Understanding and Managing Gender Identity Variance in Minors: A Qualitative Research on the Parental Role in Italy

Identities that differ from what is expected of each gender challenge the crystallised binary form of social organisation. Furthermore, having a gender-variant child is an experience that confronts parents with something unknown to them that questions most of their assumptions. In the Italian context, there is a lack of awareness about the population of transgender and gender-variant minors, and what their or their families’ needs are. In the present study, we interviewed the parents of gender-variant minors from Italy and asked them to describe the ways they got to know their child’s gender identity and how they managed such a completely new situation. The interviews were transcribed literally and analysed through discourse analysis. We carried out descriptions of how parents configure this topic and the different positionings adopted thorough their experience of understanding and managing gender variance. Overall, we discussed and promoted parent-children interacting modalities aimed at co-constructing and sharing the process of gender identity development, instead of adopting self-referential or ideological positionings. The present article offers a qualitative exploratory study of gender-variant minors and their families in the Italian context. The limitations of the study and suggestions for future research are also presented.


Introduction
Gender identity variance (GIV) in minors has been gaining increasing coverage, in spite of still being an underrepresented topic in the scientific literature. Recent international research has identified a relationship between gender variance in minors, mainly adolescents, and elevated levels of depressive and anxiety disorders and increased instances of self-harm and suicidal ideation (Kaltiala-Heino et al., 2018). In contrast, some research suggests that expressions of distress and psychopathology associated with GIV, especially in the diagnoses of gender dysphoria (DSM-5) and gender incongruence (ICD-11), may be primarily linked to the existing social stigma and negative reactions of society, friends and family (Campbell et al., 2015).
Research studies on gender-variant children and their families have shown that gender variance is a widely unknown phenomenon in common sense (Dierckx et al., 2016). In fact, it was found that before experiencing it first-hand, most parents had never even heard about gender-variant minors (Gregor et al., 2015). Not knowing how to name the experience and/or how to behave are some of the first challenges parents face (Schimmel-Bristow et al., 2018). Family members often experience feelings of guilt, embarrassment, worry, impotence, anger and/or grief (Dierckx et al., 2016). According to Ryan (2017), feelings of shock and loss are associated with the failure to fulfil the typical expectations and representations commonly related to the child's gender, causing a loss of certainty.
There is a broad variability in the ways a family responds to gender variance. In some cases, this 'deviant' behaviour is considered to be a passing 'phase' of exploration that some believe will resolve itself with time (Hill & Menvielle, 2009). In some studies on parents' experiences (Dierckx et al., 2016;Pyne, 2016), an ambivalent situation is often described: On one hand, parents wish for their child to express themselves freely and embrace their identity; on the other hand, they fear for their child's safety and others' reactions. Moreover, some parents refuse to acknowledge their child's gender identity and insist on using pronouns associated with their biological gender and birth name, limiting their child's free expression of gender, in the worst cases, with threats and aggressive behaviours (Grossman et al., 2006). In the literature, these situations have been associated with depressive symptoms and suicidal behaviours in minors (Pollitt et al., 2019).
The ways parents gain knowledge and act appear to be driven by cultural norms and gender stereotypes. Research has underlined that fathers tend to take more time in accepting the revelation of their child's variant gender identity, and they have been described as being more likely to react negatively, with the show of disengagement, disapproval or willingness to be uninvolved (Gregor et al., 2015;Kuvalanka et al., 2014). Kane (2006) associates the discrepancy between the support from mothers and fathers to the paternal anxiety that their child's nonconformity to their assigned gender could reflect on their masculinity. Moreover, many authors have observed that acceptance of a minor's gender identity can become a reason for conflict if parents take different positions on how to consider gender expression (Ferrari & Mancini, 2020;Hill & Menvielle, 2009;Malpas, 2011). Moreover, responses to gender nonconformity also vary depending on the child's gender at birth, as it seems that biologically female children expressing 'masculine' preferences are more socially tolerated that their male counterparts (Kane, 2006).
However, parents who choose to be supportive towards their children's gender nonconformity face several challenges, especially in terms of interaction within different social contexts. One of the major concerns is protecting their child from ostracism, bullying and transphobic violence (Gregor et al., 2015;Riley et al., 2013). Families of transgender minors may be victims of reproach and isolation as forms of secondary stigma just for supporting their child's gender expression (Pullen Sansfaçon et al., 2015). Different authors (Kane, 2006;Ryan, 2017) have accounted that the interviewed parents have formulated a series of rules to limit their child's gender expression in public, establishing what is permitted at home and what is appropriate in public places.
For instance, parents allow their child to wear desired clothes only at home or authorise their child to violate gender norms only partially, for example, by allowing boys to wear a very colourful shirt, but not a pink one. These actions require parents to constantly be vigilant in evaluating their child's gender expression and negotiating their child's preferences, constituting a significant form of invisible labor (Ryan, 2017). Works in the international literature (Pyne, 2016;Riggs & Bartholomeus, 2017) have highlighted how parents are often met with non-inclusiveness or hostile attitudes from institutions, healthcare professionals and different social contexts that are often inadequately prepared on the topic (Dierckx & Platero, 2018). Despite the reported difficulties faced by parents, an ever-increasing number of them are choosing to openly support their children's choices and preferences.
In the literature, there is evidence that family support is crucial in promoting gender-variant minors' mental health (Olson et al., 2016;Westwater et al., 2019). In doing so, parents challenge and renegotiate their basic conception of gender and sex (Meadow, 2012;Ehrensaft, 2016). Hill and Menvielle (2009) describes 'childtaught parents' as individuals who have learned important lessons directly from their children by experimenting with different ways of fulfiling their role as parents and giving up on the claim of determining who and how their child will become. Some parents embrace this experience as an opportunity to acquire more agency, develop critical thinking, become more tolerant and inclusive towards diversity and promote cultural change (Gray et al., 2016;Hill & Menvielle, 2009). Ridgeway (2011) describes these families as 'gender innovators' who become active agents in challenging the binary "hegemonic" gender norms as a classification principle in social organisation (Ryan, 2017), fostering a form of social justice (Pyne, 2016).
How a child's gender variance is handled by parents is scarcely examined in psychological literature, particularly in the Italian context, which is rarely represented. Moreover, the prevalence rates of gender variance are only approximate and incomplete, as the researchers have only considered the data available through specialised centres and healthcare professionals (Fortunato et al., 2020). However, in line with the data emerging from the international literature, it seems that an increasing number of minors at an increasingly young age are turning to health professionals to seek support and undertake gender transition before reaching adulthood (Caldarera et al., 2019).
In the present research, special focus was given to the role of parents who face new challenges related to their child's education, personal development and promotion of mental health, in the context of a child's needs defying the social norms. However, there are still extremely scarce data on how parents deal with gender variance in the Italian context, regarding the ways in which parents learn about the topic, their attitudes towards identity issues and what their children's needs are (Trappolin & Tiano, 2015). Moreover, it is necessary to investigate the ways parents deal with and manage the entire experience.

