Is My Child Transgender? Is that Even the Word?
By: J. Loforese
Dear Reader:
It’s likely that you found this article because you are a loving parent who is seeking help in doing what is best for your child. This may be a very frightening and confusing time for you, your child, and your family. However, you have just taken one of the bravest and most difficult steps on this journey by consciously allowing yourself to consider the question: Is my child transgender? There is no easy answer for this question, but know that you are not alone in your search.
As a Youth Development professional, I have witnessed firsthand the resulting damage that can be done by parents who suppress or deny their child’s reality, or even worse, completely reject their child’s identity – in effect, completely rejecting their child. I have also seen what a profound difference it can make in a young person's life to be fully supported by their parents. It is crucial that a child be allowed to find and develop their truest self, even when it is difficult for their family, and often times the world, to understand.
The most helpful place to begin is by defining some of the terms that you are likely to come across in your search. This is a short list, however it is one that you will build on over time. The most basic of these terms, but by no means the least complicated, is gender. Sometimes it is hard to understand exactly what is meant by the term "gender", and how it differs from the closely related term "sex". "Sex" refers to the biological and physiological characteristics that help to define males and females, like chromosomes and genitalia. "Gender" refers to the roles, behaviors, activities, and mannerisms that a society considers appropriate for males and females. (World Health Organization, 2012)
Distinct from gender, Gender Identity is how an individual sees himself or herself, rather than how society labels them. Most people develop a gender identity that matches their biological sex. For some, however, their gender identity is different from their biological or assigned sex. A child’s awareness of being a boy or a girl starts in the first year of life. It often begins by eight to ten months of age, with children becoming conscious of physical differences between boys and girls between the ages of one and two years. Before their third birthday, most children are easily able to label themselves as either a boy or a girl as they acquire a strong concept of self (American Academy of Pediatrics, 1999). On the other hand, three-year-old children may not be certain that gender is a permanent attribute, believing that girls could become boys if they acted or dressed like them or cut their hair short (Menvielle, et al., 2005).
Transgender is an umbrella term (a broad definition that encompasses a number of other, more specific terms) used to describe people whose self-identification or gender expression transcends society’s constructed established gender categories or who do not conform to the culturally defined norms of their biological sex (Green 2004; Sears, 2005).
Gender Variance / Gender Non-Conformity is characterized by patterns of intense, pervasive, and persistent interests and behaviors characterized as typical of the opposite gender. The onset of gender variant behavior typically occurs before three years of age. (Zucker, Bradley, 1995) It is important to remember, however, that in reality, some boys like Barbie dolls and glitter and the color pink, and some girls like trucks, football, and Batman. While children’s play preferences may not always be consistent with societal gender stereotypes, those preferences alone do not indicate or predict gender identity or sexual orientation.
Gender Identity Disorder (GID) is diagnosed in people who have “a strong and persistent cross-gender identification” (American Psychiatric Association [APA], 1994). GID is the desire to be, or the insistence that one is of the other sex. There must also be evidence of continual discomfort about the sex they were assigned at birth, and the gender roles that go along with it. The current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) states that "only a very small number of children" with GID behaviors will continue to meet the criteria for GID in later adolescence or adulthood, and only a small minority change their gender as adults.
Although you will continue to hear about GID, it is very important to note that the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, due for release in May 2013, will replace the diagnostic term “Gender Identity Disorder” with the term “Gender Dysphoria”(American Psychiatric Association, 2012). This is significant because the DSM, published by the American Psychiatric Association, covers all categories of mental health disorders for both adults and children. The DSM is considered by both insurance and medical industries to be the authoritative manual for assisting Clinicians and Psychiatrists in the diagnosis of psychiatric illnesses. The APA reached the decision to re-classify this diagnosis, concluding that continued labeling of expressions of gender as a mental illness is discriminatory, discourages social acceptance, and prompts shame, ultimately causing harm to transgender individuals.
While Gender Identity Disorder is intended to address mental, emotional, and social functioning, Gender Dysphoria addresses body identity. Gender Dysphoria is the feeling an individual has, that the sex of their brain doesn’t match the sex of their body – that it just feels “wrong” and/or makes them extremely uncomfortable. People with Gender Dysphoria usually find it subsides if they change their body into alignment with the "sex" of their brain, but there are specific criteria for reaching this diagnosis with children, including a noticeable disharmony between the way they see themselves and the way the rest of the world sees them, and a strong desire to be of the other gender or an insistence that he or she is the other gender. Other indicators, such as a strong preference for cross-gender roles in make-believe play, a strong preference for the toys, games, and activities typical of the other gender, or a strong dislike of one’s sexual anatomy, are among the eight primary criteria used for diagnosis of Gender Dysphoria, of which a child must exhibit at least six of the eight, and for a minimum time period of at least six months.
