Gender identity

If your child has started to question their gender, or has told you they're transgender, non-binary or gender-diverse, you're probably holding a lot at once: love, worry, confusion, and a wish to get this right in a cultural moment that feels complex. This guide is here to help you understand what gender identity is, what the questioning can look like at different ages, what the post-Cass landscape in the UK means for your family, what genuinely helps, and how counselling can support both your child and you.

A note on language and approach. We use current UK clinical terms and the framing set out by the Cass Review. Our work is gender-affirming, by which we mean supporting a young person to explore and understand themselves without directing them toward any predetermined identity or medical outcome. It's not, and never will be, conversion therapy. The goal is always to reduce distress and support self-understanding.

What is gender identity?

Gender identity is a person's deeply held, internal sense of their own gender: whether they feel like a boy, a girl, both, neither, or somewhere else. For most people it matches the sex they were registered at birth. For a smaller number it doesn't. Gender identity is not generally understood as something a person simply chooses, and it's separate from sexual orientation, which is about who a person is attracted to rather than who they are.

In adolescence, gender identity can be fluid, and exploring aspects of identity, including gender, can be part of growing up. The work for a parent is not to predict where your child will land, but to support them while they find out.

Common terms and what they mean

Young people use language about gender fluidly, and the words change over time. What matters is their lived experience, not the label. A few terms you're likely to meet:

• Transgender (or trans): a gender identity that's different from the sex registered at birth.
• Non-binary: a gender identity that sits outside the boy or girl binary.
• Gender-questioning or gender-exploring: actively working out their identity, without a settled label.
• Gender dysphoria: the recognised, often significant distress some people feel when their gender and their registered sex, or how others see them, do not match. It describes the distress, not the identity.
• Cisgender (or cis): a gender identity that matches the sex registered at birth.
• Assigned female or male at birth (AFAB or AMAB): neutral ways of describing registered sex.

Being trans or non-binary is not classed as a mental illness. In 2019 the World Health Organization moved gender incongruence out of the mental-disorders chapter of its international classification altogether ^[1].

How common is gender questioning in young people?

In the 2021 Census for England and Wales, about one in a hundred 16 to 24 year olds described themselves as trans or having a different gender identity from their registered sex ^[2]. The number is genuinely uncertain, and the ONS has since reclassified these figures as statistics still in development, but the broad picture holds: this is far from rare.

The number of young people referred to NHS gender services also rose sharply over the past decade, from around a hundred a year to several thousand, with a shift toward teenagers registered female at birth and high rates of co-occurring mental-health and neurodevelopmental conditions ^[3]. Why the rise has happened is debated and, honestly, not fully understood. What matters for your family is less the national trend and more your own child in front of you.

Why young people explore their gender identity

There is no single reason a young person questions their gender, and it's rarely just one thing. Common threads include:

• The ordinary identity work of adolescence, when working out who you are is the central task.
• A long-standing internal sense of difference that finally finds words in the teenage years.
• Distress about the changing body during puberty.
• Greater visibility and language, which can give a name to feelings held for a long time.
• Online communities, which make it easier to find peers and information, and harder to know which sources are reliable.
• For some, autism or other neurodivergence is part of the wider picture. Research has found that autism in particular is more common among people with gender dysphoria than in the wider population ^[4], though that does not mean one causes the other (more on this below).

For many young people, the exploration is genuine and real. The idea that it is "just a phase" is more complicated than it sounds, and treating it that way can push a young person further away rather than closer.

What gender questioning can look like

It looks different for every young person, and many explore quietly inside themselves for months or years before they say anything. Signs a parent might notice include:

• Asking to use a different name or different pronouns.
• Changes in clothing, hair or appearance.
• Discomfort or distress about their changing body.
• Withdrawal or anxiety in gendered spaces such as PE, changing rooms or family events.
• More interest in gender topics, online or in books.
• Persistent distress when referred to by their registered name or pronouns.
• Worsening mood or anxiety that ordinary support doesn't seem to shift.

None of these on its own means anything fixed. They're not a checklist: a young person can be questioning without showing any of them, and show some without questioning at all. Taken together and over time, they can be a prompt to ask your child, openly and without pressure, how they're feeling.

The UK clinical landscape in 2026

If you start reading about gender services, you'll quickly meet the Cass Review: an independent review of NHS gender services for children and young people, led by Dr Hilary Cass and published in April 2024 ^[3]. It led to the closure of the single national clinic (the Tavistock GIDS), a move to regional services, and a far more cautious approach to medical treatment. Since then, access to puberty blockers and to hormones for under-18s has been restricted in different ways, set out below, and this part of the picture is still changing. What we describe here is the position as of October 2026.

In practical terms: NHS England published a new service specification for children and young people's gender services in April 2026.

