Frequently Asked Questions

What does it mean to be transgender?

A transgender individual is someone who identifies with a different gender than the one they were assigned at birth. To understand this better, it can help to be very clear with our language.

“Sex” is a medical term that refers to a person’s genetic, hormonal, and physical characteristics, both internal and external. When a baby is born, their sex is assigned based on the physical characteristics that can be seen at birth. 

“Gender” refers to a person’s sense of their own identity, their internal sense of self. For some people, their sex and gender line up. They were identified as male or female at birth and that identification feels right to them. We refer to these people as being cisgender. For other people, their gender identity is different than the sex they were assigned at birth. This is the experience of transgender people. 

Some transgender people identify with the opposite gender from the one they were assigned at birth: a child is born and designated as female, but identifies as male. Other transgender individuals may identify as non-binary, meaning they don’t identify as entirely male or entirely female; gender fluid, meaning their gender identity changes; agender, meaning they don’t identify with a gender; or more. There are many different gender identities that can fall under the umbrella term of transgender.

If you want to understand more about what it means to be transgender, there are many wonderful resources available including:

Gender Spectrum has many wonderful educational articles about transgender identity:

Gender Spectrum’s “Gender 101” page:

Gender Spectrum’s “Gender Basics” video:

Gender Spectrum’s YouTube channel:

The American Academy of Pediatrics, the American College of Osteopathic Pediatricians, and the Human Rights Campaign created a wonderful guide for families of transgender children:

Supporting & Caring for Transgender Children

Central Toronto Youth Services has a fantastic guide for families of trans youth:

Families in TRANSition

Is this just a phase or a fad?
Many parents ask this question! Every child’s journey is unique. Gender exploration in early childhood is normal, and for some children it is a phase. Other children who begin exploring their gender at a young age may be gender expansive, non-binary, or transgender.
The American Academy of Pediatrics, the American College of Osteopathic Pediatricians, and the Human Rights Campaign Foundation have published an excellent guide for parents of transgender and gender-expansive children. They explore the stability of gender identity in depth. Download it here: Supporting and Caring for Transgender Children
Teens and pre-teens now feel more freedom to openly question and explore their gender identity than in past generations. Some young people might let us know their gender identity and be consistent in that identity throughout their life. Often these children have been struggling with their gender identity for years before disclosing it to us. Other young people might ask to be called by different pronouns and change their appearance, then days or years later ask to be called by their former pronouns and change their appearance to look more like they did before. This doesn’t mean part or all of their journey wasn’t authentic. We can support our children in being who they are at this time.
Research shows that children whose parents support them in their gender identity are happier and healthier, while children who don’t have this support are at high risk for depression, anxiety, substance abuse, and suicide. Therapy and other interventions designed to change a young person’s gender identity can be psychologically harmful and cause extreme emotional distress. The American Academy of Pediatrics, the American Psychological Association, the National Association of School Psychologists, and other organizations have released statements encouraging parents and schools to support gender-diverse youth.
Meeting with a knowledgeable gender therapist can help you and your child understand your child’s path and navigate it together. Talking with other families with gender diverse children can also be helpful.
Isn’t my child too young to know?

Children as young as two can understand their gender identity, whether that is transgender or cisgender. The American Academy of Pediatrics released guidelines in 2018 to help parents and professionals support children and youth who identify as transgender. Their recommendation is “gender-affirmative care.” For young children, what that means is affirming your child’s gender with your words and actions. This includes using the pronouns and name that feel best for your child and letting your child choose clothing that matches their sense of self. There is no medical intervention that can happen until puberty. However, respecting your child’s sense of self is critical to their mental health and well being.

From the American Academy of Pediatrics Healthy Children: Gender Identity Development in Children

How does gender identity develop in children?

Gender identity typically develops in stages:

Around age two: Children become conscious of the physical differences between boys and girls. 

Before their third birthday: Most children can easily label themselves as either a boy or a girl.

By age four: Most children have a stable sense of their gender identity.

How did I not know before?

Many parents have this question! Coming out as transgender is a big deal. Many young people wrestle with their feelings in private or with a trusted friend for a long time before sharing with their parents. Many transgender youth also work hard to hide their gender identity for fear of ridicule or rejection by friends, family, classmates, and others. It is not uncommon for parents to be completely surprised by their child’s disclosure.

Does this mean that my child will need hormones and surgery?

Not necessarily. A gender identity relates to one’s sense of self. All of us want to experience congruence in our lives, the sense that our insides and our outsides match and that people can see us for who we really are. For some transgender people, changing their names and pronouns is the most important step in achieving that sense of congruence. Other ways people transition include changing clothing and hairstyles, changing speech and body language patterns, using hormones to change one’s physical appearance, and using surgery to alter one’s body.

Deciding which types of changes are needed is a very personal decision, one that can take time and support. Working with a gender therapist is an excellent way to begin to sort out these questions.

What do non-binary, gender fluid and gender queer mean?

