult” to talk to if there’s something she feels she
17-year-old transgender son) can’t talk to [her parents] about. I don’t think there’s
anything specific right now, but as she gets older, that
Participants also reported purposeful, and possibly
may change, and I want to make sure she has a safe ave-
excessive, disengagement, in an attempt to achieve an nue for that. (Betty)
appropriate balance between promoting independence
and continued guidance:
Advocacy and defined expectations: Schools, family,
I’ve had to learn how to let go. Adrian doesn’t always
work, healthcare
want me in his business. My rule of thumb now is I
don’t speak to him unless spoken to and then we get Participants reported taking a proactive approach with
along really fine. (Stacy) extended family, their child’s school, and their own
workplace, by providing education on transgender
identity. Further, this advocacy became a preemptive
Selective disclosure approach as they set expectations for others, letting
Not surprisingly, decisions on when and to whom to them know that outward displays of negative reactions
disclose were a regular occurrence, and often a “need and evaluations would not be tolerated. In discussing
to know” approach was taken when deciding whom to her actions with her child’s school, Participant 4
tell. Discussions occurred a priori to disclosure: illustrates:
We talk about [disclosure] and we’ve kind of decided I discovered that it was actually a law that he could use
that from the perspective of safety that if she has some- whichever bathroom he chose to. So [my husband and
body that she wants to tell, that we’ll talk about it first. I] printed that off and sent it to the school and we said
(Betty) he will use the boys bathroom. They didn’t have any-
thing to say when they had that little law in their hands.
However, related to the theme of nurturing inde- (Stacy)
pendence in the older youth, parents often left the
decision of coming out to their children. Similarly, Participant 12 stated:

[My husband and I] left it up to him. He didn’t want to If a parent has a problem with [my child using the girls’
struggle with trying to be stealth, so he decided to make bathroom] then we request that you tell that parent that
an announcement at school. He very much wants to be a that’s fine. Their child can go use the teacher’s bathroom.
trans advocate, and this was important to him. We had (Lynn, mother of 9-year-old transgender daughter)
to honor that. (Mary)
Participants reported informing extended family
To provide a frame of reference for when and through a variety of means, such telephone, or face to
whom to disclose to, this parent provided analogies: face. Participant 7 describes informing family through
an email letter. Further, these parents made it clear
Do I have to disclose if my child has cancer if I just met
you? I try to relate it to something else. If I had a broken what their expectations were:
bone last year, do I need to tell you? How much do peo-
[My husband and I] mailed it out to every single one of
ple have a right or need to know? (Karl, father of 7-year-
our parents and siblings. It was a very, very happy, very
old transgender daughter)
positive letter. It was just like, “We are welcoming this
new person in our family. This is what’s going on, and
here’s some resources for you. We will not tolerate any
Networks negative response if you cannot accept this. But when you
Establishing supportive networks and participating are able to then we will welcome you like we are more
with support groups provided resources for education, than happy to have you be loving and supportive of us
 INTERNATIONAL JOURNAL OF TRANSGENDERISM 137

and our family.” Like we just worded it in a way that it Self-talk

was very nice and like most people sent us words of sup- Self-talk enabled participants to put things in perspec-
port. (Patty, mother of 9-year-old transgender son)
tive and realize one’s limits:
Similarly, Participant 2 informed their workplace: There’s some things that I am just not going to be able to
So with [my daughter’s] permission, I told people at help her with so I’m trying to kind of categorize, you
work. We live in a community where it’s difficult to be know, what I can and can’t do because you know ulti-
anonymous, so that’s what I did. I said, “So, I have mately I don’t have control over even knowing if she’s
some news about my son, and he’s transgender and we feeling okay" (Ann)
are going to be supporting and working with him to RQ 2 How are the identity/views of parents of
transition to female.” There were some surprised peo-
transgender children/youth affected, including self-
ple, but I let the Human Resources people know that I
am going to start talking about my daughter, and that I views and views of their child?
didn’t want people to think I was crazy, you know, and The identity and views of the participants can be
wonder what happened to the son. I said, “So if anyone described with the following themes: (1) identity/view
has questions, I’m happy to answer questions. But if reformation, (2) self-evaluation, and (3) views of
you don’t want to talk about it, you don’t have to. I future.
just didn’t want you to be confused.” It went very well.
(Ann)
Identity/view reformation
Proactive advocacy also included open communica-
Participants described the evolution of their self-views
tion on expectations with healthcare providers:
and those of their child, since first manifestation of
We just want to make sure our pediatrician is on board gender non-conformance to transition. There are four
and that we’re prepared for it when the time comes [for subthemes: (1) religiosity, (2) view of child, (3) loss,
puberty suppression] instead of waiting till the last min- and (4) duality.
ute. (Betty)

