Transgender children who are allowed to present their gender identity and change their names have good mental health outcomes, according to a study released on Friday and hailed as "crucially important".
The study, published in the March issue of the journal Pediatrics, shows the positive impact family support can have on the lives of transgender children, a group long hidden from public view.
Researchers found normal levels of depression and only slightly elevated anxiety levels in transgender children who were supported by their families.
Such support included the use of pronouns that matched the child's gender identity, calling them by the name of their choosing and, often, and allowing them to change their hairstyle and clothing to reflect their identity. Such children are also known as "socially transitioned" children.
In a commentary published with the study in Pediatrics, Dr Ilana Sherer, assistant medical director at the University of San Francisco's Child and Adolescent Gender Center Clinic, said the findings were "crucially important".
Sherer said the study was useful for responding to questions surrounding the impact of social transition, and whether and when children are old enough to know that they identify with a gender different from the one they were born with.
Sherer said: "Olson and colleagues give supporters of social transition evidence that shows what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings."
Sarah Painer, a social worker at the Transgender Health Clinic at Cincinnati Children?s Hospital, said: "I think the study is really reflective of what we see in practice."
Transgender adults experience rates of anxiety, depression and suicide that are dramatically higher than those among non-transgender adults. This is most likely tied to years of discrimination, internal conflict and rejection from social environments, the authors of the study said.