Theoretical Background
The current research adopted the interactionist paradigm that aims to understand how identity is generated through interactive exchanges (Mead, 1934;West & Zimmerman, 1987). An individual is considered as an agent who organises their own experience on the basis of the meanings generated through symbolic and linguistic processes (Salvini & Dondoni, 2011;Iudici & Fabbri, 2017). Identity is, therefore, understood as the outcome of interactive processes through which the person acquires a sense of coherence and continuity in terms of biographical experiences (Cahill, 1986;Faccio, Sarigu & Iudici, 2020). This developmental process takes place along the path of self-mirroring through which children learn gender roles and identify with the expressive and behavioural sex-typified patterns (Iudici, Antonello, & Turchi, 2019).
Once the initial awareness of the gender is acquired, children are committed to adhering to a stable and persistent self-image. A critical moment in the definition of gender identity can be located between the end of childhood and adolescence. During this peculiar period, pubertal changes begin, and entering school gender differences become more salient as they are typified in social interactions. Therefore, identity is not a pre-defined factual reality or an entity that belongs to the individual; it has rather a 'dialogical' value and is a narrative construction, understandable in terms of a pure process within a diachronic dimension, therefore, undergoes constant transformation (Turchi, 2009). Ultimately, different narrators collectively participate in generating the minor's identity through related discourses. These narrators are the minor himself, the network of people around him and every potential discourse in the socio-cultural context of belonging (Turchi & Orrù, 2014;Iudici, Favaretto & Turchi, 2019).

Participants
Specialised services, associations of activists and parents dealing with transgender minors were contacted in order to recruit participants. Thanks to the particular interest of two transgender rights activists, the proposal of the research project was presented to the families for their knowledge (directly or through a Facebook group), and some of them volunteered. The researcher then contacted the participants by phone to explain the research project, answer any questions or doubts and arrange interview appointments. The criterion for participating in the research was that the individual must be the parent of a minor who does not identify with their assigned gender; the presence of 'gender dysphoria' diagnosis was not required.
The research involved 20 parents: 11 of the female gender, 8 of the male gender and 1 who identifies as a non-binary person. Among them, 19 are biological parents, while one exercises the parental role, in that they are married to the biological parent. The age range of the parents was from 37 to 62 years (average age 47.5).

Objectives
The following were the goals of this research project: (1) To explore how parents of a gender-variant minor develop an understanding of their child's gender identity; (2) To explore how parents position themselves towards the development of their child's gender identity, and how the topic is dealt with regards to family, social and institutional contexts and the child's health needs.

