Describe difficulties transgender children face.

Parents, peers, and teachers tend to discourage gender nonconformity in children, especially boys who show interest in girls' activities and toys. Transgender children resist such pressure, insisting on their true gender identity. Many parents ignore children's wishes or outright prohibit them from adopting a transgender identity, although some parents adopt a different approach, permitting their children to "socially transition" to the gender identity that feels right to them. The few studies that have examined transgender children have found that children who have not socially transitioned reported increased rates of anxiety and depression, with more than 50% of older children in some samples falling in the clinical range of internalizing symptoms. In contrast, studies of transitioned transgender children suggest levels of depression and anxiety similar to gender-consistent children and overall norms. In contrast to social transition, biological transition is a medical process. It typically involves both developmental changes, induced by means of hormone therapy, and permanent changes to the external genitals, accomplished by means of gender-reassignment surgery. Older children who identify as transgender, in consultation with their parents and pediatrician, may take medication to delay the onset of puberty and the reproductive maturation that goes with it.