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Sexuality and gender identity have a natural, wide variety. Every variety is normal, natural and may change over time. In the recent past society has evolved in a way that gives modern teenagers unprecedented freedom of expression when it comes to sexuality and gender identity. The rules are not longer written in stone and, relatively speaking, it's a great time for them to be alive and explore possibilities. Sometimes teenagers are quite clear on how they see themselves and what they like and sometimes it's not so clear. Psychotherapy with teenagers is a great option for sorting through it all and it helps them come to a genuine understanding of their sexuality and gender identity. The sooner they get clear on these important personal matters the better. Teenagers who are not heterosexual and/or don't align with the gender they were assigned with at birth are at a much greater risk than average of serious mental health issues and mistreatment. When teenagers keep these essential aspects of who they are secret and "stay in the closet" it has a strong wearing effect and puts them as risk of acting out without conscious purposefulness. 

Coming to terms with your sexuality and gender identity can be really rough. These teenagers know that they risk rejection and discrimination and it is a tremendous act of bravery for them to accept themselves and live genuine lives. Getting clear personally, coming out in your way, and living life true to yourself are major goals in psychotherapy with these teenagers. Another major goal is to examine the origins and effects of any internalized beliefs that may cause these teenagers to hate themselves because of who they are. Just like anyone else, as children they unwillingly absorb many things from many different sources that could play a counterproductive role in their lives. 

Getting clear on who you really are and what you really like has a protective effect in the lives of these teenagers. When they come to accept, respect and love themselves as they are they are in a much better position to stand up for themselves, to refuse mistreatment and insist on respect and equal consideration. It also does wonders for the self esteem and protects against damaging mental illness and relationship issues.

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When it comes to Sex Reassignment Surgery for trans teenagers I have a conservative approach. Trans teenagers need respect and consideration like anyone else but I believe only adults have the right to undertake such measures as surgery and hormone treatments and that irreversible decisions should not be made before 18 years of age. Top/bottom surgeries and puberty blockers have real risks to health, development and proper sexual functioning including the ability to experience sexual pleasure and orgasm. There are also significant risks when it comes to regret. If it is your goal to transition your teenager through surgery and hormone treatments I am not the best psychotherapist for you. 

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When it comes to parenting these teenagers special considerations have to be made for their physical health, mental health and safety. It is important for some parents to examine their own beliefs and develop accepting attitude for the sake of their loved teenager. Sometimes there's lots of misinformation and prejudice to work through. It can be quite challenging for some parents but it's through no fault of their own. What is very clear is that rejecting, cutting off, or refusing to accept a teenager because of their sexuality or gender identity is very damaging to them. 

Below is a list of common issues relating to teenagers who are not heterosexual or gender conforming. Reading them may help you decide if your teenager would benefit from psychotherapy to clarify their sexuality and gender identity.