2024 Report on the Experiences of Parents of Transgender and Non-binary Children

Child Age

On average, respondents’ transgender or non-binary children were 13.8 years old (Table 2).

• 25.1% were between 6 and 12 years old and
• 2.4% were between 1 and 5 years old

Child Gender Identity

Parents and caregivers reported a roughly balanced gender composition regarding their children (Table 2; Figure 1).

• 36.8% were non-binary, genderqueer or gender non-conforming
• 35.4% were transgender boys
• 25.9% were transgender girls

First display of gender non-conforming behavior

Children can recognize their gender as early as age 2 and may begin developing stronger feelings in their adolescent and teenage years when puberty usually begins. On average, parents and caregivers reported that their child first exhibited gender non-conforming behavior at 8.4 years old, with a slight plurality of parents and caregivers saying their child exhibited gender non-conforming behaviors before age 6 (Table 2; Figure 2). It is important to note that this is based on the parent or caregivers’ awareness, rather than the child.

Age of gender identity disclosure

The average age at which respondents’ children first disclosed their gender identity to them was 10.9 years old, with most saying their child shared their gender identity with them at 13 years of age or older (Table 2; Figure 3).

Parents are on their own journey towards acceptance and understanding, adapting and adjusting over time to be more knowledgeable about their child's identity, and better able to express their support and to advocate on behalf of their children.

Within this sample, most parents and caregivers are supportive of their child’s identity (Table 3; Figure 4). Though results may be skewed, as supportive and affirming parents and caregivers may have been more likely to enroll in this study than those who are unaccepting of their child’s identity, more than 8 in 10 parents and caregivers reported being supportive of their child at each step of their gender journey. These levels of support are consistent across different periods of time such as when the child first disclosed to their parent about their identity, or when the child began to socially transition and changed their name and/or pronouns.

For even the most supportive of parents and caregivers, there is likely a knowledge/information gap around gender identity and how to best support and understand their transgender child. Having key information and support networks can help ensure parents and caregivers are equipped with the tools to best affirm their child and provide support to themselves as parents and caregivers.

When parents and caregivers first looked to understand their child’s gender identity, they turned to a wide range of sources, including their own research, medical professionals, social workers, friends or family (Table 4 Figure 5).

• The most common source parents and caregivers used was the internet, reported by two-thirds (63.5%) of respondents
• Half (50.5%) also sought out help from a counselor, therapist or psychologist.
• More than four in ten (42.4%) attended a support group.

Parents and caregivers also went to social media, their friends/family, doctors and LGBTQ+ focused organizations for resources to help them understand their child’s gender identity.

When it comes to the places parents and caregivers currently find resources for parenting transgender and non-binary children, about three-quarters (78.6%) said they seek information from other parents and caregivers of transgender youth, individual transgender people or other friends/family, far more common than types of information sources (Table 5; Figure 6).

Three-quarters of parents and caregivers (78.8%) said that all parental figures fully supported and affirmed their child’s gender (Table 6). Among the parents and caregivers who said that all parental figures did not fully support and affirm their child’s gender, 10.7% got divorced or separated.

Parent Mental Health

Any parent can struggle with mental health, and mental health can result from a host of external and genetic factors. However, parents and caregivers of transgender and gender-expansive youth face the unique burden of transphobic stigma, and anti-transgender social and political hostilities towards transgender youth and their families, which can place them at risk for poor mental health.

This is confirmed in the present study, with numerous respondents screening positive for anxiety and depression.

Overall, more than one in five (22.0%) parents and caregivers screened for moderate or severe anxiety (Table 7).

• An additional three-quarters screened positive for minimal (50.4%) or mild (27.6%) anxiety.
• In comparison, one study of found that 9.5% of United States adults screened for mild anxiety, as well as 3.4% who screened moderate and 2.7% who screened severe.

Additionally, nearly one in five (19.9%) of parents and caregivers screened positive for severe depression. In addition:

• Almost half (48.4%) screened for minimal depression.
• About three in ten (31.7%) screened for mild depression.

School Type

While most (63.3%) parents and caregivers said their transgender or non-binary child was attending public school in-person, many also report their children attend other types of schools (Table 8).

