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If you are asking about why you are questioning your gender or why you feel that you are transgender, then the honest answer is we do not know exactly why this happens to some people. There are lots of ideas and theories about why but when it comes to something as complicated as gender identity nothing explains things 100% for 100% of people. What we can say is that there are likely to be a lot of different factors that shape you as a person. Your biology, your personality, your life experiences and thousands of other things all add up to make you you.
Some people feel strongly that they are “born this way” when it come to their gender identity, and they might find the idea of having, for example, “a boy’s brain in a girl’s body” helpful in explaining their experience. Other people aren’t so sure. We know that how people experience and show their gender, and how people respond to gender non-conformity, is linked to the culture and the time in which they live.
As a service, we keep in mind the different ideas and theories people may have about why they feel a particular way. It’s impossible for us to have one theory as we see so many different people, with so many different experiences and hopes. In some families, different family members will each have different ways of understanding things. Rather than trying to work out who is right and who is wrong, we value all of the different ideas that you and your family might have, and will think about which ideas are going to be most helpful in supporting you.
Many young people tell us that they are less interested in why they might have a particular gender identity, and that what matters more is getting the right help or support for them and their future.
Whatever anyone thinks, we believe that you have a right to feel or identify the way you do and you have a right to be supported in this, whether this changes or stays the same.
Although attitudes are changing, it is unfortunately still the case that some people who don’t naturally fit into society’s gender norms encounter prejudice and stigma. This can take different forms, including verbal and physical harassment in relation to gender, direct and indirect discrimination and victimisation.
Prejudice and stigma often result from a lack of understanding, a lack of knowledge, or from misinformation. Many people simply do not know much about what it means to identify as gender-variant or trans. This can lead them to make assumptions and to over-generalise and say, “I’ve heard that all trans people are like *this*”. Sometimes when there are very strong stereotypes around about a particular group, those individuals can sometimes start to believe the stereotypes too. At times, this can mean that trans and gender-variant people also have thoughts or beliefs which are negative towards trans people. They can also develop very fixed ideas about how to be transgender or gender variant, as if there is only one way to do this even if this doesn’t quite feel right for them. This can then lead to people feeling ashamed about their gender identity and unhappy with themselves.
Experiencing prejudiced attitudes and behaviours from others can be extremely upsetting and sometimes frightening. It is OK to be angry when we have experienced prejudice or discrimination, but anger is most helpful when it leads us to do something useful (e.g. working out who can help us change a situation) rather than getting stuck feeling frustrated and miserable on our own. Talking to friends or family can sometimes help us get fresh ideas and come up with a plan of action for managing a situation.
Prejudice is never acceptable and is not something that you “just have to put up with” if you identify as gender-variant or trans. For more information see this introduction to The Equality Act
Understanding why things happen can make us feel more in control of the situation and give us ideas or options for how to deal with it. Some trans young people have found it useful to educate those around them. For instance, if people learn about the many ways that different societies have understood gender (which are different from our own ways of thinking), this may help them to challenge some of the assumptions they have about gender.
For all of us – perhaps especially so when we are feeling low, anxious or stressed – it can be very helpful to have a supportive network of people around us. Many young people who come to this service speak about the support they have gained from social networking and other online sites or resources, which have helped them talk to other trans people (see the ‘Staying Safe Online’ section below).
We also think it is important to make face to face connections with people in a similar situation. There may be local LGBT or other youth groups in your area, school or college – and organisations hold regular meet-ups in cities around the country. If you are under our service, then we run a regular young peoples’ group that everyone can attend.
There are many support groups locally and nationally for LGBTQI+ young people, and new organisation are being established all the time.
The Gender Identity Research and Education Society (GIRES) runs ‘Tranzwiki’, an online database of these groups. Visit the Tranzwiki website.
This may be a helpful platform for you to explore what is available within your local community.
Please note that we aren’t affiliated with this platform, or the services it features. We recommend that you and your family do your own due diligence before fully engaging with any individual organisation.
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
Many of the young people we see use a different name from the one they were given as a baby. There is not a right or a wrong time to try this out. However, many people do test out new names with a small circle of friends or family first, before telling others. This can help to see what it feels like being known by that name.
Sometimes it can be hard for people who have known you a long time to always remember your preferred name or pronouns. People in your family may also want to wait a little while before trying out using a new name for you. Often we find that not everyone in a family will all be at the same stage or have the same perspective – change can take time and be tricky – and we find it can be helpful to keep in mind the different points of view and try to understand where each person is coming from (even if you disagree with them!)
In our experience, most schools are happy to use preferred names for most purposes (e.g. in the classroom). However, there may be some circumstances (e.g. for exams) where they are required to use your legal name.
Our professionals section has more information for schools.
