Over the past nine years, my clinical practice has primarily focused on working with gender-diverse and transgender children, adolescents, and young adults and their families. My passion for this work has evolved out of my own life narrative as a trans man. It is rooted within my own journey of pain and joy and motivated by my desire to ensure trans youth and their families stay connected.

This work is incredibly rich and meaningful. I am aware at the end of each day of the ways I make a difference in their immediate and emerging lives. I watch the ways trans youth are able to become who they are in the world much, much earlier than those in my age cohort did. I am amazed at the incredible ways most parents show up for their transgender children and support them, even when parents struggle to understand everything or perhaps aren't entirely sure it’s truly OK to be transgender.

While there is increased media coverage about transgender children and teens, our world is still not an easy place to grow up transgender. Most parents, daycare workers, and school teachers do not know much about gender diversity among children. Some people still believe that gender-nonconforming or gender-diverse interests and expression among children is “wrong” and should not be tolerated, let alone accepted.

There are still medical doctors and mental health professionals who counsel parents to correct or “punish” young boys who like to play with girls’ toys, like the colors pink and purple, or want to wear a princess nightgown to bed. They tell parents to take away the girls’ toys, to not allow their gender-different boys to play with girls or play girls’ games, and instead insist upon only stereotypical masculine clothes, toys, activities, and playmates.

Many people, even mental health professionals, believe children cannot know they are transgender. They insist it is impossible for a 4-year-old, 7-year-old, 11-year-old, or even a 14-year-old to know yet that they are transgender. Consequently, the first hurdle for any transgender child or adolescent is simply getting people to believe that they are, in fact, who they know themselves to be in terms of their gender identity, that they are capable of knowing whether they are a boy or a girl (or both or neither) regardless of their body parts.

If a young person manages to convince their parents that they are who they say they are despite the sex they were assigned at birth, the next hurdle often involves whether or not that child or adolescent should be allowed to begin living in their affirmed gender. Gender transition is still challenging for adults. It can be even more difficult to navigate for children and adolescents and their families.

All of us as human beings, whether children or adults, want to be seen in the world. All of us want to be seen for who we really are, for who we know ourselves to be. We want our identity to be acknowledged and validated by those around us—particularly by the people who are important to us, the people we love and who love us, our family.

All of us long to be in relationships where we are free to be who we are, and where we are loved for who we are - not in spite of who we are. All of us long to be in relationships and communities where we can bring our whole selves. None of us want to have to hide parts of who we are. None of us want to compartmentalize parts of ourselves, to be forced to pick and choose which parts of us are “acceptable” or “safe” within a particular relationship or environment. Transgender children and adolescents want these things too.

During December 2014 the story of Leelah Alcorn, a 17-year-old transgender girl, went viral. Leelah was raised in a conservative religious home. When she came out as transgender at age 14, her family did not accept her identity as a young woman. When she asked to begin medically transitioning at age 16, she was sent to a religious therapist whose goal was to convince Leelah to accept her birth-assigned sex as male (called reparative therapy). When Leelah began coming out to friends, her family pulled her out of school and took away her internet privileges.

Leelah’s profound gender dysphoria, coupled with the refusal of those she loved to acknowledge her identity as a young woman and her increasing isolation, led, as it often does in transgender adolescents, to depression, despair, and hopelessness. On December 28, 2014, Leelah ended her life by walking out into traffic on an interstate near her home.

The risk of depression, hopelessness, and suicide among transgender adolescents is acute, especially when coupled with lack of family support and acceptance (Family Acceptance Project https://www.familyproject.sfsu.edu) Leelah Alcorn is only one of many transgender adolescents who have taken their own lives because they despaired of ever being able to be who they were in the world or ever being accepted for who they were. 

These realities compelled me to write my new book, Transgender Children and Youth: Cultivating Pride and Joy with Families in Transition (Norton, 2017). The more social workers, psychologists, school counselors, family therapists, and other mental health providers understand gender identity and expression, the more we learn about the experiences and needs of transgender and gender-diverse youth and their families, the greater the possibility that we can not only prevent other transgender children and adolescents from taking their own lives, but also enable them to live happy and fulfilling lives as adults. The more families, teachers, and youth workers know how to communicate acceptance and support for the trans and gender-diverse youth in their lives, the greater the possibility these young people will grow up to become healthy, happy, productive young adults. Sometimes even one person can make a difference.

Sheilah Mabry, used with permission
Dr. Nealy signing a copy of Transgender Children and Youth at the NYC Book Launch
Source: Sheilah Mabry, used with permission

Transgender Children and Youth: Cultivating Pride and Joy with Families in Transition (2017) is available through Amazon, local bookstores, or directly from the publisher, http://books.wwnorton.com/books/Transgender-Children-and-Youth/

Dr. Nealy discusses what this book offers parents, therapist, and educators:

https://www.youtube.com/watch?v=Er0HYrPyKnE&t=16s

https://www.youtube.com/watch?v=CTrNyintJrg

https://www.youtube.com/watch?v=BTC_wo3JQGE

About the Author

Elijah C. Nealy Ph.D.

Elijah C. Nealy, Ph.D., is an assistant professor of social work at the University of Saint Joseph and therapist who works with transgender and gender-diverse children, youth, and adults.

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Transgender Children and Youth

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