Joint Statement Supporting and Care of Transgender Children

Supporting and providing access to gender affirming care for transgender children promotes health and well-being. It is not child abuse. This approach is recommended by the prevailing standards of care, best practices, and guidelines endorsed by national and international professional organizations including the World Professional Association of Transgender Health, the American Psychological Association, the American Medical Association, the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, the National Association of Social Workers, and the Australian Professional Association for Transgender Health and is associated with improved mental and physical health outcomes. 

The gender affirmative model of care includes obtaining a child’s assent before engaging in any medications or surgical procedures. Until puberty, there are no medical or surgical interventions involved related to gender affirmative care. After the onset of puberty, comprehensive gender health planning — including consideration for medical interventions (e.g., pubertal suppression, hormone therapy, gender affirming surgery) — is completed with interdisciplinary teams, following established guidelines, and only with the assent of the youth. 

As signatories to this letter, it is our position that all children should be able to express their gender identity without fear of rejection. Supporting transgender children and children who are expressing a different gender than expected includes providing opportunities for the child to explore their gender identity freely. This can include facilitating a social transition where a child is able to live in the gender role that is most authentic to that child. This usually includes a new name, pronouns, attire, hair length and/or style in order to present as their self-identified gender. Parents are also encouraged to seek gender affirming medical and mental health care services from experienced providers to support their child’s healthy development and wellbeing. 

This gender affirming model of care is based on the latest scientific evidence which demonstrates that family acceptance of a child’s gender identity and providing gender-affirming care are associated with improved well-being and mental health including reductions in symptoms of depression, anxiety, and suicidality. Children who experience negative family and caregiver responses of indifference, rejection, and/or attempts to change their gender identity or expression are more likely to experience negative psychological and social outcomes including depression, anxiety, suicidality, substance abuse, as well as heightened risk of lower educational attainment and homelessness. 

The signatories of this statement support parents’ rights to support their child’s gender identity and access gender affirming care for their child without fear of Child Protective Services’ (CPS) involvement. It is a CPS mandate that they must act in the best interest of all children, which also means protecting the rights and needs of children including needs of gender expression. We also oppose any efforts to restrict the ability of healthcare professionals to provide care consistent with established standards and best practice guidelines, or the ability of parents to access and consent to such care for their child.