Long story short, raising a transgender youth is expensive. Whether it’s affirming your child with a social transition, addressing your child and your mental health, or later on supporting your youth or young adult with medical care, the costs quickly add up.
I purposefully chose not to dive too deep into this topic when I wrote the book Beyond Pronouns: The Essential Guide for Parents of Trans Children for two main reasons. First, I didn’t want to discourage parents from affirming and supporting their gender-diverse youth. While this can be an expensive journey, there are supports available. Also, I wanted the book to focus on that initial stage of social transition, and this blog will take a deeper look past those first 100 days.
Social Transition Costs
Socially transitioning refers to the process of publicly presenting as a gender that is different from the one assigned at birth. It involves changing one’s name, pronouns, clothing, hairstyle, and other aspects of their appearance to align with their true gender identity.
Here are some items that you as a parent or caregiver may need to purchase to support your child socially transitioning:
Clothing, hair care and grooming products, makeup, and voice training: Depending on the youth’s gender identity, they may need to purchase new clothing and accessories that align with their preferred gender expression. They may want to dress, groom, or speak more femininely, masculinely or androgynously.
Legal name change and ID documentation: Some youth may choose to change their name legally, which can involve court fees and other legal document expenses. You may also need to register for new ID documentation, such as a driver’s license, birth certificate or passport that reflects your child’s new name and gender marker.
Gender-affirming gear, such as packers or breast forms, are prosthetic devices that can be worn in underwear to give the appearance of a bulge. They can be made of silicone or other materials and come in various sizes and shapes. Stand-to-pee devices allow trans masculine people to stand and urinate. Gaffs are undergarments that can be worn to flatten the genitals, and binders are compression garments to help flatten the chest or create a more masculine or androgynous shape.
The cost of socially transitioning can vary greatly depending on the youth’s needs and your financial resources. Some people may need to purchase all of these items, while others may not need to buy any of them. The tricky part for a parent is to be able to budget wisely because buying everything at once may not always be possible.
Mental health support
In my blog on finding a gender-affirming psychologist, I cover that not every trans person needs a therapist. But if there is a need, the cost of seeing a psychologist can vary greatly depending on several factors, such as where you live, your insurance coverage, and the specific type of services you seek.
Generally, the cost of seeing a psychologist can range from around $75 to $250 per hour. Some psychologists charge a flat rate for each session, while others charge according to a sliding scale based on the client’s income.
It’s also worth noting that while seeing a psychologist can be expensive, it can also be a valuable investment in one’s mental health and well-being. In some cases where there is a co-occurrence of a severe mental illness, mental health is essential and not optional. Therefore, it’s important to consider the potential benefits of therapy when evaluating the costs.
I could write an entire book on what it’s like to parent a child through a medical transition (and I’m strongly considering it), so I will briefly explain it here. Access to health care varies widely according to the country and province or state you live in. They can include hormone blockers, puberty blockers, cross hormones, hormonal replacement therapy, and surgical procedures on the face, chest, genitals and more. (Quick side note for any misinformed doubters: surgery is not performed on 8-year-olds! There are scientific international standards of care.)
Generally, medical interventions are typically covered by Canadian public healthcare and private health insurance when prescribed as part of a gender-affirming therapy plan. However, out-of-pocket costs can still be high, particularly if a person does not have insurance coverage or if their insurance has a high deductible. An American coaching client of mine shared with me just last week that for her insurer hormone blockers are billed at 8 times the rate when the child is under 18 compared to over 18! And the medication is four times the cost in the US compared to Canada. Mindblowing. Therefore, it’s advisable to check with your healthcare provider and insurance provider for specific cost information and to explore options for financial assistance if needed.
Here are a few examples of extra medical costs that your provincial health care or insurance won’t cover. Some families may need to travel to a different location for medical interventions, which can include expenses for transportation, lodging, and meals. You may need to take time off work before and after, which can result in lost wages or income. Also, you may need to arrange for childcare or eldercare during medical appointments, especially if travelling. Finally, deductibles or choosing providers who your insurance company does not cover will also result in paying out of pocket.
Self-care for parents
I am a massive advocate for a parent to prioritize their respite and self-care. I wrote a blog here with several ideas of how you can fuel your resilience to stay the course. Some ideas are reasonable, such as taking a bath or walking in nature, while others are more costly.
