NHS Arden & GEM National Referral Support Service

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Social transition for younger children

Over the past few years, we have seen increasing numbers of younger children making a full social transition – from living in the social role associated with their birth-assigned sex (male or female) to living, across all contexts, in the social role with which they identify.

When children wish to be known as neither male nor female, as some do, we do not usually speak about social role transitioning, as these children are sidestepping the traditional public categorisation of binary gender roles.

At GIDS we do not take a position on early social transition, either for or against. Whether a child formally transitions is a decision that families and children make together. We understand that this move is often driven by the child. Many families report that their child is happier after transition and functions better in everyday life.

Clinically, we have observed some positive changes from this transition, but we have also seen some potential pitfalls which we hope it is helpful to share, to support families to make their decision.

A full social transition may help children:

  • feel that their gender identity is accepted
  • interact more confidently with peers
  • feel more securely a part of their social groupings
  • experience less anxiety in facing new situations and new people

And yet, we know that in early childhood, children view the world in concrete terms and do not easily reason about abstract or hypothetical issues. They have not yet developed the cognitive and social maturity that will emerge later in childhood, and they find it difficult to see any given decision in a larger time context.

It is worth thinking what it might mean, subjectively, for a young child to be seen and known in a particular gender role, while still managing the fact that their body does not match their experience of themselves. We hear from families that socially transitioned children often experience great distress at any mention of the physical body. This can cause problems later, when there needs to be a full discussion of potential physical interventions and what they mean for the young person’s body.

Social transitioning is not right or wrong, but it does need a lot of consideration. It is tempting to avoid talking to children about their sex characteristics if this causes distress. And yet, discussing these things in a matter-of-fact way is important in building resilience, and in attempting to reduce any feelings of shame about the body as it currently is.

In some families, it can be tempting to avoid all conversations about gender norms and social roles once transition has taken place. But it is important to go on questioning gendered social ‘rules’ in order to create a freer social space in which gender diverse children can grow and develop.

For families thinking about social transition for their child, there are some messages that can helpfully be given:

  • that the child’s gender identity is accepted
  • that having sex characteristics that do not ‘match’ this does not undermine the family’s recognition of their gender as the child experiences it
  • that the body as it is should not be feared or hated: it is what it is.
  • At the same time, parents and carers need to keep in mind:
    • that important conversations need to continue about the potentially limiting way that gender roles and gender stereotypes operate, questioning simple binary gender rules about how we live our lives
    • that any potential alterations to the body that may lie ahead need to be thoughtfully discussed, in matter-of-fact terms, as possible medical interventions have to be understood, discussed and fully decided on in later childhood
    • that it is good to encourage the child’s curiosity about people whose bodies and identities do not entirely ‘match’ and whose lives have the same potential to be interesting, rewarding and worthwhile
    • that simple messages about the future, that may be strongly reassuring for a child in their early years, need to increase in richness and complexity as the child develops and matures.

If you are on our waiting list and have any questions or concerns about the above, remember that you can call our clinician rota to speak to someone in the service.

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