A Psychiatrist’s Guide To Speaking With Children About Sexuality & Gender Identity

Dr. Gordon Wong, a psychiatrist with over 20 years of experience treating mental health, shares practical advice for parents on navigating their child’s journey of discovering their gender and sexual identity.

Raising children in Hong Kong, it can often feel like there are endless things to worry about, from monitoring grades and extracurriculars to rising health risks like space oil. But amidst all the noise, it’s worth pausing to consider what’s happening inside our children’s hearts and minds — particularly as they discover who they are.

We sat down with Dr. Gordon Wong of Optimal Clinic, a Honorary Consultant in Psychiatry at Gleneagles Hospital and Honorary Clinical Assistant Professor at the University of Hong Kong, to get his professional advice on how Hong Kong families can navigate conversations around sexuality and gender identity. While these topics can feel daunting, Dr. Wong’s insights reveal that the principles of good parenting — support, open communication  and education — are the same tools needed to raise an affirming child.

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A Starting Point For Hong Kong Families

While Dr. Wong notes that parents don’t often come to him specifically regarding a child’s sexual orientation, conversations around gender identity are becoming more common in his practice. The dynamic is often a familiar one, wherein a teen, usually accompanied by a parent (typically mum), voices questions they’ve long reckoned with during first consultation.

“It may be important to remember that sexual orientation and gender identity are formed at an early age,” Dr. Wong says. “Children and teens often spent years exploring and accepting self before discussing it with others.”

That means when your child finally comes out to you, it isn’t the beginning of their journey — it’s the culmination of a long, private process of self-discovery. Parents might be surprised, but for the child, this is often the final step in a long exploration.

Read More: Mental Health For Kids – How To Start The Conversation

Addressing Parental Concerns

Dr. Wong notes that while parents’ reactions to children coming out vary, their concerns often follow a predictable pattern. That is, for many parents, a child coming out can trigger a sense of shock, loss or even grief. They might mourn the future they had imagined for their child or worry about the challenges their child will now face.

Along with questioning whether their child is ‘too young’ to truly know their identity, “some common concerns are whether the teen is ‘sure’, what happens if the teen regrets their ‘choice’ or if life will be tougher,” Dr. Wong says.

He often hears parents frame it as, “Why choose a difficult path when there is an easy one?” This is especially true of parents who fear the “side effects of gender-affirming hormone therapy, or have concerns about societal discrimination.”

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How To Move Forward

Dr. Wong’s advice to parents is to process negative feelings or fear, and to not let this define their relationship: “No matter what your child identifies with, it is important to remember that your child hasn’t actually changed when coming out. Your child is still the same child.”

“Another important thing to remember is that sexual orientation and gender identity is just one aspect of a person, and definitely not the whole. We don’t have to reject the whole person when we do not like or understand one aspect. Parents can remember that there are other aspects of their child, and continue to love, respect and support them.”

More practically, Dr. Wong advises that, in his experience, “time is the best healer.” One powerful example from his practice illustrates how, over time, understanding can replace fear:

“I vividly remember a mother coming with her trans young adult to see me. She was in quite a shock,” he recalls. After discussing the common concerns — regret, societal hardship, side effects — Dr. Wong addressed her misconceptions and scheduled a follow-up. “To my huge surprise, after just two months, the mother told me that not only has she already completely accepted her child’s trans identity, but even booked and paid for a gender-affirming surgery for her child overseas. A huge turnaround in just two months!”

What changed? Education. “Through education and finding out more, parents often find that their initial fears are often due to misunderstandings and misconceptions.”

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Navigating Tradition & Online Influence

One major misunderstanding? In today’s digital world, parents often worry that their child is being ‘influenced’ by what they see on social media or online peer groups. Dr. Wong suggests a collaborative approach rather than a restrictive one.

“It’s a good idea to find reputable sources of information,” he says. “This issue can be addressed by parents co-reading information from registered organisations, such as Quarks Hong Kong or Pink Alliance, with their child. This helps each other to understand the topic and each other’s viewpoints better.”

For parents who come from religious or traditional backgrounds, the internal conflict can be especially painful. Dr. Wong offers a perspective that allows for both love and faith.

“There are churches that are supportive and affirmative towards people with different sexual orientation and gender identity,” he notes, suggesting families seek out inclusive communities like Kowloon Union Church, or read examples of how other parents have supported their children, such as this article by The Sun.

Read More: What You Can Do to Safeguard Your Child’s Social Media Influences

Beginning An Ongoing Conversation

Parents often believe that sexuality and identity are a one-time conversation best saved for the teenage years, but Dr. Wong suggests a different approach.

“It may be a good idea to have an ongoing dialogue regarding sexual orientation and gender identity,” he advises. This doesn’t mean formal sit-downs. For primary school-aged children, this ongoing dialogue can be as simple as acknowledging diversity.

“An ongoing dialogue may consist of an acknowledgement of people with different sexual orientation and gender identity, or expressing a positive attitude towards them.” This normalises the concept, making it just another part of the diverse world we live in.

He also encourages parents to embrace the fluidity of discovery: “Though sexual orientation and gender identity are formed at an early age, they can be fluid throughout life,” he explains. “They may shift as time goes on. Just be supportive, and let your child explore on their own.”

Read More: How To Talk To Your Children About Sex

The Ultimate Goal: A Secure Base

So, what is the long-term benefit of creating an affirming home? It’s the same benefit that comes from any form of supportive parenting.

“As with any aspects of raising a child, parents who are supportive and affirming foster confident and happy children. Parents who often criticise their child often lead to low self esteem and anxiety,” Dr. Wong explains. “The same principle would apply for children who may have different sexual orientation and gender identity. Be supportive and affirmative, so that they have a secure base at home to succeed in the world.”

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