Additionally:

• 13.9% are homeschooled
• 6.8% attend a private nonreligious school in person
• 6.1% were in college/early college
• 4.8% attended charter school in-person.
• 2.4% attend a private catholic or religious school
• <1% attended online school full-time

School Policies and Practices

Few parents and caregivers report that they are aware of whether their child’s school has anti-bullying or nondiscrimination protections for LGBTQ+ students, defined as policies which specifically enumerate protections on the basis of gender identity/expression, sexual orientation, and for transgender and non-binary students.

• In particular, less than one in seven report their child attends a school with anti-bullying and non-discrimination policies that enumerate protections on basis of gender identity or gender expression. (Figure 7; Table 8).
• About one-quarter of parents and caregivers said their school has formal guidance for supporting transgender and non-binary students.

Gender Support Plans

Generally speaking, a gender support plan is a tool for a child and their school which provides a guide for a student’s gender transition. Gender support plans can be helpful, but not every parent says they had one offered at their school (Table 8).

Perceived School Support for Child

It is important for transgender and non-binary youth to feel supported in all aspects their school life, from the classroom to afterschool. In this sample, parents and caregivers largely perceived that their child’s school supported them in multiple aspects of their day-to-day school lives.

The vast majority (about 9 in 10) reported their schools were supportive around correct name and pronoun usage, and while roughly two-thirds each of parents and caregivers say their schools are supportive with regard restrooms, locker rooms and sports (Table 9; Figure 8).

LGBTQ+ inclusivity in schools is critical to ensuring LGBTQ+ youth, especially transgender and non-binary youth, have the tools necessary to thrive. Inclusivity can be achieved with small changes to how teachers and staff speak in school, using language that does not reinforce gender stereotypes and gender norms that limit all children.

It may also include school exhibiting signs of support or transgender and non-binary people or observe LGBTQ+ history. Inclusivity can evolve into structural changes, such as implementing LGBTQ+ inclusive curriculums.

Results show that two-thirds (66.5%) of parents and caregivers said their child’s school uses gender-inclusive language (Table 8).

Only a quarter (25.3%) of children attend schools where they are taught about transgender and non-binary people and history, or where there are visible signs and symbols of support (Table 8).

In light of recent policy changes passed after the survey was collected, including Don’t Say LGBTQ+ laws and pronoun bans, it is likely that these percentages would be even lower if the survey was conducted today.

Bullying

Over half (55%) of parents and caregivers said their child was bullied due to their gender identity or expression in the last year. Among those who said their child reported they were bullied:

• 45.2% said it happened rarely
• 37.2% said it happened sometimes
• 10% said it happened often
• 7.6% said it happened frequently

Child Chronic Health Conditions

About two-thirds (67.5%) of parents and caregivers said their child had at least one chronic health condition (Table 10), most of which were emotional or behavioral diagnoses (Figure 9).

Child Mental Health

It is important to note that being transgender is not a mental illness, though transgender people may have elevated rates of mental health challenges (Table 10).

• Many parents and caregivers report that their transgender or non-binary child has depression (39.6%) or an anxiety disorder (49.4%).
• According to the Centers for Disease Control and Prevention, 9.4% of children age 3-17 have been diagnosed with anxiety and 4.4% have been diagnosed with depression.
• 15.9% of parents and caregivers said a doctor or health care provider told them that their child had ever been hospitalized for mental health needs
  • Among those parents and caregivers, 35.5% said it was related to their gender identity.

Gender-affirming care is a part of health care critical to the overall well-being of transgender youth.

Gender-affirming care, sometimes referred to as transition-related care, is life-saving healthcare for transgender people of all ages. It is not a single category of services but instead is a range of services, including mental health care, medical care, and social services. At all ages, clear, well-established, evidence-based standards of care exist for who can access what form of gender affirming care, and when they are eligible to receive it.

Among those with a provider, most had to travel 25 miles or less to find care for their child (Table 11; Figure 10).

A large percentage of parents and caregivers whose children are receiving gender-affirming care say their child’s provider had high levels of knowledge of transgender health care (Table 11; Figure 11).

Most parents and caregivers who have accessed care for their child said they had to wait longer than a month to find a competent health care provider for their child (Figure 12).

Lack of access to competent care is a general experience of transgender people, so these results may be the result of a selection of parents and caregivers who already completed the (arduous) task of navigating the health care system to find their child competent gender-affirming care.

