Social Transition: Supporting Our Youngest Transgender Children

Those of us who work with transgender children frequently face decisions based on evidence that is conflicted or lacking and encounter opponents who are rightfully wary about what they see as experimental treatments without well-examined outcomes. However, in a transgender population where nearly one half experience suicidal ideation, the risk of nonintervention is quite high.¹ In this issue of Pediatrics, Olson and colleagues² provide evidence in support of social transition, a completely reversible intervention associated with lower rates of depression and anxiety in transgender prepubescent children. Socially transitioned children, or those who have adopted the name, hairstyle, clothing, and pronoun associated with their affirmed, rather than birth gender, have become more visible in the media over the last several years. Although to date there has been no published evidence to support providers in suggesting social transition as a beneficial intervention, many families, often guided by mental health...