In the 2015 BBC documentary Louis Theroux: Transgender Kids, award-winning journalist Louis Theroux travels to San Francisco to explore the work of doctors and families supporting children who identify as transgender. Set primarily at the Child and Adolescent Gender Center at UCSF Hospital, the film provides an intimate, sometimes joyful, sometimes uneasy look into the experiences of young people navigating gender identity, the parents standing by them, and the professionals guiding them through complex medical and social landscapes. At the outset, Theroux acknowledges the subject’s sensitivity, noting that the question of how old a child should be to make life-altering decisions is fraught with difficulty. Yet, as the documentary unfolds, it becomes evident that many of the assumptions fueling public unease are based on misunderstandings. For very young children, transitioning is primarily a social process, wearing different clothes, using a different name or pronouns, without any permanent medical steps. While puberty blockers may be introduced at a later stage, their effects are reversible, a fact the documentary unfortunately fails to clarify clearly.
The children Theroux meets are compelling, articulate, and often disarmingly self-aware. A five-year-old girl named Camille performs a Lady Gaga number with such passion and confidence that it's impossible not to smile. Teenagers like Nicky speak openly about their transitions and the emotional toll of growing up trans in a cisnormative world. Their stories are powerful, yet never sensational. The documentary also draws strength from its portrayal of parents. These are not confused or careless adults pushing their children into something unnatural; rather, they are cautious, deeply loving individuals who, in the words of Nicky’s father, are “protecting the life of [their] child.”
Dr Diane Ehrensaft, a key medical voice in the documentary, puts the stakes into sharp perspective. When asked about the risk of transitioning too early, she responds that the real, documented risk is in not affirming trans children, leading to depression, anxiety, self-harm, and suicide. “If we can facilitate a better life by offering these interventions,” she says, “I weigh that against there might be a possibility they may change later, but they will be alive to change.”
One of the most touching moments is when Camille’s mother reflects on how her daughter is helping her become more “authentically myself.” Nicky’s mother, too, breaks down in tears as she recounts memories of her child’s life before transition, not out of regret, but from the fear of the challenges that lie ahead for her daughter in an often-hostile world. These moments illustrate the emotional complexity and bravery required not just of trans children, but of the families who stand by them.
Yet, despite the documentary’s many strengths, it falters at times under the weight of Theroux’s signature investigative style, which can lean toward manufactured discomfort. His narration occasionally slips into language that reinforces outdated ideas, referring to children as being “born into the wrong body,” or focusing on their pre-transition identities with uncomfortable insistence. At one point, he refers to a child’s past self using “it,” an unfortunate lapse that underscores how even well-meaning journalists can fall into dehumanizing patterns.
One particularly complicated case is that of Crystal or Cole, a child with divorced parents who disagree over how best to support their gender non-conforming child. Theroux appears uncertain whether Crystal is a trans girl repressed by her father or a gender-fluid child comfortable with multiple identities. Despite Crystal clearly expressing contentment with living as both Crystal and Cole, Theroux wonders aloud whether they were “ever trans in the first place.” Curiously, he never names the concept of being non-binary or gender-fluid, even though that seems to be the most fitting description.
The omission is telling. For all its merits, the documentary frames transgender identity almost entirely through a medical lens, frequently returning to discussions of hormones and surgery, even though none of the featured children are eligible for such procedures. Viewers are taken to visit plastic surgeon Dr Curtis Crane, who proudly shows Theroux photographs of phalloplasties and points to a bulge in a patient’s underwear as proof of male identity. While such surgeries are certainly relevant for adult trans individuals, their inclusion in a documentary about children feels misplaced and distracts from the real issues at hand.
By focusing so heavily on anatomy, the documentary risks reinforcing the very binary boxes that so many trans and non-binary people are trying to escape.
One of the most powerful lines in the film comes from Dr Crane, who says, “We’re trying to solve dysphoria. We’re not trying to put everyone in a box that the rest of society believes in.” Ironically, much of the documentary does exactly that.
The true challenges faced by the transgender children in the documentary stem not from internal confusion but from the external world: a father who refuses to accept his child’s identity, a grandfather who misgenders them, school bullies who mock and ostracize. Even in Crystal’s case, the conflict is more about societal expectations and parental disagreement than personal uncertainty. The kids themselves appear remarkably clear and confident in their identities.
In his effort to introduce tension and controversy, Theroux at times undermines the clarity and strength of the children’s experiences. Nevertheless, the documentary is emotionally resonant and informative. It succeeds in portraying its young subjects not as victims or anomalies, but as children who want the same things all children do: love, support, and the freedom to be who they are.
Theroux’s talent as a storyteller is evident in his gentle, empathetic interviewing style, particularly in his interactions with Camille and Nicky. He knows when to step back and let a moment breathe. Camille shines in front of the camera, a joyful spirit whose identity is supported unconditionally by her parents. When her parents say they’d support her no matter how her identity evolves, they offer a masterclass in parenting through love rather than fear.
Nicky’s story, by contrast, is more somber but equally powerful. Already undergoing hormone therapy, she’s old enough to articulate her own frustrations and fears. Her parents’ unwavering support, especially in the face of societal prejudice and personal grief over losing the son they once knew, is deeply moving. Watching Nicky attend a medical appointment, anxious and unsure, is a quiet yet powerful reminder of the mental toll that transitioning can carry, especially in a world that too often sees trans youth as controversial rather than courageous.
As the documentary draws to a close, Theroux warns again of the difficulty in “knowing who it is we really are.” But that doubt doesn’t reflect the clarity shown by the young people he’s spent an hour getting to know. Almost all of them know exactly who they are, it is the adults around them, and society at large, that seem confused.
Despite its flaws, Louis Theroux: Transgender Kids is an important and moving documentary. It opens up vital conversations about how to support trans children, challenges outdated notions of gender, and gives space to voices too often silenced or misunderstood. For all its uneven moments, it offers a powerful message about love, acceptance, and the courage it takes to simply be yourself in a world that often demands conformity. Documentaries like this matter because they help us imagine a future in which no child has to fight for their right to exist.
Image credits: Vimeo
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