Advocacy extended to changing providers as Religiosity

needed when microaggressions or intolerance was Participants described situations in which it was clear
evident: that parents’ decision to allow the child to transition
was not supported, and in which children would not
We did have that first dentist that we explained the be allowed to participate in activities as their authentic
whole situation to. They said “Oh yeah, they’ll be okay,”
gender. Parents for whom religion was an important
yet he would still call Roger by his old name. He would
still use the she pronouns so we just switched dentists. part of their worldview described being faced with a
(Patty) decision on their religion. Participant 7 describe leav-
ing the Mormon Church and physical community
they had been raised in:
Self-care
We—we were willing to—we had to – make huge
To cope with stressors and challenges, participants changes in our family and everyone in the family was
engaged in self-care. Two subthemes emerged: (1) willing and able to like make these huge changes—leav-
time for self and (2) self-talk. ing the church, moving, making different friends, going
to different school and all kinds of things. This has cre-
ated some dissonance within us, and it leaves a hole
Time for self inside me, but we had to do it for Roger. (Patty)
These activities provided respite from child-centered
concerns and served to build emotional reserves: Similarly, Participant 8 described the tension recon-
ciling her personal beliefs, the Catholic Church, and
Making time for myself is so important. I’m learning caring for her child:
Spanish and going for runs. At some level, I was trying
to get some control back for my life. As much as your I think that the Church hasn’t caught up yet because it’s
child needs you and you support them, you’re not just a a bureaucracy and it’s slow moving and it hasn’t figured
vessel for that and you have a life of your own. And you it out. I mean I’m more of like love is love, and my child
need to protect that as well. (Denise, mother of 15-year- is who he is, and I mean I think [the Church] will even-
old transgender son) tually get there maybe, I don’t know. It’s tough, because
138 C. ARAMBURU ALEGRIA