If you need a mentor coach for a personalized plan, a therapist to work through childhood trauma, or a couple’s therapist to avoid an even more costly divorce, please work caring for yourself into your budget for caring for your child. This is an enriching journey this raising transgender youth. The sense of pride and joy and connection and authenticity is beyond measure. But we must make it through the stressful parts first, which can only be accomplished if we put on our oxygen masks as parents.
Many of these financial realities are unavoidable and can vary according to your family’s resources and your trans youth’s needs. My best advice is to go into affirming your trans child as an informed parent or caregiver with a clear plan of action, including a workable budget.
Download the ebook Defining Transgender here to stay in touch through my newsletter and don’t forget to grab your copy of Beyond Pronouns: The Essential Guide for Parents of Trans Children.
No matter at what age our children come forward with their truth about their gender identity, once we start affirming them and supporting a social transition, we eventually must have conversations with extended family. I have dedicated a whole chapter around this in Beyond Pronouns, focusing mainly on the need to let the child take the lead, the parent’s experience coming out to service providers, and especially how to protect the transgender person from microaggressions and outright transphobia.
Since writing the book, I have had some excellent conversations with grandparents of trans children about their experiences. It was pretty enlightening to hear their point of view. There is a unique quality of love felt by a grandparent, but it is love just the same. So let’s look at the nuance outside the binary of being a perfectly affirming grandparent and a transphobic one.
Many self-aware grandparents understand their place in the pecking order of decision-making with children in the family. Many a mother-in-law over history has been told to keep her opinions to herself. Because of that, grandparents have said to me that they feel lost and have no control when they are told about their grandchild dealing with gender dysphoria. I could relate to that loss of power as a parent myself. Still, at least I was in the doctor’s office and making therapy appointments and had some sense of participation and immediacy in the process. In contrast, grandparents often hear about it after the fact.
No room for grace
One grandmother told me she struggled with being told by her daughter how she was to feel when she learned that her grandchild was a trans girl. She was only to feel happy about the transition, not ask questions, and there was absolutely no room for occasional mistakes with chosen names or pronouns. Further, her daughter threatened to remove access to the grandchild if grandma couldn’t be completely affirming immediately. While I fully understand the want and need to protect transgender children from harm, this description didn’t sound very fair when I consider how I made my own mistakes early on in my son’s transition, and I am a fierce ally and advocate. Sometimes grandparents need to be seen for their humanity and given some grace.
No access to support
While extended family can easily read my book, the subtitle says specifically it’s for parents of trans children and most of the support groups out there are also focused on parents, even though we welcome all caregivers. Grandparents may not realize they are welcome to access those supports. Add to that the reality that grandparents come from a generation where gender diversity was never discussed or taught in schools. So they are coming at this completely in the dark. Further, they were mostly raised not to discuss this type of topic in polite company, and if the child has chosen to be stealth, they won’t be able to discuss the transition with friends. It is difficult to process a major life change alone.
Again, protecting trans children from painful rhetoric and microaggressions is very important. We also need to consider the perspective of grandparents who love their grandchildren and need more education and opportunities to practice using a chosen name and correct pronouns. That might look like sharing resources like an Understanding Gender webinar with the grandparent or going coffee alone as adults and having an open, loving conversation about the new terminology.
One last word for grandparents, I understand having a heart full of love and also feeling fear about something you don’t understand. Please learn as much as you can on your own from reputable sources such as Trevor Project, and be patient with your children as everyone is processing a significant change that can be stressful for everyone involved. You’ve got this. Just keep leading with love.
Download the ebook Defining Transgender here to stay in touch through my newsletter and don’t forget to grab your copy of Beyond Pronouns: The Essential Guide for Parents of Trans Children.
There is no doubt that the holidays are a nerve-wracking time of year, no matter your family circumstances. Filled with often unattainable expectations that stress us out, add a new announcement of gender diversity, and you have a recipe for added anxiety.
For many of us, this might be the first year that we are introducing our child as a different gender with a new chosen name or pronoun when we go to visit other families during the holidays. Maybe you are signing your Christmas cards or holiday cards with a new name. Because there can be many changes in the lives of families with gender-diverse individuals, I have four tips for you this holiday season.