Puberty blockers are not routinely available on the NHS for under-18s. A clinical research trial (the PATHWAYS trial) was cleared to begin recruiting in August 2026.

Hormones are a separate question. NHS England's policy on prescribing masculinising or feminising hormones to under-18s has been paused since March 2026, during a public consultation on a revised policy. Some existing patients aged 16 and 17 can continue where the young person, their family and their clinical team all agree.

Because these details keep changing, NHS England's own pages are the place to check for where things stand now ^[5].

One of the review's central findings is worth understanding carefully, because it's easy to misread in the headlines. It concluded that the evidence for medical treatments such as puberty blockers in under-18s is weak and uncertain, not that anyone should or should not be trans. The review was informed by systematic reviews from the University of York. One of these looked at 50 studies of puberty blockers and rated one as high quality, 25 as moderate quality and 24 as low quality ^[6]. That conclusion has itself been both strongly endorsed and strongly criticised by clinicians and researchers, and the field remains divided.

Finding Therapy's role in all of this is steady and simple. We are not a medical service and we take no side on medical treatment. We support each young person and family, whatever views you hold, without pushing toward or away from any pathway.

Gender dysphoria: when distress is part of the picture

Not every young person who questions their gender is distressed. Some explore with curiosity, feel settled, and aren't troubled by it at all. Others feel significant distress about the mismatch between their gender and their body, or how others see them. This is what clinicians mean by gender dysphoria, and it can come alongside low mood, anxiety, difficulties with eating or self-harm. It can affect a young person's mental health deeply, and counselling can offer a supportive space to work with that distress.

Therapy here is not a substitute for any medical assessment. For many families, though, it's a useful support: a space to explore, to understand the distress, and to be supported with anything else going on alongside it.

Gender identity and mental health

Gender-diverse young people do, on average, face higher rates of anxiety, low mood and body-image difficulties than their peers, and a large international review found higher rates of self-harm ^[7]. It's important to see this in context. Research links these difficulties with factors including stigma, rejection, discrimination, bullying and isolation, sometimes called minority stress ^[8]. A young person's gender identity is not itself a mental health problem. And crucially, these difficulties are not inevitable. Where young people are supported, many do much better: in one US study, socially supported trans children showed levels of depression no higher, and only slightly more anxiety, than other children their age ^[9].

If your child is struggling with anxiety, low mood, body image or eating, those difficulties deserve support in their own right, alongside anything to do with gender. The same is true of anxiety and low mood and depression more broadly.

Why acceptance at home matters

One finding that comes up again and again in the research is that having at least one supportive adult who accepts them is linked with better mental health for gender-diverse young people. Often, that adult is a parent.

One large US study, which asked trans adults about their childhoods, found that in families that supported their child, the raised risks that can come with gender-identity milestones, such as coming out, were largely not seen ^[10]. Feeling connected at home, and having caring adults around, is linked to lower distress and less substance use ^[11], and using a young person's chosen name is associated with better mental health ^[12]. Much of this research comes from the US, and every family is different, but the pattern is consistent.

None of this asks you to have all the answers, or to feel no fear or grief of your own. It asks something simpler: that your child knows they're loved and safe with you while they work this out. Acceptance cannot protect a young person from every difficulty, but it gives them somewhere steady to come back to.

What if my child changes their mind later?

The evidence here is limited, but it suggests that for children who are supported, identity is mostly stable over time. In one North American cohort followed for five years after socially transitioning in childhood, about 94 in 100 still identified as trans, and around 7 in 100 had changed how they identified at least once during that time, for example back to the gender they were registered with at birth, or to non-binary ^[13].

That study followed young children who identified early and were well supported, so it can’t tell us everything about every young person. The honest point is this: supporting your child to explore is not the same as deciding anything for them. Exploration is real and valuable in its own right, and staying open and steady leaves room for whatever they come to understand about themselves.

Gender identity and neurodivergence (autism and ADHD)

There is a genuine, well-documented overlap between gender diversity and neurodivergence, autism in particular, and it runs both ways. In studies of people diagnosed with gender dysphoria or gender incongruence, around one in nine also had an autism diagnosis ^[4], and autistic young people are more likely than others to be gender-diverse ^[14].

A very large study of medical records found gender-dysphoria diagnoses were around three times more likely in young people who were also autistic ^[15]. This is co-occurrence, not cause: being autistic doesn't make a young person gender-diverse, or the other way round.

What it means in practice is that if your child is both gender-questioning and autistic or has ADHD, that combination is not unusual, and it deserves a counsellor who can hold both with curiosity and respect. Good support neither reduces a young person's gender to their autism, nor dismisses their exploration as just an autistic thing. An autistic young person may simply need more time and clearer communication to express how they feel about their gender. If autism is part of your child's picture, you may find our guide to autism a useful companion to this page.