Survey Tool: The Semi-structured Interview
The tool used for data collection was a semi-structured interview, typically used in qualitative research (Cohen & Crabtree, 2014;Patton, 2005). This research methodology allowed, through non-directional questions, for access to the symbolic and experiential universe of the interlocutor as they understand it (Flick, 2009;Wengraf, 2001). The role of the interviewer is to manage the goals and timing of the interview while allowing the interviewee to freely express their beliefs and experiences (Willig, 2001). This tool was also chosen to share the different meanings attributed to terms, especially in the context of gender studies; the same term may not mean the same for all respondents since the meanings of words depend on their use and the context in which they are used (Corbetta, 2003;Fylan, 2005).
To ensure accurate and complete clarification of the procedures for conducting the research project and qualitative analysis of discursive data, the COREQ checklist was adopted to guide the preparation of this article (Tong et al., 2007).

Data Collection
The interviews were conducted in person. All participants were given an informative document elaborating on the purposes of the study, and ensuring anonymity and privacy, and an informed consent signature was obtained from each one of them. All the works were validated by the ethics committee of the University of Padua. The answers were recorded with a voice recorder and then transcribed literally. Overall, the duration of the interviews ranged from a minimum of 35 min to a maximum of 50 min. Interview track was in Table 1.

Data Coding: Discourse Analysis
The textual data obtained through the interviews were analysed through discourse analysis. This method included a heterogeneous set of tools for performing qualitative research, understood as a relational and collaborative practice and a dialogic process (van Langenhove & Harrè, 1999;Seikkula & Arnkil, 2006;McNamee, 2014).
Starting from the conception of the discourse as a situation-oriented practice (Potter & Edwards, 2001), the focus was on the procedural dimension of the discourse. The type of discourse analysis made draws on the methodology of Harré's discursive positioning, proposed to study and understand the ways the person is placed in social interactions (Davies & Harré, 1990;Harré & Moghaddam, 2003). The positioning construct allows for highlighting the organisation process of personal experience from which one can understand and individual's possibilities of action. Voices and positions can be in dialogue, and they can change and talk about individuals, social groups or institutions (Mininni, 2003;Harrè et al., 2009). During this process, the person positions themselves in relation to others and is relocated to the social system by other's discourses (Riessman, 2004).
The analysis of the interviews was carried out individually by the present authors. The results of the first coding were discussed and subsequently reviewed jointly by the two authors. The first reading of each interview was made individually to observe the particular ways of codifying the discourses in reference to theoretical assumptions. Individual responses of each interviewee were reported according to the topics to identify what positionings were adopted, to which repertoire of argumentation belonged and which 'positionings' were generated throughout the experience. Once the practices parents have put in place to To explore how the parent positioned him\her-self towards child's variant gender identity development and how this topic has been managed towards different social contexts and with regard to his\her development needs 4. How did you manage what was gradually understood as gender identity variance? 5. How did you live this experience? 6. What difficulties did you encounter? understand and manage GIV were identified, we sought to systematise them into conceptual dimensions that would allow for their description and observation.

GIV as an Objective State
In the provided reports, GIV is something that 'exists' within a person; it can be stated or displayed through behaviour. In this sense, GIV is configured as an objective state, something that can be objectively observed. The term 'dysphoria' is often understood on an ontological level, both when it refers to one's own 'well being' and one's own 'malaise'. For example: "It's a big mess, a big mess for everything there is, that there is around. Apart from that, it is clear and glaring that she is dysphoric since she was… I know that I make her angry [laughs], I tell him always, since he was in the cradle. I always saw that she was… different in movements, in attitudes".

GIV as a Mismatch Between the Gendered Body and the Gendered Mind
Some parents configured GIV by comparing the gendered body with the gendered mind. In this case, there was a mismatch between the way the person feels, involving gender identity, and the body that expresses gender differently than the experienced one. When configuring gender variance as a mismatch between the gendered mind and the gendered body, the parents positioned themselves by contrasting how one lives with a certain kind of body and how one lives on a psychological level. This contraposition creates a discrepancy between these ideas, in that one must be more valid than the other. Thus, a radical difference could be seen between what is observed on the outside and how one feels internally. A participant parent stated: "Gender variance is practically a person who doesn't collide with his own body, his thoughts, his intellect, etc. is of a certain type, while his body describes him as another".
In discursive terms, parents also configure GIV in terms of judgment and the body is connoted as wrong or defective compared to what is desired. One of them shared: "At this moment, I would define it [GIV] as my daughter's struggle to accept her body, as she; in her head, [she] feels like a woman, and she has a male body".

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The binary conception of gender is most evident in the arguments brought about by contrast or judgement. The body is indeed the place where actions are taken to change and adapt it with the felt gender or one's own thoughts regarding gender.

