As recently as last July, my young-adult daughter announced herself “transgender”. Although there were clues along the way, I was woefully unprepared to respond.  What red flags should I have seen? And what advice would I now give my earlier self?

1. Don’t assume your family is immune. My parenting style emphasized my daughter’s personhood over conformity to female stereotypes. Now I understand this left her vulnerable to transitioning because of the confused sense of not fitting in with makeup-wearing, fashion-sensitive girl groups. Balance is preferable, and I now see I stressed tree climbing to the exclusion of more traditionally feminine pursuits.

2. Be inquisitive about untypical behaviour. Being bright ,and uninterested in sex or typical sexual behaviour for the age group, does not necessarily mean everything is all right.

Every parent is now aware that they need to limit screen time and be on high alert regarding sexualizing kids. But when my daughter used the term “asexual” as a teen, I missed the cue. I tucked her into the Nancy Drew model of female modesty and set aside my fears, parenting on cruise control. Even though I’d studied feminism and knew a bit about queer theory, I assumed it lived only in the distant ivory towers of academe, not thriving and replicating online.

Like an alien being hatched within the minds and hearts of kids, gender theory has grown into a powerful, emotional, sticky online web of shared bodily distress outstripping the normal confines of self -understanding.

3. Your child’s strengths can be weaknesses. Independence, creativity, giftedness, and intellect are no barriers to the corrosive discontent.  They actually can make your child more vulnerable. Don’t take for granted, either, her self-confidence, purity of heart or naturally upstanding character. There will be no one to warn you. If you are waiting for someone else to clue you up, such as school officials, medical professionals, or church youth group leaders, good luck with that.

4. I missed red flags. Two clothing items in particular are typical. Once, when my daughter came home for a visit from her first job after college, she let me know she wore a binder to stave off undue attention to her chest. She quickly abandoned it, so I was not particularly alarmed. Sharing my own body discontent as a young woman, I pointed out that her feelings about her body are fairly normal in girls. Since she quit wearing it, I didn’t stress the physically harmful effects of binding.

Then there was the male underwear showing up in the laundry basket. You’d have to know my daughter’s generally nonstandard hipster clothing choices to understand why my concern wasn’t especially triggered; after all, she has always been a bit of a stylish gender- bender. Believing there is nothing inherently wrong in nonconforming dress, I interpreted this as simply a comfort choice. I was wrong to leave unmapped the confusion this signalled.

5. Sexual orientation confuses the picture. One plausible line of inquiry by those questioning transitioning is whether it involves homophobia, as in the phrase “trans the gay away”.

While living on her own after college, my daughter focused to the point of exhaustion on her career and lacked her former friend group that provided real-life support. While at college, she had regularly cultivated friendships, a wonderful distraction when going through college challenges and trials. A key parenting takeaway is that active offline pursuits and non-trans social activities can dissipate a single-minded body distress focus.

Research earlier on would have helped me to avoid such parenting pitfalls. Yet even with research, be forewarned that sources of information and expertise necessarily require tough-minded scrutiny, as transitioning is now framed and claimed as a civil right demanding support rather than critique. Jennifer Bilek writes: “Far from a grassroots movement born from oppression, it is generated by the highest echelons of society and attempts to linguistically obfuscate its aim of creating an abstraction out of biological reality.”

6. Avoid what psychologists call idiot compassion. This is prominently modelled by the parents of trans celebrities like Jazz Jennings. Her mother, Jeanette Jennings, explains her compassionate “you be you” ethic in terms of unquestioning affirmation.

Obviously, as parents we want our kids to be genuine in their presentation to the world. I respect my daughter’s honesty and uphold her right to be nonconforming. As true love demands, I strive to maintain a cherished connection with her, yet genuine relationships demand honesty, and when I’ve attempted to respond with sincere concerns, she regards it as unsupportive and withdraws further.

Other parents share such similar stories that it is evident any questioning of the orthodoxy will result in a parent being cut off from all communications. Parents of younger kids have a bit more influence, but even then, parents cannot assume their right to communicate with their child openly about transitioning, or attempt to influence whether their child can be medically transitioned.

Following the lead of other parents, I will use my daughter’s preferred name but resist reassigned pronouns that disrupt my own grounding in reality. I try to invoke the spirit of “being in this together” to understand and deal with this issue.

7. Be sceptical about “studies”, even those conducted by prestigious schools. Widely-recognized research institutions rely more than ever on endowments, and big money can dictate research assumptions and interpretations of findings.

One extensively cited study claimed that kids experienced decreased anxiety when parents supported transition. An assessment of that research, however, showed there was only temporary relief from anxiety. (“Our findings should serve as a warning against accepting research at a surface level, which can lead to acceptance of invalid information and pursuit of ineffective interventions.”)

Generally speaking, it is important to examine the follow-up period of the study, as many cover only the honeymoon following biological modifications. The only data available for long-term health outcomes comes from Sweden, and because the loss to study rate is so high for this population, research claiming good health outcomes is highly questionable.

8. Do not count on just any authority figure or expert to help. You will need to screen very carefully to find a therapist willing to explore comorbidities and underlying issues. These vary from trauma to autism, for which transitioning becomes a temporary coping mechanism. My young adult daughter chose a therapist who practiced gender affirming therapy (GAT), which generally entails a checklist assessment of issues before green lighting a biological treatment plan.

Discomfort with one’s body, or gender dysphoria, is obviously real; it stems from real feelings and personal histories filled with inner conflict and often trauma. The condition exists, but GAT fails to address the complexity of a person’s thoughts and feelings over time.

GAT practitioners assert the false options of transition or suicide, but psychologists have long- established protocols that do not include abdicating to suicide threats. This is important since it is commonly known those seeking sex reassignment surgery are coached to play suicidal. And it works. Parents are daunted by the suicide card. If a psychotherapist identifies a person at risk of suicide, the reasonable step would be hospitalization.

Recognizing that my daughter’s therapist was operating unethically according to the state board’s online guidelines for therapists, I filed a lengthy complaint detailing failures in light of the board’s own listing of ethical standards. For more than six months I kept updating the board until I finally realized they had no intention of reviewing the complaint and only kept it on file in the event there was a lawsuit.

9. Look for the other side of the story. The affirmative model propagated by social media has proven unhelpful to many, as the increasing number of detransitioners attests.  The latter groups’ videos proliferate online and are an excellent resource for understanding how the psychological and cultural dynamic become intertwined.

10. You are not alone. For your own sanity, find and join a trustworthy parent group, such as the US Kelsey Coalition or the UK site Transgender Trend. Other parents can help you in taking the next small step forward.

Some groups are focused primarily on parent to parent emotional support.  Others primarily point parents to good resources. Still others address news items and actions parents are taking to. It’s such a minefield to navigate, and your child comes with unique personality traits and experiences.

Since transitioning is everywhere, it is easy to dismiss as just youth culture, but it can readily appropriate your child’s suffering, whether that comes from a specific unresolved mental health diagnosis or the general angst experienced by most teens.

And, as my own journey of research has led me to conclude, transitioning thrives in secret – until it suddenly threatens to dismantle all relationships in its path.

Monica Rose is the writer’s alias.