Overview
Reminder
Not all people who will eventually come out as transgender/nonbinary do so as a child. Some people are aware that they are not the gender assigned to them at birth from a very young age. Some minors express gender in ways that do not match stereotypes of their assigned gender. Some of these children may grow up to be transgender and some may not. Some people do not recognize themselves as transgender until much later in life.
Many people who will later identify as transgender first identify as lesbian, gay, bisexual, or queer, but this is not true of all transgender people. Sexual orientation and gender identity are distinct identities, but may have many overlapping components, especially as a young person is exploring their identity.
When service providers are working with children, it is important to note that some children may not use language that would indicate they are trans/nonbinary. They may not be out to themselves or others, may not have the language to share this information, or may have been told to not disclose. When harm has targeted a child’s gender identity or gender presentation/expression, the provider can acknowledge and document that harm. Mirroring the child’s language can be affirming and increase the accuracy of documentation. There may be a difference in how adults in a child’s life may reference the child’s gender vs. how the child discusses or embodies their gender.
Throughout this section, data on LGBTQ+ young people is often used. This is due to the lack of data specific to trans youth and the fact that many young people may be out as LGBTQ+ or perceived as LGBTQ+ by others, but not yet out as trans.
Definition
The World Health Organization (WHO) defines child maltreatment as “all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity.” There are four main types of abuse: physical abuse, psychological abuse, sexual abuse, and abandonment/neglect. Abuse is defined as an act of commission and neglect is defined as an act of omission in care leading to potential or actual harm. [i]
Throughout the United States, criminal statutes related to child abuse vary. The child welfare system has non-criminal processes for investigating child abuse and neglect. Each state/territory varies in its reporting and investigation process.
Many families who get investigated by child welfare services are in need of support, not policing. Increasing family access to financial support – cash, food, housing, and healthcare, would solve an incredible number of cases within the child welfare system. These cases should not be conflated with other types of abuse or neglect.
Trans Specific Dynamics
Transgender/nonbinary youth experience abuse and neglect that is specifically targeting their gender or perceived gender, as well as abuse and neglect that is similar to that which any child may experience. People working with transgender victims of child abuse may want to be familiar with child abuse dynamics in general, as well as some of the ways that trans youth are targeted.
“Only one-third of LGBTQ youth experience parental acceptance and, one-third suffer from parental rejection. We also know that transgender youth who feel accepted by the adults and peers in their lives have significantly lower odds of attempting suicide, and benefit from increased mental wellbeing.”[ii]
Parents and caregivers are not the only perpetrators of child abuse. Abusers may be any adult in the child’s life.
Types of abuse
Psychological abuse. Abuse against trans youth may include denial of their gender identity, harassment or violence related to gender identity, or a refusal to allow social transition. Psychological abuse may include threats or insults, “punishment” if the child acts in certain ways, or ignoring the child. Some youth have reported that a parent stopped talking to them or communicating in any way after the child came out.
Physical abuse. Physical abuse may target a child’s gender or gender presentation. In addition to commonly known physical abuse tactics and behaviors, physical abuse can also include forcing a child to dress a certain way or cutting their hair. It can include violence towards a child after a child acts in specific ways (e.g. playing with certain toys), or dresses in particular clothing or accessories.
Physical abuse may include restricting what a child eats or forcing exercise. Note that in these examples, the force is extreme and not the same as when a parent encourages exercise or picks out the clothing for a young child. In child abuse, there may be a threat of increased violence if the child does not comply.
Sexual abuse. Trans/nonbinary young people report high rates of sexual abuse.[iii] Many people falsely conflate a child’s gender identity or mannerisms associated with such an identity with the child being sexual at an early age. LGBTQ+ children are more likely to be treated as older than they are. Some adults will sexually assault children as a way to “punish” the child for their gender differences or try to force them to be heterosexual and cisgender.
Sexual violence may also target a child’s genitalia or chest – areas that are typically gendered.
