- Explore supportive program elements for gender-expansive and transgender children and their families.
- Reflect on barriers to supporting gender-expansive children.
- Define and describe gender-neutral programs and how these benefit all children.
- Understand the importance of self-definition through names and pronouns.
- Explore the role of medical and mental health professionals in the support of gender-expansive and transgender children.
Learn
Know
Creating a 勛圖厙ive Environment for Gender-Expansive and Transgender Children Thinking about Play
When allowed, many children engage in gender-expansive or more fluid gender play. Boys may be drawn to fancy shoes, pretty dolls, dresses and tea parties. Girls want to play rough-and-tumble, action-packed games with superheroes or play in the mud. What is viewed as boy or girl behavior is culturally defined.
Yet play preferences are influenced by the responses of peers and adults. Gender-expansive children are often redirected to what is seen as more appropriate gender-confined play, or play that aligns with the cultural expectations for the gender the child was assigned at birth. Young boys are often discouraged from playing with dolls and young girls are told not to engage in rough, physical play. Gender-expansive children may quickly realize that their play preferences invite negative interactions with some staff and caregivers. Even if not directly scolded, children typically learn that in order to avoid unwelcome attention, they must keep certain aspects of themselves hidden.
It is the responsibility of the entire program staff to create a supportive environment for all children. In many settings, it is still a challenge to support play that affirms gender-expansive children. Many of the ideas that support gender-expansive children actually help all children in the program, regardless of their gender identity, as all children can benefit from the freedom of a more gender-expansive classroom. Keeping the following guidelines in mind can help programs more successfully support all children, including those who are gender-expansive or transgender:
- Remember that play is just thatplay.
By definition, play is imaginative. Its whimsical. Its a chance to break away from the demands of daily life. Play preferences can change day to day. Caregivers should strive to encourage play without passing judgment. This includes not setting rules or passing comment on gender-expansive or gender non-conforming play. If this guideline seems difficult to follow, remember that caregivers often act in a nondirective manner regarding other areas of imaginative or creative play, such as when children make up the rules to a game or pretend that the classroom is a jungle. In these areas, childrens imagination is encouraged. Indeed, the goal of play is to reimagine the ordinary world. Caregivers who limit imaginative play prevent exploration and discourage creativity. Below are examples of ways children demonstrate more gender-fluid play:- A young boy asks you to tie a lacy apron on him while he pretends to make muffins for "the family."
- A girl constructs giant skyscrapers out of mud on the playground.
- A kindergartener, assigned female at birth, plays the role of the older brother in her dramatic play with peers.
- A school-age boy spends hours constructing colorful friendship bracelets.
- Think of non-gender conforming play within the context of breaking harmful job stereotypes.
Not too many years ago, caregivers, parents, and school counselors steered girls and women away from careers thought to be more appropriate for boys. Girls were told they were smart but couldnt be doctors because girls are supposed to be nurses. Boys who exhibited a passion for caring for others were guided into traditionally male careers, such as becoming doctors instead of nurses. Being able to break out of traditional gender roles is still a struggle for many. For gender-expansive and transgender children, being guided toward a constrained gender role is additionally harmful. Not having the opportunity to be themselves, or receiving direct or indirect messages that this aspect of themselves should be hidden, is wrong or shameful, can create undo stress for the child, negatively impacting their development as well as their own self-concept. - Create an environment where children and youth can have a positive image of themselves and can form trusting relationships with their peers and caregivers.
While all children in a classroom can benefit from the freedom of an environment that accepts gender creativity or gender expansion, for children or youth who do not clearly identify with a particular gender, or who identify with a gender different from that which was assigned to them at birth, a gender-neutral classroom is vitally important. Staff and caregivers who accept gender-expansive children and listen to what they have to say are modeling qualities of respect and kindness for all the children in the classroom. They are showing all the children a positive way to respond when people act in a way that may seem unfamiliar or different.
Gender-Neutral Classrooms
In Lesson One, the boy who wanted a turn with the pink Power Ranger-costume was discussed with some suggestions on exploring the caregivers role in choosing to acknowledge, affirm or advocate in response to the situation. 勛圖厙ing children who engage in gender-expansive expression in a program can take a variety of different approaches.
