Around the time of puberty our daughter (aged 12) began to assert that she was male. She became very distressed by periods and her developing breasts. We supported her desire to have her hair cut, to wear a binder and boys’ clothes and go on the pill to prevent periods. She selected a boy’s name and would fly into a rage if we used the wrong pronoun/name. She talked very openly with us about the possibility of surgery and what it involved and we took a very fact based approach to the entire process. Her focus on gender identity was very similar to previous areas of focus (which border on obsession), only to switch after a number of months.

Because she is on the [autism] spectrum I believed her desire to be male was potentially a reaction to both the trauma of puberty and not feeling like “normal” girls in terms of interest in boys, make up etc. We spoke with our GP and were referred to Child and Adolescent Mental Health Services, who referred us to the Tavistock in February 2016. Over the last few months I noticed small changes to her mind-set. She began to wear more feminine colours and to use her birth name when signing cards. Last week she said “I’d be very happy for you to refer to me as your daughter”. This happened the day before the Tavistock appointment came through! She’s now back to wearing girls’ clothes. Going on previous experience of her obsessions I don’t expect the gender identity issue will return but I imagine it might be something like questions around sexuality, the whole journey has taken 2 years. 

Our approach throughout the journey was to remain very open minded and to support non-permanent changes (such as hair, clothing, names) and to not make a “big deal” out of it either way. Throughout the whole process we focused on telling our child we loved her whatever happened and we’d be there to support. I feel being relaxed about things (whilst inside being extremely fearful), allowed her to work through her fear of puberty/growing up and to be comfortable with changing her mind, rather than feeling pushed into a particular path. 

Many young people will end up changing gender and it’s critical that support is there for them. For those on the spectrum (whose emotional age is typically well below their chronological age), I feel it’s best to allow plenty of time for the young person to explore their gender identity before permanent changes are made.

We recognise that puberty and the physical changes that it brings can be distressing for some people. Many, although not all, of the adolescents we see consider at some point having physical interventions (such as hormone blockers) through our service.  There are also many people who choose not to have physical interventions.

Learn more about puberty, and our approach to assessment and intervention here