'Letting him know that we love him': the experiences of young people who question their gender and the parents who support them.

Background: Gender identity services for children and young people are currently being reorganised in England and Wales. Provision is required to negotiate clinical uncertainty and a public debate that cannot agree on what care should look like.

Objectives: To explore how young people, parents and young adults respond to gender dysphoria, distress or discomfort; and to understand how they negotiate referral, assessment and possible interventions.

Design: Qualitative study, using narrative interviews with young people, aged between 12 and 18 years old (n=14), referred to a gender identity service; their parents (n=12); and young adults, aged between 19 and 30 years old (n=18), who sought gender affirming care. The study took place between March 2022 and December 2023.

Results: Young people in our study describe supportive relationships with parents, but regard them as too cautious when discussing medical pathways. Young people enter specialist care with a sense of urgency. They are disappointed when realising that access to medical pathways does not occur immediately. They do, however, come to appreciate talking about their experiences. Parents face considerable anxieties and, like young people, value the support they receive from specialist clinicians.

Conclusions: Young people who question their gender require access to safe and effective treatments, alongside respectful therapeutic support. Young people and their parents emphasise the importance of an open-minded approach, where they are given space to explore and understand their experiences, before making decisions about the future. The young adults we spoke to confirmed the importance of this.