Supporting children and young people who are gender questioning, gender diverse or trans

This page gives information about the role of speech and language therapy in supporting children and young people who are gender questioning, gender diverse or trans

For information on supporting gender questioning, gender diverse or trans adults, visit our guidance pages on (currently only accessible by RCSLT members) Trans and gender diverse voice and communication

Back to: Clinical Guidance A-Z

Last updated: September 2026

RCSLT Guidance Info
The RCSLT develops guidance to promote good clinical and professional practice in line with HCPC standards. Please read our statement on guidance to understand how it is developed and how to use it.
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RCSLT Guidance Info
The RCSLT develops guidance to promote good clinical and professional practice in line with HCPC standards. Please read our statement on guidance to understand how it is developed and how to use it.
Download IconDownload as PDF

Role of speech and language therapists

The role of SLTs working with gender questioning, gender diverse or trans children and young people includes: 

  1.  Differential diagnosis of neurodevelopmental conditions e.g. autism, Developmental Language Disorder   (DLD), and selective mutism
  2.  Identifying and supporting speech, language, communication and voice need that may not have been  identified previously
  3.  Facilitating discussions involving the child or young person who has speech, language, communication and voice needs relating to their gender identity
  4. Advocating and facilitating the voice of the child or young person in decision-making and consent related to their care by: supporting them to communicate their wishes, ensuring accessibility of written and verbal information (Cass., 2024, pp211.); supporting the assessment of capacity to consent or make informed decisions about their present and future care (Coleman et al., 2022).

 

Scope of practice  

The pre-registration training and development programmes undertaken by SLTs equips them to: 

  • Identify and Support Speech, Language and Communication Needs: Accurately assess and address a range of speech, language and communication needs. 
  • Identify and Support Voice Needs: Evaluate the voice by assessing auditory perceptual, acoustic and functional voice characteristics to formulate a support plan. 

Cover page of the position statement, green background with abstract design and title

SLTs working with children and young people who are gender questioning, gender diverse or trans may identify support that children and young people need beyond the scope of practice of the SLT. Examples include psychological support, physical health needs, medical, occupational therapy or youth work. SLTs should make appropriate referrals to other professionals. 

See RCSLT Position Statement on the role of speech and language therapists in supporting children and young  people who are gender questioning, gender diverse or trans. 

 

Referral links for UK nations

The referral pathways across the UK nations varies and is subject to change. This list was correct as of September 2026.

Nation
Links
England Referral pathway (https://www.england.nhs.uk/long-read/referral-pathway-for-children-and-young-peoples-gender-services-community-and-hospital-paediatric-services/)

 

Service Specification

(NHS England » Service specification: NHS Children and Young People’s Gender Service)
Scotland The Gender Identity Healthcare service in Scotland for under 18s operates from Sandyford Clinic, Glasgow. Referral is via GPs, paediatric services or Child and Adolescent Mental Health Services (CAMHS). The Scottish Government is considering gender identity healthcare services for children and young people in paediatric clinical settings via a regional model and moving to clinical referral only.
Wales The Welsh Gender Service will only accept referrals for patients aged 17 and over years with the appointment after 18 years of age is reached. Referral is via GPs.
Northern Ireland Northern Ireland operates different services for adults and children and young people.

  1. https://online.hscni.net/gender-identity-service/ (adults)
  2. https://belfasttrust.hscni.net/service/knowing-our-identity/ (Children and young people)

How SLTs can contribute to emerging practice

This is an evolving area of clinical practice and RCSLT encourages members to:

  • support the development and compilation of evidence-based research into clinical needs and management of this population
  • contribute to the Children and Young People’s Gender Identity and Expression CEN
  • respond to public consultations (from NHS, Government and academic organisations)
  • seek to represent the profession in national and international research, for example, participating in advisory groups and committees.