A growing number of parents and parent-advocacy groups are criticizing schools for facilitating students’ social gender transitions without the knowledge or consent of their parents. The issue has become a focal point in the ongoing gender wars, both in the United States and abroad.

This week, the National Health Service of England released a module explaining that schools should involve parents in decisions regarding student gender transition at school. In March, Prime Minister Rishi Sunak promised to release guidance for schools in handling these issues, but his government has yet to do so. The NHS statement is not meant to replace the expected Department for Education guidance but instead to convey the current wisdom of health authorities on best practices. 

Advocates of socially transitioning children at school without parental notification argue that parents may respond abusively if a child professes a sex different from his or her own. It is not safe, they claim, to report a student’s decision to be treated as the opposite sex to his or her parents without first seeking the student’s consent. Some go further and say that, even without credible evidence of an abusive home, a student’s feeling that he or she is transgender is a private matter, about which parents have no right to know.

Critics of secret social transitions counter that a child’s dissociation from his or her body and sex is not a mark of “authenticity” but rather a sign of potentially bigger problems. They point to evidence showing that development of a transgender identity is associated with serious mental health concerns that are well within the right of parents to know. They argue that no one is more invested in the health and wellbeing of students than their parents, and that socially transitioning a child significantly increases the risk of unhealthy identity development and unnecessary medicalization down the road.

The Biden administration is trying to use Title IX to create a regulatory environment in which it is legally risky for schools to involve parents in these decisions without student consent. The Office for Civil Rights (OCR) in the Department of Education need not explicitly threaten legal action; OCR need only provide schools with vague guidance about “safety” and “privacy,” and let organizations like the ACLU and the Gay, Lesbian & Straight Education Network (GLSEN) dangle model policies and “gender support plans” to school administrators, who then face a decision: agree to adopt the plans or face lawsuits and civil rights investigations launched by these same groups. This approach of regulation through strategic ambiguity has proven very effective: risk-averse school board members consult with their attorneys, who recommend “inclusive” policies as a legal safe harbor.

Meantime, however, parents whose children were socially transitioned at school without their knowledge have filed numerous lawsuits against schools. The outcomes of these suits remain to be determined, but in two of them, the Manhattan Institute has filed amicus briefs explaining the research behind social transition and urging courts to consider it an intervention that requires notification of and consent from fit parents.

Many Americans don’t understand what the fuss is all about. Some teachers ask students for their preferred names and pronouns. What’s the big deal? Asking students for their preferred name and pronouns is not a medical or mental health intervention, this line of thinking goes, but merely a show of respect and an effort to be inclusive.

This argument may be well intentioned, but it is deeply misguided. More often than not, invoking the word “inclusion” has the effect, and perhaps also the intent, of trying to settle a difficult debate without appearing to do so. “Inclusion” is a euphemistic abstraction that ends up infuriating parents who want schools to be transparent about and take responsibility for their policies and practices. No one opposes “inclusion.” At issue is who or what is to be included, on what terms, at what cost, and why. 

Social transition involves referring to a student according to his or her preferred “gender identity” (a term used here as a stand-in for sex), not just with pronouns but in all aspects of school life including bathrooms, locker rooms, and sports. If the point of asking students for their preferred names and pronouns is that teachers and school staff will actually refer to these students as something other than their sex, then name and pronoun inquiries constitute social transition. The question, then, is whether it is appropriate for schools to facilitate the social transition of students without parental notification and consent.

American medical groups have not taken an official position on this question. The American Academy of Pediatrics (AAP), for instance, has said that children can know that they are transgender from an early age and should be immediately and unqualifiedly “affirmed” in their self-declarations. The AAP’s position is based on an egregious misreading of the research as well as the axiomatic supposition that some children are simply born transgender. The more relevant point, however, is that even if the AAP were correct about the mental-health value of social transition, it doesn’t follow that parents should be kept in the dark about it. 

NHS England and other health authorities are increasingly of the opinion that social transition is not the neutral show of respect and inclusivity that its American proponents claim it to be. Earlier this year, gender clinicians and medical groups in Finland urged the Finnish parliament not to extend a proposed gender self-identification law to minors on the theory that doing so might interfere with their healthy development.

Such skepticism is well-founded. Five decades of research have shown that most children with cross-sex feelings and desires, including children with gender dysphoria, outgrow their distress by adulthood, typically during puberty. For this reason, clinicians have long supported, and many still support, “watchful waiting” as the appropriate response to childhood gender dysphoria. This approach does not encourage parents either to agree or to disagree with their child in his or her asserted identity. Instead, it counsels parents to give the child room for creative self-expression while attending to other, related psychological and emotional needs.

Most gender-dysphoric children (especially boys) turn out to be gay, not trans. Childhood gender dysphoria is a more reliable predictor of future homosexuality than of a lifelong struggle with one’s sex. This important finding has led gay rights advocates to argue, with good reason, that gender affirmation and social transition in children is really gay conversion therapy masquerading as “trans rights.” Thus, when schools inquire about students’ preferred name and pronouns, they may be unintentionally harming gay and lesbian kids. This outcome is concealed from the view of well-meaning school administrators and school board members because of how activists have convinced the public that being trans is like being gay. Hence the acronym “LGBT.”