I mean I believe in the [Catholic] sacraments. But if you daughters but I’m not exactly sure why. I’m still working
still believe in that, then what do you do? And that’s on that one." (Ann)
kind of where I’m kind of stuck." (Kim, mother of 12-
year-old transgender son) Similarly, participant 8 describes a disconnect when
looking at pictures of her child prior to transition:
You know there was a time when [looking at the old pic-
View of child
tures] was really hard and painful ….but now, now…it’s
Participants overwhelming described their children as almost like they’re just really cute pictures of some child
happier and better adjusted after transition: who I don’t really have a relationship to. You know that
This has been the first real experience as he truly is. this little girl in the dress with the pigtails is a really cute
Since puberty, since 11, 12, we were losing him. He little kid, you know, who’s like some sort of distant rela-
was drifting away with the depression, with the with- tive but not really you know the child that I gave birth to
because the one I gave birth to is this 12-year-old boy.
drawal. Now he is back and is the adolescent he should
(Kim)
have been all along. Getting As and Bs. Excited about
his life. (Denise)
Participants also described the transition of how Loss
they viewed their child’s gender. For some parents, the Related to changing relationships between child and
transition of viewing their child as assigned gender to parent is the theme of loss and grief. Participants
authentic gender required little effort. For others, the described their own sadness, and the expressed need
challenge to reform their views continued. These par- of their children to extinguish markers of themselves
ticipants illustrate: as their assigned gender prior to transition.
It’s weird how fast [our view of our child] changed for We wanted a boy and we wanted his name to be Mark
us. We had him as a girl for 13 years, and now 6 months and we had him for 4 years, and it’s almost like maybe
worth of being a boy has kind of erased that out. I think he died. (Lynn)
because he never wanted to wear dresses, or get nails
done, or any of that, it’s maybe easier. He was never a Similarly, participants described having to let go of
girl. (Carol, mother of 13-year-old transgender son) how they had envisioned their lives with their child:
In contrast, Participant 8 describes the slow evolu- [My wife and I] went through a period of grief. You
tion of her view of her trans son: know we had a little boy, and you know I was excited
about having a little boy, and excited about, you know,
It was a little bit of a slow evolution. It takes time. So throwing the football and, you know, dressing them in
basically in my brain, in my brain now when I try to the cute little clothes—you know like when there’s a
think of this child as a girl, it totally does not work. But baby and stuff and I dressed him in little suits and ties.
that was slow. I used to still see the girl in him. Some You know like it was fun and you know little—you envi-
mannerisms. But now, there’s no recognition of that. sion things. (Betty)
Like there’s pictures of this child who’s this little girl
who I knew grew up to be the boy that he is now. But Purposeful self-talk and positively framing the situ-
they don’t feel like the same person anymore. It feels like ation was used to provide a different perspective on
somebody who used to exist, but doesn’t exist now. the situation:
(Kim)
There was a mourning period. I felt I was losing my
Participant 2 described trying to resolve her view of daughter. I reminded myself, “I never had a daughter.”
her relationship to her child, who came out at age 16: Clay was always a boy, we just didn’t realize it. This is
how Clay always has been and always will be. That made
I see my daughter as a friend now. Since the transition. I it 100 times easier. (Denise)
mean I think that it’s the trans stuff. I kind of look at it
maybe because she’s older and she didn’t transition until In a similar vein, Participant 10 describes the cogni-
older, so I think I had a little baby boy, I had a son, and tive process of perspective.
now I’ve got a daughter but we are more of the “friends”
level. I’m trying to support her and trying to connect For child’s health and safety, you have to, sooner rather
with her and make sure that I’m there for her, but not so than later, make the decision and whatever it takes to
much as a daughter. I feel like it’s a little different rela- support your child for who they are. Whatever it takes
tionship than I see some of my friends having with their to get there. You have to go quickly, or you’re telling
 INTERNATIONAL JOURNAL OF TRANSGENDERISM 139

your kid you don’t care enough. You have to support him for who he was?” I’m still dealing with that. The
your child. You can’t change it. This is who they are. It’s guilt. A parent should know their child. (Kim)
not a phase or acting out. Or if it is, let it run its course.
Remembering that kept me focused and helped me keep Similarly, this participant reflects on the improve-
Emily first and foremost in all of this. My daughter’s ment in her son since transition and expresses regret
health was at stake. (Sandy, mother of 9-year-old trans- over not recognizing her son’s gender dysphoria
gender daughter)
sooner:
There is no way we could have known because he didn’t
Duality know, but I wish we had known sooner and had this
Discomfort with a duality of gender presentation was Clay sooner. I wish – we should have – had recognized
something. We could have had more of this for longer if
predominant among the participants. Phases in their
we had known sooner. [But how he is now] reminds us
childrens’ lives when a single gender expression was on a daily basis that it’s absolutely the right thing. The
not yet established triggered dissonance in parents. right thing for Clay. (Denise)

