June is Pride Month: a time to raise awareness of the issues facing the LGBTQ+ community and to encourage inclusiveness. It’s also a time for parents and others to educate themselves about the differences between a person’s biological sex, gender and sexuality, and how understanding these differences can help them become supportive of sexual and gender minority youth (SGMY).

At birth, babies are assigned a sex, traditionally either “male” or “female,” based on their external organs. As a profession and a society, we’ve come to understand that a person’s “sex” doesn’t always align with the gender with which that person will eventually most identify. Gender identity refers to a person’s internal sense of oneself, which can differ from a person’s assigned sex at birth and which also develops over time. Usually by the age of 4 and 5 years old, most children are able to tell you their gender identity. A child’s gender identity may also change as they progress through normal adolescent development, with influence and enlightenment from their social, cultural and ethnic influences and through their own self-reflection.

It is also important to understand that gender can be expressed in many different ways – from the types of clothing we wear, to the hairstyles we adopt, to the different behaviors and mannerisms we express, this exists along a spectrum. This concept is called a person’s gender expression. A person’s expression of their gender may not be what we typically expect based on societal or cultural norms, but this is perfectly normal.

By the time your child becomes a teen or begins puberty, they may start to have an interest or attraction towards someone else – which can be physical, emotional or romantic. A person’s sexual orientation cannot and should not be assumed based on their gender. It is a normal part of development for teens and adolescents to explore these attractions and interests. Youth may have fantasies or explore possibilities of being with a person of the same sex. This doesn’t necessarily mean that they identify as gay or lesbian.

Adolescence can already be a stressful and confusing time, it is important that children and adolescents feel loved and accepted for whom they are and who they are to become. Studies have shown that parental rejection is directly linked to negative health outcomes for sexual and gender minority youth – such as increased rates of depression, substance abuse and engaging in high risk sexual behaviors. But we also know that with the love and care from a parent, these youth can live just as happy and fulfilling lives as their peers.

Ways parents can support their child or teen

  • Accept your child or teen for who they are and do not feel obligated to change them.
  • Educate yourself.
  • Talk to your child about how they feel.
  • Read books showing men and women in non-stereotypical and diverse gender roles. Look for  books about different gender identities.
  • Talk to their teachers about how they can support your child.
  • Watch for signs of depression or bullying and seek advice from your pediatrician.
  • Encourage your child to form strong friendships.

Resources for parents and their children or adolescents


Joseph H. Waters, MD, is a fellow in the Division of Adolescent and Young Adult Medicine at Children's National.

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Posts from Joseph H. Waters, MD