A cut finger, a bruised knee, even a cough or cold – these are scrapes and illnesses that are easy for parents to treat. But when it comes to mental health and the complex topic of gender, knowing your child’s needs can be tricky, and that’s when expert advice can help.

Leading the way

Since 2003, the Royal Children’s Hospital’s (RCH) Gender Service has been helping children and young people who have questions about their gender.

The RCH is pioneering work around gender services in Victoria and across the country, and the Gender Services team has seen the service expand from one or two referrals each year to more than 220 referrals for 2016.

Clinical psychologist Carmen Pace says the growth is reflected in increased awareness, and by parents seeking help for their child “when they see things that might be a bit different with gender”.

“Having public advocates really helps,” Dr Pace says.  ”But I also think it’s just happening within schools – there’s lots of training out there now.

“Teachers are becoming more aware, parents are becoming more aware, and there’s media exposure as well.”

Is my child gender diverse?

It’s normal for children to explore and be curious about gender as part of healthy development. But if your child seems distressed about their gender or you have concerns, there are some areas you can look out for:

• Language – children might become distressed when they’re being referred to as a boy or girl, or brother or sister, or whatever it is that is gender specific.
• Behaviour – children might start to have trouble at school, or learning or behavioural problems, which may be related to underlying discomfort about gender.
• Asking to talk about it – children might want to express themselves, and may ask questions about their gender. Talking with them can help you to understand what they are experiencing.

What do I do?

Being gender diverse is not a problem in itself, nor is it a disorder. Dr Pace says some kids can be gender diverse and it doesn’t upset them at all.

But for some children, the changes in their body – even if these are just anticipated changes – can cause them to become very distressed because it’s not consistent with how they feel inside.

Speaking to your local doctor can be the first step, as many GPs and psychologists in the community can support families. If needed, a referral to the RCH can be made.

“Additionally, there are also some really wonderful parent support groups that are run by parents of kids who are gender diverse,” Dr Pace says.

“I know a lot of parents get an enormous amount of support from that.”

Questions children ask

According to Dr Pace, the most common question children ask is ‘what will happen when I grow up?’.

“Lots of kids have worries and questions about puberty and what will happen to their bodies,” she says.

“So we do lots and lots of talking about puberty in our clinic, particularly if they’re expecting to go through pubertal changes that their body is not destined to do biologically.”

Sometimes, she says, questions are asked about things like having surgery when they’re older.

“We often talk about the fact that no one needs to change their body if they don’t want to, in order to be the gender that they identify with.

“For some people, medical intervention and surgery in adulthood is the right path for them, and for others social changes are sufficient.”

Questions families ask

Mostly, Dr Pace says, parents are concerned about their child’s future.

“They want to know ‘is my child going to continue like this or is it going to go away?’

“And that’s why a lot of the work that we do is with parents as well as their children.”

Many families find it helpful to learn about great role models in the community who are transgender. Talking about these positive stories, as well as understanding the importance of family support, gives gender diverse children the best opportunity for positive outcomes.

A supportive environment is vital in preventing mental health concerns. See a GP if you have questions about your child’s gender identity. You can read more on gender dysphoria at rch.org.au/kidsinfo/fact_sheets/Gender_dysphoria/  or vist the RCH’s Gender Services page at rch.org.au/adolescent-medicine/gender-service/