Child abandonment. Abandonment is generally defined as failure to provide for a child’s needs while being able to do so. While abandonment may conjure images of a parent leaving a child behind, it also applies when a caregiver/parent kicks a child out of the home or otherwise refuses to provide for their needs. LGBTQ+ youth face high rates of being kicked out of family homes.[iv]
Key Tips for Service Providers
- Mandatory Support.
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- Mandatory reporting laws vary from state to state. Learn more about applicable laws here.
- If a mandated report is necessary, involve the young person as much as possible. Be transparent about what will be shared and why, and what next steps may happen.
- Regardless of if reporting is necessary, adults can provide support. This means helping the young person to get their needs met and increase their safety. Remember that support isn’t necessarily provided by reporting.
- Work to understand what the young person wants the adults in their life to know.
- Young people may use different names and pronouns in different situations. Check with the young person about what name should be used in front of other people or in documentation to ensure the child’s safety and strengthen a respectful bond.
- Young people may also not want the adults in their life to know all the details of the harm that has happened to them. Work with the young person to identify which adults need what information.
- Assist in identifying safe/supportive adults.
- Identifying safe and supportive adults may take time. Not all young people already have such adults in their lives. A person who works with a young person repeatedly may help them to establish relationships with trusted adults or to think through how they may want to initiate conversations with adults.
- Believe and affirm the person’s gender.
- No matter what age the child is, use the name and pronouns they ask you to use.
- Support the young person in accessing gender affirming care and social supports they want. For some young people, this may be a primary concern or immediate need, and for others, it may not be.
- Recognize that abuse and neglect can have traumatic impacts on childhood development, AND that does not mean the child is not able to make decisions for themselves or know their own gender.
- Foster care is not a viable solution for many trans youth, given the high rates of violence within the system. Consider alternatives before resorting to foster care or group homes.
- Discuss with the young person what housing arrangements would feel safer for them. Work with them to assess if there are extended family members, friends, or others in their life who may be able to provide safe, stable housing, as an alternative to foster care or group homes.
- For some youth, unstable housing – such as couch-surfing, moving from place to place, or sleeping outside –may be preferable (and safer) to foster care or a group home. Adults can respect this decision while helping the young person be as safe as possible.
- Increasing penalties for parents and disrupting family acceptance does not help kids.
- Penalties on parents have not been shown to increase children’s safety and well-being. The vast majority of cases in the child welfare system are cases where families need more support, often financial support.
- Some states are seeking to penalize parents who are accepting of their children’s gender identity. This is harmful to youth and families.
- Counter harmful messages that the child has received about their gender.
- Some transgender/nonbinary children may have heard misinformation or hateful messages about their identity. Adults can provide support by countering those messages and letting children know that their gender is valid.
- Use strategies you would with other abused or neglected children.
- Children who have experienced trauma may act in ways that are harmful to themselves or others. Adults can provide support by seeking to understand the behavior rather than punishing the child. By providing positive connections, helping to build relationships, and using healing approaches, adults can support young people in more effective ways.
Case Examples
Max grew up in a strict, wealthy home. His parents had very specific expectations of their children. They were not accepting of the fact that Max was a transgender boy. They forced him to wear dresses outside of the house and sent him to a therapist to try to convince him that he was a girl.
When Max was seen wearing pants out with friends, his parents grounded him for the weekend, forcing him to stay in his room without access to food, water, or the bathroom for two days. They told his siblings that Max was hurting himself and the family with his actions and encouraged his siblings to not talk to him. While this was the most severe punishment, Max’s parents frequently withheld food, clothing, or other forms of care as part of what they considered discipline.
When Max turned fifteen, he was sent to a conversion therapy camp. At this camp, he was assaulted by one of the counselors and told that all the harm he suffered was his own fault.
Throughout all of this, Max used school as an escape tool. He received good grades and had no disciplinary issues at school. He did not have any close friends but was nice to everyone. No adults ever asked him about his home life or expressed concern when he lost weight or seemed distracted.