GIV as an Existential Possibility
Some of the interviewees configured GIV as one of the many possibilities of expressing oneself. All these parents criticised gender attribution within binary categories and claimed that identity and gender expression can be placed within a wide continuum: "I would describe gender identity variance as an attitude that a person has from the point of view of expressing gender which does not correspond with social expectations. Because this person was given a gender according to physical characteristics, very limited, very binary. Then over time, this person expresses himself in such a way that society, in general, connects to the other gender. While the expression of mankind is much wider, much more varied".
This way of constructing gender identity considers the demise of the male-female dichotomy and allows indeterminacy in the outcomes of gender identity development. The focus is put on inherent individual differences and personal autonomy and freedom to self-determination. One of them shared: "But for me, it is something that does not exist substantially. There are males, there are females, and in the middle of these two points, there is immensity. One can be a little bit more like this, a little bit more like that, but this pointing out of gender variance is wrong in my opinion. That is, there are people, and we are all different from each other; as with hair color, eye color, skin color, there is also this variance, this multitude, this fluid, this world, and you just have to accept it".
The specific way each parent configures GIV has pragmatic implications for how the situation will be addressed and the actions that will be taken.
Signifying GIV as an objective fact denotes the idea of building diversity on ontological expectations, based on which you can see that 'something' appears as different. Many parents, therefore, consider GIV as a concrete existence, often connoted as a problem for the child who lives it. From the interviews, it was possible to note that some parents needed to identify 'what the child has' or to establish that the child 'was born this way…'. An implication is that the parent might approach identity issues in the search of explanations or solutions to the 'problem', as it often happens in the first period. Gray et al. (2016) reported in a study that the parents who believed in an innatebiological explanation of gender identity variance were more accepting than those who believed in environmental causes that might therefore need intervention (Miscioscia et al., 2020).
GIV as a mismatch between the gendered mind and the gendered body is articulated within conflicting dialectics, defined from the implicit conception of gender binarism. This conception was built discursively by opposing and judging both instances. In fact, the 'wrong' or 'disagreeing' body rhetoric postulates its correctness between the inside and the outside of the body according to the stereotypes of being female or male in outwardly recognisable ways distinct from others. However, when the sense of 'false embodiment' (McQueen, 2014) is rooted in the essentialist narrative of the 'wrong body', it can preclude further existential and discursive forms of being. Assumptions regarding an improper body can imply and legitimise resorting to surgical interventions to 'correct' the 'wrong' body. This was noted by Bornstein (2016), who considered it to be an 'unfortunate metaphor' that conforms conveniently to cultural expectations.
Most of the interviewed parents configured GIV as an existential possibility through which individual differences are expressed. This concept deviates from the common sense discourses about transgenderism and allows those who adopt it to position themselves in ways that exceed the strict gender expectations.
A positioning towards uncertainty is more difficult for many of the parents than referring to binary categories. Reducing gender to two possibilities facilitates the reassuring belief of being able to predict developmental outcomes more easily, as also found in the studies of Wiseman and Davidson (2012), Carrera et al. (2012) and Gregor et al. (2015). Configuring GIV as a possibility instead creates the opportunity to manifest diversity in multiple ways and allows for more tolerance towards the unpredictability of developmental paths. By privileging this configuration of GIV, parents could be the first ones to be sensitised to thinking of identity and gender expression in ways that go beyond what is socially required.

Understanding the Child by Making Comparisons Between Children or With Parents' Own Expectations
In the cases where parents compare their children with their peers or siblings as a way to understand gender variance, the normative standard is drawn from the proximal context. A participant parent stated: "She was born N. But since she was little, from the age of 2, 3 years old, if you compare her with boys and girls, she has always had girly behaviors, thoughts, and attitudes. So we already knew that there was something that wasn't what is defined 'normal' by the masses".
From the parents' reports, it was found that a common way of understanding is observing 'something' not in line with their expectations regarding the gender assigned at birth. These parents adopted normative criteria that are also implicit and culturally available in order to determine what is appropriate for each gender. They observed preferences, attitudes or movements in the child that went in the 'opposite' direction and compared him\her with their own expectations. In distinguishing the 'appropriateness' of gender expression, the criteria adopted by most parents appeared to be strongly based on a binary perspective. One of them shared: "Well, I got it right away because L. at 2.5\3 years old began to behave in a way that seemed not the same as the others. I don't know […] he'd put my skirts on his head, he'd wear my shoes. So there was an identification that didn't go the usual way. Because children, boys, put on their dad's shoes, they identify with male figures and did not happen […] with L. Instead, […] she identified with all the feminine, very feminine things".