When she started first grade, she still wanted to be called

[her boy name], dress like a girl, looked like a girl, played
girl’s stuff, had all girl friends and wanted to use the boys Self-doubt
bathroom and be called “he.” And so it was—was like oh Participants often expressed explicit self-doubt over
my God this is really hard—that was what she wanted to decisions related to social transition, puberty suppres-
do and [my wife and I] supported it. And to be honest sion, and hormone therapy. In that they doubted their
with you that—I think that that was—is the hardest decisions, the re-emergence of their child’s dysphoria
transition point for us thus far because she looked like a
when confronted with the salience of their assigned sex
girl and wanted to do all girly things and yet wanted to
be called “he” and [her boy name]. (Betty) often came as reassurance. Participant 10 illustrates:
My daughter was playing a sport, and it was required
Further, the lack of settling on “one gender” created that she get a [testicle] cup. This created such distress, I
uncertainty in the authenticity of the child’s identified couldn’t believe it. Crying, acting out, anger. I was kind
gender. of surprised, but what I’ve been more surprised about is
that there hasn’t been more intense gender dysphoria.
I remember going and talking to some of the parents’ So when this happened, it actually was almost like
groups, saying, “I’m just ready for her to do this. The back “There it is.” A relief. A sign we’re doing the right thing
and forth [with gender]…” I don’t want to rush her, but at with transition. (Sandy)
that point it had been a year…. And [her not fully transi-
tioning] actually made me start to doubt [her transgender This parent goes on to state:
identity] a little bit…is she not going to do this, is she not
sure. Why is it taking so long. But my goodness, she just Something else too—she just, just a couple nights ago,
has to have her own time frame. (Ann) she said to me, “I’ll always be your daughter.” And just
you know, because I’ll say things like “You’ll always be
my baby.” And things like that. She just kind of out of
Self-evaluation the blue said, “I’ll always be your daughter.” And that,
too, was reinforcing. (Sandy)
Just as participants’ views of their children and their
relationship with their children evolved and reformed,
so did their views of themselves. Four subthemes Personal growth
emerged: (1) guilt, (2) self-doubt, (3) advocacy, and Participants described personal growth, often taking
(4) personal growth. the form of advocacy and broadened worldviews.
I have offered myself up in an education role, for anyone
Guilt and everyone. You can ask me anything and I won’t be
Participants reported feeling guilt about not recogniz- offended. Ask me all your dark uncomfortable questions.
ing their child’s dysphoria earlier. As a mom that has a kid who’s transgendered, I’ll answer
them. (Alisa)
There’s a part of me that says “Did I miss all these signs
early on, how much turmoil did I put him through by Their experiences provided opportunities for
having this take so long before I was able to recognize greater empathy:
140 C. ARAMBURU ALEGRIA

I’ve become more educated and hopefully a little more I’m very concerned about the future and it’s sometimes
open-minded from the standpoint of like now that I’m very upsetting to know that life is just going to be harder
on the other side of it I guess I see kind of, I see that for him than for others. It’s very hard to think about
there’s a lot more prejudice and ignorance in the world because it’s just that there’s no set thing that I can count
and like that’s very sad. (Carol) on happening. So many unknowns about what his future
holds. So I just don’t think about it. I just try and take
Views on heteronormativity and gender stereotypes every day as it comes. (Patty)
were also reformed:
Much of the uncertainty and concern expressed by
It has completely changed the way that [my wife and I] participants revolved around the current political
see things. And just me personally too. Like I’m not a
climate:
man’s man—a macho guy. I’m not a stereotypical man.
And so it makes me feel better, like okay, I don’t have to She has expressed some fear [about current politics on
be macho. I don’t have to fit that mold. I don’t have to trans issues] and I feel like I have to have an answer, but
portray that kind of father figure to my boys for them to I am also coming from a white middle class privileged
turn out to be decent people. They can be whoever type background. I never really thought about my rights
they’re going to be and they’re going to be decent people being taken away. I don’t think of basic human rights as
because we’re going to teach them decent values. They being reversible. But, yeah I guess they are. (Ann)
don’t have to be macho, they don’t have to be a man’s
man, they don’t have to be what everyone’s definition of Similarly, participant 11 reported distress at over-
a man is. And now, even when we talk to them about hearing anti-LGBT sentiment at work:
future relationships, we—we don’t say “when you have a
girlfriend, “we say, “when you fall in love with someone Unfortunately, you know, in the past months since
or when you find someone that you really love and care everything has happened the way that it has with our
about…” (Paul, father of 9-year-old transgender son) country, it just feels like, you know, [my family and I]
are more on edge, because of the way things have gone.
Similarly, the views of participants who self-described It’s bad. I’ve heard people at work talking about trans-
as feminists were challenged as they worked to make gender people and gay people and you know you really
sense of “nature versus nurture” in gender expression: kind of see this, how people really feel about stuff.

