My 16-year-old son says that he wants to change sex. He used to be an intellectually gifted, loving and happy boy, but recently has become morose, uncommunicative and surly.

His father has always been committed to the children and I was at home with them full-time until four years ago. I now only work part-time. We have always tried to give them all the love and support we could.

My son has always been reluctant to socialise with friends outside school - he says he has nothing in common with the boys, and talks to some of the girls from the adjacent girls' school online, occasionally going shopping with them at weekends. He has never given any indication of being effeminate in the past. He says he isn't sexually attracted to men and that he "doesn't fancy anyone".

Last week, we became aware that he had scarred his forearms by scratching them with something, but he refused to tell us why or how. I have begged him to promise not to do this again and he has agreed. He has had some counselling at school and they have suggested he sees a specialist in sex disorders. We have also made an appointment with his GP to discuss the situation. I am desperately worried that he may be coerced into changing sex before he is fully aware of what he really wants. How can we help him?

Don't let your child end up like me

In order to help your child, educate yourself as much as you can about transexuality and drop any preconceived ideas about it. This will enable you to make the distinction between gender and sexuality, which is essential to understanding what your child is experiencing.

A specialist's help will be invaluable in giving your son the space to explore all the hidden feelings, unspoken thoughts and dark fears that he has been repressing. The fact that your son can confide in you about his deepest fears is encouraging and you should feel proud that he feels able to do so. Your child has, in all probability, been dealing with these anxieties for a long time. I am 38 and have spent most of my adult life trying to mask my gender-identity issues with alcohol and drugs. I am now desperately lonely and unhappy; please do not let your child end up like me.
Name and address withheld

Get some specialist help

Let your son know that you love him and that you will support him through this. People who feel as he does have usually bottled up their feelings and become isolated. You are right to seek guidance, but I would suggest that you speak with a counsellor who works with gender identity, if you haven't done so already. Self-harm is not uncommon in someone who feels their mind and body are out of kilter. At this stage, nobody can say whether a change of gender is a solution, but your son deserves the opportunity to explore his feelings around this.

In addition to seeing a psychotherapist, your GP can organise a referral to a specialist clinic. This is a distressing time for your son but also for you; you need support too. The Gender Trust has a national helpline staffed by volunteers who are familiar with these scenarios. The number is 0845 231 0505.
Michelle Bridgman,
Psychotherapist, The Gender Trust

Self-harm is the more pressing issue

You need to approach your son's questions over his gender with an open mind and a sense of reassurance. You may be feeling rejected by his aloofness, but he may simply feel unable to articulate his feelings about his gender identity at the present time. The more pressing issue is his self-harming, which could be an expression of his transgender anxiety, or the isolation he is enduring at school.

You need more than a mere promise from your son that he will not continue to self-harm and he should be encouraged to speak to his GP and school counsellor about anything he feels uncomfortable discussing with you. Remember that he is still the gifted and loving young man he was before he made these revelations to you. Try to have an open and honest conversation with him about his concerns.
K, Surrey

Lucky to have your support

Your son is troubled and has been brave to confide in you about his unease. At 12, I felt the same as him and I still do even though I'm 63, with a successful career. When I was younger, I didn't dare to tell my parents, or anybody else except a priest or two in confession. I tried hard to conform to what I thought a boy or a man should be, and when I finally found a woman who loved me enough to simply want me to be happy, I ended up failing her. Life isn't over or all bad, and I'm comfortable with myself now. However, your son does not have to suffer the same fate as me; he is very lucky to have your love and support.
Name and address withheld

He is too young to make this decision

Having a sex change is extremely ill-advised and you need to tell your son that this is simply not an option. We all experience confusions about our gender when we are young - I always wanted to be a boy like my brother and his friends, and some of my girlfriends' brothers dressed up in our clothes - but thank goodness that in those days no one took any notice of such notions. We just took it all as part of being young and doing daft things.

