Gender Identity Disorder

"Very few young kids who say they want to be another gender actually become transsexual. That's why I'm trying to get parents to slow down and listen to the kids and see what happens." Dr. Walter Meyer, Texas-based child psychiatrist. "You go years without seeing a child, and now I'm seeing a new child each month."

Another human disorder. Always thought to be fairly rare, but suddenly in the limelight as it has become fashionable in some quarters to question gender designation by happenstance of birth, with the claim that whether male or female, if the psyche is unhappy with how the dice rolled, modern medical technology can always come to the rescue. So it is not transgendered adults only - chafing under the unwanted persona of a male or female, yearning to be otherwise - who may now express their dissatisfaction, but children as well.

Actually children have always expressed a gender dissatisfaction or jealousy. It's just that what they said in their pique was not always taken seriously. Boys would prefer to be girls because girls get off easy, boys always get blamed for things; girls would prefer to be boys because boys are allowed to do the kind of neat stuff that girls are restrained from doing through societal expectations. At least traditionally; more latterly, the restraints have been loosened, and there plenty of crossover in sports and role opportunities.

Gender roles are not nearly as carefully delineated, expectations are more relaxed, boys are now able to express themselves just as girls always have, and girls can do whatever they like, for activities of a certain nature are no longer restricted. It's not enough, and doesn't meet the needs, many doctors now say, although there remains disagreement within the medical community. It is estimated that somewhere between one in one thousand and one in ten thousand young people are afflicted with gender identity disorder.

Which transcends mere wishful thinking. Some teens, however, having convinced themselves, their parents and their doctors that they really were meant to be other than how they were born, find that once whatever it was about their gender that they found unsatisfactory has dissipated, they're not so gender-averse after all, and drop their insistence on changing gender.

One doctor reported his experience of an 8-year-old boy who preferred to be a girl because "girls don't have to play football". A 16-year-old girl hated menstruating, felt being a male would be preferable. When puberty-blockers were prescribed and she stopped menstruating, her problem was solved and she resolved to remain female. A 15-year-0ld boy switched school, used puberty blockers, lived as a girl, then decided to revert to his original gender type.

All of which more than adequately fall into line with today's populations who have little patience for what they don't care for, demand instant satisfaction, reach impetuously for whatever it is that they want, and won't take 'no', or 'wait awhile', for an answer. Concerned parents, listening to the medical community that talks of so many newly-named disorders, worry about the future happiness of their children, and prepare to do whatever it takes to ensure they are happy.

Even if it means supporting the child's wish to effect a gender alteration. "Complicated notions of gender identity are pretty common in children, but a real disorder is different. That's a big jump", commented Dr. Margaret Moon, member of the American Academy of Pediatrics' bioethics committee. The disorder, she feels, could be over-diagnosed, to identify rebellious children as being afflicted with the disorder.

There has been an average four-fold increase in children and young adults insisting they require gender re-assignment, that their actual gender does not for whatever reason, match who they feel they are, and what they want to be. In Vancouver, Dr. Gail Knusland at the Transgender Health Program in B.C. claims a five-fold increase of adolescents appearing at clinics with their concerned parents.

Some doctors insist that for some of their patients the need to have their genders re-assigned is so deep-seated that to avoid additional and future emotional stress there is an obligation on part of the medical community to help the child make a physical transition at puberty onset.

"Parents told me they had to make a decision: You can have an unhappy child who's a boy but feels like a girl, or you can have a happy child who becomes the gender they think they really are and have a happy family."

The Endocrine Society and the World Professional Association for Transgender Health have both issued new standards, recommending against blockers in children who have not yet embarked upon puberty and recommending against irreversible cross-sex hormones before the age of 16. The sensible idea behind this is to give the child the opportunity to think things about before final commitment.

"Children don't have a lot of capacity to make their own decisions about health care, but they will someday. If you can avoid irreversible therapy long enough so a child can grow into his or her decision-making capacity, that's generally a good thing."