Transgender is an umbrella term used to describe the spectrum of gender identity and gender expression diversity. Gender identity is the internal sense of being male, female, neither or both. Gender expression — often an extension of gender identity — involves the expression of a person's gender identity through social roles, appearance and behaviors.

For parents, it can be challenging to know how to support a gender-nonconforming or transgender child.

Most children typically develop the ability to recognize and label stereotypical gender groups, such as girl, woman and feminine, as well as boy, man and masculine, between 18 and 24 months. In many cases, children will say how they feel, strongly identifying as a boy or girl — and sometimes — neither or both. While children might go through periods of insisting that they are the opposite gender of their birth sex, if they continue to do so, it was likely never a phase.

It is important to discuss your child's gender identity and gender expression with his or her health care provider to address the health concerns that transgender people face. The health care team also should include a counselor or therapist with training in transgender needs.

On the Mayo Clinic Q&A podcast, Dr. Aida Lteif, a Mayo Clinic pediatric endocrinologist; Nicole Imhof, a pediatric social worker; and Katherine Ley, a pediatric endocrinology nurse, discuss medical care for transgender children.

Additional resource: Trans Student Educational Resources