I am often asked by parents of gender variant children about the different stages which might make up their transition journey and I thought it might be helpful to share these, along with an indication of the types of support needed at each stage.

There is plenty of literature out there that you can share with your child’s wider network to help them to understand your child’s situation. Mermaids is a great place to start.


Social transition

The child changes his/her appearance through clothes, hair, shoes, make-up etc. Behaviours become more reflective of their true gender identity and this tends to manifest in their choice of belongings, the way their bedroom looks and feels and in their chosen friends, toys and hobbies.

The first priority during this stage is for the parent or carer to provide the child with the psychological and emotional support that goes with any life event or series of events. Many parents find this the easiest stage and just allow their child to be themselves without any firm ‘change’.


Family transition

This is the second stage in which the wider family becomes involved in the child’s transition. His or her preferred identity is acknowledged and accepted. Their chosen name and pronouns begin to be used at home and by family. Behaviours become less of a focus and there is less expectation to act according to birth gender. This stage quickly broadens to incorporate even further extended family members and friends.  

Educating the child’s wider support network during this time is essential. Just because you are willing to support your child does not mean that everyone will understand and agree. Where there is resistance, take the time to share your understanding of the situation. Share as much information as you can. If you can come to terms with your child’s gender variance there is no reason why others can’t follow suit. Where there is ongoing resistance, put the needs of your child first. If a particular person of influence refuses to accept the child’s gender variance or is abusive, remove the child from the situation, it is their wellbeing should be the priority.

This stage can often have a profound impact on the child, and acceptance can alleviate stress and anxiety as well as facilitating improvements in social interactions.


School transition

As the environment in which the child spends the majority of their time, positive school transitioning is vital. The school in question must be on board and committed to educating the wider student population and their parents, as well as adopting a zero tolerance approach to transphobia or bullying. When the child is ready, their name and gender can be changed on the school register and those within the school environment will be expected to refer to the child accordingly.

Social transition through the school environment is a huge step and if not carried out in a supportive way, can be devastating for a transgender child. Communication with the key parties is crucial, as is obtaining a commitment from the school that they will support and nurture your child through this period.

If your child is not being allowed this vital part of their transition, and you feel it would be beneficial for them, then be ready to educate, inform and take a stand, even if that means finding a more sympathetic school. Support groups and forums are an incredible source of information and a good way of meeting other people in the same situation. Stonewall has a directory of support groups which you can check out here.


Medical transition

At a later stage, social transition is followed by the introduction of medication, initially to halt puberty to give some time and space, and then later to introduce hormones to bring on the correct secondary sex characteristics.


Surgical transition

The final stage on the transgender journey is any surgical intervention which may be desirable, in order to allow the final realignment of the external genitalia and secondary sex characteristics to more closely match the internal gender expression and identity of the person in question. It is worth noting that procedures such as top surgery (breast removal) for trans men, and facial feminisation surgery for trans women would be avoided altogether by the correctly timed use of puberty blockers during adolescence.

Genital affirming surgery is clearly a big step to take and not routinely carried out under the age of 18 in the UK.


We prescribe hormones according to stage not age. Find out about our care for trans youth


If you’re looking for ways to support your trans child, we collated some suggestions from our GenderGP community. If you would like to know more about our service and how we can help, please feel free to get in touch.




Dr Helen Webberley is the founder of GenderGP. A passionate advocate for the transgender community, she continues to campaign for real change in the way that trans people are treated in society and particularly in relation to the barriers they face when accessing healthcare. Dr Webberley believes in gender-affirmative care and that the individual is the expert in their own gender identity.