As with adults, gender-affirming care can differ from child to child. Most gender affirmation before puberty includes no medical interventions at all. If a five-year-old child declares he is transgender—“Mom, I’m actually a boy!”—he might get a different haircut, new clothes, and perhaps use a new name and pronouns. No gender-affirming surgery is performed on a five-year-old. No hormones are provided at that age.
