Gender-affirmative practices recognize and support an individual’s unique gender self-identification and expression. Gender-affirmative practices are becoming more widely adopted in the mental and physical health fields in response to research showing that clinical practices that encourage individuals to accept a certain gender identity can cause psychological harm^[1]. In 2015, the American Psychological Association published gender-affirmative practice guidelines for clinicians working with transgender and gender-nonconforming people. Preliminary research on gender-affirmative practices in the medical and psychological settings has primarily shown positive treatment outcomes^[2]. As these practices become more widely used, longer-term studies and studies with larger sample sizes are needed to continue to evaluate these practices.

Research has shown that youth who receive gender-affirming support from their parents have better mental health outcomes than their peers who do not^[3]. Youth who report that their parents “strongly support” their gender identity and gender expression report higher self-esteem, fewer depressive symptoms, lower suicide risk, greater life satisfaction, and improved mental health than those whose parents either “somewhat support” or "do not support" them^[4].

Gender-affirmative practices emphasize gender health. Gender health is an individuals’ ability to identify as and express the gender(s) that feels most comfortable without fear of rejection^[5]. Gender-affirmative practices are informed by the following premises^[6]:

• gender variance is not a psychological disorder or mental illness
• gender expressions vary across cultures
• gender expressions are diverse and may not be binary
• gender development is affected by biological, developmental, and cultural factors
• if pathology occurs, it is due to stigma and discrimination that gender variant people face rather than from a cause of gender variance itself