What Age Does Transgender Start?

Children often go through phases where their gender identity becomes nonconforming; girls might wear dresses while boys might play with trucks for example; however, this doesn’t always indicate transgender identity and it’s important to recognize this phenomenon.

Gender transition isn’t like any other medical procedure: its severity varies for every individual and its timeline is unique to each. Most children begin hormone therapy before adolescence and undergo surgeries such as mastectomy or womb removal before age 18. Individualized treatment plans are decided with help from physicians.

Medical Treatment

Transgender communities have long discussed when and why medical treatment should begin for transgender individuals. Some, like urologist Maurice Garcia, advocate that children begin hormone therapy as soon as they identify as their true gender; otherwise they often experience high levels of anxiety, depression and self-harm due to body development that does not correspond with gender identity. He discovered in one recent study that children who started therapy earlier experienced lower suicidal behavior rates than those starting treatment later in life.

Garcia is one of many experts to oppose state laws that prevent transgender kids from receiving hormone therapy and surgery. Opponents often cite studies which purport to demonstrate that most untreated transgender kids will outgrow their identities by adolescence or adulthood – yet these conclusions rely on limited samples with biased samples, failing to consider experiences of transgender youth who have received early treatment as well as any negative impacts their transition may have had.

Garcia and colleagues conducted the new research by analyzing data from the 2015 U.S. Transgender Survey, with responses from more than 27,000 adults. They discovered that those who began hormone therapy early experienced higher quality of life; depression rates, substance abuse, and suicide attempts were significantly reduced among them.

Hormone therapy for transgender kids can be the key to creating a happier and healthier future, yet determining when and how best to start hormone treatment may be complicated by factors like mental health and surgery options available. A patient must fully comprehend both risks and benefits before making their decision to start taking hormones; generally this means waiting until reaching legal age, typically 16 for females and 18 for males respectively. The Endocrine Society recommends waiting until these adults can provide informed consent – typically 16 for females and 18 for males respectively – before beginning hormone treatment.

Hormone Replacement

Hormone replacement therapy is often an integral component of transgender people’s transition process, and depending on one’s gender identity can either feminize or masculinize. By taking hormone replacement drugs during transition, transgender people may reduce or even eliminate feelings of discomfort or distress caused by differences between their assigned gender at birth and body features such as anatomy or genitalia – something many transgender youth experience regularly resulting in emotional stress and anxiety.

Hormone treatment can often be an excellent option for transgender children, yet many parents are concerned about its side effects on both mental and physical health. They may worry about depression, self-harm and suicidal thoughts as well as an increased risk of cancer.

The Endocrine Society recommends that adolescents begin puberty-blocking medication when their bodies start showing physical changes consistent with the gender assigned at birth, such as breast-budding or pubic hair growth. Unfortunately, some states, including Connecticut, are trying to legalise its use earlier on even for preschoolers – something which goes against both AAP guidelines and Endocrine Society recommendations.

Dr Mitrani frequently encounters transgender children in juvenile detention facilities, where they face challenges and are susceptible to bullying and isolation. According to him, it’s crucial for families to accept their child’s gender identity and support them no matter the age they come out as transgender; also that families be willing to give access to hormone treatments and surgeries as early as possible for optimal care of these young individuals.

Accessing hormones before body development starts can make transitioning less painful and stressful, potentially decreasing or even eliminating complications like hirsutism (a condition in which trans women grow facial hair on their forehead, cheeks and ears) or male pattern baldness. Furthermore, accessing hormones before maturation starts can reduce surgery needs such as hysterectomy/mastectomy in trans men or gynecomastia procedures for trans girls.


As children age, they may opt to undergo genital surgeries that will align their gender identity more accurately with physical body. Puberty blockers and hormones may help transgender people experience less distress while waiting to undergo gender-affirming surgeries like hysterectomy or salpingo-oophorectomy.

Parents need to realize that gender transition is more than a passing phase; gender dysphoria is real and can lead to depression, anxiety, self-harm and other mental health issues. “Without appropriate treatments it could become chronic leading to depression, substance abuse or even suicide” warns Maurice Garcia MD from Cedars-Sinai Transgender Surgery and Health Program.

Garcia is among a growing number of doctors who advocate for early social transition for transgender teens, not just as soon as they’re ready. He points to a recent Pediatrics study which followed children who began social transitioning at an early age: Over five years, 94% still identified as female or nonbinary – evidence that their gender transition wasn’t just temporary. He points out these kids don’t just pass through this phase quickly.

Some experts disagree with Garcia. Psychiatrist Jack Drescher was on the American Psychiatric Association committee that revised gender identity disorder’s definition in 2013. Drescher believes it’s too soon to know if children will stay with their gender identities. He advises parents against trying to force a child into one specific sex through denial, punishment or reparative therapy.

Therapists at UCSF’s Gender Center Clinic have witnessed children begin social transition as young as three. Therapists advocate a gender-affirmative approach, acknowledging and using correct pronouns; changing names; or even surgical removal from medical records may all take place under this approach. According to The Endocrine Society’s recommendations, children aged 16 or above can access puberty blockers, hormones or surgery if desired – these will have less long-term psychological ramifications according to many physicians.

Social Support

Transgender people require social support during their transition. Their family will need to use names and pronouns that reflect their identity; friends should call out any transphobia they witness. The Human Rights Campaign offers resources for families, educators, and others looking for ways to provide assistance for transgender children and teenagers.

Young children who undergo social transitioning, including changing names, hairstyles, pronouns and pronoun usage tend to continue identifying with their gender later on, according to a study released Wednesday. The research began in 2013 and tracked 317 children through their teenage years – kids who switched pronouns or started wearing makeup and dresses were twice as likely to feel satisfied with life than children who didn’t transition.

The research employed surveys, but its cross-sectional design restricts extrapolations regarding cause and effect relationships. Snowball sampling–where people who were approached to participate nominate other individuals–limits the ability to fully represent a population; nonetheless, its results are significant. Researchers found that participants on average became aware of their transgender identities around puberty onset (mean age of awareness being 10.8 years). Researchers note this finding as significant because it indicates that gender dissatisfaction among transgender individuals may not simply stem from their anatomy or birth sex, but may instead reflect mismatch between their identity and what was assigned them at birth.

Gender dysphoria can become even more problematic for transgender youth when faced with discrimination or social exclusion, leading them to experience feelings of depression, anxiety and suicidal thoughts; especially among teens.

Parents of transgender children can reduce these negative outcomes by making a commitment to supporting their son or daughter’s gender identity, even when it conflicts with their own. Even parents who were initially opposed have changed their minds when seeing how much happier their son or daughter has become when given appropriate names, clothing, and pronouns.