Understanding by Hypothesis
Faced with the situation of 'not knowing', the parents tried to find an anchorage with culturally available, knowable, and as much as tolerable explanations. As explained by most of the interviewees, GIV was an unthinkable possibility for them. Some admitted that they suspected earlier that their child wanted to be born the 'opposite' gender, but they thought that nothing could be done about this, or they hoped to be wrong. Some of these parents assumed that what they had observed was just a phase or an exploration of the opposite gender. A further hypothesis advanced by the parents was that these behaviours, connoted as 'feeling bad' and a cause for concern, were due to something that had happened to or something suffered by the children. One of the hypotheses forwarded by most parents was that the child might be homosexual, while only one parent thought that their child might be transgender. A participant parent stated: "We initially thought of homosexuality, we didn't even know the topic of gender dysphoria, and we didn't even think about it. It seemed to us so far away that: 'No! It's not possible".

Understanding Through the Search for Information and Help
Faced with the circumstance of not knowing what the situation was, some of the parents claimed to have actively sought information, especially on the internet. One of them stated: "Pink, we had seen that there was a love for pink. All those things that didn't seem normal to us. So we said that when there's something that doesn't seem normal, that you don't know, you inform yourself. You say: 'What is it? Is there something weird? Is it an exploration? Let's find out! Let's look on the internet".
Finding themselves in a difficult situation, other parents turned to professionals in the psychological field to understand how to behave with their child. For one parent, being in the LGBTQ + community was an informative resource, but it did not help the parent identify early on how their child was experiencing his\her gender identity.

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Understanding and Managing Gender Identity Variance in Minors:…

Understanding by Addressing and Asking the Child Directly
Only some of the parents stated that they understood GIV by directly addressing their child, asking and talking about how they were doing or what was going on. Sometimes addressing the child occurred only after observing meaningful behaviours such as signs of malaise or discomfort. A participant parent stated: "The period and breasts were the things that bothered him the most. Then I asked him if something had happened. I also thought that he had suffered something from someone. Then I worked on it [by] talking to him and informing myself [and] I understood that it could be that. Until he just told me openly, he told me 'I know I'm transsexual, I just feel like a man".

Understanding Because of the Child's Coming Out
Although some parents claim to have 'always' observed gender-atypical behaviours and preferences, they chose to wait for the 'natural' evolution of the situation. One of them stated: "We already knew, we foresaw, but we never forced the hand. So we just let it go, and then over time, slowly, it came out on its own".
Other parents stated that they had no previous suspicions and that they did not expect their child to come out as trans when it was happening. This occurred when the child, assigned female at birth, behaved in a way that was considered 'tomboyish' or 'anonymous', although they never associated him with a male identification. A parent reported that their child made it clear that he wanted to be identified as a female as soon as he learned to speak at two years old: "He always exhibited that he wasn't strongly masculine. And then, when he started talking, it was very clear[…]: 'I hate you, you gave birth to me as a boy, but I'm a girl. I'm S., I'm not L., so you have to treat me like a girl." The interviewees reported that the paths towards understanding their child's gender identity were achieved in heterogeneous and specific ways for each family, which was also argued by Westwater et al. (2019). Personal beliefs, social contexts, gender-specific expectations, parents' knowledge, specific life events (e.g. a parent's illness) and the interactive ways carried out within the family are all relevant in the described process. Unlike what was argued by some authors (Lev, 2004), no structured or fixed sequential 'phases' were reported during the interviews, but there are some 'movements' that many parents described to have undertaken.
When comparing the child with peers or the stereotypical models of masculinity and femininity, parents subjected their child's experience to common-sense standards and what the others do, as if to preserve the boundaries of normalcy. It may imply that the child is denied the possibility of being seen and considered according to the felt gender identity. The normative gaze applied to a child is likely to oblige him\her to suit the existing and knowable ways of being. It, therefore, implies that there is a constant comparison between the child and their peers that his\her parent considers adequate or normal, and possibly affecting the parent-child relationship.
Making assumptions is another way through which the parents had approached the knowledge of 'something' that they did not have prior knowledge about. Assumptions such as that the child was just going through a phase or that he\she could have suffered 'something' from someone show how GIV is an unthinkable option for them. At the level of common sense, the ways transgender identities are expressed and realised are confined to adulthood and to the stereotypes of transsexual people that they earn their living through illegal activities.
Interviewed parents reported that they initially hypothesised that their child was homosexual to explain their 'abnormal' behaviour. This hypothesis brought these behaviours back into thinkable and known regions of meaning and therefore, reassured them. This differs from what has been reported in the literature (D'Augelli & Grossman, 2001;Baiocco et al., 2015), that having a homosexual child may be experienced as a difficulty by some people to such an extent they refuse to accept him\her, kick him\her out of the house or attack him\her.
Nonetheless, in the process of understanding and intercepting GIV, both the comparison and making assumptions, maintain the parent in the positioning of solitary thinking, in the proliferation of doubts and uncertain answers.
Many of the parents, although they had known or had 'always' observed manifestations of diversity, did not create the condition that allowed understanding and sharing of what their child might be experiencing.
As noted in the literature, adolescence is already critical stage in terms of identity and physical changes, and this can be even more difficult for transgender adolescents (Drescher & Byne, 2012;Ristori & Steensma, 2016). It would be useful for the parent to privilege conversations regarding the gender identity experienced by the pre-pubescent child, who could be hiding his\her feelings due to fear of blame or of not being accepted. This aspect emerged in the reports of these parents who became aware of the situation only after their child came out. In contrast to this, searching and asking for help may allow for early interception of situations of suffering and discomfort. Parents are likely under go the suspension of their own knowledge, therefore seeking answers to their questions, educating themselves and confronting others about the situation.