Some questions to consider together as a staff:
- How is play gendered in society? In the classroom? In other words, what kinds of play are boys versus girls encouraged to try? Or what kinds of play do we assume boys versus girls want?
- What does traditional girl gender expression look like?
- What does traditional boy gender expression look like?
- What effect do negative responses regarding gender-expansive or gender-creative play have on children?
- What are the barriers to calling children by the pronouns and names they choose?
- How can you provide support for a child when peers or professionals refer to them by unpreferred pronouns? (Please see additional information below about the importance of names and pronouns).
By exploring these questions together, you help unpack the everyday assumptions we live by. Many individuals, especially those who have not yet had many opportunities to interact with a gender-expansive or transgender person, may not really be aware of all the ways in which gender shows up in our daily lives and conversations. Taking time to reflect can help make the gender language and practices within a program more obvious and help staff be ready to respond to a diversity of gender expression.
To some individuals, the term gender-neutral means the absence of gender, for example, providing green and yellow clothes for an infant. In reality, a gender-neutral program is one in which no item has gender. This means that the clothing items provided, the toys and materials available, and the activities presented are available for everyone regardless of the gender they were assigned at birth, and that there are a variety of different clothes, toys, materials, and activities available - including those that may be assumed to be more traditionally feminine (e.g., lacy, purple dresses and baby dolls) or masculine (e.g., construction hats and wood working tools).
Gender-neutral programs also do not create different standards or criteria for boys and girls to participate. Think back to the example in Lesson Two where a staff member wanted to ask boys to wear pants and girls to wear skirts to a program event. Gender-neutral programs do not ask children to wear, do, or bring different things based on their gender. Ensuring that requirements are not different based on gender provides better support to all children in your program giving them the flexibility to contribute in the ways they want or how they feel comfortable. For example, within the schoolage program there may be youth who identify as female, but prefer to wear pants instead of skirts and dresses, or who may prefer to build the theater set and operate the lighting instead of dancing and singing in a performance. Hence, gender-neutral programs offer a variety of choices and support children and youth in picking the clothes, toys, and participation that feels right to them.
As introduced in Lesson One, terminology for gender expression has changed and continues to change. Historically, people who do not define themselves or fit neatly into the gender boxes of male or female were referred to as gender nonconforming. However, the term gender non-conforming may be off-putting to some gender-expansive individuals, as this term describes them by what they are not and can be interpreted by some gender-expansive individuals as making their gender expression seem like a problem. As discussed in Lesson One, today, the terms gender-expansive (or gender-fluid, or gender-creative) can help describe people with more diverse or non-traditional gender expression in more respectful ways. And they are terms gender-expansive individuals often use in describing themselves, or terms families may use to describe their children. The term gender-expansive in particular helps to emphasize that there are more than the two gender choices of male or female (Murchison, 2016). Remember gender-expansive and transgender are not interchangeable terms. Gender-expansive children are not necessarily transgender, but rather this is an umbrella term for all children who express non-binary identities, as well as those whose gender [expression stretches] societys notions of gender (Gender Spectrum, n.d.).
Gender-Fluid and Transgender Experiences How You Can Respond
It is important to understand that gender-expansive children are a larger part of the population when compared to transgender children. It is actually common to be gender-expansive as a child. In two studies of children brought to clinics because of their gender-expansive traits, 50 to 90 percent of those assigned female at birth, and about 80 percent of those assigned male at birth, grew up to be non-transgender adults (Murchison et. al., 2016). The current standard of care for parents and their health team is to ask whether a childs gender is expressed consistently and persistently (Meier & Harris). If a child continues to express that she is a girl, though AMAB (assigned male at birth), then additional support for that child is evaluated with a transgender identity often explored.