Preplan as much as possible
Pre-planning is very important because you don’t want to come out to grandma on Christmas morning by showing up with a child who’s presenting as feminine using a feminine name and she/her pronouns if they were assigned male at birth and grandma has only ever known her as her grandson. It can be a shocker, and it’s unfair to grandparents or your child. So, preplan as much as you can. Call people, email people and let people know if your child is going to be presenting as a different gender than what your family or friends are accustomed to. If you are asking people to use a different name, let them know what the chosen name will be. If you’re asking them to use a new pronoun, let them know what the pronoun will be.
Yes, it is stressful. It is stressful to be coming out as a parent for your child. But avoiding difficult conversations doesn’t make it easier on you or your child. Doing so in advance also allows you to have bigger conversations explaining what gender diversity means and how it differs from romantic and sexual attraction. It allows you to offer them resources such as Defining Transgender and Beyond Pronouns.
Big asterisk here: all of this is under the assumption that your child wants everyone you will be visiting to know about their gender identity. Some families choose not to gather and not say anything. And that is important for you to discuss with your child ahead of time. Hence the pre-planning. These are not decisions you want to make 10 minutes before you head out the door to go and see family or 10 minutes before you get onto the zoom call with your whole family.
Affirm and advocate for your child
As stressful as it can be, if people continuously make mistakes using the wrong pronouns, you correct them. Every. Time. “Actually, it’s she,” or “Sorry to interrupt, it’s she,” or “can you please use she when you’re referring to Rose?” You don’t need to make it a loud scene. You don’t need to shame the other person. But you do want to be consistent and insistent. When you’re correcting people in front of your child, you are affirming them, making them feel safer.
Advocate for yourself
Realize that this is a lot. You are, as a parent, vulnerable every time you come out for your child, and it does end up being a lot of emotional labor. So, if you need to take a break, pass the buck off to another parent, aunt, cousin, or someone else in the family who’s affirming. Let them do some explaining or pronoun corrections for a few minutes. It takes a village, right? Take care of yourself, affirm yourself, and don’t feel like you have to back down and be someone different. Isn’t that what our children are teaching us, to be our authentic selves? If you’re uncomfortable in a situation, advocate for yourself like you would for your children. You matter too.
My best secret trick to surviving the holidays
It’s easier to leave than to ask someone to leave. So, if you have a choice, go visit someone instead of inviting them over. And if they are misgendering and using the wrong name, and being completely rude around your child, you can leave. Or even if everything is going swimmingly, but your child is just getting overwhelmed by everything, you can leave. You can be honest and upfront, “you’ve misgendered Rose so many times today that I’m exhausted, and I just have to leave.” Or you can offer an excuse for not feeling well if that makes you more comfortable.
I speak from experience when I say that coming up with those excuses to leave is way easier than asking belligerent Uncle Bill to leave after he spews hate about transgender people three glasses of wine into dinner. So as much as you possibly can, go visit other people.
Those are my four holiday tips: Preplan and advocate for your child. Always, always, always advocate for your child. It is what keeps them safe. Also, advocating for yourself, visiting others, and leaving if you must is much easier than kicking someone out. Wishing you a wonderful holiday season with few expectations, much spontaneous joy, authenticity and rest. Lots of rest.
Have you taken the parenting style quiz yet? Find out if you are the parent your gender-diverse child needs and get some tips for moving forward.
Because I am a parent myself, I have spent much of my time over the past six years advocating for parents and caregivers of transgender and gender-diverse youth. However, as I continue meeting people and doing training for different groups, I have heard a similar refrain from educators: Teachers and school staff also have to learn about gender diversity and how to affirm their students.
So, I reached out to an experienced and compassionate former schoolteacher and principal to get her perspective on what it’s like to have a child transitioning at school.
Learning What’s Involved in Transition
I sat down with Elizabeth Bennett, a recently retired educator with 35 years of experience and author of the book Courageous Conversations: a guide for parents to understand and connect with their teen. She shared the story with me of her first experience with a gender-diverse student. It was several years ago, and at the time, the family had to guide the school on how to affirm the child and what changes were needed in the classroom.