Discussion questions
- What are some of the forms of harm and abuse that Max experienced?
- How would your agency provide services to Max?
- What would need to change for Max to have gotten access to support as a child?
- In what ways might his family’s wealth have made Max’s situation different from a child in a low-income home?
Statistics
Keep in mind that some statistical information that is gathered from adults may not disaggregate based on the identity the child used at the time they had certain experiences.
In a 2021 study of adolescents, 73% of transgender adolescents reported psychological abuse, 39% reported physical abuse, and 19% reported sexual abuse. This study compared those experiences with that of heterosexual cisgender adolescents and found that transgender adolescents had an 84% higher likelihood of psychological abuse, 61% higher chance of physical abuse, and a 104% higher likelihood of sexual abuse.[v]
In 2024, FORGE conducted a survey of trans adults. Respondents reported on their experiences as a child (under 18).[vi]
| Adverse Childhood Experiences (n = 887) | ||
| ACE | Prevalence (% of sample) | |
| Swear at you, insult you, put you down, or humiliate you? OR Act in a way that made you afraid that you might be physically hurt? | 62.34% | |
| Were you punished, shamed, or yelled at by family members for not conforming to gender expectations (being too manly or not manly enough, being too feminine or not feminine enough)? | 58.98% | |
| Were you bullied in school by other children, teachers, staff, or school administrators (i.e. principal) because of your sexual orientation or gender identity? | 52.05% | |
| Did other kids, including your siblings, often or very often hit you, threaten you, pick on you, or insult you? | 49.72% | |
| Push, grab, slap, or throw something at you? OR Ever hit you so hard that you had marks or were injured? | 33.71% | |
| Touch or fondle you or have you touch their body in a sexual way? OR Attempt or actually have oral, anal, or vaginal intercourse with you? | 33.26% | |
| You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? OR Your parents were too drunk or high to take care of you or take you to the doctor if you needed it? | 24.58% | |
| Were you kicked out of your home or your parents/guardians threatened to kick you out of your home because of your sexual orientation or gender identity/expression? | 15.23% | |
Resources
- Fighting Anti-LGBTQ+ Grooming Rhetoric
- Resources to support families who want to be affirming:
- Addressing childhood trauma:
- Academic articles:
- Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents
- Child sexual abuse/exploitation and LGBTQI+ children: Context, links, vulnerabilities, gaps, challenges and priorities
- Childhood Abuse Among Transgender Youth: A Trauma-Informed Approach
- Prohibition of Gender-Affirming Care as a Form of Child Maltreatment: Reframing the Discussion
[i] Daley SF, Gonzalez D, Bethencourt Mirabal A, et al. Child Abuse and Neglect. [Updated 2025 Apr 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459146/
[ii] Reaffirming my Transgender Child’s Identity is Not Child Abuse. BWJP. https://bwjp.org/reaffirming-my-transgender-childs-identity-is-not-child-abuse/
[iii] Trans Youth Face Higher Levels of Abuse | #LGBTWellness News. (n.d.). In LGBTQ HealthLink. Retrieved July 23, 2026, from https://www.lgbthealthlink.org/News/Trans-Youth-Face-Higher-Levels-of-Abuse
[iv] The Trevor Project. (2022). Homelessness and Housing Instability among LGBTQ Youth. In The Trevor Project. https://www.thetrevorproject.org/research-briefs/homelessness-and-housing-instability-among-lgbtq-youth-feb-2022/
[v] Thoma BC, Rezeppa TL, Choukas-Bradley S, Salk RH, Marshal MP. Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents. Pediatrics. 2021 Aug;148(2):e2020016907. doi: 10.1542/peds.2020-016907. Epub 2021 Jul 5. PMID: 34226247; PMCID: PMC8344346. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344346/
[vi] FORGE. “Trans/Nonbinary Experiences with Stressful Events.” FORGE, 20 May 2024.