Small children might know what it means to be transgender, or know that they are transgender, but lack the appropriate language they need to be understood. It is important to allow a child to describe their experiences with respect to their developmental stage and in their own words. As discussed in Lesson Two regarding the impact of developmental stages on transgender or gender-expansive children, it is important to actively listen to children and families as they share their experiences. The concept of active listening is also addressed within the Social & Emotional Development, Self & Cultural Understanding and the Positive Guidance courses. Active listening around the ideas of gender expression might look something like this:
Example:
Child: Girl stuff is funner than boy stuff.
Caregiver: You want to be able to play with these toys because you like those toys, too!
Active listening, sometimes called reflective listening, is a way to hear the underlying feeling or desire behind a statement or behavior. Sometimes people practice with a formula until the practice becomes easier for them.
The formula looks like this:
You feel or want
(state feeling or desire)
because
(state your understanding of what the feeling means to them, or why the person likes or want a particular item or action)
In the example above, this childs one statement does not imply they want to be a girl. Notice that the caregivers response simply affirms that the child wants toys or materials that are traditionally assumed to be for girls, and acknowledges that the child is able to like whatever toys they wish. The purpose of active or reflective listening is to better understand a childs statements and point of view. Active listening affirms or acknowledges what children express, and allows you to seek clarity about childrens comments or behaviors. It opens the door for more communication and can help all children feel seen and heard within the program space.
In contrast responses such as, No, you know you like boy stuff, even with a warm and light-hearted tone, or ignoring the childs comments provides a message that it is not okay for this particular child to like girl things. These responses fail to validate the childrens expression and stifle creativity.
Pronouns, Names, and Language
Pronouns and name changes are an important consideration for gender-expansive or transgender children. If you were a woman and people repeatedly used the pronoun he to describe you, it would be frustrating to continually correct them. This is often the situation transgender individuals find themselves in. Children who are transgender often want to change their names and be consistently referred to with the gender pronouns they use to define themselves; it helps them to live authentically, in a way that matches how they understand themselves. Using names and pronouns that validate a childs identity supports the childs self-esteem. In addition, research on transgender youth has found that when people address them by their chosen name and pronouns, transgender youth report significantly lower depression, and lower thoughts of suicide (Russel, Pollitt, Li & Grossman, 2018). By consistently using appropriate gender-confirming pronouns, you help provide respect for the child and their gender identity.
As children transition from their assigned gender to their experienced one, or rather, the important others in a childs life transition in how they view and address the child, it is natural that those who care for them will make mistakes, occasionally using the incorrect pronoun or name. This can also happen with gender-expansive children, who may identify as a boy somedays and a girl on others, or who may prefer a different gender label all together. For example, a child may prefer to be addressed as they instead of he or she. Using new language takes practice and we all make mistakes. It can be helpful when you use the incorrect pronoun or name to simply apologize and correct yourself, this affirms the childs identity and demonstrates you want to support them.
The handout, LGBTQ Inclusive Language Dos and Donts, available below as a Learn resource and created by , offers other good tips for how to talk to and about individuals who are gender-expansive or LGBTQ. The guide provides more information on why certain words and phrases are disrespectful and what you can say instead.
Health and Mental Health Concerns
Children or families who have explored or experienced non-binary, gender-expansive, or transgender identities may seek assistance from a health-care practitioner, whether with a medical or mental health focus. In Lesson One, you read LGBTQ children and families are at increased risk for discrimination and its accompanying life stressors. The Learn resource in Lesson Six, 勛圖厙ing and Caring for Our Gender Expansive Youth: Lessons from the Human Rights Campaigns Youth Survey, explains that gender-expansive and transgender individuals are bullied, sexually and verbally harassed, and rejected by their support networks at much greater rates than the general population. These negative circumstances affect mental health and peoples sense of well-being, with many individuals exhibiting signs of depression and considering suicide. For these reasons, families may seek mental health supports to help build and reinforce resiliency in their children.
