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See also: Gender identity disorder in children

Transgender youth are children and adolescents who identify as transgender and/or transsexual. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, and because most doctors are reluctant to provide medical treatments to them, transgender youth face different challenges compared to adults. Transgender issues manifest at different times in life in different individuals. In most cases of gender identity disorder (GID), the condition is often apparent in early childhood, when such a child may express behavior incongruent with and dissatisfaction related to their assigned gender. However, many of these children experience rejection as a result of their differences and quickly attempt to repress them. Therefore, people who see these children regularly may be unaware that they are unhappy as members of their assigned gender.

According to the DSM-IV, most children diagnosed with gender identity disorder will establish an identity as a member of their assigned sex in adolescence or adulthood.

Coming out

In many parts of the world, transgender is not widely accepted by the public. Transgender youth may feel that they need to remain in "the closet" until they feel that it is safe and appropriate to reveal their gender identity to their parents and other family members and friends. It may be impossible to predict a parent's reaction to such news, and the process is fraught with tension for many transgender youths. Many parents will react negatively to such news, taking actions such as kicking the youth out. However, some parents are very supportive when such news is broken to them. Additionally, reactions of parents to transgender children can change over time. For example, parents who initially reacted with negativity and hostility may eventually come around to support their transgender children. And parents who were initially supportive may later develop hostility toward their child's gender identity.

Vulnerability

Transgender youth are extremely vulnerable to a multitude of problems, including substance abuse, suicide, childhood abuse, sexual abuse/assault, and psychiatric disorders .

The transgender symbol

Gender dysphoria

Gender dysphoria is a strong, persistent discomfort and distress with one’s gender, anatomy, and birth sex. Transgender youth who experience gender dysphoria tend to be very conscious of their body; appearance, weight, and other people’s opinions of their body may become very important. Body esteem of several transgender youth was measured in an interview in three categories (personal satisfaction of appearance, personal satisfaction of weight, and perceived satisfaction of others of one’s body appearance). It was found that those transgender youth who experienced less personal satisfaction with their weight and who perceived others’ satisfaction with their body as worse were more likely to practice life-threatening behaviors than those who were more satisfied with their weight and thought that other’s view their body more positively .

Physical, sexual, and verbal abuse

Transgender youth are at an increased risk for physical and sexual abuse. There is evidence that indicates around ¾ of transgender youth were verbally abused by their parents or caregivers, and around 35% had faced physical abuse by the hand of their caregiver. As one transgender youth said, “Throughout my whole life, I was abused physically and mentally by relatives in my family. Have marks on my body. I have things that I remember happened to me.” Youth who have parental support of their atypical gender presentation are much more likely to be better off in several ways: mentally, financially, academically, etc. Transgender youth who face physical abuse may be forced to or choose to leave their homes, which can be a particularly traumatic experience. The lack of housing was found to often lead to financial difficulties for such youth. Lack of support at home and constant harassment at school may lead to academic difficulties for the youth as well, who face a much higher drop out level compared to their cisgender counterparts

Lack of access to healthcare

Transgender youth potentially face many hardships in obtaining medical treatment for their condition. This lack of access may be due to doctors refusing to treat youth or youth fearing negative reactions from heath care providers. Psychiatrists and endocrinologists are generally reluctant to provide hormone therapy to youths under 16, and obtaining sex reassignment surgery prior to the age of 18 is almost impossible in most countries. Many youth who have used hormones to develop desired secondary male or female sex characteristics have obtained these hormones from the street. This can be very dangerous, and can result in a multitude of health problems for the youth, including improper pubertal growth and HIV due to contaminated needles.Sexually transmitted infections are a large health problem for transgender teens as well, as sexual partners often do not perceive these youth as health risks, especially since male-to-female youth cannot become pregnant. This trend of unprotected sex among the transgender population puts them at increased risk and has led to higher numbers of STI’s among the group However, the latest revision of the Standards of Care for the Health of Transgender, and Gender Nonconforming People has addressed the needs of transgender children. Currently, the SOC allows for medications for prevention of puberty to be prescribed to these children as soon as the first signs of puberty become apparent.

Bullying

School settings can be some of the toughest for transgender youth. Several problems may be faced at schools, including verbal and physical harassment and assault, sexual harassment, social exclusion and isolation, and other interpersonal problems with peers. Transgender students were much more likely than their LGB peers to report harassment, assault, and feeling unsafe in school settings. These experiences, of course, vary between different individuals and different schools attended. Larger schools tend to have safer climates for transgender students, as do schools with more low income and racial/ethnic minorities.

Results of a 2009 study of 6th through 12th grade transgender students showed that most experienced a hostile school climate with regular harassment from peers. 82% of these youth reported that they felt unsafe at school because of their gender identity, and almost 90% reported experiencing homophobic harassment from peers frequently. A majority of these students also reported physical harassment at school, with nearly half reporting that they had been punched, kicked, or injured with a weapon. Sexual harassment among these students was also reported with alarming frequency (76%). Restrooms and locker rooms pose an especially high threat to transgender students. They frequently reported fear an anxiety about using these facilities at school because of experiences of harassment by both peers and adults when using them. Negative comments about gender presentation may be frequently overheard in these places, and surveyed students have reported being "pushed around," "getting the crap beat out of them," and "getting their asses kicked" by peers.

