Despite transgender children receiving more attention, acceptance and understanding than previous decades, along with many of the rights of transgender children and youth being put into laws and practice, confusion, discrimination, misinformation and a lack of understanding in order to help, aid and guide transgender youth is still widespread in the United States and other parts of the world.

In Transgender Children and Youth: Cultivating Pride and Joy with Families in Transition, Elijah C. Nealy, himself a transgender man, provides the reader with an extensive guide to not only understanding transgender youth, but also a foundation for discussing issues for such youth, along with training for mental health educators, psychiatrists, teachers, parents, other adults working with transgender youth and our communities overall. Nealy starts out by discussing the importance of understanding and adopting the various terms used in the transgender community (even though such terms are always changing; with some being added or replaced). The four foundational terms that we need to be able to distinguish are biological sex — a person’s genitalia, gender expression — how we express ourselves, gender identity — an internal sense of who we are, and sexual orientation — who we are attracted to. Being able to understand and distinguish between these terms provides the reader with the foundation of understanding how many transgender youth view themselves. Nealy then moves into the DSM mental health guide, using the clinical understanding of gender dysphoria to discuss both the negative notion of youth having to be diagnosed in order to receive certain treatments (especially surgical) to the more positive changes that have been made in DSM over the years.

Nealy also shifts his attention to when transgender youth is in therapy, how we should respond to them, what questions we should ask, and the assumptions we often hold. Nealy stresses the importance of using the child’s own vocabulary and their preferred name (since this is important for most transgender youth), while working with families overall to strengthen relationships and cultivate understanding and acceptance.

Nealy also brings up important legal aspects of transitioning, such as updating legal documents and how to go about the process of doing so. For many transgender youth, after “coming out” to family, friends, or the whole community, medical transitioning may be the next step. Nealy goes into detail describing the various forms of hormonal treatments and surgeries available to youth in transitioning, with puberty often being a critical point in which transgender youth experience stress, depression and unhappiness, as their bodies are changing in ways that may not like or want. This can be a very stressful time in adolescents lives as they are struggling with the internal sense of who they are in addition to their bodies changing. As Nealy notes, rates of addiction, homelessness and suicide along with other risk factors are much higher than for cisgender teens, as transgender youth often lack support and resources from their families and communities. Transgender youth also face many struggles, bullying and discrimination in school, at worksites and when going to college, contributing to the higher number of transgender youth who struggle to fit in and to become accepted members of society.

Nealy therefore spends much time discussing the impact of family acceptance which can negate many of the negative feelings that transgender youth go through daily, such as confusion, shame, feeling isolated, hopelessness, and depression. Throughout the book Nealy reinforces how strong and resilient transgender youth are despite many living in environments where they are rejected, misunderstood or viewed as different and strange.

Transgender Children and Youth is as much an educational book as it is a book that advocates for the rights of transgender youth to grow up to be the person that they have dreamed about, want to be, or always viewed themselves as . Adding vignettes from his work with transgender youth and their families solidifies the importance of acceptance and understanding. The book is a valuable resource not only for mental health professionals, but also for families with transgender children. With Nealy taking his time to explain the issues facing transgender youth, the book is truly accessible to any reader, no matter their level of interaction with, or understanding of transgender youth.

© 2017 Hennie Weiss

Hennie Weiss has a Master’s degree in Sociology from California State University, Sacramento. Her academic interests include women’s studies, gender, sexuality and feminism.