Some gender-expansive or transgender children and their families may choose to share with their caregivers information about the medical or mental health support they are receiving. Hence, we provide a very brief introduction below to help program staff be aware of medical supports that gender-expansive or transgender individuals may seek or receive. Please note: it is not appropriate to ask gender-expansive or transgender children, or their families, if they are seeking medical or mental health care related to their gender identity. However, you can be a safe listening space if families or children wish to share their experiences. It is also important to remember that whatever a family or child shares about their medical or mental health care should be treated with care and confidentiality. If you feel that a child or family member shares something with you that should be communicated with your program manager, training or curriculum specialist or other program staff to ensure the best care for the child, make sure to let the family know and ask them first before sharing. In addition, if a child shares something that leads you to believe additional communication with the child's family would be helpful, kindly let the child know that you appreciate their willingness to open up to you, and that to best support them, you want to have a follow-up conversation with their family.
Transgender children may have a medical team in place that includes a counselor, a primary care physician, and an endocrinologist. Because puberty is a stressor for children with a transgender identity, a medical team may decide to place a child on hormone blockers. Hormone or puberty blockers are medicines that delay the onset of, or continuation of, sexual maturation and they have been used previously with children who experienced puberty early, at age eight or nine.
Hormone therapies, however, are not the same as puberty blockers. Hormone therapies cause the body to change and display secondary sex characteristics, such as testosterone helping to deepen ones voice and grow facial hair, or estrogen helping to suppress these developments. Children who are in their teen years may begin to take estrogen or testosterone if they, their parents and their medical team believe it is in the childs best interest. There are some long-term effects of taking hormones as a teen, such as voice change and reduced fertility. The childs medical team will continue to evaluate hormone levels and monitor these factors.
When children and their families feel comfortable sharing their identities, details of their medical treatment may be shared with staffagain only if the child and family permit. Acknowledging the feelings of a transgender child in an active listening style can benefit the child. Your program can also support children and families by providing resources and empathy. Lessons Four and Five provide additional information on where to find supportive resources for families, child care, and school-age centers.
Caregivers and family members who create a supportive environment can have an impact on the distress experienced by gender-expansive and transgender individuals. Many transgender children describe distress when they are bullied about their gender identity or expression. Remember that any polices you have in place regarding bullying, also apply to gender-expansive and LGBTQ children and youth. In addition, many transgender individuals report distress at not being able to use the bathroom that matches their gender identity, and that bathroom access can be a major stressor in their lives. Having at least one gender-neutral bathroom on site, such as a single person bathroom, can help reduce this stress. A program director should explore the barriers to acknowledging gender-expansive and transgender individuals and their stated needs within the program, and together develop a plan to best meet their needs.
See
Listen below as a faculty in early childhood development and parents share the practices and experiences that have felt inclusive, and some that have felt unwelcoming. What strategies do you hear for creating inclusive programs for gender-expansive and LGBTQ children or youth? How do these strategies support all children, regardless of their gender identity, sexual orientation, or gender expression?
Do
Listen, and If You Are Unsure, Ask
One of the main points in this lesson is to hear the experiences of the children and youth, and staff members in your program, and to provide acknowledgment of their statements and expressions. Children will share their understandings of themselves with you if you create safe spaces for them to do so.
If a child consistently states they are a gender other than what they were assigned at birth, you can notice that and ask a follow-up if you unsure what to do. See this example: Lately, I have heard you say, no, Im a girl to your friends. If your friends wish to play with you, what should they call you?
Speak Up When Gender Confining Statements Are Made
Affirming that gender can be expressed in a multitude of ways (girls can get muddy, play kickball and assert their ideas, and boys can be sensitive, like classical music, and cry when they are hurt or sad) is one clear way you make an environment safe.
If you hear children or staff members making gender-confining statements, or statements that limit the creative expression of gender, you can often simply provide different information.
- Girls dont play football. You can respond, Some girls do play football. You could also find and share a real-life story about a female football player.
- Boys dont wear pink. You can respond, Some boys do like pink. You can follow this up with real life examples, I saw Malikas dad wearing a pink tie this morning!
You can also try to stay aware of the messages you or fellow staff members send about gender and the assumptions you convey about who should be attracted to whom. For example, reflect on this message sometimes given to young girls,
Oh, your daddys going to have to lock you up to keep away the boys. Even if this message is said in an affectionate tone and from a place of warmth, it reinforces:
- stereotypes about boys (e.g., they should chase after girls) and girls (e.g., they need to be protected from boys),
- the assumption that boys are only attracted to girls, hence sending a limiting message about romantic or sexual attraction, and
- concepts that happen in later life (like dating) onto young children, which is not developmentally appropriate.