What it's like for parents

Parents arrive at this with an enormous range of feelings, often several at once: confusion, worry, grief for a future you had imagined, pride at your child's honesty, concern about outside pressure, frustration with the public conversation, and a quiet fear of getting it wrong. Many are also navigating disagreement at home, with a partner or wider family who see things differently. It can be exhausting.

Many parents worry that they don’t know enough, that they won’t find the right words, or that they’re not the parent their child needs right now. You don't need to be an expert. What helps is being a supportive, approachable, safe place to land. Almost everything else can be worked out from there.

What to say and what not to say

You don’t need a script, and you will not get every word right. What tends to help, and what tends not to, is fairly consistent.

What tends to help

• Listen, and let your child lead. You can acknowledge how much courage it takes to talk about this.
• Use their chosen name and pronouns. Research with teenagers and young adults links using their chosen name with better mental health ^[12].
• Keep the channel open. Make it clear, in words, that your love is not conditional on their gender.
• Be honest about your own process. Something like "this is new for me too, I'm working on it, and I love you" usually lands better than pretending to have it all figured out.
• Be curious without interrogating. "What helps?", "What’s hard?" and "What would you like me to call you at Grandma's?" open things up.

What tends not to help

• Dismissing or arguing. "You’ll grow out of it", "it’s just a phase", "you’re too young to know" are often experienced as rejection and can deepen distress.
• Telling others without permission. Wherever possible, let your child decide who knows, what is said, and when. Sharing their identity without their agreement, even with family, can feel like a serious breach of trust. There can be times when information does need to be shared, for example for safeguarding or legal reasons.
• Pushing toward any outcome. Pressuring a young person toward or away from a particular identity or outcome is unlikely to help, and can shut down the exploration they need to do.
• Expecting the worst. Your own worry and grief are understandable. Working them through with your own support can help you stay calm and present with your child.

What you can do as a parent

Beyond the conversations, several practical things can make a real difference.

• Make home a safe place. As the research above shows, knowing they'll be accepted at home is linked with better mental health for young people.
• Educate yourself, at your own pace. You don’t need to become an expert overnight. Mind's information on LGBTQIA+ mental health ^[16] and YoungMinds' resources on gender identity ^[17] are good, calm starting points.
• Talk to school. With your child's agreement, a conversation with the pastoral lead can make a real difference to their day-to-day experience.
• Be patient with your own process. It's allowed to be hard, and to grieve a future you pictured. Doing your own emotional work, ideally with support, lets you bring a calmer presence to your child.
• Look after the rest of the family, and yourself. Siblings have feelings too. And your own time, peer support, or therapy are not luxuries; they help you keep showing up.

School: safety and belonging

School can be where a gender-diverse young person feels most exposed, and where being accepted can matter a great deal. US research has found that a safe, connected school, where a young person feels they belong and has at least one supportive adult, is linked with less of the harm that bullying and exclusion can otherwise do to their mental health ^[18]. Since September 2026, government safeguarding guidance for schools and colleges in England (Keeping children safe in education) has set out how they should respond when a child or their parent asks for support with a social transition, and it expects parents to be actively involved in most cases. How schools put this into practice still varies, so it's worth finding out what your child's school actually does.

When to seek professional help

Exploring gender is not, in itself, a mental health problem. But the pressures around it, and any wider difficulties, often mean professional support is helpful. It's worth considering counselling if your child is:

• Experiencing persistent low mood, anxiety or distress connected to their gender.
• Withdrawing from school, friends or family, or no longer feeling safe or seen.
• Leaving you feeling overwhelmed or unsure how to support them.
• Struggling with body image, eating or self-harm.
• Showing any signs of suicidal thinking. If so, take it seriously and ask them about it calmly. Contact your GP for an urgent appointment or call NHS 111, and if you think they're in immediate danger, call 999 or go to A&E. You don't have to be sure how serious it is. You can reach the Samaritans on 116 123, Childline on 0800 1111 (for under-19s), or text SHOUT to 85258. Finding Therapy is not a crisis or emergency service.

As a broader guide, distress that lingers, overwhelms your child, or gets in the way of school, friendships, sleep or daily life is a reason to act rather than wait.

How counselling helps

At Finding Therapy, our counsellors offer integrative talking therapy. They work relationally, which means building a trusting, accepting space is an important part of the work, alongside appropriate assessment and interventions. Across children's and young people's therapy, a trusting relationship between a young person and their counsellor is consistently associated with better outcomes ^[19].

