Gender Affirming Care
Research

Learn more about what the research says about social transition and affirmation. 

Introduction to Social Transition & Affirmation

Social transition and affirmation are terms used to describe non-medical changes during a person’s gender journey.1,2 Social transition and affirmation can include changing names, pronouns, and appearance.1,2 This process is different for every person. For example, a person may or may not change their name or try out different pronouns. Appearance can be changed in many ways, including through clothing, accessories, hairstyle, hair removal, speech, mannerisms, binding, packing, tucking, and padding.

Research about Social Transition & Affirmation

The following sections summarize research findings showing that social transition and affirmation help TTNB youth to better understand their genders and serve to support youth well-being. Following this summary, ideas are presented to support TTNB youth’s social transition and affirmation.

Social transition and affirmation support people to understand and experience their gender more fully. Social transition and affirmation can be helpful for people who want to take steps to live more fully in their gender. Social transition and affirmation allow people to explore their genders and learn more about their identities.3–5 For some people, this process may be helpful in deciding whether to access medical transition care, such as puberty blockers or hormone therapy.

Steps taken toward social transition and affirmation are flexible and reversible.3,6 For example, a person who explores their gender through new names and pronouns may decide those changes are not right for them. They might begin using their previous name and pronouns again or explore different names and pronouns. There is no evidence that these experiences cause distress when youth are living in affirming, supportive environments.7

Social transition supports well-being

Affirmation of a person’s gender by other people in their life is important for well-being. Being addressed by correct names and pronouns (the names and pronouns the person goes by), having correct names on medical and school records, participating in affirming sports teams, and using certain washrooms may be part of social transition and affirmation. Youth who take steps around social transition or affirmation may or may not want or require gender-affirming medical care in the future. Research shows that youth can benefit from social transition and affirmation alone or in combination with gender-affirming medical care.8,9

Social transition and affirmation can relieve anxiety, depression and gender-related distress. Relief from anxiety and gender-related distress can be experienced immediately after a person begins to socially transition.10 Research shows that youth who have socially transitioned have rates of depression and self-worth similar to cisgender youth.2

Social transition and affirmation can improve mental health, happiness and self-confidence. One of the main benefits of social transition is improved mental health.2,8–12 Parents report that social transition improves their youth’s happiness and self-confidence.13 Youth and adults who were not able to transition before puberty have reported that many experiences of distress and discrimination would have been avoided if they had started transitioning sooner.14

Support from families and peers during social transition improves well-being. TTNB youth identify family support as an important factor throughout their gender journeys.15 Those with accepting families and supportive peers are less likely to attempt suicide or report symptoms of depression and anxiety than those without social affirmation.8,16,17 Parents of TTNB youth recognize social transition and affirmation as important for supporting and protecting youth well-being.13 Acceptance in other relationships is important too. Peer acceptance of youths’ gender expression can support a positive sense of self-worth.18

Ways to Support Social Transition and Affirmation may include:

  • Asking the youth what kind of support would be helpful
  • Using correct names and pronouns
  • Helping others practice and remember new names and pronouns at the youth’s request
  • Finding clothes that are affirming
  • Finding hairstyles that are affirming
  • Practicing using affirming make-up
  • Helping youth access binders, bras, and other gender-affirming supplies
  • Advocating for inclusion and safer spaces in school and community

References

  1. Turban JL. Transgender Youth: The Building Evidence Base for Early Social Transition. J Am Acad Child Adolesc Psychiatry. 2017;56(2):101-102. doi:10.1016/j.jaac.2016.11.008
  2. Durwood L, McLaughlin KA, Olson KR. Mental Health and Self-Worth in Socially Transitioned Transgender Youth. J Am Acad Child Adolesc Psychiatry. 2017;56(2):116-123.e2. doi:10.1016/j.jaac.2016.10.016
  3. Ashley F. Thinking an ethics of gender exploration: Against delaying transition for transgender and gender creative youth. Clin Child Psychol Psychiatry. 2019;24(2):223-236. doi:10.1177/1359104519836462
  4. Wong WI, Van Der Miesen AIR, Li TGF, MacMullin LN, VanderLaan DP. Childhood social gender transition and psychosocial well-being: A comparison to cisgender gender-variant children. Clin Pract Pediatr Psychol. 2019;7(3):241-253. doi:10.1037/cpp0000295
  5. Ehrensaft D. Found in transition: Our littlest transgender people. Contemp Psychoanal. 2014;50(4):571-592. doi:10.1080/00107530.2014.942591
  6. Sherer I. Social Transition: Supporting Our Youngest Transgender Children. Pediatrics. 2016;137(3):e20154358. doi:10.1542/peds.2015-4358
  7. Durwood L, Kuvalanka KA, Kahn-Samuelson S, et al. Retransitioning: The experiences of youth who socially transition genders more than once. Int J Transgender Health. 2022;23(4):409-427. doi:10.1080/26895269.2022.2085224
  8. Budge SL, Adelson JL, Howard KAS. Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. J Consult Clin Psychol. 2013;81(3):545-557. doi:10.1037/a0031774
  9. Thoma BC, Jardas E, Choukas-Bradley S, Salk RH. Perceived Gender Transition Progress, Gender Congruence, and Mental Health Symptoms Among Transgender Adolescents. J Adolesc Health. 2023;72(3):444-451. doi:10.1016/j.jadohealth.2022.09.032
  10. Kuvalanka KA, Weiner JL, Mahan D. Child, Family, and Community Transformations: Findings from Interviews with Mothers of Transgender Girls. J GLBT Fam Stud. 2014;10(4):354-379. doi:10.1080/1550428X.2013.834529
  11. Fontanari AMV, Vilanova F, Schneider MA, et al. Gender Affirmation Is Associated with Transgender and Gender Nonbinary Youth Mental Health Improvement. LGBT Health. 2020;7(5):237-247. doi:10.1089/lgbt.2019.0046
  12. Warwick RM, Shumer DE. Gender-affirming multidisciplinary care for transgender and non-binary children and adolescents. Child Health Care. 2023;52(1):91-115. doi:10.1080/02739615.2021.2004146
  13. Horton C. “I never wanted her to feel shame”: parent reflections on supporting a transgender child. J LGBT Youth. 2023;20(2):231-247. doi:10.1080/19361653.2022.2034079
  14. Ehrensaft D, Giammattei SV, Storck K, Tishelman AC, St. Amand C. Prepubertal social gender transitions: What we know; what we can learn—A view from a gender affirmative lens. Int J Transgenderism. 2018;19(2):251-268. doi:10.1080/15532739.2017.1414649
  15. Schimmel-Bristow A, Haley SG, Crouch JM, et al. Youth and caregiver experiences of gender identity transition: A qualitative study. Psychol Sex Orientat Gend Divers. 2018;5(2):273-281. doi:10.1037/sgd0000269
  16. Weinhardt LS, Xie H, Wesp LM, et al. The Role of Family, Friend, and Significant Other Support in Well-Being Among Transgender and Non-Binary Youth. J GLBT Fam Stud. 2019;15(4):311-325. doi:10.1080/1550428X.2018.1522606
  17. Sherer I, Hanks M. Affirming Pediatric Care for Transgender and Gender Expansive Youth. Pediatr Ann. 2021;50(2). doi:10.3928/19382359-20210115-01
  18. Smith TE, Leaper C. Self-Perceived Gender Typicality and the Peer Context During Adolescence. J Res Adolesc. 2006;16(1):91-103. doi:10.1111/j.1532-7795.2006.00123.x