When you are introduced to new terminology, you should not be hesitant to ask what it means. Whenever someone uses a word that you don’t understand, stop the conversation for a minute and ask the person to explain the word. Knowledge and education are your most critical tools in providing for the health and happiness of your child. The more you know, the more you understand, and the better you can explain things to others. The next steps will include more reading and research, getting in touch with qualified professionals, seeking the support of families who are on this same journey, and continuing to love and support your child.
References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.) (pp. 532-538) Washington, DC: Author.
"American Psychiatric Association DSM-5 Development." Home. N.p., n.d. Web. 13 Nov. 2012. <http://www.dsm5.org/pages/default.aspx>.
Brown, Patricia Leigh. "Supporting Boys or Girls When the Line Isn’t Clear." The New York Times 2 Dec. 2006: n. pag. Print.
Gracious, Barbara L., Kenneth J. Zucker, and Susan J. Bradley. "Gender Identity Disorder and Psychosexual Problems in Children and Adults." Journal of the American Academy of Child & Adolescent Psychiatry 37.3 (1998): 337. Print.
Green, Jamison. Becoming a Visible Man. Nashville, TN: Vanderbilt UP, 2004. Print.
Menvielle, E. J., Tuerk, C., & Perrin, E. C. (2005). To the beat of a different drummer: 415. The gender-variant child. Contemporary Pediatrics, 22(2), 38–46.
Schor, Edward L. Caring for Your School-age Child: Ages 5 to 12. American Academy of Pediatrics Series. Child Care Series. Revised ed. New York: Bantam, 1999. Print.
Sears, James T. Gay, Lesbian, and Transgender Issues in Education: Programs, Policies, and Practices. New York: Harrington Park, 2005. Print.
Valentine, Sarah. Queer Kids: A Comprehensive Annotated Legal Bibliography on Lesbian, Gay, Bisexual, Transgender, and Questioning Youth (August 16, 2008).
It’s likely that you found this article because you are a loving parent who is seeking help in doing what is best for your child. This may be a very frightening and confusing time for you, your child, and your family. However, you have just taken one of the bravest and most difficult steps on this journey by consciously allowing yourself to consider the question: Is my child transgender? There is no easy answer for this question, but know that you are not alone in your search.
As a Youth Development professional, I have witnessed firsthand the resulting damage that can be done by parents who suppress or deny their child’s reality, or even worse, completely reject their child’s identity – in effect, completely rejecting their child. I have also seen what a profound difference it can make in a young person's life to be fully supported by their parents. It is crucial that a child be allowed to find and develop their truest self, even when it is difficult for their family, and often times the world, to understand.
The most helpful place to begin is by defining some of the terms that you are likely to come across in your search. This is a short list, however it is one that you will build on over time. The most basic of these terms, but by no means the least complicated, is gender. Sometimes it is hard to understand exactly what is meant by the term "gender", and how it differs from the closely related term "sex". "Sex" refers to the biological and physiological characteristics that help to define males and females, like chromosomes and genitalia. "Gender" refers to the roles, behaviors, activities, and mannerisms that a society considers appropriate for males and females. (World Health Organization, 2012)
Distinct from gender, Gender Identity is how an individual sees himself or herself, rather than how society labels them. Most people develop a gender identity that matches their biological sex. For some, however, their gender identity is different from their biological or assigned sex. A child’s awareness of being a boy or a girl starts in the first year of life. It often begins by eight to ten months of age, with children becoming conscious of physical differences between boys and girls between the ages of one and two years. Before their third birthday, most children are easily able to label themselves as either a boy or a girl as they acquire a strong concept of self (American Academy of Pediatrics, 1999). On the other hand, three-year-old children may not be certain that gender is a permanent attribute, believing that girls could become boys if they acted or dressed like them or cut their hair short (Menvielle, et al., 2005).
Transgender is an umbrella term (a broad definition that encompasses a number of other, more specific terms) used to describe people whose self-identification or gender expression transcends society’s constructed established gender categories or who do not conform to the culturally defined norms of their biological sex (Green 2004; Sears, 2005).