So I was this big feminist, and always when people would

start talking about gender toys and the gendered ways Fear/safety: Socially inflicted
that kids play, you know, I would come back with how
Concerns and fears on safety were paramount
gender is all a social construction. So you know when
Tony wanted a Nerf gun, I was like well girls can like Nerf among the participants. Parents feared for their child’s
guns… so I always kind of was challenging these gender physical safety as well as society’s micro- and
stereotypes and these boxes that we were putting kids in. macroaggressions.
And then when we made this realization [about my child
being not identifying with the assigned sex], and we It’s a long journey and it’s absolutely terrifying thinking
made this cognitive shift, I’m re-questioning all my views about it. I mean she is growing… and thinking about if
on that. So maybe there is something innate that makes the wrong person finds out or sees something…. It’s
boys more likely to play in certain ways, that there is absolutely terrifying. (Betty)
something innate that makes girls prefer pink. (Kim)
Similarly, Participant 10 described concerns over
possible future discrimination:
Views of future
What if she’s rejected from jobs because she’s trans?
Naturally, the participants reported concerns over What if she can’t rent an apartment because she’s
trans? And the [legal] documentation… birth certifi-
their child’s future. Three themes emerged: (1) uncer-
cate, driver’s license…. None of it’s a given for her.
tainty, (2) fear/safety: socially inflicted, and (3) fear/ (Sandy)
safety: self-inflicted.

Uncertainty Fear/safety: Self-inflicted

Participants described concern over their child’s Participants were aware of the high suicide rate among
future, realizing that the potential for negative events transgender persons, and they feared for the mental
is greater for them than for cisgender persons. health and safety of their children:
 INTERNATIONAL JOURNAL OF TRANSGENDERISM 141