Being aware of these kinds of statements can help you choose more appropriate messages that affirm all individuals in your program. It is best to refrain from such messages. Instead, remember caregivers and staff can comment on childrens work, play and interests.
Consider How You Can Help Make All Experiences Feel Safe
Lastly, take time to consider how you will help maintain supportive environments across different experiences for gender-expansive or transgender children. For example, work with your program administration to plan how you can ensure an inclusive, respectful program environment on field trips, overnight camps, or other special experiences. Consider experiences where children need to change clothes (e.g., daily trips to the pool), or when restroom access may be different than what is provided in your typical program space. Thinking about these special experiences ahead of time, and consulting with the childs family and your program administration allows you to develop a plan and provide consistent, caring messages to children and youth.
Explore
Visit the American Academy of Pediatrics Healthy Children site on Gender Diverse and Transgender Children (see ). Using the attachment Gender-Expansive & Transgender Children, answer the questions as you explore this website. Share your responses with a trusted colleague.
Apply
There are many additional resources you can use to better understand the experiences of individuals with diverse gender expression and identity, as well as with children or youth who identify as LGBTQ. The attachment, Books to Create 勛圖厙ive Environments contains books for both adults and children.
Your program staff can consider purchasing some of the books for your program library. The adult books are great to share with caregivers if a child in their classroom or program is genderexpansive or transgender, because it gives caregivers more in-depth knowledge about support. The childrens books expand your childrens library by having materials readily available to help caregivers combat gender stereotypes and assumptions. The childrens books also offer a great way to spark conversation about gender assumptions.
Glossary
Demonstrate
American Academy of Pediatrics (2015). Gender Non-Conforming & Transgender Children. healthy children.org.
Gender Spectrum:
Human Rights Campaign (2017). Transgender FAQ.
Human Rights Campaign (2017). 勛圖厙ing and Caring for our Gender Expansive Youth.
Lambda Legal (n.d.). FAQ: Answers to some common questions about equal access to public restrooms.
Lerner, K.L., and Lerner, B.W. (Eds.) (2008). The Gale Encyclopedia of Science, Vol. 5, 4th ed., pp. 3888-3890. Detroit: Gale.
Meier, Colt & Harris, Julie. (n.d.) Gender Diversity and Transgender Identity in Children.
Murchison, G., et. al. (2016). 勛圖厙ing & Caring for Transgender Children. American Academy of Pediatrics.
National Academies of Sciences, Engineering, and Medicine. (2019). Fostering healthy mental, emotional, and behavioral development in children and youth: A national agenda. The National Academies Press.
National Academies of Sciences, Engineering, and Medicine. (2020). Understanding the well-being of LGBTQI+ populations. The National Academies Press.
National Alliance on Mental Illness (NAMI) (2017). Find 勛圖厙: LGBTQ.
Russell, S. T., Pollitt, A. M., Li, G., and Grossman, A. H. (2018). Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth. Journal of Adolescent Health.
Toomey, B. T., McGuire, J. K., Olson K.R, Baams L., Fish J.N. (2022). Gender-affirming Policies 勛圖厙 Transgender and Gender Diverse Youths Health. Society for Research in Child Development.
Sperry, L. (2016). Diagnostic and Statistical Manual of Mental Disorders DSM. In L. Sperry (Ed.), Mental Health and Mental Disorders: An Encyclopedia of Conditions, Treatments, and Well-Being, Vol. 1, pp. 340-342. Santa Barbara, CA: Greenwood. Online edition.
Sperry, L. (Ed.). Mental Health and Mental Disorders: An Encyclopedia of Conditions, Treatments, and Well-Being, Vol. 2. Santa Barbara, CA: Greenwood, 2016. pp. 500-501.
Temkin, D. and Vega, C. (2018). Research shows the risk of misgendering transgender youth. Child Trends Blog.