Join Dr. Brock Libby, a specialist in Adolescent Pediatrics, Christine Caulfield, a long-time volunteer with Maine Transgender Network, Margo Rubero, gender-nonconformist and advocate for gender-affirming healthcare, and Sarah Copperberg, parent of two transgender teens.to learn more about this often misunderstood topic.

Gender-affirming care, as defined by the World Health Organization, encompasses a range of social, psychological, behavioral, and medical interventions “designed to support and affirm an individual’s gender identity” when it conflicts with the gender they were assigned at birth. The interventions help transgender people align various aspects of their lives — emotional, interpersonal, and biological — with their gender identity. As noted by the American Psychiatric Association (APA), that identity can run anywhere along a continuum that includes man, woman, a combination of those, neither of those, and fluid.

The interventions fall along a continuum as well, from counseling to changes in social expression to medications (such as hormone therapy). For children in particular, the timing of the interventions is based on several factors, including cognitive and physical development as well as parental consent. Surgery, including to reduce a person’s Adam’s Apple, or to align their chest or genitalia with their gender identity, is rarely provided to people under 18.

“The goal is not treatment, but to listen to the child and build understanding — to create an environment of safety in which emotions, questions, and concerns can be explored,” says Rafferty, lead author of a policy statement from the American Academy of Pediatrics (AAP) on gender-affirming care.