I actually do worry that she is one of those kids that independence, factors associated with improved psy-
would be in the suicide statistic. She has that nature. I chological function (Grossman et al., 2011). In the
think maybe it is some depression from her dad’s side,
present study’s population, to help deflect adverse
but when things go bad, she really withdraws. (Ann)
events in more immediate situations such as navigat-
ing extended family, schools, and healthcare, parents
often set ground rules preemptively, with generally
Discussion
positive results.
As in previous studies (e.g., Hill & Menvielle, 2009), The experiences of the study participants can be
parents’ initial reactions at observing gender non-con- compared to the outing of an adult transgender person
formity in their young children included confusion, within a relationship that was established with the
concern, dismissal of the behavior as “just a phase,” assumption that both members are cisgender
and efforts to rationalize their child’s birth-assigned (Aramburu Alegrıa, 2010). Similar to the present study
gender to them with statements such as “Why do you participants, cisgender partners of male-to-female per-
want to be a girl” (Kristi, mother of 7-year-old trans- sons discussed changes in their views of themselves,
gender son), and “Girls can play with trucks and have each other, and their relationship, and having difficulty
short hair too…” (Kim). Parents’ initial reactions to with their partners’ duality of presentation (i.e., alter-
their adolescents’ coming out as transgender included nating man/woman) during transition. The parents in
confusion and concern, and the conviction to support the present study also reported personal growth, similar
their child. to parents in previous research (Kuvalanka, Weiner, &
All parents made the decision to allow their chil- Mahan, 2014), and to cisgender partners of transgender
dren to socially transition, and for those who were adults (Aramburu Alegrıa, 2010).
approaching or had reached puberty, GnRH agonists, Related to uncertainties and self-doubt on the best
and/or hormone therapy were prescribed, respectively. way to parent a transgender child, transgender iden-
As in previous studies (Olson, Schrager, Belzer, tity became a dominant family focus within the
Simons, & Clark, 2015; Simons et al., 2013), parents participants’ families, providing a lens for decisions
saw their children as more social, happy, and engaged. and actions. For some of the participants, this was to
Though parents grieved the loss of an envisioned the detriment of the parents’ relationship. For those
future with their children in their birth-assigned gen- participants who reported it, taking time for and
der, the positivity that resulted from transition rein- reminding oneself of the need to let go of what cannot
forced parents on their decision. Unlike previous be controlled was beneficial.
findings (Hill & Menvielle, 2009), participants in the Several themes, view of the child, duality, and guilt,
present study did not report setting limits on when demonstrate the deeply personal struggles of parents
their child could present in their authentic gender. and their relationships with their children and with
The parents of young children did report that they themselves. One mother discloses that she has diffi-
often encouraged gender-neutral clothing, particularly culty seeing her transgender daughter as a daughter;
during the early phase of social transition. rather she sees her as a “friend.” This young woman
As the work of recreating stability and reformed disclosed her authentic identity at age 16, approxi-
views progressed in the home, parents reported con- mately 1 year prior to the interview for the present
cerns and anxieties consistent with those in previous study. The difficulty in continuing to maintain a
studies (Katz-Wise, Budge, Orovecz, Nguyen, & parental role raises a number of potential issues,
Nava-Coulter, 2017; Reisner et al., 2015, Riley, Sithar- including the difficulty of reforming views of another,
than, Clemson, & Diamond, 2011). All participants in the challenges that this difficulty may present to the
this study reported uncertainty about their child’s parent-child relationship, and the risk of rejection. It
future and concerns for their safety. The shifting polit- also highlights the importance of recognizing and
ical climate further concerned many parents, and they affirming a child’s identity early. Parents whose chil-
feared that gains made in recent years may be lost. To dren manifested gender expansive expression early
mitigate these concerns and build resilience in their frequently stated that the shift in their view of their
children, parents employed proactive strategies, seek- child, from assigned gender to authentic gender, came
ing out supportive networks and fostering with relative ease.
142 C. ARAMBURU ALEGRIA