This is important to note, as 25.1% of parents and caregivers with children not receiving gender-affirming care say they could not locate an experienced provider (Table 11; Figure 13) and was most frequently cited as the reason why their child had not received care.

Additionally, 24% of parents and caregivers say they have had to teach a doctor or health care providers about transgender people to receive appropriate care (Table 11).

21.6% have changed providers due to mistreatment, lack of competency or other reasons related to gender-affirming care (Table 11).

Health Insurance Coverage

Even if a provider is found, it may be additionally challenging for parents and caregivers to obtain coverage for their child’s gender-affirming health care through their health insurance plans. When observing what health care services parents and caregivers say are covered under their child’s health insurance, many gender-affirming services and other health care services were covered – with one exception (Table 12; Figure 14). The exception was gender-affirming surgeries, which were most often cited as not being covered.

Only one-third or less of parents and caregivers say that all gender-affirming care procedures were covered by their insurance (35.6%), while 55.1% said all of their primary care services were covered.

Awareness of Nondiscrimination Protections

For parents and caregivers of transgender and non-binary children, nondiscrimination laws can be critical to ensure their children are able to thrive free of discrimination, stigma and bias. However, the United States has no federal law enshrining enumerated non-discrimination protections for LGBTQ+ people. Instead, LGBTQ+ people and their families live under a patchwork of laws whereby legal protections (or lack thereof) varies across sector (e.g. housing protections vs. Employment protections) and geography.

As a result, not every parent is familiar with their state’s or community’s laws (Table 13).

Exposure to Anti-Transgender Legislation

At the same time, anti-transgender legislation has been exponentially increasing in state legislatures across the United States over the last few years. To no surprise, most parents and caregivers said they are concerned about their state passing anti-transgender laws, while one in three have said their state has already passed or introduced an anti-transgender law in the last year (Table 13).

Identity Documents

Given the volatile and hostile political environment, some parents and caregivers have taken steps to legally affirm their child’s gender identity. Two-thirds (65%) of parents and caregivers have had at least one of their child’s identity documents updated with the child’s correct name/gender (Table 14; Figure 15).

Advocacy and Engagement

Parents and caregivers of transgender and non-binary children are often tasked with being advocates for their families amidst the attack on transgender people’s rights and freedoms. Half (50%) of parents and caregivers have written to or called their political representatives regarding transgender issues, among many other forms of advocacy (Table 15; Figure 16). Overall, parents and caregivers were more likely to say they have engaged in advocacy than their children.

Nearly one in five (17%) of parents and caregivers said their child has spoken publicly about transgender issues, while 1 in 10 (10.3%) have written to or called political representatives. Fewer wrote editorials/blogs or engaged in formal advocacy. Similarly, parents and caregivers said they and their children were least likely to write editorials/blogs or engage in formal advocacy.

Resource Needs

Parenting a transgender or non-binary child has its challenges, whether it’s finding adequate health insurance, an inclusive school, updating government records or preparing for a child’s future education and career. When asked what sort of resources parents and caregivers needed:

• Two-thirds of parents and caregivers in the survey said they need additional resources to assist them with advocating for their child at school (Table 4).
• Six and ten (60.5%) said they need additional resources on navigating health insurance for their child.
• Additionally, over half said they need additional resources for obtaining updated identity documents (53.8%) and disclosing their child's gender identity to other people (53.3%).
• Slightly less than half (44.9%) of parents and caregivers said they wanted more resources for navigating applications for things like college or employment.

• Share age-appropriate books, movies, and resources with them that teach about transgender and non-binary people, histories, and identities.
• Check out Welcoming Schools Booklists for ideas.
• Affirm your transgender or non-binary child by sharing your pride in their identity, positive messages of love and acceptance, and your hope for their future.
• Use the name and pronoun your young person goes by, and allow them to express themselves and dress in accordance with their gender identity in age-appropriate ways.
• Support your transgender or non-binary child in sharing their identity (including name and pronoun) with their siblings as well as extended family if it is safe to do so.
• Learn about and engage with your local school board to advocate for inclusive policies, practices, and curriculum for all transgender and non-binary students.
• Show up for your transgender or non-binary child in school by advocating for inclusive practices in their classrooms and professional development training for their teachers.
• Check out Welcoming Schools Training Program.
• Check in with your child about bullying at school and ask for specific details to determine if they are being teased or verbally harassed, being physically harassed, or otherwise being bullied
• Get the facts on gender-affirming care
  
• Check out the guide for Supporting Transgender, Non-binary, and Gender-Expansive Children.

