• Child Development
• Child Health
• Child Welfare

Paediatricians, and society in general, often feel very uncertain about trajectories of gender questioning in children. Gender-questioning children have not historically been referred to paediatricians, but the new National Health Service England referral pathway as of September 2024 is that those who don’t also meet criteria for Child and Adolescent Mental Health Service referral will be seen by general paediatrics before referral to regional services.1 The Cass review of gender identity services also recommended that paediatricians with a special interest will be part of regional gender identity services.2 Paediatric endocrinologists may have an important role in considering puberty blockers or hormonal treatments. In all these ways and as leaders in child health you are important advocates for gender-questioning and transgender children’s best interests.

As a parent, I wanted to tell you my child’s story so far. Not because I have any easy answers or simple actions to recommend. But because our societal narrative is messy and full of fear and I want you to centre the children at the heart of it.

My child was six when they first started telling us they thought they were a boy. Over a period of months they were consistent in saying that they were a boy inside, expressing dysphoria about their body and a strong desire to be seen in the world as male. My child was seven when, after months of thinking and reading and listening, we agreed to a ’social transition' (changing pronouns and name to fit a male gender identity, both at home and at school). We felt that as …