The number of gender non-conforming and transgender children/adolescents presenting to mental health providers is increasing. Therapists are liable for delivering care that is unbiased and comprehensive (Guss, Shumer, & Katz-Wise, 2015). Professionals who work with children and adolescents who are transgender and gender non-conforming (TGNC) should be prepared to work sensitively with these clients. Notably, gender identity issues are often not related to sexual orientation. The purpose of this paper is to discuss the challenges to be aware of when working with gender non-conforming or transgender children and adolescents.
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Children at the age of two or three may start to display their gender behavior, and it is not uncommon for children of a male or female sex or intersex minors. It is usually temporary and does not imply cross-gender expression or identification. Nonetheless, some minors may continue to persist with it while growing up (Guss et al., 2015). In such cases, it is recommended to support a child, allow their gender-variant behavior, and watchfully wait.
Importantly, most families may benefit from talking with a counselor experienced in the field. For instance, families need professional support in making decisions regarding whether the child should socially transition or regarding a name change and alteration of gender status at school. Such a type of consultation may help to prevent psychopathology in TGNC youth. In situations when the TGNC adolescent does not have the support of the family, they may be at risk of homelessness (Guss et al., 2015). Thus, it is essential to ask patients if they have any concerns about homelessness in a situation when their gender identity is revealed to their family members.
Educational institutions are a crucial social environment for young individuals. TGNC adolescents are at a greater risk of suffering from violent behavior from the side of their peers. Changing clothes or using a bathroom may be stressful for gender non-conforming adolescents. A patient should be educated about anti-harassment policies at their institution, and it could be useful to identify a teacher or a counselor who could be the patient’s ally. Moreover, TGNC adolescents are especially vulnerable to the problem of substance use. Researches show that “TGNC youth of any gender are more likely than non-TGNC boys to use alcohol, tobacco, marijuana, and other illicit substances” (Guss et al., 2015, para. 12). Thus, if TGNC adolescents are harassed, they are at higher risk of developing substance abuse.
Furthermore, the specialist should ask patients with dysphoria related to their genitals about the terms they prefer using. If a patient is on hormone replacement therapy, it is necessary to inform them that infertility can be a side effect. Nevertheless, the medications used cannot be regarded as a method of contraception (Guss et al., 2015). In addition, it is essential to evaluate TGNC patients for mental health disorders such as anxiety, depression, or suicidal ideation.
Various therapies may be recommended to patients based on their current needs. According to researchers, “family counseling and psychotherapy may be necessary to address gender dysphoria, comorbid mood disorders, and the effect of these conditions on the rest of the family” (Guss et al., 2015, para. 15). Therapists should assist young individuals in learning how they can express their gender experiences. They need to determine what patients would like to achieve as a result of pubertal suppression, hormone replacement therapy, or surgical intervention. Mental health professionals can also help “to develop strategies around disclosure, self-acceptance, integration of transgender identity, intimate partnerships, and social transition if that is desirable” (Olson-Kennedy, Rosental, Hastings, & Wesp, 2016, para. 4). Therefore, healthcare professionals have an important goal of educating parents and educational institutions on the needs of transgender or gender non-conforming individuals.
Thus, healthcare specialists working with transgender and gender non-conforming children and adolescents should be well aware of transgender issues. They need to be prepared to work with these clients sensitively and with due respect and caution to their choices and feelings. It is the role of healthcare professionals to inform patients about the possible consequences of different therapies and provide support to clients and their families.
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Guss, C., Shumer, D., & Katz-Wise, S.L. (2015). Transgender and gender non-conforming adolescent care: Psychological and medical considerations. Current Opinion in Pediatrics, 27(4), 421-426. Web.
Olson-Kennedy, J., Rosental, S., Hastings, J., & Wesp, L. (2016). Health considerations for gender non-conforming children and transgender adolescents. Web.