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Book Review: Transgender Children & Youth

Transgender youth, particularly transgender youth of color, are disproportionately the targets of bullying, familial abuse and violence in our society. LGBT youth make up a significant portion of the young homeless population, with transgender teens facing higher rates of homelessness than their lesbian, gay and bisexual peers.

As state legislatures enact anti-transgender laws regarding schools and bathrooms, the rights and needs of transgender individuals, especially transgender young people, belong more than ever in our national discourse. In other words, there could not be a better time for Elijah Nealy to write his comprehensive text, Transgender Children and Youth: Cultivating Pride and Joy with Families in Transition.

A social worker, therapist, professor and trans man himself, Nealy brings his thorough knowledge, experience, and understanding of supporting transgender young people and their families to this timely guide. Although written with clinicians and social workers in mind, Transgender Children and Youth offers insights and valuable information for anyone in a young trans person’s community, including parents, teachers, coaches, clergy and extended family members.

Nealy has written an accessible, meticulously explained and supported introduction to the particular issues trans children and teenagers face, and how best to address them.

Nealy assumes no specialized knowledge of his reader. After a poignant and personal introduction discussing his own experiences being trans, he begins with a chapter that deals exclusively with terminology and makes necessary distinctions between the concepts of birth-assigned sex, gender identity, gender expression and sexual orientation. He notes the ways in which our understanding of these concepts have evolved and recently become more fluid.

Happily, Nealy includes nonbinary, bigender, agender, gender fluid and gender diverse individuals in his considerations. It is an excellent primer, and those new to these terms will find much of value just in these first twelve pages.

Nealy proceeds by refining the above definitions and explaining how gender diversity and gender dysphoria—or the sense and accompanying distress that one’s birth-assigned sex does not match one’s gender identity—manifest in and affect children. He also explores the history and categorization of gender dysphoria in the Diagnostic and Statistical Manual of Mental Disorders, explaining the necessity of avoiding the implication that being transgender means that individuals are sick or mentally ill.

Language, in fact, reappears throughout Transgender Children and Youth as a crucial component of supporting and affirming the experiences of transgender children and teens. Nealy even devotes the final chapter to “Top 10 Life-Affirming Practices for Adults in the Lives of Trans Kids.”

After establishing his conceptual framework, Nealy addresses the particular needs of trans children, including the mechanics of social transition, hormone blockers and medical transition. He provides resources for how to approach social transition with schools, as well as samples of the documentation needed in order to enact name changes, be prescribed hormones and hormone blockers or proceed with gender-confirming surgery. The appendices of Transgender Children and Youth contain numerous and vital resources for therapists and families of transgender children and teens.

Perhaps most compelling, however, is Part 2: Trans Youth and the World Around Them, which includes “Helping Families,” “Beyond Help to Deeper Understanding” and “All About School.”

Nealy doesn’t only makes suggestions for clinicians dealing with families who are new or even resistant to the idea that their children are transgender, he moves far beyond the mechanics of coming out and transitioning. He discusses the particular questions of attending college, being employed, and considering adult life as a trans individual; all key points for trans teens trying to imagine life after adolescence. Yes, Transgender Children and Youth seems to say, those futures are possible and within reach.

Transgender Children and Youth is liberally peppered with case studies and anecdotes from Nealy’s own sessions, providing excellent examples for those reading in the mental health or social work fields. For layreaders, these stories serve another, equally necessary purpose: they illustrate the experiences of the children, teens, and families with which the text concerns itself. For those trying to understand their trans child or teen, they provide an excellent opportunity to explore the perspective both of trans youth and their parents.

Significant work remains to ensure the rights and safety of transgender individuals, particularly trans people of color. Trans teens continue to face homelessness and abuse, in part because they live with families who don’t accept them. While many restrictions regarding changing one’s name and gaining access to hormones have been eased, mental health providers still find themselves as gatekeepers between trans people and medical transition. However, Nealy illustrates repeatedly through Transgender Children and Youth that acceptance can be fostered, schools held accountable and progress made.

Transgender Children and Youth: Cultivating Pride and Joy with Families in Transition

Elijah C. Nealy


448 pages, hardcover


Book Review: Transgender Children & Youth

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Worth Your Time! +++

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Julia Patt

APA Reference
Patt, J. (2017). Book Review: Transgender Children & Youth. Psych Central. Retrieved on October 30, 2020, from
Scientifically Reviewed
Last updated: 1 Sep 2017
Last reviewed: By a member of our scientific advisory board on 1 Sep 2017
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