This was also my experience when Mitchell first came out as transgender in 2016. I wrote about the harrowing experience in an article for LGBTQ Nation, but essentially the school had pathologized and othered Mitchell because they didn’t understand what gender diversity meant. So today, when I do training for school boards and other businesses and organizations, I start with a clear explanation of how gender develops in children and that it is very different from sexual and romantic attraction.
Seeing the Person Instead of the Policy
Elizabeth shared with me that she made a concerted effort while leading her staff to focus on making their school a safer place and to be welcoming and inclusive. Understandably, any organization with a governing body must live and operate within a policy structure. But it is so important to be sensitive to the vulnerable children affected by those policies.
Another school principal once shared with me that it was more often closed-minded parents who took exception to the affirming actions the school had taken for transgender and gender-diverse students. But, for the most part, fellow students had no issues. When making decisions in schools, we need administrators to think first about the child and not the rigid or uninformed opinions of adults.
Gender Inclusive Language
Learning to say “everyone” or “friends” instead of “boys and girls” was a tricky one at first for Elizabeth. Schools are often set up for gender segregation, from pink and blue cubbies to gym classes. Further, teachers in middle and high school can attest to the difficulties of using chosen names and different pronouns with the students in class but then having to switch to the old name and pronouns when talking with parents as requested by the child if they haven’t come out to their parents yet.
While it can be challenging to learn new ways to address students, again, these kids are on an often difficult journey, and we adults with our fully developed pre-frontal lobes get to do the heavy emotional labour.
Being a Proactive School
Elizabeth’s final advice was that it is so important for schools to learn about gender diversity and how to accommodate transgender students early on. You don’t want to be constantly in a reactive, knee-jerk state. It’s imperative to be purposeful in our actions and conversations.
If you feel that your school, school board, or organization that interacts with children and their families could use more training on what transgender means and how you can accommodate and affirm gender-diverse youth, please reach out to find out how I can help.
Almost two years ago, my youngest child asked to have the robot wallpaper in their bedroom removed, and the walls painted pink. That request was followed up quickly with the reassurance, “I’m just a boy who likes pink.” My child then proceeded to grow long hair and wear nail polish to school for another year. Finally, my youngest child asked for skirts and tights as a birthday present this past April. We sat in that tastefully decorated pink room a month later and had the most honest and authentic conversation in 15 years.
“Mom, I’m transgender.”
I wasn’t surprised, but I was still shocked. A cold tingle pricked at my cheeks while I took a split second to give myself a pep talk mentally. Okay, Tammy, you wrote the book on this. So what’s the first thing you’re supposed to do and say here?
“I love you. I support you. What do you need from me?”
My fourth and youngest child is a transgender 15-year-old girl who was assigned male at birth. Her chosen name is Rose. To know her and her love of flowers is to know that it is the most fitting name a person has ever worn.
I may have written the essential guide for parents of trans children, but I still needed support upon learning that I was about to embark on the road I had just travelled with my trans son. So, my first call was to my dear friend Kiersten, the co-leader of Parenting with Pride and a trans woman. She reminded me of all the things we both say to parents when they come to our support group—most importantly, to let Rose drive the bus. Allowing Mitchell to take the lead terrified me because I didn’t know the road we were travelling on. It wasn’t any easier this time because I knew where the road led. I still had to wait and allow Rose to make all the right choices for her.
The question I saw behind everyone’s eyes
Could Rose be saying she’s transgender because of all the attention Mitchell received for being trans? For most people, that question hung in the silence between our telling them our youngest child now uses a new name and their range of replies from “okay” to “great!” But some friends were close enough and comfortable enough to come out and ask the question point blank.
For those who really know Rose, the last thing you would assume of her is to want any form of attention. But knowing her can be a difficult feat in and of itself because she is so reserved. Rose is also not swayed by anyone’s suggestions or current trends. She marches to the beat of her own drum and is quite happy to be the only one in the band.
The Pain and Pleasure Theory
I’ve studied humans a lot in my careers as a registered nurse, as a life coach, and in university psych courses. We are all hardwired for survival, and that includes avoiding pain—physical pain and the social pain of not belonging. If avoiding pain is such a deep-seated survival instinct for humans, why on earth would anyone pretend to be a trans woman for attention?