Gender Variance / Gender Non-Conformity is characterized by patterns of intense, pervasive, and persistent interests and behaviors characterized as typical of the opposite gender. The onset of gender variant behavior typically occurs before three years of age. (Zucker, Bradley, 1995) It is important to remember, however, that in reality, some boys like Barbie dolls and glitter and the color pink, and some girls like trucks, football, and Batman. While children’s play preferences may not always be consistent with societal gender stereotypes, those preferences alone do not indicate or predict gender identity or sexual orientation.
Gender Identity Disorder (GID) is diagnosed in people who have “a strong and persistent cross-gender identification” (American Psychiatric Association [APA], 1994). GID is the desire to be, or the insistence that one is of the other sex. There must also be evidence of continual discomfort about the sex they were assigned at birth, and the gender roles that go along with it. The current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) states that "only a very small number of children" with GID behaviors will continue to meet the criteria for GID in later adolescence or adulthood, and only a small minority change their gender as adults.
Although you will continue to hear about GID, it is very important to note that the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, due for release in May 2013, will replace the diagnostic term “Gender Identity Disorder” with the term “Gender Dysphoria”(American Psychiatric Association, 2012). This is significant because the DSM, published by the American Psychiatric Association, covers all categories of mental health disorders for both adults and children. The DSM is considered by both insurance and medical industries to be the authoritative manual for assisting Clinicians and Psychiatrists in the diagnosis of psychiatric illnesses. The APA reached the decision to re-classify this diagnosis, concluding that continued labeling of expressions of gender as a mental illness is discriminatory, discourages social acceptance, and prompts shame, ultimately causing harm to transgender individuals.
While Gender Identity Disorder is intended to address mental, emotional, and social functioning, Gender Dysphoria addresses body identity. Gender Dysphoria is the feeling an individual has, that the sex of their brain doesn’t match the sex of their body – that it just feels “wrong” and/or makes them extremely uncomfortable. People with Gender Dysphoria usually find it subsides if they change their body into alignment with the "sex" of their brain, but there are specific criteria for reaching this diagnosis with children, including a noticeable disharmony between the way they see themselves and the way the rest of the world sees them, and a strong desire to be of the other gender or an insistence that he or she is the other gender. Other indicators, such as a strong preference for cross-gender roles in make-believe play, a strong preference for the toys, games, and activities typical of the other gender, or a strong dislike of one’s sexual anatomy, are among the eight primary criteria used for diagnosis of Gender Dysphoria, of which a child must exhibit at least six of the eight, and for a minimum time period of at least six months.
When you are introduced to new terminology, you should not be hesitant to ask what it means. Whenever someone uses a word that you don’t understand, stop the conversation for a minute and ask the person to explain the word. Knowledge and education are your most critical tools in providing for the health and happiness of your child. The more you know, the more you understand, and the better you can explain things to others. The next steps will include more reading and research, getting in touch with qualified professionals, seeking the support of families who are on this same journey, and continuing to love and support your child.
References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.) (pp. 532-538) Washington, DC: Author.
"American Psychiatric Association DSM-5 Development." Home. N.p., n.d. Web. 13 Nov. 2012. <http://www.dsm5.org/pages/default.aspx>.
Brown, Patricia Leigh. "Supporting Boys or Girls When the Line Isn’t Clear." The New York Times 2 Dec. 2006: n. pag. Print.
Gracious, Barbara L., Kenneth J. Zucker, and Susan J. Bradley. "Gender Identity Disorder and Psychosexual Problems in Children and Adults." Journal of the American Academy of Child & Adolescent Psychiatry 37.3 (1998): 337. Print.
Green, Jamison. Becoming a Visible Man. Nashville, TN: Vanderbilt UP, 2004. Print.
Menvielle, E. J., Tuerk, C., & Perrin, E. C. (2005). To the beat of a different drummer: 415. The gender-variant child. Contemporary Pediatrics, 22(2), 38–46.
Schor, Edward L. Caring for Your School-age Child: Ages 5 to 12. American Academy of Pediatrics Series. Child Care Series. Revised ed. New York: Bantam, 1999. Print.
Sears, James T. Gay, Lesbian, and Transgender Issues in Education: Programs, Policies, and Practices. New York: Harrington Park, 2005. Print.
Valentine, Sarah. Queer Kids: A Comprehensive Annotated Legal Bibliography on Lesbian, Gay, Bisexual, Transgender, and Questioning Youth (August 16, 2008).