Similar to partners of adult transwomen (Ara- color. Conversely, they also suggested that being part
mburu Alegrıa, 2010), parents also reported disso- of a racial minority has the possibility of providing
nance with duality of gender expression, experiencing group affiliation and support, which are protective fac-
anxiety if their child manifested gender fluidity. In a tors for transgender youth (Hackimer & Proctor,
similar vein, once transition was underway, parents 2015). More research needs to be done in this area.
often felt an urgency to complete it—watching their The majority of the participants are mothers.
child living “between genders” was uncertain and Research indicates that fathers may be less supportive
uncomfortable. For example, one participant stated of their transgender child (Riggs & Due, 2015). Future
that her husband was accepting of their transgender studies should strive to include a greater number of
son transitioning, but “…if he is going to be a boy, fathers. Participants were recruited either at a trans-
then he needs to be a masculine boy, not girly” affirming conference or social network sites that are
(Mary). The discomfort with duality and gender fluid- supportive of families with transgender children/
ity appeared to stem from a couple of factors: (1) youth. Parents who do not participate in these venues
parental self-doubt that they were taking the most may differ in their experiences and views. Lastly, par-
appropriate action by following their child’s lead on ticipants were localized to the Western and Eastern
transition, and (2) the general unease of suspension or United States. The United States varies culturally
vacillation between two genders when the anticipated throughout. Participants from other parts of the
outcome is a single gender. This in turn illustrates the United States are needed for a more comprehensive
following: (1) living in an anticipatory state when the examination of issues.
expected result is seemingly protracted is often a
struggle, and release from this tension is sought; and
Conclusion
(2) the possibility of a non-binary gender identity
must be realized and accepted. Society needs to be An in-depth understanding of the myriad of parents’
educated on the concept of binary gender, whether experiences, struggles, and strategies can serve to
trans or cis, as a social construct; space must be made strengthen parents and children alike. A transgender
for greater diversity of gender. identity in one family member affects all household
Lastly, several parents tearfully expressed guilt over members. Parents/guardians may experience signifi-
not acknowledging their child’s authentic gender cant guilt and self-doubt and may benefit from oppor-
sooner and/or dismissing it. They feared the hurt and tunities to express uncertainties and uncomfortable
damage their children suffered due to their lack of emotions. Factors that may improve outcomes with
attention to their child’s identity. This is a parental extended family and schools include families’ preemp-
experience that, to date, has not been generally tive dissemination of information on transgender
addressed in the literature. It is possible that relational identities and explicating expectations of respect and
enmeshment and transition urgency may result from non-intrusion. Advocating for transgender youth and
efforts to compensate for any hurt the child may have viewing oneself as a trans advocate and activist had
experienced, and to assuage feelings of guilt. positive effects. Challenging deeply ingrained beliefs
Though efforts were made to recruit a diverse sam- (e.g., religious ideology) may force life-altering deci-
ple, all participants were white. Future research efforts sions for the benefit of the transgender child.
should continue to strive to recruit a more diverse
sample. Previous research demonstrates that transgen- Ethical approval
der youth of color may experience both racial discrim-
ination and trans-discrimination, which puts them at All procedures performed in studies involving human partici-
pants were in accordance with the ethical standards of the
risk for even greater psychological stress, PTSD, and
institutional and/or national research committee and with the
suicidal thoughts (Wilson et al., 2016). Research by 1964 Helsinki declaration and its later amendments or compa-
Hackimer and Proctor (2015) concluded that some rable ethical standards.
racial communities may have more negative attitudes
about gender-nonconformity, which can lead youth to
face greater discrimination inside their own commu- Declaration of confict of interest
nity. This presents a challenge in recruiting persons of The author has no conflict of interest to declare.
 INTERNATIONAL JOURNAL OF TRANSGENDERISM 143

