Social transitioning can begin at any age. Elements of physical transitioning may need to wait until certain physical development and age milestones are met.

You can start transitioning at any age! It’s never too late to start living your truth. Likewise, many trans kids report expressing a desire to live as a different gender from a young age.

When young children start to transition, the elements they engage with are referred to as social transitioning. This includes things like names, self-expression, and other age-appropriate aspects of gender.

Medications or other aspects of physical transitioning are not discussed until the child is approaching puberty — and then only under the guidance of physical and mental healthcare professionals.

Gender socialization is a large part of childhood, for cisgender and transgender children alike. Social transitioning for children and adolescents (or adults!) may look like:

  • trying out new names or nicknames
  • using new pronouns, including they/them
  • experimenting with different fashions, haircuts, or makeup
  • exploring activities or hobbies that align with their interests
  • participation in gendered or genderless scouting organizations
  • sports participation, on gendered or genderless teams
  • acceptance into gendered aspects of family life (like “girls/boys nights”)

At what age can you change your gender?

With parental support, children can pursue aspects of transitioning like legal name change or changing gender markers on their legal identifications in much the same way adults do.

Because the age at which puberty begins can vary widely, sometimes as early as 10 years old, there is not a current recommended age that it’s best to start puberty blockers. Puberty blockers are typically started at Tanner stage 2 of puberty, so it’s best to discuss the timeline with your primary healthcare professional.

In the U.S., parental consent will also be required until the age of 18. If puberty blockers are part of an adolescent’s transition, they will be carefully regulated by both medical and mental health professionals.

The current standards typically recommend that estrogen or testosterone-based HRT be started no earlier than 13-14 for transfeminine teens and 14-15 for transmasculine teens. This may or may not occur alongside puberty blockers, depending on the recommendations of your physician.

These age restrictions keep the changes brought on by HRT in line with the other hormonal changes happening in your body during puberty. Dosages and administration schedules are carefully regulated and monitored to ensure that transgender teens develop at similar rates to their cisgender peers.

Before the age of 18, parental consent is also required to be prescribed HRT in the U.S. Many states have also banned the use of HRT for gender-affirming care, regardless of parental consent.

In rare cases, minors may be eligible for gender confirmation surgeries. This is done under the guidance of their legal guardians, a primary physician, a surgeon, a psychologist, and often a therapist as well.

In most cases, transgender teens need to wait until 18 for gender-affirming surgeries. In rare circumstances, breast removal, reduction, accentuation, or “top surgeries” can be done at age 16-17. It is especially rare for genital-related surgeries or “bottom surgeries” to be done before the age of 18.

All gender confirmation surgeries require consent from the parents and primary healthcare providers until the age of 18. Learn more about the age restrictions for top surgery in this article. In the U.S., numerous states have also banned any gender-affirming surgeries before the age of 18.

Even after the age of 18, your doctor may also recommend undergoing at least a year of HRT before surgery to allow for the majority of changes to take place before the procedure. This will depend on the exact procedure, your age, and your body’s needs.

A note about health insurance

In many cases, your health insurance provider may require that you meet certain prerequisites or have the approval of certain specialists before coverage will be granted for a procedure or medication. They may ask for a doctor’s letter of approval or for you to attend multiple counseling sessions before a procedure.

It’s best to check in with your provider in advance to see what their requirements are.

When people of any age start to transition, they begin with what is called social transitioning. This addresses the social aspects of gender, such as names, pronouns, fashion, and other forms of self-expression. These aspects of transitioning are available to people of any age.

When a child approaches puberty, they may decide to discuss options like puberty blockers or HRT with their doctors. WPATH regulations limit HRT use to no younger than 14 years old.

Any discussion of top surgeries is recommended to those no younger than 15, and any general-related surgeries are recommended only for those ages 17 and older. All surgeries are carefully overseen by legal guardians, primary physicians, psychiatrists, and sometimes a therapist as well.