Managing GIV in Line with Parents' Own Self-referential Criteria
Parents assume specific positionings regarding gender variance that are inserted on a virtual continuum between acceptance and non-acceptance, characterised by the use of personal and self-referential criteria.
One of the positionings emerging out of the interviews was an explicit nonacceptance of what was observed in the child's behaviour. Some parents reported that they initially placed themselves in an opposing and repressive positions regarding GIV. A participant parent stated: "She expressed a preference for the female world. More and more growing up. Of course, we prevented her. We kept her from displaying, especially publicly, didn't we? But only at home, we allowed to manifest her essence, what it was, indeed at the time we did not understand that she was so." A further positioning concerns unconditioned acceptance. Some parents immediately accepted their child's gender identification after its revelation, sometimes in an undisputed manner. One of them said: "So yes, let's just say the first thing I did was I activated myself to start the transition".
Another positioning relates to the accompaniment of choosing gender based on the parent's personal ideas. A parent reported that she helped her daughter find her gender positioning, believing that it was not possible to maintain a male name and express the female gender through appearance: "We helped him finally decide what he wanted to be because you can't be called N. [male name] and go out with your skirt or nail polish. So then, we finally managed to help her get out who she truly is".

GIV as an Occasion for Reflection and Parental Redefinition
The parents described GIV as an occasion on which they found themselves restructuring their held representations, evaluating their actions, redefining their role and making changes to their family relationships. They developed the situation as a process of adaptation and habituation of the whole family after an initial moment of difficulty in which the passing of time is essential. One of them shared: "Having this situation in front of you, you have to say 'Okay, what do I do now? Do I go ahead, indulging him and standing next to him and so on, or do I have a complete rejection?' One thing follows another, that is, without being able to go back. And so, you face situations, as they came out and yet manage it as a parent. Of course, you have to change both the viewpoint from which you see things and even the everyday life. And so he is changing, but so are you." Another identified positioning concerns considering GIV as a situation of being assimilated into family dynamics. Parents have positioned themselves with respect to GIV in an attempt to 'normalise' and integrate their child's experience in everyday life. Such parents believe that the child should receive equal treatment as their siblings, and that he\she should be educated beyond difficulties, albeit without receiving greater support or facilitation. One of them said: "We tried to deal with it in the easiest way possible. So, giving her space. We teach her to talk. Whatever problems they have, they talk. Because it's not that we put it differently than the siblings. At first, she was nervous, maybe we let something slide more, but then slowly we got back to [the]normal regime as usual." Another positioning relates to experiencing the situation as something that requires co-managing by both the parents. Managing GIV had led to the arousal of conflicts for a couple of parents, who were initially motivated by having taken different approaches to GIV, but, over time, they happened to share a common stance after negotiating their parenting. One of them shared:

"[…] things have been […] tense […] between us. Because [we] clearly [had]
two different theories: What she wanted, I absolutely didn't. Oh yes, of course, because you know I came home and she had made him watch Cinderella, Snow White […] And I said: 'Fuck! Put on a Superman, put on a Batman, put on someone masculine.' The early times the question was: 'But why me?' And after, the definition became 'Luckily, it happened to me.' That's the difference."