Funding among youth and caregivers in the trans youth family

study. Journal of Counseling Psychology, 64(1), 26–40.
Smernoff Grant doi:10.1037/cou0000186
Kuvalanka, K. A., Weiner, J. L., & Mahan, D. (2014). Child,
family, and community transformations: Findings from
References
interviews with mothers of transgender girls. Journal of
Aramburu Alegrıa, C. (2010). Relationship challenges and GLBT Family Studies, 10, 354–379. doi:10.1080/
relationship maintenance activities following disclosure 1550428X.2013.834529
of transsexualism. Journal of Psychiatric and Mental Malpas, J. (2011). Between pink and blue: A multi-dimensional
Health Nursing, 17(10), 909–916. doi:10.1111/j.1365- family approach to gender nonconforming children and
2850.2010.01624x their families. Family Process, 50, 453–470. doi:10.1111/
Baldwin, M. (1992). Relational schemas and the processing of j.1545-5300.2011.01371.x
social information. Psychological Bulletin, 112(3), 461–484. Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A.
doi:10.1037/0033-2909.112.3.461 (2016). Mental health of transgender children who are sup-
Costa, R., Dunsford, M., Skagerberg, E., Holt, M. R., Carmi- ported in their identities. Pediatrics, 137(3), e20153223–
chael, P., & Colizzi, M. (2015). Psychological support, e20153223. doi:10.1542/peds.2015-3223
puberty suppression, and psychological functioning in ado- Olson, J. O., Schrager, S. M., Belzer, M., Simons, L. K., & Clark,
lescents with gender dysphoria. Journal of Sexual Medicine, L. F. (2015). Baseline physiologic and psychosocial charac-
12, 2206–2214. doi:10.1111/jsm.13034 teristics of transgender youth seeking care for gender dys-
de Vries, A. L. C., Steensma, T. D., Doreleijers, T. A. H., & phoria. Journal of Adolescent Health, 57, 374–380.
Cohen-Kettenis, P. T. (2010). Puberty suppression in ado- doi:10.1016/j.jadohealth.2016.04.027
lescents with gender identity disorder: A prospective fol- Reisner, S. L., Vetters, R., Leclerc, M., Zaslow, S., Wolfrum, S.,
low-up study. International Society for Sexual Medicine, 8, Shumer, D., … Mimiaga, M. J. (2015). Mental health of
2276–2283. doi:10.1111/j.1743-6109.2010.01943x transgender youth in care at an adolescent urban commu-
Durwood, L., McLaughlin, K. A., & Olson, K. R. (2017). Mental nity health center: A matched retrospective cohort study.
health and self-worth in socially transitioned transgender Journal of Adolescent Health, 56, 274–279. doi:10.1016/j.
youth. Journal of the American Academy of Child and Ado- jadohealth.2014.10.264
lescent Psychiatry, 56(2), 116–123. Riggs, D. W., & Due, C. (2015). Support experiences and atti-
Glaser, B., & Strauss, A. (1967). The discovery of grounded the- tudes of Australian parents of gender variant children. Jour-
ory. Aldine, Chicago, IL: Routledge. nal of Family Studies, 24, 1999–2007. doi:10.1007/s10826-
Grossman, A. H., & D’Augelli, A. R. (2007). Transgender youth 014-9999z
and life-threatening behaviors. Suicide and Life-Threatening Riley, E. A., Sitharthan, G., Clemson, L., & Diamond, M.
Behavior, 37, 527–537. doi:10.1521/suli.2007.37.5.527 (2011). The needs of gender-variant children and their
Grossman, A. H., D’Augelli, A. R., & Frank, J. A. (2011). parents: A parent survey. International Journal of Sexual
Aspects of psychological resilience among transgender Health, 23, 181–195. doi:10.1080/19317611.2011.593932
youth. Journal of LGBT Youth, 8(2), 103–115. doi:10.1080/ Simons, L., Schrager, S. M., Clark, L. F., Belzer, M., & Olson, J.
19361653.2011.541347 (2013). Parental support and mental health among trans-
Hackimer, L., & Proctor, S. L. (2015). Considering the commu- gender adolescents. Journal of Adolescent Health, 53, 791–
nity influence for lesbian, gay, bisexual, and transgender 793. doi:10.1016/j.jadohealth.2013.07.019
youth. Journal of Youth Studies, 18(3), 277–290. Singh, A. (2012). Transgender youth of color and resilience:
doi:10.1080/13676261.2014.944114 Negotiating oppression and finding support. Sex Roles, 68,
Hill, D. B., & Menvielle, E. (2009). “You have to give them a 690–702. doi:10.1007/s11199-012-0149-z
place where they feel protected and safe and loved”: The Wilson, E. C., Chen, Y., Arayasirikul, S., Raymond, H. F., &
views of parents who have gender-variant children and ado- McFarland, W. (2016). The impact of discrimination on the
lescents. Journal of LGBT Youth, 6(2–3), 243–271. mental health of trans female youth and the protective
doi:10.1080/19361650903013527 effect of parental support. AIDS Behavior, 20, 2203–2211.
James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & doi:10.1007/s10461-016-1409-7
Anafi, M. (2016). The Report of the 2015 U.S. Transgender Sur- Wren, B. (2002). “I can accept my child is transsexual but if I
vey. Washington, DC: National Center for Transgender Equality. see him in a dress I’ll hit him”: Dilemmas in parenting a
Katz-Wise, S. L., Budge, S. L., Orovecz, J. J., Nguyen, B., & transgendered adolescent. Clinical Child Psychology and
Nava-Coulter, B. (2017). Imagining the future: Perspectives Psychiatry, 7, 377–397. doi:10.1177/1359104502007003035

View publication stats