XVI Harry Benjamin International Gender Dysphoria Association Symposium
17 - 21 August 1999, London

Reflections on "Transsexualism and Sex Reassignment" 1969 -1999

Children of a Parent Undergoing a Gender Transition: Disclosure, Risk, and Protective Factors

Ettner, Randi Cahan, Ph.D. –Clinical Psychologist, President – New Health Foundation; White, Tonya Jo Hanson, M.D. – Fellow Associate, Mental Health Clinical Research Center, University of Iowa Hospital and Clinics.

Among individuals undergoing gender transition, approximately fifty percent of genetic males, and a smaller number of genetic females have had children. A gender transition places a child in an atypical situation in the present cultural milieu. There exists a paucity of research on the effects of such parental gender transition on children, adolescents, and young adults. The present study is a preliminary attempt to delineate the effects on children, at different stages of development, whose parents have undergone a gender transition. Our initial hypothesis was that protective factors for such children would include the parent transitioning when children are younger, maintenance of contact between the transitioning parent and the children, and low rates of family conflict.

A questionnaire was developed and mailed to therapists working with transgendered clients who are listed in the directory of the Harry Benjamin International Gender Dysphoria Association. The form contained a number of variables, in an attempt to determine the risk and protective factors for children of both genders and at varying developmental levels. The clinicians’ impressions of both the harmful and beneficial aspects of disclosure of the transition to children are also assessed.

The preliminary results are consistent with the original hypothesis: Children fare better, overall, when the parental transition occurs at an earlier developmental stage. Adolescence, however, was noted to be a more difficult time for youth dealing with parental gender transition. None of the therapists who responded view gender transition as a neutral event, and the general consensus is that it places the child at moderate risk. On the other hand, a ubiquitous response among therapists is that waiting to transition until the children are older and simultaneously withholding all forms of disclosure is actually more difficult for children to deal with. The exception to this is later adolescence, with several therapists recommending the parent wait until the children have reached young adulthood.

There was an overall consensus that factors within the parental relationship and family constellation had significantly more bearing on the outcome for the children than the transition itself. Such factors as abrupt separation from the transitioning parent, non-supportive family members, parental conflict, and an inability for families to work together, are all considered to place the child at risk for adjustment difficulties. Parental conflict also adversely effected long term adjustment for the child.

In summary, a parental gender transition is not a neutral event in the lives of children. It appears, however, that postponement and non-disclosure place the children at greater risk than the transition itself. Factors that prove protective include the children being at an earlier age at the time of the gender transition (except for later adolescence), family members working together, maintenance of contact with both the transitioning and non-transitioning parent, cooperation regarding parenting, and the extended family taking an active role in the lives of the children.

As this is a pilot study and limited to querying therapists rather than directly studying the children and adolescents, reporting errors and sampling bias are possible. Future studies should have a prospective design and evaluate the children directly within their family constellation.