Puberty for transgender youth | Transgender, non-binary and gender diverse children

We asked some transgender/non-binary/ gender-diverse (TGD) people and parents of TGD children the question “What do you think TGD children need support around as they go through puberty?”.

Here are some of their responses:

‘The process of going through the wrong puberty is debilitating, there is no joy in each step and instead the further disconnect between them and their body.’ 
‘When kids know there is a drug (hormone blockers) that can stop them from growing boobs or having facial hair growth it seems like a no brainer they would want to take it.’
– Bodhi (28yo trans man, he/his)

‘If they are anxious or stressing around going through puberty support them to seek a specialist and consider hormone blockers to give them time to decide what puberty fits with their identity.’
– Liam (35yo trans man, he/him)

‘Explain to them what is actually happening. Don’t just say a period means you can get pregnant. Explain the cycle and the phases and the discharge. If they struggle with anatomically correct terminology, then find alternatives. Just because it makes them dysphoric doesn’t mean they don’t need to know what will occur.’ 
– Bodhi (28yo trans man, he/his)

‘Information around hormones and sexual health and contraceptive methods etc. how to safely tuck or bind.’ 
– Nina (trans woman, she/hers)

‘Relationships!! social and romantic.’ 
– Sara (mother of a 21yo trans man)

‘Visible support is fundamental – if it isn’t available from family then it must come from elsewhere.’
– Rich (father of a 24yo non-binary child, they/them)

‘They need tools to articulate how they feel, what their fears are. They need social support of peers who have knowledge of gender diversity and with that acceptance.’
– Daniel (father of an 18yo trans man, he/him)

‘My child is not in puberty yet so I can only guess.  Gender affirming care for sure.  I’ve met adults who transitioned long after puberty and it’s so rough for ones who went through a very strong puberty that is out of alignment with who they are.  I imagine possibly a therapist would also be helpful for those who are experiencing dysmorphia related to parts that cannot be changed until adulthood.  For instance, my child doesn’t feel one way or the other about her penis this point except that it’s convenient to pee standing up but as she gets older and possibly becomes sexual interested in her peers, I wonder is she will  feel the same way or if she will struggle with not having a vagina (she has told me she wants one many times).’
– Annalise (mother of a 7yo trans girl)

People often think of puberty as starting around 13 when you are a teenager. In reality, puberty for kids with ovaries/vulvas typically starts between 9-10 years of age, and for kids with testicles, puberty typically starts between 10-12 years of age.

The onset of puberty is important to get your head around as it’s a time when our bodies typically develop in ways that make us look like the sex we were assigned at birth. It’s also a time when there is increased pressure and expectation to conform to gender norms.

Some TGD people will arrive at puberty with an already developed understanding of their gender identity as a trans boy, trans girl, non-binary, or gender-diverse person. For others, puberty will be a time when understanding of gender identity shifts. However, some young people won’t necessarily have a language around their gender identity. For other TGD people, an understanding of their authentic gender identity occurs after puberty, in adulthood. 

For many TGD people gender dysphoria can emerge or be exacerbated during puberty. However, not all TGD people experience gender dysphoria. Some experience gender incongruence alone rather than gender dysphoria. This doesn’t make them any less trans.

Puberty typically has a predictable sequence for kids with testes and kids with ovaries. This sequence has been broken down into five stages, called the Tanner stages in the medical world. 

This would be a good time to watch or read the following to know what secondary sex characteristics and changes occur in the different Tanner stages. You can watch these clips by a paediatrician on male pubertal stages https://www.youtube.com/watch?v=q1JFnbK63Xw and/or female pubertal stages https://www.youtube.com/watch?v=BKMz6oYdXoQ. Alternatively you can read the 5 stages of puberty in girls https://sexedrescue.com/stages-of-puberty-in-girls/  and or the 5 stages of puberty in boys https://sexedrescue.com/stages-of-puberty-in-boys/.

References

• Female Puberty Overview by Ask Doctor T 2021.
• Male Puberty Overview by Ask Doctor T 2021.
• Our Sexuality by Crooks, Baur, & Widman 2021.
• Sexual-Minority, Gender-Nonconforming, and Transgender Youths by Lisa M. Diamond 2013.

• Supporting Parents of Children Who May be Transgender/Non-binary/Gender-diverse – Questionnaire for Parents Who Have Transgender/Non-binary/Gender-diverse Children by Felicity St.John 2024.
• Supporting Parents Raising Children Who May be Transgender/Non-binary/Gender-diverse – Questionairre for Trans Adults by Felicity St.John 2024.
• The 5 Stages of Puberty in Girls by Cath Hakanson 2024.
• The 5 Stages of Puberty in Boys by Cath Hakanson 2024.
• Trans Pathways: The Mental Health Experiences and Care Pathways of Trans Young People by Strauss et al., 2017.