The Coming Out Process for Assigned-Female-at-Birth Transgender and Non-Binary Teenagers: Negotiating Multiple Identities, Parental Responses, and Early Transitions in Three Case Studies

In this study, I examined three case studies of Assigned-Female-At-Birth (AFAB) teenagers who came out to their families in the course of therapy; all cases are derived from private practice work from 2015 to 2018. These all have in common some of the important and distinct differences between “coming out” as LGB and “coming out” as transgender or nonbinary. Overall, these cases emphasize: (1) Specific needs of transgender teenagers and young adults, particularly with regard to appealing for permission to use hormones; (2) Race and class implications for coming out as transgender and non-binary; (3) The necessity of better general education about transgender lives; and (4) The impact of parents on transitioning experiences and self-identity. The different outcomes of gender identity outness, including different parameters for what parental approval and validation means, are explored. I conclude with clinical implications for doing work with transgender teenagers and their parents, along with advice to practitioners for how to work with a sample of parental responses in order to minimize trauma and harm to transgender and non-binary teens.