By Rose standing in her truth, she is completely aware that she is giving up the privilege of a white man to be targeted by misogyny. She’s already received cat calls. She’s very aware of transphobia because while we choose to show the positives of Mitchell’s transition, there have been negatives over the years. Rose’s requests for affirming her gender identity were for hormones and surgery, which include a plethora of pain from blood tests and injections to later undergoing elective surgical procedures. What person moves towards that sort of pain only to get their family’s attention?
I readily believe that my child is transgender because I have seen the beauty on the faces of affirmed gender-diverse people for six years now. While I am not trans and will never experience gender dysphoria, I have witnessed it enough not to wish it on anyone for a second longer than it needs to exist. I believe we all have bodily autonomy and would all benefit from a prolonged internal exploration of who we truly are. When someone tells me they’ve done that exploration, I will always celebrate them.
Welcome to the world, Rose!
For more information on Defining Transgender, you can download the free eBook here and sign-up to my email list.
While the Staples commercials like to tote this as “The Most Wonderful Time of The Year,” and I know many parents who look forward to the return of routines for their forever bored and hungry summer kids, there are some caregivers and transgender kids for whom back-to-school means back to anxiety of being judged, outed, or bullied for using a new pronoun.
When my children were little, there was a phrase I repeated almost every summer, “The bumble bee is much more afraid of you than you are of it.” That thought comes back to me now as I consider the many conversations I’ve had with teachers recently. School staff try so hard to learn the new pronouns of their students and then worry about messing things up in front of a parent who might not know.
I say this because, in 2022, schools are much more open about using new pronouns for students than they were five years ago. Of course, this isn’t a given for every school in Canada (certainly not every school in the United States), but it is a turning tide. If your gender-diverse child is returning to school this year with a new name and pronoun as a result of a social transition, here are some of the solutions that worked for us.
Be an Advocate
It took a while for this lesson to sink in for me because I never wanted to be “that” mom who was forever in the office demanding things for my child. Alas, if this journey of gender identity has taught me anything, it’s that things are not always black and white, boy and girl. You can be an advocate for your child without being mean and disrespectful. You can be clear and affirmative. You can also be diplomatic and patient, all while holding your child’s safety and mental wellness as your goal. If you are looking for resources on your child’s rights in school as a gender-diverse person, here are some helpful links for Canada and the United States.
Come Out on Your Terms
Your child may be perfectly comfortable telling strangers, teachers, and classmates, “My name was Emily and now it’s Connor,” and some children desperately want to hide any evidence of their previous gender label. Obviously, some school staff will need to know your child is transgender for emergency health reasons and for administrative purposes. But from there, you get to choose how much the other parents or students need to know. My son chose to be known only as a boy at his new school for a few months, and then when he was ready to come out, the school arranged for some training for everyone to understand what being transgender meant so that a 12-year-old boy didn’t have to answer a bunch of questions. It all went extremely smoothly.
This was also a very difficult decision for our family. We did not want to teach our children to run away from their problems, and we had already moved across the country, which also caused a change in schools. But environmental factors have a huge impact on humans thriving, and I just did not want to risk my child’s mental health with the time it was going to take to change a school’s culture and tolerance. While most schools say they have a zero tolerance for bullying, I can’t tell you how many stories I have heard of children being told to ignore abuse or to toughen up. If that is the school’s response, I don’t feel that my child’s welfare is taken seriously. This is clearly not needed in every situation, and I understand this is not an easy decision when there are siblings and transportation to consider as well. But I have to say that changing schools was the best thing we could have done for my son, and he would be the first one to tell you so.
This is a long journey with many bumps in the road, and I would not have survived these stressful decisions without the support of other caregivers who have walked this path and the support of the counsellors who have worked extensively in this field. I continue to co-lead a peer support group over Zoom once a month called Parenting with Pride which is a great place to not feel alone on this journey. There is also a fantastic support community for parents raising trans youth led by Dr. Shawn Giammattei called the TransFamily Alliance.
Wishing you the best back-to-school season possible and may you be empowered and supported in your decisions for your child, and may they feel safe and supported as well. If you haven’t already, I invite you to join my email list for parents of trans children here.