Table 3.

Antecedents of 1st social transitions.

Code	No. of youth participants who mentioned code	No. of parent participants who mentioned code
	n = 10 youth interviews reporting on 10 initial transitions	n = 21 parent interviews reporting on 21 initial transitions
	n (%)	n (%)
Child made a statement (e.g., “I am a girl”)/brought it up	7 (70.0%)	19 (90.5%)
Parent inquired about/suggested/explained the options	1 (10.0%)	11 (52.4%)
Child’s gender preferences/presentation (peers, toys, clothing, hairstyle)	4 (40.0%)	19 (90.5%)
Child role-played/identified as different gender in fantasy play (could be on the internet)	1 (10.0%)	6 (28.6%)
Someone else brought it up (e.g., therapist, support group, teacher, parent’s friend)	0 (0%)	2 (9.5%)
Went to a therapist/support group about gender (child or parent)	1 (10.0%)	9 (42.9%)
Child mental health/wellbeing/behavior issues that seemed to be related to gender	1 (10.0%)	11 (52.4%)
Gender segregation (e.g., boys’ and girls’ sports, boys’ line vs. girls’ line) in school or other activity brought it up	1 (10.0%)	2 (9.5%)
Issues related to body/puberty/hormones/blockers	0 (0%)	2 (9.5%)
Learned about a new identity (e.g., gay men, lesbians, nonbinary)	1 (10.0%)	3 (14.3%)
Met a role model of a particular gender / LGBT identity	0 (0%)	1 (4.8%)
Child’s internal gender identity experience	5 (50.0%)	1 (4.8%)
Child wanted to live authentically	2 (20.0%)	0 (0%)
Peers — acceptance or rejection from peers of one gender (e.g., being bullied by the boys; being accepted by the girls)	0 (0%)	3 (14.3%)
People were misgendering them/were transphobic toward them in previous gender	0 (0%)	1 (4.8%)
Believed gender expression had to align with gender identity (e.g., believed feminine people had to be girls)	1 (10.0%)	2 (9.5%)
Child thought it would be cool/edgy/make a political statement to transition	1 (10.0%)	0 (0%)