Unfortunately, school administrations often do not take reports of victimization of transgender students seriously. Only a third of transgender students who reported victimization to school staff members feel that their situation was taken care of adequately and effectively. The other two thirds often run into situations where the school staff members blame the victimized students. One student, when reporting bullying, said that they were told "that I need to stop flaunting my sexuality". School administrations often single out transgender students and discipline them for doing things such as wearing appropriate clothes for their gender identity, using restrooms consistent with their gender identity, and insisting on using their preferred name and personal pronouns. These things serve no educational purpose and only isolate transgender students further.

High drop out rates and low grade point averages seem to plague the transgender population. The severity and frequency of bullying and harassment are directly correlated to these things. in one study of transgender youth, three quarters of the participants dropped out of school, almost all citing the main reason the constant acts of violence against them due to their gender identity. Anti-transgender bullying in schools has also been found to directly correlate with other negative outcomes, such as homelessness, unemployment, incarceration, and drug use.

Suicide

Though several studies that estimate life-threatening behavior for gay, lesbian, and bisexual youth have been done, few have been done regarding transsexual youth, and thus comparable estimates do not exist. The few studies that have been done, however, have all concluded that transgender youth are at increased risk even over their gay, lesbian, and bisexual counterparts. A 2007 study of transgender youth found that, of the youth interviewed, about half had seriously contemplated ending their own lives. Of those who had thought about suicide, about half had actually made an attempt. Overall, 18% of all interviewed transgendered teenagers reported an attempted suicide that was linked to their transgender identity. A similar study was conducted with gay, lesbian, and bisexual youth, with results showing 15% had made a suicide attempt that was due at least partly to their sexual orientation. Both of these numbers are considerably higher than the 8.5% of high school students who had reported life threatening behavior.

Youth are generally predisposed to life-threatening behaviors due to a number of conditions, such as self-hatred, victimization via bullying, substance abuse, etc. Transgender youth may also face victimization from peers and family members’ negative reactions to their atypical gender presentation, increasing their risk of life-threatening behaviors. Of the transgender youth who were interviewed and reported an attempt at taking their own life in the aforementioned study, almost all had been verbally abused by their parents, and a significant number had been physically abused as well. In comparing those transgender youth who had and had not attempted suicide, there were significant differences in family relations, peer relations, and school performance

Ensuring the child's security

In recent years, some transgender children have received counseling and, in some cases, medical treatment for their condition, as well as the ability to change their gender role. It is thought to be a criminal act in most states where counselors and behavioralists who are not certified in adolescent gender role playing take on the task of determining whether or not it is a pre-teen stage or an actual case of transgenderationalism. At such an early age, the child's mind is at its most sensitive - and grandiose feedback on the subject can mentally lead that child in the wrong direction. In some countries, schools are working to accommodate gender identity and expression by eliminating traditional gendered activities.

Families with a young child who may identify as a member of "the opposite" sex and who chooses to alter his or her gender role through dress or behaviors may respect their child's decision, and sometimes, may decide to relocate the child to another area in order to afford the young person the best opportunity to live in their desired gender role among a novel set of peers and community. This helps protect trans children from peer rejection, bullying, and harassment.

Families who choose to continue living with such a child within an intolerant community which has had previous experience with the child as a member of his/her assigned sex, may face challenging issues. Gwen Araujo of Newark, California was a young person who was living as female, when she had been assigned to the male gender at birth. When her trans status was revealed at a party she attended, she became the victim of violent crimes that resulted in her death. Thankfully the Araujo case is an extreme one, however parents should be aware of the social implications of their transgender child living in an unsafe environment.

Media representations

The film Ma Vie en Rose (My Life in Pink) (1997) by Alain Berliner depicts a similar scenario. Ludovic is a young child who is assigned male but who lives as a girl and tries to make others agree with her identification. Ludovic's "gender play" incurs conflict within the family and prejudice from the neighbors; in the end, the family had to relocate to a new community.

Australian socio-legal perspectives

The Australian Socio-legal foundations for transgender youth were only recently established. Foundations were formed with the case 2004 Fam CA 297 ("Re Alex"). Re Alex examined the rights of a 13-year-old born female to take hormonal treatment to facilitate “becoming” male. The courts gave the alias of Alex to protect [him]. Debate emerged over if it was the body or the mind that required treatment. Throughout the case a variety of views were expressed, this article attempts to cover a representative variety of the views.

Mr. Flemming put forward argument that if Alex was granted treatment it would follow that if someone deemed themselves to be a horse would society then be required to allow treatment to become a horse.

Associate Professor Jeffreys, a Political Science at the University of Melbourne argument disagrees with Flemming’s argument. Jeffreys argues that Gender Identity Dysphoria is a “fossil” and that there should be no correlation between body shape and right behaviour.

Senior Law Lecturer Millbank from Sydney University supported Jeffreys’ argument. Millbank argued that male roles are not fixed, a community in South Africa as an example. The community in question allows families without sons to give the oldest female the role traditionally assigned to the male. This means he will marry and take on traditional functions of the male.

Catholic Spokesman Mr. Campbell argued along a similar line to Flemming. Campbell claims that for a large number of people this is just a “stage” and will pass. Consistent with his argument he recommends psychotherapy treatment.

Outcomes

Recent research has shown that in carefully selected patients, people who transition young suffer few ill effects, and maintain a higher level of functioning than before transition. Additionally, results of treatment are considered better when it is offered at an earlier age.