These are three examples out of many different gender identities. Binary gender identity refers to people who identify as either male or female, opposite ends of a binary spectrum. People who identify as non-binary experience themselves as not exclusively male or female. Gender fluid means that one’s identity changes, rather than remaining static. And gender queer is an umbrella term for non-cisgender identities. Its meaning will vary, person to person. It can be helpful to ask someone what the term they choose to describe their gender identity means to them.

Gender Spectrum has a helpful guide called The Language of Gender, if you’d like to learn more.

Does this mean that my child is gay or lesbian?

This is a very common question! Gender identity (transgender, cisgender, non-binary, etc.) has to do with an individual’s sense of self. Sexual orientation has to do with a person’s attraction to other people. So just as a cisgender person (someone whose gender identity matches the sex they were assigned at birth) might be straight, gay, or bi-sexual, a transgender person may also be straight, gay, or bisexual. (Of course, just as there are many different gender identities, there are also many different sexual orientations. These are just a few examples.) Transitioning from one gender to another doesn’t tell you anything about a person’s sexual orientation. 

My child is telling me that they are female/male, but they are not presenting in a feminine/masculine manner. Does that mean that they are not sure about their gender?

Good question! It is easy to confuse gender identity, our own internal sense of our gender, with gender expression, the way we show our gender to the world through clothing, hair, etc. We are familiar, for example, with cisgender women who dress in stereotypically masculine clothing. That doesn’t necessarily mean that they feel like men. It just means that they feel comfortable in more masculine clothing. Similarly, trans women may dress in stereotypically masculine clothing while still experiencing themselves as women. You don’t have to wear a dress to be a woman!

Did I do something to make my child become transgender?
We don’t yet know all the factors that contribute to the development of gender identity. While some research suggests biological factors may play a role, there is no evidence that parenting choices do. Parents can have a huge impact on their children’s well-being, but not on their gender identity. 
Where can I find help for myself and my child?

Finding support for yourself is an excellent first step. The more you know about gender identity and affirmative parenting practices, the better able you will be to support your child.

  • See our next FAQ on “Gender Therapists” for help in finding a therapist who has meaningful experience in working with gender diverse children and families.
  • Come to a TransFamilies meeting! Meeting other families who have similar experiences will provide comfort and reassurance. If your child is young, we also run family play groups, when there is sufficient interest from group members: TransFamilies calendar
  • Call a TransFamilies volunteer at 831.205.0078
  • Listen to this podcast by local therapist Debra Sloss, TransFamilies of Santa Cruz County's co-founder Heidi Koronkowski, and gender therapist Daniel Blumrosen on KSQD:
  • Download this wonderful guide for parents of transgender children from the American Academy of Pediatrics, the American College of Osteopathic Pediatricians, and the Human Rights Campaign: Supporting & Caring for Transgender Children
  • Download this terrific guide for parents of transgender youth from Central Toronto Youth Services: Families in TRANSition
What is a gender therapist?

Gender therapists work with clients (adults, youth, or children) who are exploring their gender identities, as well as with parents and other family members who may need information, support, or guidance. In addition to being a licensed mental health professional, gender therapists should have extensive knowledge and understanding of the components of gender and the questions that people who are exploring their genders will have. Ideally, they will have extensive experience working with transgender, non-binary, and gender non-conforming clients.

Not all clinicians who state that they treat transgender individuals have the same level of knowledge and experience. The link below will help you ask the right questions to make sure that your gender therapist has the training, experience and sensitivity to be right for you, your child, or your family.

Tutorial on finding a trans friendly therapist

Where to look for gender therapists?

The following organizations have lists of local therapists who have experience providing gender-related therapy:

Santa Cruz Trans*

Gender Identity Awareness Network of Santa Clara County

Tutorial on finding a trans friendly therapist

Where can I find medical, personal care, insurance or legal help?

Resources For Santa Cruz County:

Santa Cruz Trans* Resources provides information about all sorts of local and national resources, including therapists, health care practitioners, personal care providers, insurance support, legal advocacy, and more.

Resources For Santa Clara County:

Santa Clara County's Gender Heath Center

County of Santa Clara Office of LGBTQ Affairs

The Q Corner is a peer-driven, Behavioral Health Services Department program dedicated to supporting the LGBTQ+ community and their friends, families, and allies, in Santa Clara County. 

Outlet of Adolescent Counseling Services 

Resources For San Mateo County:

Outlet of Adolescent Counseling Services 

San Mateo County Pride Center

LGBTQ Commission

Office of Diversity and Equity

Where can I find help with school issues?

Gender Spectrum is at the forefront of training schools and their annual conference is an awesome resource for families with gender diverse children of all ages:

Safe Schools Project of Santa Cruz County works with schools and school districts to promote safe and inclusive schools especially for LGBT youth in Santa Cruz County and throughout California:

Trans* Teen Project has links to local and national resources:

Schools in Transition: The National Center for Lesbian Rights and Gender Spectrum, in conjunction with the ACLU and the Human Rights Campaign, have produced a terrific guide for schools striving to become more gender-inclusive:

Schools in Transition

County Offices of Education provide support, information, advocacy, and referrals for LGBTQ students:

Santa Clara County

Santa Cruz County

San Mateo County

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