GIV as a Situation in Which Relationships are Managed with Contexts
Parents reported that, over time, they have adopted strategies that allowed their child to progressively reach a different gender expression and anticipate responses from the social context, which is often a matter of concern. Specifically, the parents negotiate with their child's gradual and moderate ways of expressing the desired gender through clothes and accessories in an attempt to discriminate the appropriateness of the places in which they can do so. This situation created uncertainty in many parents, and for some of them, it has become essential to use some educational strategies. Moreover, they reported that they have talked openly with the child, anticipated possible social responses, and defined together tactics in addressing any offense or negative attribution. A participant parent stated: "He doesn't like to strongly dress as a male, so we rely on a very sporty matching. He prefers a tracksuit instead of jeans. If he finds something with fur, we decide together whether to take it. Rather than [taking] it pink, I don't know, we take it white or beige. We try to[…] moderate this thing up. [This is] mostly because we were very clear with him, and unfortunately, we live in a society where this thing is not accepted, and I don't want my son to be labeled [as] something that he hasn't even decided yet." A specific positioning in the context of management concerns the direct and mediated involvement of the parent. Some of the parents take their positioning to the extreme, carrying out actual mediation and advocacy activities. One of them shared: "I put myself on the front line to talk to teachers, to talk to the principals of any school. I contacted a council member in the small town where we live to make gender culture in schools, [and] we are starting to do it." Through such management ways, parents shape the situation they are facing as a civil and cultural'battle' such that transgender children may obtain the civil rights they currently lack. Parents who do so provide their relational resources and skills, and they contact associations, newspapers, lawyers and local administrators; in doing so, they position themselves as citizens rather than as a mere parent. However, trying to achieve what is expected, some parents make their own ideological point of view prevail over the child's specific and contingent developmental and biographical needs.
The processes of managing GIV were generated starting from the parents losing the certainty regarding the identity of their child generated by taking it for granted. Losing these certainties leads the parents to seek acknowledgements, information and answers about what is the best thing to do. Parents are constantly confronted with the presence of the social context, imagined or real, whose judgments or violation of their child's safety they fear.
This oscillation is described in the literature by several authors (Gregor et al., 2015;Pullen Sansfaçon et al., 2015) as a sort of ambivalence that parents feel torn between the will to affirm their child's preferred identity and gender expression and the will to protect him\her from of a world viewed as non-accepting, judgemental and hostile. Faced with variant gender expression, the parents reported that they relied on what they already knew and their prejudices, considered as natural, to sanction deviant behaviours. Changing positioning and allowing the child to begin the transition path have sanctioned a shift in the focus from pursuing the cultural ideals of normalcy to what the child desires and expresses through words and behaviour. However, even unconditional acceptance can be critical if it is only based on parent's own ideological and moral criteria, without sharing how the child is living the experience, what his\her needs are and what are the identity, social and medical implications of the transition path.
In our research, we identified an initial rejection of GIV by some parents, although there were no substantial gender differences in parents with regard to the assumed positionings or the way they addressed the issue. This evidence differed from other studies where a greater disengagement or explicit refusal by fathers towards the gender-variant child have been found (Kuvalanka et al., 2014).
The parents reported that they dealt with the experience in a way that made them learn what they did not know from and with their child. The process of role reversal in the parent-child relationship emerging during the interviews confirmed the data in the literature, as in the studies of Hill andMenvielle (2009) andPyne (2016). Rather than denying the 'reality' of their child, these parents were willing to consider further possibilities of expressing previously unthinkable gender identities despite their concerns and fears, as reported by many.
GIV often entailed these parents to redefine their roles within the family. To manage the situation, the parents questioned the knowledge they held and the ways they had always exercised their role; this is in line with the findings of several authors (Pyne, 2016;Wren, 2002). While they actively made changes to their roles, parents claimed to have tried to 'normalise' GIV management by integrating it within the family dynamics.

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A further result, in line with what is already present in the literature (Dierckx et al., 2016), is the possibility that the two parents do not share the same positioning towards GIV and the ways to manage it, which results in conflict between the two. However, it was also found that for some respondents the experience related to GIV was an opportunity for reconciliation and union between the two parents, even if formally separated.
Research shows that parents assume a particular 'buffer' positioning between the family and the outside world. In the management of gender expression and during the social transition, a distinction between the 'inside' home and the 'outside' home is often made. When thinking about gradual strategies and ways for the child to make a public display, the parents anticipated the implications of choosing a dress or using the chosen name for their child. Regarding the difficulties, some participants reported having felt concerns and embarrassment during the first public going out. However, most respondents reported that they managed these situations by establishing a clear dialogue with their child regarding possible reactions from people.
The management of GIV also presents an opportunity to engage in activities to promote an inclusive culture with respect to non binary identities and gender differences. This can be an experience in which parents find the motivation to get involved, confront and have an active role in his\her community, to engage as a spokesperson and foster the rights of a minority that is neglected by institutions. At the same time, these activities may lose their positive value by the time they become a personal ideological battle disregarding the specific needs of the child.