It is possible to legally change a child or young person’s name by deed poll or statutory declaration. Usually this requires consent from (and agreement between) their parents, although there are legal options available in cases of dispute.
The UK government website provides more information about how to change a child’s name by deed poll:
https://www.gov.uk/change-name-deed-poll/overview
There are many services both online and offline which offer to produce deed poll certificates for a fee – and we know the cost for these can vary hugely so it might be best to shop around if you are going to use one of these services. However, we also know that some young people we see have also used free services or templates to change their names and these have also been accepted and valid.
If you have dual nationality or are not a British citizen, please check with your country’s embassy or high commission for more details about how to legally change your name.
You are able to change the name on your passport with proof of a legal change (e.g. deed poll or statutory declaration). You can also change the gender marker on your passport. For this, you will usually need a letter of support from your GIDS clinician(s).
As a service we have also written letters of support for children or young people who have not yet changed their name legally or their passport, in case of any questions being asked at border controls.
HM Passport Office have produced guidance for trans people who are applying for a new passport.
To change your name and gender on your birth certificate, you will first need to apply for a Gender Recognition Certificate. It is not possible to do this before the age of 18. If you are seen at an adult gender identity clinic, they will be able to advise you further about this process.
There is a simple process for this, which is accepted by many government departments including the Department of Health:
Trans patients have a legal right to change their name and gender on their NHS records and would be able to bring a civil claim against any GP or practice which I refused to accede their request.
Reference: NHS Coventry (June 3rd 2010). Process for changing name and gender in primary care.
Many trans male, trans masculine or non-binary identified young people who are assigned female at birth report that distress can focus on chest development.
This can be the trigger for social anxiety and can lead to withdrawal from social activities such as interacting with family and friends, being able to attend school, or in some cases leaving the house at all.
Some young people use a chest binder to help reduce social anxiety and thoughts of self-harm. We know some young people say that wearing a binder decreases anxiety in social situations and in some cases has given them confidence to start back in education.
We also know that there are also potential downsides. Prolonged use of a binder can be extremely uncomfortable. Some methods of binding can be dangerous.
Some young people coming to our service are already using binders. families often ask us for advice about using binders.
To minimise harm, we make recommendations based on a recent meta-analysis of the evidence and more recent research in the field. When families ask us about their use, we offer strategies to reduce potential harm:
Read the paper, ‘Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study’
Read the paper, ‘The Impact of Chest Binding in Transgender and Gender Diverse Youth and Young Adults’
Read the paper, ‘Chest Binding and Care Seeking Among Transmasculine Adults: A Cross-Sectional Study’ (2018)
Read more about reducing harm if wearing a binder on the Genderkit website
Many young people who question their gender identity report feelings of low mood, particularly if they are also experiencing other difficulties such as bullying, relationship issues, abuse or traumatic experiences, or feeling unsupported.
As other sections of this website mention, it is recommended that you speak to a trusted adult about how you feel – someone who can support you to seek professional help if needed. As well as family and friends, you could also speak to your GP, or a school nurse, or teacher/lecturer. Some young people will need support from mental health professionals such as Child and Adolescent Mental Health Services (CAMHS).
However, there are some steps that we can all take to benefit our emotional and physical health, and which can reduce the likelihood of experiencing longer periods of feeling low.
Stay Active and take part in activities you would usually enjoy. This may be socialising and connecting with people, activities outside of the house like seeing friends or going for a walk, or things inside the house like reading or watching a film. It is a good idea to have a mix of all three. Maintaining activities is important as they improve our mood by giving us a sense of achievement and enjoyment, as well as allowing us to feel socially connected to other people. These are all important elements of balanced mental wellbeing.
When we are feeling low, we often want to avoid these things,but whilst this can sometimes give short term relief it can also mean that we no longer benefit from the positives we used to get from them. It can therefore help to actively plan in activities across each week to encourage ourselves to actually do them. It may help to write them down or involve other people in supporting you to achieve these goals that you set for yourself.
It is really important to keep in a routine with attending school, college or work. Sometimes, when we are low we can predict that something will be unpleasant or harder than it is. Even if you don’t enjoy an activity, or you are having a tough time there, it still might help distract you from your worries for a while and it will mean that you don’t have to worry about catching up with work or friends later on top of your existing concerns.
It can feel difficult to look after ourselves when we are feeling low, but not looking after our general health can in turn maintain low mood or even worsen how we feel. It therefore is really important to eat regularly and an as balanced diet as possible, to have a consistent sleep routine, and to do regular exercise. Exercise has been shown in research studies to have a significant benefit in terms of improving mood due to the endorphins that are released. If you are struggling with any of these areas, speak to your GP who should be able to advise or refer you on for additional support.
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