More young transgender people are coming out, a sign that societal attitudes are becoming more welcoming when it comes to gender issues, according to an Alberta psychiatrist.

Edmonton-based Dr. Lorne Warneke is speaking out after CBC News reported Monday that two judges in southern Alberta had ruled that a child at the centre of a custody battle — who was born male but began identifying as a girl as early as age three — must dress as a boy.

A third judge later overturned that ruling, but Susan Smith — not her real name — is still fighting to regain primary custody from the child's father, who blamed her for the child's gender confusion and anxiety after she vowed to support the child's desire to wear feminine clothing.

Smith refers to her child — who is now five — with the gender-neutral pronoun "they," rather than "him" or "her."

Warneke, who has been seeing transgender patients for decades, says as parents have become more supportive, his patients are now getting younger.

Izzy, a transgender University of Calgary student, offers support to a young child in Medicine Hat, Alta., who was ordered by judges not to wear feminine clothing in public. The child, now 5, was born male but identifies as a girl. (Colleen Underwood/CBC)

Lack of parental support can increase risk of suicide

He says he has treated children as young as five years old. "And when I see these children, there's absolutely no doubt they are who they say they are. A biological girl, but you see a little boy in front of you and vice versa," Warneke said.

On the flip side, Warneke says a lack of parental support has been proven to increase the risk for behavioural problems, depression and even suicide.

The psychiatrist says people are born with their gender identity, just like sexual orientation or the ability to walk.

Kris Wells, an assistant professor with the Institute for Sexual Minority Studies at the University of Alberta, says more resources, better education and a more welcoming culture are allowing transgender people to come out at younger ages.

"It's a definite trend that we're seeing," he said. "There are more and more positive role models, challenging old stereotypes of being sick or diseased or being treated as a freak or a monster. Thankfully, that discourse is changing."

Dr. Greta Bauer with the department of epidemiology and biostatistics at Western University also says she has noticed that trans young people are coming out at younger ages.

"I think that that time period is getting compressed now because … with the internet, people are able to connect and find out that it's not just them," she said.

"And I think overall, that's a very good thing, that they're able to find the language for what they're experiencing."

'That's not how it works'

University of Calgary student Izzy, who is transgender, says looking back, she didn't know why she liked certain things, just that she felt she shouldn't like them because she was born a boy.

"When I was really little, I just knew there were girly things I liked," Izzy tells CBC News.

"I heard one person say, 'Oh well, that's for girls' and I was like, hands in the cookie jar, kind of worried and I tried to shut it down."

Izzy hoped her feminine tendencies would disappear once she hit puberty and she never told her parents.

"I did it a lot on my own or through support networks and through other people and it took a long time for me to accept it, not just because I didn't go to my parents … but I didn't know how I could come to them, so this little girl is doing a lot of things ....that people who spend a little bit longer in the closet think they should have done in hindsight."

Now at age 24, she's made peace with herself.

"No matter how much you try to bury it, suppress it, pretend it's not there, that's not how it works," she explained.

"It's a part of you."

Wells says it's vital that parents and caregivers of young transgender people have access to the tools they need to help guide a child in their journey, without being prescriptive.

"The question is always, what's the most appropriate course of treatment, and the consensus is generally that you affirm the child's gender identity," he said.

"Parenting doesn't really influence a child's gender identity. That's an innate part of who they are. It's being in non-supportive environments that cause the most damage."

The absence of a supportive atmosphere often leads to tragic outcomes, Bauer says.

Her research into the experiences of trans young people in Ontario found that 57 per cent, among those who did not report having strong parental support, had made suicide attempts within the last year.