Lately, the news media has been full of coverage on whether schools should “teach” children about sexual orientation and gender. Like so many issues in front of the country right now, it has become politically charged where nuance is rarely heard. I think it would help to first discuss the language in use before arriving at any conclusions. (See table 1 below for a complete list.)

The term LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer or Questioning) came into use around 2005. Whether our society ultimately looks upon these terms through the lens of individual testimony, law, religion, art, or science remains to be seen. At the moment, it is all quite fluid.

Let’s start by defining two important terms. Gender dysphoria is defined as discomfort, unhappiness, or distress with one’s physical or assigned gender and the gender with which he/she/they identify. Sexual orientation relates to which gender one is attracted to (opposite sex, same sex, or more than one gender). Both of these terms are probably best viewed as a continuum than an either-or concept.

Over the years, these issues did come up in my pediatric office. It may have been simply a worried parent asking about their child playing with toys generally associated “with the opposite sex.” But it also included more serious issues where a teen questioned their gender or sexual orientation. Some patients were “closeted” and had not even shared their feelings with their parents. Others were outright victims of harassment.

LGBTQ youth are normal, just different. Every child with a distinctive gender identity or choice in sexual orientation needs support and affirmation, especially from their parents. When discussing these issues, I always started by assessing the well-being of the child in their own home. Can both parents accept their child for however they identify themselves by gender and for however they chose to express themselves in their intimate sexual relationships? When this type of support does not occur, the outcome can be quite damaging.

When these issues came up in my pediatric practice, I often asked the patient what, if any, information they wished to have from me? Some wanted to explore hormonal and surgical options. Some were experiencing emotional distress and needed to talk to someone. Others were sharing their concerns confidentially but sought my help in telling their parents.

Not all parents, or even physicians, will be equally comfortable with these issues, after all, they are quite complex. All medical care delivered must be affirmative and delivered without judgment, but also sensitive to the fact that children and adolescents are exploring their identity in so many different ways. In some cases of gender dysphoria, families should expect to be referred to a specialist. If the issues are physical or there is an expressed desire to consider puberty-blocking drugs or hormonal therapy to allow for, or delay, the development of secondary sex characteristics, this referral might be to an endocrinologist who specializes in transgender youth. If the issues are psychological, the referral might be to a psychiatrist or psychologist who specializes in these issues.

Socially, most people I speak with prefer these issues only be addressed in their own home or with a medical professional. This position is in contrast to advocates in the LGBTQ community who believe that only by having students and their parents acquire literacy in these areas through classroom curriculum for all, and at the earliest of ages, will schools be ensured to be safe spaces. It is a point well-taken, but at what age should this take place and should parents be allowed to have their children opt out of such conversations in the classroom.

I started this column by suggesting I would arrive at certain conclusions, but really, they are just my opinions. Here goes. Though it is never easy to pick a specific age, I believe children under 10 should not receive education on these matters in a school setting.

Not all are developmentally ready for these topics at this age. That does not mean that children should not be educated to respect differences among their fellow students and have empathy for those around them.

I believe most of the “education” being debated is of this nature, not truly conversations about genitalia as some opponents suggest. My grandchildren are getting that type of education currently and I find the results quite impressive. Being sensitive to differences in each other can be learned and should be taught.

After that age, parents should be well-informed on the curriculum and information their children will receive about gender and sexual orientation. These topics should be taught as a part of general sexual education. They need not be the sole focus. This will give each home a chance to prepare their children for what they will be asked to learn. It will also give families an opportunity to teach and stress their own values.

Families, in my opinion, should not be allowed to have a child opt out, but make the school aware of any reasons they view their own child to be at unique psychological risk when hearing these conversations in the classroom.

When children under 10 years of age do have questions about their gender or sexual orientation, they can and should be addressed at home and/or with their physician. It is certainly possible, even at these young ages, for a child’s perception that they are “different” to play out over time.

Science is likely to surprise us in this entire area. I suspect we will learn that biology is at play when individuals define themselves with different gender identities than the sex they were assigned at birth or find themselves attracted sexually to different sexes than we might traditionally predict.

We all need to be open to learning more about these matters and be accepting of others as we move forward. My overwhelming goal when working with LGBTQ youth was the same that it was when working with all adolescents—that they develop a high level of self-esteem and self-acceptance and have strong connections to their own family and the community in which they live.

Dr. Richard Lazaroff is the author of “Some Assembly Required, A Guide to Savvy Parenting.”