There is, however, an important caveat to all this: most gender-dysphoric children desist and come to terms with their bodies and their sexuality, provided that they are not socially transitioned. A 2022 study of 317 children showed that, among those with cross-sex feelings and desires who were socially transitioned, 97.5 percent failed to come to terms with their sex five years later. Though some activists have tried to spin this study as evidence that “trans kids know who they are and rarely change their minds,” this interpretation lacks equipoise—the principle that researchers should have genuine uncertainty about their findings and try to interpret them without bias. Considering how the study conflicts with 11 previous studies finding desistance to be the norm, and in which (with one partial exception) the children were not socially transitioned, a more plausible interpretation is that social transition locks in a temporary state of distress or confusion, giving the semblance of a fixed transgender identity.

When it comes to social transition at school, the new NHS England module explains, “professional and research evidence varies and it is acknowledged to be a complex decision and should be considered an ‘active intervention.’” The module cites the interim Cass Review, published last year at the conclusion of pediatrician Hilary Cass’s investigation of the Gender Identity Development Service, which stated:

Social transition—this may not be thought of as an intervention or treatment, because it is not something that happens within health services. However, it is important to view it as an active intervention because it may have significant effects on the child or young person in terms of psychological functioning. There are different views on the benefits versus the harms of early social transition. Whatever position one takes, it is important to acknowledge that it is not a neutral act, and better information is needed about outcomes.

Indeed, research has not established a clear benefit to mental health from social transition. One study published by U.K. clinician-researchers earlier this year found “preliminary” evidence that social gender transition in children and adolescents was “not associated” with improvement in their mental health, at least in the short term.

According to the NHS, “Supporting a social transition without the involvement of parents or carers can create complex difficulties within families and is not recommended. Secrets between parents or carers and their children are problematic and are likely to create further issues in the future.”

We can see a chilling example of the kinds of issues created by social transition without parental involvement in the story of Sage, a teenage girl who was socially transitioned in her Maryland school without the knowledge of her grandmother, who had become her adoptive mother. Sage, who has a history of mental health issues, ended up running away from home. She was then sex-trafficked and raped by several men in four states over a period of months. Sage has since been reunited with her grandmother, who recently filed a lawsuit against the local school board and two school counselors.

Last year, Erica Anderson, a child psychologist who works with gender-diverse youth, served as president of the U.S. Professional Association for Transgender Health, and is herself transgender, filed an amicus brief on behalf of parents suing the Montgomery County Board of Education, which is also in Maryland, for socially transitioning their children without their knowledge or consent. The school claimed that its policy was merely a “curriculum” decision and thus did not require parental notification. In her brief, which cites the literature extensively, Anderson explains why such decisions cannot credibly pass as “curricular” and why keeping fit parents in the dark does more harm than good to gender-diverse students. Social transition, says Anderson, is a “major and potentially life-altering decision.”

This past August, a school district in California settled out of court for $100,000 in a lawsuit involving secret gender transition at school. The settlement comes as parents in six school districts across the state have successfully organized to get parental notification policies passed in their school boards.

Advocates of secret social transition insist that “trans children” face a high risk of rejection and abuse from their parents. The assertion is often made without evidence, or on the basis of anecdotal recollections of adults about their own childhood experiences.

To be sure, some kids may experience abuse by their parents if they tell them that they wish to be treated as something other than their sex. It is far from clear, however, that this is the norm, and regardless, activists are defining parental refusal to “affirm” their child’s self-asserted “gender identity” as “abuse.” Given the existing research on desistance rates, mental-health outcomes from social transition, and the likelihood that for many teens, adopting a trans identity may be a maladaptive coping mechanism for ongoing mental-health problems or internalized homophobia, it’s reasonable for parents to be skeptical that instantaneous affirmation is the right way to go. If this counts as “abuse,” then the term has been stretched beyond its reasonable limits.

In its newly published materials, the NHS recommends that “if there are significant concerns about the safety of a young person in terms of how their parents or carers may react to their gender identity, schools should seek careful and detailed safeguarding oversight to assess risks.” It is unclear what this means, but if school authorities have sincere concerns about abuse—actual abuse, not mere withholding of affirmation—then they should contact the appropriate child welfare officials.

American public schools are in a difficult situation—caught between, on the one hand, the Scylla of litigation-hungry transgender activist groups and aggressive federal and state regulators, and, on the other, the Charybdis of parents who demand to know what is happening to their children at school. School administrators and board members not ideologically committed to one of the two warring camps will understandably seek to take the path of least resistance. But that often means doing what is popular rather than what is scientifically, medically, and ethically right.

The right thing to do is to familiarize oneself with research and with best practices in other countries as well as this one. The right thing to do is to recognize that social transition in childhood is a powerful psychological intervention, one that potentially poses risks to a child’s health and development. The right thing to do is to recognize that fit parents, not teachers or school counselors, should be the ones to make such decisions.

Photo by Gina Ferazzi / Los Angeles Times via Getty Images


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