For a young person who often feels unseen, the experience of being accepted, without judgement, by a steady adult can itself be part of the change. In practice, the work usually involves:

• Building a safe, private space to explore feelings without pressure toward any conclusion.
• Helping name and understand feelings, including any dysphoria or distress.
• Working with anything alongside it, such as anxiety, low mood or body image, with the work adapted for autistic and other neurodivergent young people.
• Creative approaches, such as drawing, writing, storytelling and games, which suit younger children and those who find direct conversation overwhelming.

One thing we want to be completely clear about: we do not deliver conversion therapy. We follow the Memorandum of Understanding on Conversion Therapy, signed by more than 25 UK health, counselling and psychotherapy organisations including BACP and NCPS, which explicitly opposes any attempt to change or suppress a person's sexual orientation or gender identity on the basis that one is better than another ^[20]. Our work supports a young person to understand themselves. It never tries to change who they are, in any direction. Counselling is a supportive space, not a medical or crisis service, and it does not replace your GP or NHS care where those are needed.

A clinical perspective from one of our counsellors

Gillian Murgatroyd, MBACP, a Finding Therapy play and creative arts therapist with experience in supporting young people around gender and identity, shares how she works in her sessions:

"I have experience supporting young people around gender and identity, across counselling teams in school clusters, private practice, and LGBTQ+ focused charity work with young people who are trans, non-binary, or gender-questioning. Alongside my professional experience, I also have personal experience which has given me a deeper understanding of some of the experiences young people and their families may encounter around gender and identity. I recognise that every young person's experience is different, and that the people and world around them can influence how they feel and experience everyday life. I see young people as the experts in their own experiences and work alongside them with curiosity, openness and respect, helping them make sense of what they are experiencing and navigate the world around them. I offer a space where young people feel accepted, understood and able to be themselves."

"Reaching out for therapeutic support can feel daunting, both for young people and their parents and carers. When a young person comes to me, my priority is to create a safe, welcoming space where they can express themselves in whatever way feels most comfortable. I use creative materials and activities to help them communicate thoughts and feelings, especially when words feel hard to find. My approach is warm, accepting and focused on building self-esteem, so each young person feels seen and valued."

"The young person's interests guide our sessions through creative activities, storytelling or games, which can be gentle ways to build trust and explore their experiences. We can talk, draw or be creative around whatever feels important to them, whether that's relationships, friendships, family life, school or simply how things are feeling. I work at the young person's pace, with gentle listening and curiosity, making sure they feel heard without judgement."

"Online therapy can be particularly helpful for young people navigating difficult experiences with family, friends or the wider world, as being in their own home can feel safer than walking into an unfamiliar therapy room. The interactive way that Finding Therapy delivers sessions is especially supportive for young people who are also neurodivergent. We can communicate through talking, the chat function, drawing canvases and other creative media, so each young person can engage in the way that suits them best."

"My aim is for the young people I work with to feel confident in themselves, accepted for who they are and better able to navigate the world around them. Progress looks different for everyone, but this might include growing confidence, greater self-understanding or improved emotional resilience. If you're looking for support for a young person around gender, identity, relationships or some of life's challenges, please do get in touch."

Why online therapy can suit this work

Many gender-questioning young people have found gendered spaces, such as changing rooms, corridors and family events, to be exposing or unsafe. Walking into an unfamiliar therapy room can feel similar. From their own bedroom, with the camera, the lighting and what they show under their own control, engaging can be easier. For anxiety and depression in children and young people, research suggests therapy delivered through a screen can work about as well as meeting in person ^[21]. That research was not about gender identity specifically, so treat it as general reassurance about online therapy for young people rather than proof for this. And for younger children, our interactive creative tools, drawing, writing and games, give a wider range of ways to communicate than an ordinary video call. Online counselling isn't right for every situation: where there is a significant risk to safety, a safeguarding concern, or a need for more intensive or specialist assessment, other support may be better.

What doing well actually looks like

Recovery is not quite the right frame here, because the work is not to produce a particular outcome. The work is to support your young person to a place where they feel calmer in themselves, more accepted and understood, and able to get on with school, friendships, family and life without the weight of unresolved distress.

For some young people, that means settling into a clear, stable trans or non-binary identity with strong family support. For others, it means working through a period of intense questioning and settling back into a cisgender identity. For others again, it means ongoing exploration without any urgency about labels. None of these is the right outcome. Each one is a young person supported in coming to know themselves. Progress is rarely a straight line, and every young person's path is different.

A final word

If your child is questioning their gender, they're doing demanding identity work, in a loud and contested moment. Your job is not to predict where they will land, or to steer them toward any outcome. Your job is to be a steady, loving presence while they come to know themselves, and to get the right support around them.

At Finding Therapy, our counsellors are experienced in supporting gender-questioning young people and their families. If you'd like to talk to a specialist, you can browse our directory of children's and young people's counsellors, or book a free consultation and you'll speak to our Head of Counselling, who can help with a recommendation.