As cultural attitudes about gender variance have undergone a profound shift, much of what therapists believed about what it means to be transgender is now hopelessly outdated. But how do people know that they’re the wrong gender? And what does that kind of knowing mean for our assumptions about males and females as “opposite sexes”?

I found talking to the transgender kids and their parents that I interviewed for this issue not only enlightening and educational, which I expected, but also viscerally moving. I was bowled over by the stubborn integrity of young kids who would insist upon being who they feel themselves to be, regardless of what anybody thought. Where, I wondered, did they find that spirit, that audacity, that sheer heroism, and at that age? But, then, talking to the parents of these kids, I began to understand a bit better.

Parents typically view their children in the largely gendered terms society lays out for them. Rearranging that internal mind map requires tremendous effort and adjustment. Given the alarming suicide rates for transgender children, it can also be a matter of life and death.

Until very recently, most families with transgender children had never met another family like theirs. Now parents and children from the trailblazing Ackerman Institute’s Family & Gender Project talk about their experience of joining a healing community that offers acceptance and a validating mirror of their own experience.

A school counselor’s patient work with a sad, uncommunicative young boy demonstrates what a difference just being there can make. * Commentary by Janet Sasson Edgette

OCD in children can operate like a kind of cult leader, demanding acceptance of an extreme view of a perilous reality and offering solutions that can’t be resisted, no matter how absurd they may sound. Given the overwhelming fear and worry the condition generates, falling in line with the cult leader can seem like the best strategy—except that it doesn’t work.

When it comes to eating disorders, therapy can be a matter of life and death.

While research indicates that most anti-bullying projects don’t work, a disarmingly simple approach has shown promising results. * Commentary by Signe Whitson

There’s a crucial point in the parenting life cycle that’s not often discussed in the literature.

How to keep it real with teenage clients.