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How trans kids and their parents are deciding when to start medical transition

Some families and doctors are deciding to start medical intervention before puberty

For parents of transgender children, a complex question is emerging: How early is too early for medical transition to begin?

As the debate continues over which bathroom transgender people should use, families and doctors are rewriting the rules as they decide when and how to start medical intervention, with some deciding to start before transgender youth hit puberty.

About 1.7 percent of American youth identify as transgender, and that estimate is conservative since the population is likely underreporting.


“I feel comfortable saying that any survey of LGBT identity likely underestimates the full population because it only accounts for one part of sexual and gender minority status, ‘identity’,” said Bianca Wilson of the Williams Institute, a national think tank at the UCLA School of Law that advances sexual orientation and gender identity law.

In addition to fighting for acceptance, transgender children and their families are faced with medical questions that could be life-changing.

These decisions are even harder for those young trans and gender nonconforming people who don’t have family support. Estimates show that about 40 percent of homeless youth identify as LGBT.

VICE News explores the emotionally charged and rapidly evolving issues faced by trans youth and their parents in a time of drastic political and societal change.

We meet Kai, a 5-year-old transgender girl whose mother, Kimberly Shappley, is fighting with the local school board over her daughter’s right to use the girls’ bathroom. “Most of the leadership in Texas have come out and made strong stands against the transgender community. The school district has an ultra-conservative school board and an ultra-conservative superintendent. We are probably in the worst school district in the worst state right now at this time, starting kindergarten,” her mother said about Kai’s situation.

Then there’s 8-year-old Max, who decides with his parents to start taking hormone blockers to delay his puberty further; 15-year-old Steviee, who is already taking testosterone; and 17-year-old Charlotte, who is transitioning while trying to find her way out of the foster care system.