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Introduction to transgenderism, transsexualism, & gender identity

Part 4:
GID in children.
Options available to transgender
persons. Terminology.
Is transgenderism a "disorder?"

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This is the continuation of a previous essay

Detecting transgender children:

There is no test to detect gender dysphoria in infants. However transgender children generally become aware of their gender dysphoria early in life, long before reaching school age, and communicate it to parents.

The Gender Management Clinic (a.k.a. GeMS) at Children's Hospital Boston was founded as the first clinic in the Western Hemisphere to evaluate and treat transgender children and pubescents. It was founded by Normal Spack, an endocrinologist who specialized in gender disorders. 1

Stephanie A. Brill and Rachel Pepper, authors of "The Transgender Child: A Handbook for Families and Professionals" write:

"Dr. Norman Spack, an expert in this field and founder of the GeMS clinic ... for children with disorders of sexual differentiation or who are transgender, notes that there are several important and clear ways young children typically reveal their transgender identity. He says to watch for:

bullet Bathroom behavior: does your little girl insist on peeing while standing up?

bullet Swimsuit aversion: most trans kids absolutely will not wear the bathing suit of their anatomical sex.

bullet What type and style of underpants kids select: does your son want the girl-cut panties with flowers on them?

bullet A strong desire to play with toys typically assigned to the opposite sex." 2

These are indications of gender-variance in children. However, Brill and Pepper write:

"... the vast majority of gender-variant children are not transgender; they are just gender-nonconforming." 2

Also, playing with toys of the opposite sex is much more likely to be a indicator of future homosexuality rather than transsexuality. Since adult homosexuals are perhaps 100 times more common than transsexuals, the toy symptom by itself is probably not an indicator of transexualism.

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Options available to transgender persons:

Since various forms of therapy have had a zero success rate at converting transgender persons into cisgendered persons, a transgender person's mind apparently cannot be changed to harmonize with their genetic gender. The only successful treatment found to date to harmonize their mind and body is the gender reassignment process. The full processmay involve:

bulletExtensive evaluation and counseling, typically by two psychologists or psychiatrists.
bulletThe "Real Life Test" (RLT): Living as a person of their perceived gender for a year or more.
bullet Taking hormones to transform the appearance of parts of the body to resemble the other gender.
bullet Perhaps undergoing gender reassignment surgery. This final step is generally restricted to adults.

The American Psychiatric Association considers such a mismatch between gender perception and genetic gender to be a disorder, and not a disease or mental illness.

The distress caused by gender dysphoria can be overwhelming; it leads to an unusually high suicide rate. Some suggest that about half of all transsexuals die by the age of 30, usually by their own hand." 3 This may have been true in the past. However, with advances in gender reassignment surgery (GRS) and growing public acceptance of transsexuals, this number is probably significantly lower today, and in decline.

The essays in this section will deal mainly with conflicts between genetic gender and gender identity, as well as the protection of transsexual people from discrimination and abuse.

About terminology:

Discussing gender identity, transsexuality and transgenderism is a bit of a minefield. There are many conflicting definitions for each term. We will try to use definitions that are in common use by transgender persons. However, there is no real consensus on definitions. So we are bound to alient some people.

We have assembled a glossary of terms related to these terms.

Horizontal line

Differentiating transsexuality from transgenderism:

  • Some define a transgender person as one who experiences gender dysphoria but has not undergone gender reassignment surgery.

  • Others define transgender very broadly to include everyone who doesn't fit into conventional gender norms: Included are: transsexuals, cross dressers, drag queens, etc.

  • Some transsexuals are proud to be referred to by that term. Some transsexuals are offended by the term and wish to be called simply "he" or "him" or "male"/ "she" or "her" or "female" according to their perceived gender identity.

hoizontal rule

Is transgenderism a "disorder?"

  • Some transgender persons object to use of the word "disorder" as in "gender identity disorder" (GID). Others accept the term.

  • Some suggest "cross-gender identification" as a more neutral and acceptable term.

  • Religious and social conservatives often use the term "gender confusion." They may have chosen this term to support their belief that transgenderism can be cured by prayer or therapy. It does not seem like a particularly useful term, because transgender persons are generally not confused about their identity; they are quite certain of what their gender identity is. Most are troubled simply because the gender that they know they are does not match their genetic gender.

  • The American Psychiatric Association (APA) used the term "Gender Identity Disorder" (GID) in section 302.85 of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4 Their updated manual, called DSM-5, released in 2013, has replaced the term "Gender identity Disorder" with "Gender Dysphoria." They have also introduced the term "Gender Incongruence," which they feel is clearer and less stigmatizing." 6

  • Some in the transgender community are urging that GID be removed from the book just as homosexuality was deleted in 1973. In the case of homosexuality, although homosexuality itself is not listed in DISM-IV, a situation in which a person cannot accept their homosexual orientation is still included.

This essay continues in Part 5

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. "Gender Management Service (GeMS)," Children's Hospital Boston, at: http://www.childrenshospital.org/
  2. Stephanie A. Brill & Rachel Pepper, "The Transgender Child: A Handbook for Families and Professionals." Read reviews or order this book safely from Amazon.com.
  3. Nancy R. Nangeroni, "About the TG Symbol," GenderTalk, at: http://www.gendertalk.com/
  4. "Gender Identity Disorder, DSM-IV" American Psychiatric Association, at: http://www.dsm5.org/
  5. "DSM-5: The Future of Psychiatric Diagnosis," American Psychiatric Association, 2012, at: http://www.dsm5.org/
  6. "Dysphoria," Wikipedia, as on 2014-FEB-10 at: http://en.wikipedia.org/

Site navigation:

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Copyright © 2007 to 2014 by Ontario Consultants on Religious Tolerance
Original posting: 2007-JUN-08
Latest update: 2014-FEB-15
Author: B.A. Robinson

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