The number of teens and young people medically transitioning has exploded across the Western world in the past decade. That is the observation of therapists Sasha Ayad, Lisa Marchiano and Stella O’Malley. Their new book, When Kids Say They’re Trans, describes the impact on parents, families and the children themselves. Crucially, in a profession that too often affirms whatever ideas children have picked up on social media, these three authors empower parents: “If you hear advice or hypotheses from professionals that simply feel wrong, inaccurate, or grossly incomplete, don’t discount your own take. Nobody knows or loves your child more than you do, and thinking for yourself is crucial.”

This book’s appeal extends far wider than for the parents of transgender-identified children. Adults who have been watching from the sidelines will find it a useful explanation of this bizarre phenomenon. Gender identity ideology — a belief that everyone has a gender identity that takes precedence over biological sex — has gained huge traction in schools and youth organisations. Teachers like me, therefore, will find it a reassuring antidote to the rather simplistic (and in my view, destructive) idea that social transition is the answer for children distressed by their sex.

It is parents, however, who can find themselves in the eye of the storm when a teenager announces their new identity and demands to be referred to by a new name and pronouns. As the authors put it, “a trans identity can feel galactically important”. They know what they are talking about, drawing upon their expertise and experience as therapists.

They set out their stall with the title of their book. It is not directed at the parents of “trans children”, rather children who “say they’re trans”. That subtle distinction matters. Can a child be trans? The authors think that is the wrong question. Instead, they “prefer to look at a child’s gender distress through a psychological lens that considers the whole person”. In this book, they seek to “redress the balance” in a market where other books have been written for parents who are facilitating a child’s gender transition, but few — if any — for parents who decide that social and possibly medical transition is not the best option for their child.

The authors are neither prudish nor conservative in their outlook. Sex and sexuality are discussed openly and objectively throughout. At the same time, they “believe that it is best that parents affirm gender-nonconformity whilst asserting the reality of biology”. That proviso perhaps sums up the message of the book: encourage kids to be their real selves, but keep them rooted in real life. Sadly, as the authors explain, too many children have bought into a fantasy — widely shared on social media — that being a boy or a girl is a matter of choice. Two of the authors are mothers themselves. As professionals, they understand the dynamics of family life and, significantly, the responsibilities of the adults: “It is the role of teenagers to push against the boundaries, but it is the role of parents to maintain boundaries in their children’s lives.”

As an example: “if at the weekend your son comes out of his bedroom wearing a dress, simply proceed as if nothing is out of the ordinary.” They insist, however, “if it is his sister’s dress then you might react as you would if he had borrowed anything else without permission.”

Social transition is not neutral; it is a stepping stone to medicalisation

Elsewhere the book is honest about the difficulties that gender non-conforming people face in contemporary society. Widespread ridicule might not be the biggest concern; today they may be labelled as “trans”. Such pigeonholing is hardly progressive, and it can be downright dangerous. Social transition is not a neutral act. It is a stepping stone to medicalisation, with the potential for life-long consequences including sterilisation and loss of sexual function. So much is unknown. “Never before,” readers are told, “have children changed pronouns and identities en masse and it will be years before we have a body of research to properly inform us about the long-term impact of social transition.”

The authors are clear in their focus. They acknowledge that some people can thrive after transitioning, and they “passionately believe that trans-identified people deserve rights, protections, compassion and dignity”. They don’t think transition is appropriate for children and adolescents whose bodies and minds are still developing, however. That said, they offer kindness to parents who have transitioned their children, and they give sound advice to those who wish to “row back after affirmation”. The authors go beyond an exposition of theory; in their practically based book, they include role plays that parents can adapt to their own situation.

Our children are still our children when they are fully grown. By then, however, they are in charge of their own lives. The book has much to say to parents in that position. How do you cope when your 21-year-old, or indeed your 43-year-old, announces their transition — perhaps as a fait accompli? You can’t send them to their room to think about it. Very wisely, the authors explained how to accept a decision without agreeing with it. I transitioned at age 43. The authors did not direct the book at my demographic, but such was the strength of their writing that it helped me to further understand what my own family went through.

Where young people are concerned, however, the authors were clear in their message: “This is an unfolding medical scandal that has treated loving parents cruelly. The devastation that parents have experienced can be indescribable.”

Until this outrageous situation is resolved, this book can provide parents of transgender-identified children with the guidance and support that they need to get through it, with relationships intact. For other parents — and indeed any adult who cares about the healthy development of children — to be forewarned is to be forearmed. This is a vital resource, and I highly recommend it.