You say you are afraid that your son may be coerced in to changing sex before he is fully aware of what he really wants, but he is too young to make such a decision, particularly without his parents' consent.

He is blessed with parents who love him and are so concerned about him. Helping other youngsters who are not so fortunate may prove very rewarding for him.
EF, France

· For further help, download the booklet entitled 'Medical care for gender variant children and young people' from dh.gov.uk. The Gender Identity Development Centre at the Tavistock clinic can be contacted by email: gidu@tavi-port.nhs.uk or telephone 020-8938 2030.

What the expert thinks - Linda Blair

You've already begun to help your son by making an appointment for him to see his GP, and by appealing to him not to harm himself again. Let's consider whether there's anything else you can do. You say that recently, he has changed dramatically and become morose, uncommunicative and surly. Many teenagers go through this phase, but when the changes are extreme and persistent and, in particular, when these include self-harm, parents need to react swiftly and appropriately.

It is not clear to me, and probably not even yet clear to him, whether his desire to change sex is really at the root of his distress or whether he has wider concerns about his identity and about how he fits in with other people. It will take time and skilled help for him to understand why he is feeling the way he is. Your immediate task is to make sure he is able to talk to someone experienced in dealing with the concerns he is expressing.

Once your GP has spoken to your son, they will decide whether to refer him to a psychiatrist locally for a more detailed assessment, or whether to refer him directly to the Gender Identity Development Service (Gids) at the Tavistock and Portman NHS Trust. This is the only clinic in the UK dedicated to helping those under 18 who are suffering from "gender dysphoria" - a tension between their biological sex and the gender they most identity with, or a confusion about whether they are male or female.

You are concerned that your son may be "coerced" into changing sex if he starts talking about it with these professionals. I can reassure you that this definitely would not happen. Doctors are extremely careful about recommending major and irreversible treatments for gender dysphoria. If your son is referred to Gids, he will be assessed by a team of skilled professionals. They will assess him with great care, and they would expect to work not only with him, but also with his family and local NHS professionals. In the UK, hormone blockers and counselling may be recommended at this point, but no other treatment would even be considered until he is at least 18.

There are two other ways you could help. First, try to stop looking for reasons to blame yourselves for his state of mind. Most teenagers experience a crisis of identity, although it is true that only some question their sexual identity or orientation, which are separate issues in any case. We do not yet fully understand why some people experience conflict between their sex and their gender identity, so a search for "reasons" will only cause unnecessary anxiety and distress. It sounds like you and your partner have loved, encouraged and supported your son, so please be assured that you have done the best you can already.

Second, try to stop feeling that he has somehow "gone wrong". He undoubtedly wants you simply to accept him for the person he is. Show him that you want to understand him, that you love him, and that you will try to help him discover how to find happiness and fulfillment, whatever that may mean to him.

· Linda Blair is a clinical psychologist and an associate fellow of the British Psychological Society

Next week

I fear my partner has been unfaithful

Fifteen years ago I met a man at work and we had a brief relationship before I discovered he was seeing another woman, so we split up and lost touch. They were together for 10 years until she died. Six months later, he contacted me, and we have now been back together for five years.

He has recently asked me to move in with him. He's a wonderful man and says that he loves me and that I am his life, but my children have left home and I have a successful business, so I feel I don't need anyone to see me through. I've been hurt before and I accept that I am wary of relationships: my ex-husband was a serial philanderer and eventually left me for another woman and did nothing to support me and our three children.

My partner also got divorced as a result of an affair, with the woman who died. He left his mobile at home a year or so ago and I read a message that came through from another woman and have checked his phone regularly since then. She texts him about their lunch dates, her period problems, his prostate anxieties and about how she wants them to have more time to talk to each other.

I am not jealous or controlling. However, I feel that my partner should have told me that he is spending time with another woman and sharing personal details with her too. I am not prepared to have another emotional catastrophe because I was too "understanding", but how do I raise the issue without telling my partner that I've been reading his texts?

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