Additonal information on transgender
individuals, transsexuals, & gender identity
Gender Dysphoria in children.
that are available to transgender
Is being transgender a "disorder?"
This is the continuation of a
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 often 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 pubescent children. 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
||Bathroom behavior: does your little girl insist on peeing while standing
||Swimsuit aversion: most trans kids absolutely will not wear the bathing
suit of their anatomical sex.
||What type and style of underpants kids select: does your son want the
girl-cut panties with flowers on them?
||A strong desire to play with toys typically assigned to the opposite
These are indications of gender-variance in children. However, Brill and
"... 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 a transgender identity. Since adult homosexuals are perhaps 8 times more common (5% compared to 0.6%) than
transgender adults, the toy symptom by itself is probably not a good indicator of
Options available to transgender persons:
Various forms of counseling have had a zero success rate at converting transgender individuals into cisgender persons. A transgender person's mind apparently cannot be changed to harmonize with their genetic
gender through therapy. The only successful treatment found to date to harmonize their mind and body is the gender reassignment process. The full process may involve:
|Extensive evaluation and counseling, typically by two psychologists or
|The "Real Life Test" (RLT): Living as a person of their perceived gender
for a year or more.
||Taking hormones to transform the appearance of parts of their body to resemble the other gender.
||Perhaps undergoing gender reassignment surgery. This final step is generally
restricted to adults.|
For children approaching puberty who are not sufficiently mature to make decisions about surgery, hormones, etc., puberty blocking medication is sometimes suggested to allow the children more time to reach decisions.
The American Psychiatric Association considers such a mismatch between gender
perception and genetic gender to be a disorder, and not a disease or mental
The distress caused by gender dysphoria can be overwhelming; it leads to an
unusually high suicide rate. Some have suggested 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
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.
Discussing gender identity, and transgender topics 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 the LGBT community. However, there is no real consensus on definitions. So we are bound to alienate some people.
We have assembled a glossary of terms related to
Differentiating transsexuals from transgender persons:
- Some define a transgender person as one who experiences a mismatch between their birth-assigned sex and their current gender identity, 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 own perceived gender identity.
What term(s) should be used to refer to transgender persons?
- 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 transgender persons can be cured of their gender identity problems 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 and often does not match their appearance.
- The American Psychiatric Association (APA) once used the term "Gender Identity Disorder" (a.k.a. GID) in section 302.85 of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4 Many people viewed this term as stigmatizing. Some in the transgender community urged 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 DSM-IV, a situation in which a person cannot accept their homosexual orientation is still included.
- The APA's updated manual, called DSM-5, was released in 2013. It replaced the term "Gender identity Disorder" with "Gender Dysphoria." They also introduced the term "Gender Incongruence," which they feel is clearer and less stigmatizing." 6
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
- "Gender Management Service (GeMS)," Children's Hospital Boston, at: http://www.childrenshospital.org/
- Stephanie A. Brill & Rachel Pepper, "The Transgender Child: A Handbook for
Families and Professionals." Read
reviews or order this book safely from Amazon.com.
- Nancy R. Nangeroni, "About the TG Symbol," GenderTalk, at: http://www.gendertalk.com/
- "Gender Identity Disorder, DSM-IV" American Psychiatric Association, at: http://www.dsm5.org/
- "DSM-5: The Future of Psychiatric Diagnosis," American Psychiatric Association, 2012, at: http://www.dsm5.org/
- "Dysphoria," Wikipedia, as on 2014-FEB-10 at: http://en.wikipedia.org/
Copyright © 2007 to 2017 by Ontario Consultants on Religious Tolerance
Original posting: 2007-JUN-08
Latest update: 2017-JAN-17
Author: B.A. Robinson