Foreword

All good conversations begin with a common ground of a desire to learn with respect. Before you proceed in this subject. There is something that you must learn. I was a child who was Transgender. My approach to these questions come from a stand point of my lived experiences and my current education. My point of view is NOT an agenda nor does it follow trends. I agree that every child should be allowed to be a child without misunderstandings or hatred directed towards them.

Q: When did you know you were transgender?
A: I did not know the term for it when I was young (6-10). Back when I was questioning there was not a large amount of understanding. Like most children we all start to understand our bodies and their uniqueness around the age of 5 or 6. Though that said children do not understand the functionality of the differences. Though some signs of Gender Incongruity for children who are Transgender begin to appear at this time. At this time the scientific community does not have a clear understanding as to why.
At the age of 10-12 when puberty begins is when such things as Gender Dysphoria can also begin. Early understanding on the part of Parents and Community reduce the risk factors for children during this age period. It is advised to seek proper mental health assistance if your child is questioning beyond what children normally question. Or is the child is showing signs of Gender Dysphoria or Incongruity.

Q: Why is there such a high suicide rate in Transgender youth?
A: Without proper medical assistance and understanding from parents, community, and peers. Transgender youth are at a higher than normal suicide rate (worldwide 42%, 53% in the US, 30% in Australia). Much of this number can be reduced simply through proper education and understanding by those who are in the child’s life.

Q: Why are children receiving hormone treatment?
A: The Transgender community has heard this far right political spin for far to long. The truth is that it would be highly unethical for any doctor to prescribe such medications. What is being prescribed is Puberty blockers [1][2][3][4][5]. The youngest persons who have received hormone replacement therapy are [1][2]. Teen youth who transition through to surgery are rare as there are a large amount of legal requirements that have to be met as well as the high costs of the court system. Though most of youth who are Transgender must wait until they are of adult age. Such as with Jazz Jennings [1][2]

Q: When do children start to understand their gender?
A: Most studies are stating that children begin to see their gender between the ages of 3-5. This does not mean that they fully understand the issues of Gender. At this time there are only subtle hints that a child might be experiencing A+B does not equal C. This also does not mean a child is Transgender as large amount of children who experience A+B does not equal C become Transgender as some will grow out of this minor incongruity. [1][2][3]

Q: What are puberty blockers?
A: “gender identity is real, and there are medical treatments you can use to help your body better reflect who you are. Some young trans, intersex, and gender nonbinary people may decide to take puberty blockers after talking about it with their parents or guardian and a nurse or doctor. Puberty blockers are medicines that prevent puberty from happening. They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth. 

There are two kinds of puberty blockers:

• A flexible rod called histrelin acetate that goes under the skin of the arm and lasts for 1 year. 
• A shot called leuprolide acetate, which works for 1, 3, or 4 months at a time.”

[Thank you to Planned Parenthood for such a great answer.]

Q: Is there any risk to Puberty Blockers?
A: “Possible side effects of GnRH (puberty blockers) analogue treatment include:

• Injection site swelling
• Weight gain
• Hot flashes
• Headaches

Use of GnRH analogues might also have long-term effects on:

• Bone density
• Future fertility

Children will likely have their height checked every three months. Your child’s doctor might recommend yearly bone density and bone age tests.

If children with male genitalia begin using GnRH analogues early in puberty, they might not develop enough penile and scrotal skin for certain gender confirmation genital surgical procedures, such as penile inversion vaginoplasty. Alternative techniques, however, are available.

In addition, delaying puberty beyond one’s peers can be stressful. Your child might experience lower self-esteem.”

[Thank you to the Mayo Clinic for their wonderful answer.]

Q: Where can I find more information about puberty blockers?
A: Below is listed both commonly used drugs with a link to their information data. This data is very verbose containing a large amount of information about the drugs.
Histrelin acetate [Information Link]
Leuprolide acetate [Information Link]