OBJECTIVES Parents and caregivers' responses to their child's gender identity or expression play a pivotal role in their mental health. Despite increasing visibility of transgender and gender diverse (TGD) children, few scientific resources exist to advise their parents and caregivers. METHODS We used an online Delphi study to generate expert consensus. Expert adult participants (N = 93; 55% cisgender women, 12% cisgender men, 33% gender minority; 83% White race or ethnicity) rated statements describing parenting strategies compiled from a systematic search of community-generated online literature. Participants represented 3 distinct "panels" of expertise: parents and caregivers of a TGD child, TGD persons, and/or professionals working with TGD populations. Statements rated as essential or important by 80% to 100% of each panel were endorsed as a guideline. Three rounds of surveys were used with iterative feedback to develop consensus. RESULTS Of 813 total statements, only 125 were endorsed by all 3 panels. Key domains of consensus included: supportive strategies for parents (eg, open communication, listening), behaviors to avoid (eg, pressuring a child into a gender transition), strategies for navigating healthcare and school systems, and common responses for parents (eg, confusion). Areas of disagreement, in which professional and TGD panels concurred but the parent panel did not, included whether to allow gender identity experimentation during childhood, the value of providing access to gender diverse media, and how to avoid misgendering a child. CONCLUSIONS These consensus-based guidelines offer a unique and needed resource for parents and caregivers and clinicians and can be used to promote the mental health and well-being of TGD children.

中文翻译：

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制定育儿指南以支持跨性别和性别多样化儿童的福祉。

目标 父母和照顾者对孩子的性别认同或表达的反应在他们的心理健康中起着关键作用。尽管跨性别和性别多样化（TGD）儿童的知名度越来越高，但很少有科学资源可以为他们的父母和照顾者提供建议。方法 我们使用在线德尔菲研究来达成专家共识。成年专家参与者（N = 93；55% 的顺性别女性，12% 的顺性别男性，33% 的少数族裔；83% 的白人种族或族裔）对描述育儿策略的陈述进行了评分，这些陈述是通过系统搜索社区生成的在线文献而编制的。参与者代表了 3 个不同的专业“小组”：TGD 儿童的父母和照顾者、TGD 人员和/或与 TGD 人群一起工作的专业人员。每个小组 80% 到 100% 的陈述被评为基本或重要的陈述被认可为指导方针。三轮调查与迭代反馈一起使用以达成共识。结果 在总共 813 份声明中，只有 125 份得到了所有 3 个小组的认可。共识的关键领域包括：父母的支持策略（例如，开放式沟通、倾听）、避免的行为（例如，迫使孩子进行性别转换）、引导医疗保健和学校系统的策略以及父母的共同反应（例如，混乱）。专业和 TGD 小组同意但家长小组不同意的分歧领域包括是否允许在儿童时期进行性别认同实验、提供访问性别多样化媒体的价值以及如何避免对孩子进行性别歧视。