Despite growing social and political hostilities toward transgender and non-binary people – and their families, many parents and caregivers have remained steadfast in support of their transgender and non-binary children. Parenting a transgender and non-binary child is not easy. Many parents and caregivers must endure challenges such as accessing competent health care for their children, watching their children experience bullying or see their child struggle with mental health challenges. Still, a lot of parents and caregivers have taken actions to affirm the identities of their children in places where they have that ability. Whether it is through updating identity documents or engaging in advocacy, parents and caregivers play an important role in their transgender or non-binary children’s well-being.

AUTHORS

Charleigh J. Flohr, MPP, Associate Director, Public Education & Research

Charleigh J. Flohr is Associate Director of Public Education & Research at the HRC Foundation, where she has been for over half a decade. As Associate Director, she primarily leads research projects around economic policy, program evaluation and survey research. Charleigh has nearly a decade of experience in research with experience across multiple organizations, including the Edgar Dyer Institute of Leadership and Public Policy, the Congressional Management Foundation, Center for American Progress, Democracy Fund and the National Center for Transgender Equality. She has several research publications, including peer reviewed publications. Charleigh attended Coastal Carolina University where she obtained her Bachelor’s, focusing on political economy and public policy. She holds a Master’s in Public Policy (‘19) from Georgetown University’s McCourt School of Public Policy, where she primarily studied causal econometrics and applied survey statistics. She is currently based in Washington, DC.

Shoshana K. Goldberg, PhD MPH, Director of Public Education & Research

Shoshana K. Goldberg is the Director of Public Education & Research at the HRC Foundation. In her role, she oversees research projects that use quantitative and qualitative data to better understand the lived experiences of LGBTQ+ individuals in all aspects and dimensions of daily life, as well as public education products that aim to educate and inform advocates, policy makers and the general public. Prior to joining to HRC, Goldberg held both research and academic positions in the fields of LGBTQ+ health and policy, working with organizations such as The Williams Institute at the UCLA School of Law, UNC-Chapel Hill, and Strength in Numbers Consulting Group. Through her prior work, she has co-authored numerous academic articles, book chapters and research briefs, gaining expertise in the use of population-based data to understand the demographics of the LGBTQ+ population, as well as how existing social, structural and political factors contribute to vulnerabilities, marginalization and health disparities faced by the LGBTQ+ community. Goldberg holds a Master’s of Public Health in Maternal and Child Health, and a Ph.D. in Maternal and Child Health and Epidemiology, both earned from the Gillings School of Global Public Health at the University of North Carolina-Chapel Hill. She is currently based in Brooklyn, N.Y.

Ellen Kahn, MSW, Vice President, Education and Systems of Care

Ellen Kahn is Vice President of Education and Systems of Care at the Human Rights Campaign, overseeing a portfolio of programs and initiatives aimed at improving the lives of LGBTQ+ children and families, including Welcoming Schools, All Children-All Families, Youth Well-Being, Economic Empowerment, and the Parents for Transgender Equality Council. In her 18+ years at HRC, Ellen has shaped innovative system-change work in child welfare, education, and healthcare, and is nationally recognized as an expert on LGBTQ+ youth and families

A self-described trans-affirming, progressive lesbian feminist social worker, and mother of two wonderful daughters, Ellen has dedicated her career to improving the lives of LGBTQ+ people--from working on behalf of people living with HIV/AIDS in the early days of the epidemic, to facilitating dozens of “Maybe Baby” groups for prospective LGBTQ parents. Before joining HRC, Ellen spent 12 years at Whitman-Walker Health (formerly Whitman-Walker Clinic), leading the Lesbian Services Program for eight of those years; in that role Ellen led the expansion of programs to meet the needs of the growing community of LGBTQ people prospective parents, and those already navigating life with children.

Ellen earned her M.S. from Temple University and her M.S.S. from Bryn Mawr College School of Social Service and Research.

ADDITIONAL ACKNOWLEDGEMENT

This report would not have been possible without the contributions of various HRC staff, including, Hillary Esquina, Jarred Keller, and Josette Matoto.