title: Gender nonconforming and transgender children/youth: Family, community, and implications for practice.
abstract: OBJECTIVE
  The aim of this article is to provide foundational knowledge on gender nonconforming/transgender children/youth. With this knowledge, providers' confidence and ability to address the needs of patients/families can increase.
  
  
  METHODS
  Academic Search Premier, Cinahl, PubMed, World Professional Association for Transgender Health.
  
  
  CONCLUSIONS
  The number of gender nonconforming/transgender children/youth presenting to healthcare providers is increasing. The situation presents a myriad of challenges to families. The identity trajectory of gender nonconforming children is variable, and watchful waiting while providing support to the child and family is advised. If gender dysphoria persists as puberty approaches, treatment with puberty blockers is recommended. This provides youth time to further explore their identity, while alleviating the distress of developing unwanted secondary natal sex characteristics. For these individuals, cross-sex hormones may be started at age 16.
  
  
  CONCLUSIONS
  The complexities of providing care to gender nonconforming children/youth and their families are best met through an interdisciplinary approach. Consultation with and/or referral to specialists knowledgeable about transgender health care is advised. Beyond a basic understanding of gender nonconformance, of primary importance to patients/families is being heard and supported by their providers. Establishing a safe and welcome environment is paramount. Resources are provided.
authors.affiliation: Orvis School of Nursing, University of Nevada Reno, Reno, Nevada. aramburu@unr.edu.
authors.forename: Christine Aramburu
authors.initials: CA
authors.lastname: Alegría
mesh_terms: D000293:Adolescent; D002648:Child; D003153:Community Health Services / Q000639:trends*; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D063106:Transgender Persons
keywords: Families; gender dysphoria; gender nonconforming children; gender transition; transgender