For transgender children, gender dysphoria may present as a strong preference for cross-dressing or for cross-gender roles., make-believe play and for toys that are stereotypically used by their experienced gender, a preference for playmates of their experienced gender; and a strong dislike of their own sexual anatomy while displaying a preference for the anatomy of their experienced gender. Adolescents may experience a strong desire to be rid of (or to prevent the development) of secondary sex characteristics of their assigned gender; a strong preference for the secondary sex characteristics of their experienced gender; a strong conviction that they have the typical feelings and reactions of their experienced gender; and a strong desire to be treated as their experienced gender.
It is now known that gender exists on a spectrum with individuals identifying somewhere along this line. Additionally, for some individuals gender can be fluid and change over one’s lifespan. Because of this, gender non-conformity should be celebrated as a normal part of human diversity. Gender non-conforming children may or not grow up to be transgender. What is as common theme among transgender and gender non-conforming children is gender dysphoria.
Gender dysphoria in children can be incredibly painful psychologically and emotionally. Defined as an incongruence between their expressed and assigned gender for at least six months that create distress or impairment in daily functioning, it is considered a psychiatric condition because it creates great difficulties in the child’s life. However, it is important to note that gender dysphoria is a result of an underlying biological and hormonal issue. It is now known that gender is mapped on the brain at birth and happens at a different time than the development of the sex organs. It is thought that in transgender children, the gender brain mapping is opposite of the development of sex organs. This mismatch results in gender dysphoria.
Gender dysphoria can happen at any age and due to increased awareness and education, it is being noticed and diagnosed more frequently. Some children that present with gender dysphoria are fortunate to be in accepting families that allow them to explore their identity. In fact, allowing a child to naturally express who they are results in increased self-esteem and confidence.
It is important to note that in younger children prior to puberty, the only course of action is to let the child naturally express who they are. This may be cross-dressing or playing and identifying with their chosen gender. Sometimes, these feelings subside over time and the child no longer feels conflicted. Other times, the dysphoria increases and can be very difficult during puberty. At puberty, the child may work with an endocrinologist to be prescribed puberty blocking hormones. This blocks the body’s production of testosterone or estrogen which provides the adolescent more time to decide what course of action is best for them.
If the adolescent continues to suffer from gender dysphoria and decides that a transition is the best course of action for them, the endocrinologist will work with the family physician to prescribe hormone replacement therapy. This will be estrogen and anti-androgens (testosterone inhibiting) for the transwoman and testosterone therapy for the transman. This will result in the transgender adolescent going through the natural puberty of their identified gender.
Children and adolescents who suffer from gender dysphoria benefit greatly from therapy and intervention at an early age. Talking with an expert and thriving in an understanding and accepting family, can reduce anxiety and depression in the child or adolescent.
At the International Center for Transgender Care, our surgeons have over twenty years of experience treating gender dysphoria in children. Please visit us to schedule a consultation or call us at 469-429-7557.