Conclusions and Limitations
In this research, specific attention was paid to the direct experience of parents in dealing with a complex issue in a context that is not always inclusive of social and gender diversities.
The developmental processes of gender identity in minors are indeed delicate issues and are linked to the most intimate spheres of a person. Such processes are anchored on biographical dimensions, and it is necessary to approach them respectfully and recognise what the person claims for him\herself, particularly for the developmental path involving minors. In this research, it was found that the adoption of ideological schemas or behaviours that is guided by one's own normative knowledge without considering the peculiarities of the interlocutor can undermine the construction of personal identity. For example, configuring the GIV as an objective problem or understanding the child according to the self-referential logic, i.e. without considering his\her point of view.
Questioning the dogmatic conceptions of 'being male' or 'being female' leads us to see them within their social, cultural and historical structure. We can understand how they act as a cultural and institutional enclosure in establishing a distinction between normality (rectitude, integrity, health) and deviance (maladjustment, illness). In our research, we noted how this matrix of meanings can limit thought and conduct of each one of them. It is indeed transmitted at an early stage through cultural means and leads back to the available and tolerated models of gender identification and expression, which are inevitably binary and hetero cis-normative. As noted by Ryan (2017), it is possible to observe the ways in which gender acts as an 'organising force in people's lives' in line with culturally dominant patterns. The interviewed parents constantly referred to the stereotypical gender norms, even in those discourses in which they are willing to criticise and disown them.
Detecting the ways of configuring GIV, therefore, allowed us to observe how discourses on gender variance have been constructed and the consequent practical implications in managing them. From our analyses, we believe that it was necessary not to assume GIV as something intrinsically problematic or linked to a 'problem in the body'. In our work, only a few parents supported this rhetoric.
On the other hand, there is the possibility to conceive heterogenous and complex ways based on the discourses generated and available both culturally and scientifically.
It was possible to detect meaningful positionings for a co-constructed identity development for the parent as well as the child. Positionings that are based on asking or talking directly to the child, seeking information or help from others, such as redefining the parental role, all aimed at relating to child's gender identity, even if it meant that these new positionings questioned what the parents always knew and being confronted with doubts and fears. According to Hill and Menvielle (2009), gender-variant minors act as 'agents' of change towards their parents' beliefs, within a path of bidirectional influence and construction (Gray et al., 2016).
The results of the present research highlighted how parents adopted the positionings of 'gender innovators' (Ridgeway, 2011), setting themselves up as the forerunners of a cultural change, now necessary and inevitable, envisaged by some cultural niches (feminists, activists and LGBTQ + communities, authors and scientific experts) during the last century. We have also seen how such a process, if exasperated, can lead the parent to engage in ideological battles against the specific needs of their child.
Gender-variant children constantly test social responses to their own way of feeling and expressing gender. First, attention must be paid to the child and the needs that he\she expresses in protecting his\her health. As constantly emerging during the interviews, the parents find themselves contributing to the development of the child's singularity while simultaneously acting as mediators between the child's needs and the social context, which is not always inclusive of diversity (Malpas, 2011;Robertson, 2014).
However, the question cannot be reduced to a child's gender expression, leaving aside what the goals of identity development are in the broadest sense. From a pragmatic point of view, it would be desirable for children and adolescents to be relieved of their duties so as to position themselves and show adherence to the assigned gender. The disregard of these duties is strongly blamed and entails humiliation or ostracism from peers, who, at a very young age, have been taught to recognise and sanction such transgressions. As actors within an interacting community and constructors of meaning and habits, it is necessary for us to ask what are the benefits or the disadvantages in ceasing to consider names, objects, places, colours, games, behaviours, activities, inclinations, clothes and any other human product as 'male' or 'female'. Let us ask ourselves: What would be the worst thing to happen if these distinctions disappeared?
The situation of Italian families with a minor experiencing GIV requires further study. Future research could address the issue by directly contacting the children themselves in order to understand how they construct and narrate their own identity experience and what their needs are. We could also further examine the family environment from the perspective of the child's siblings whose personal experiences have been taken into consideration by only very few studies. Another aspect of exploratory studies could be that families of children who are not in charge of or in contact with associations or services related to gender identity have still not been represented in the existing literature. At the same time, with regard to the social and development contexts of minors, it would be appropriate to address the everyday social contexts of minors who are followed up by health services, including schools, recreational and sports activities and health services in the territory.
A limitation of the present research is the relatively small number of participants. Nevertheless, this number of interviewees is in line with most of the qualitative research in the literature. It is also sufficient due to the exploratory nature of the research and the need for the data to be applied to parents who might need it as soon as possible.
The involved participants represent a group of individuals who have been experience this for some years and, as such, have developed a peculiar positioning and attitude towards the topic. Many of the parents are also part of groups, virtual or otherwise, where families of gender-variant minors support each other, share experiences and connect. It is, therefore, possible that the ways of thinking and talking about the subject may be drawn from a common culture formed within these groups. In addition, another limitations related to the group of respondents included being only Caucasian and persons hailing from the European Union. Therefore, there is a lack of evidence from non-European parents, whose understanding and management of gender-variant identities could be interesting to observe, drawing from a different cultural matrix.
Funding Open access funding provided by Università degli Studi di Padova within the CRUI-CARE Agreement.

Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All the works were validated by the ethics committee of the University of Padua.
Informed consent Informed consent was obtained from all individual participants included in the study.
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