“Is it a boy or girl?” This is often one of the first questions that parents are asked when a new baby is born. But for children who identity as gender non-conforming, the answer to this question may not be so simple. In Western culture, it is common to think of gender as fixed and binary—people are born male and female, and they remain male or female throughout their lives. However, many experts believe that gender actually exists on a spectrum, and that gender expression can be fluid and changing over one’s lifespan. As such, gender non-conformity in childhood should be viewed as a natural aspect of human diversity, rather than as a psychological problem.
The term “gender non-conforming” refers to children who think and act in ways that may be different than what is typically expected from someone of their birth gender. These children may or may not grow up to be transgender. Another term, “gender dysphoria”, refers to the psychological distress that transgender or gender non-conforming people may feel about their condition. To be diagnosed with gender dysphoria, a patient must experience incongruence between their expressed and assigned gender for at least six months, and this incongruence must create distress or impairment in daily functioning. Unlike being transgender or gender nonconforming, gender dysphoria is considered a psychiatric condition, since it creates difficulties in the patient’s life. Gender dysphoria is typically the focus of treatment when a patient enters gender therapy.
Gender dysphoria may begin at any age, and recent years have seen an increase in the number of children who present with this condition. One clinic in California reported a 200% increase in their juvenile patients between the years 2012 and 2013. This change is likely due to an increase in awareness of the condition, as well as an increase in family and societal support for gender nonconforming children, rather than an increase in the condition itself.
Gender dysphoria does differ somewhat between children and adolescents. In younger children, gender dysphoria may present as a strong preference for cross-dressing; a strong preference for cross-gender roles in make-believe play and for toys that are stereotypically used by their experienced gender, while rejecting play activities that are typical to their assigned 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.
While experts are still unsure of the exact biological causes for gender non-conformity, they do agree that gender non-conforming/transgender children should receive support and acceptance from their families and medical professionals. So called “conversion therapies”, in which gender non-conforming individuals are subject to treatments that attempt to change their gender identity, are both harmful and unethical. Unfortunately, gender non-conforming children are at increased risk for poor mental health outcomes like depression, substance abuse, and suicide. Children who receive family support and gender affirming treatments are able to build the resilience and self-confidence needed to protect against these negative outcomes.
At the International Center for Transgender Care, our team of doctors and therapists are highly experienced in treating children and adolescents with gender dysphoria. The holistic therapy division at ICTC is headed by Caroline Gibbs, a licensed clinical therapist and an expert in transgender mental health issues. Here, our focus is on treating the patient as a whole person, improving coping, and relieving any distress related to gender dysphoria. All of our services are offered in a knowledgeable, respectful, and empathetic environment.
Children who are transgender or gender non-conforming often benefit immensely from gender therapy. Talking with an expert can assist the patient to clarify and accept their gender identity, cope with stigma related to gender diversity, and better manage distress related to gender dysphoria. Additionally, because anxiety and depression are common in gender non-conforming youth, therapy at ICTC often focuses on treatment for these conditions.
Some gender non-conforming children and adolescents will choose to transition to living as their experienced gender. It is important to point out that children who identify as transgender are not typically treated with hormones or other medications. Rather, treatment at this stage focuses on supporting the child and their family. Around the onset of puberty, children may be prescribed puberty-blocking medications to delay the development of menstruation and secondary sex characteristics like body hair and voice change. However, the effects of these medications are not permanent. Once the adolescent is cognitively and emotionally mature, he or she may be prescribed hormonal medications, if desired. Holistic therapy at ICTC can assist the patient and their family in navigating this treatment process.
Because the family is so important to the well-being of gender non-conforming youth, therapy at ICTC also focuses on helping the family in coping with their child’s gender dysphoria. In addition to family therapy sessions, our clinicians can work directly with parents to provide information and assist them in best supporting and advocating for their child. Because one’s gender identity is a life-time journey, we practice a long-term approach to care.
Coping with gender dysphoria can be challenging, but it is possible for gender non-conforming children and adolescents to thrive—particularly when they receive support from their family and appropriate treatment from knowledgeable doctors and therapists. At The International Center for Transgender Care, our team of clinicians are experts in caring for transgender and gender nonconforming youth. We’ve assisted thousands of children and their families in managing gender dysphoria and navigating the transition process. Contact us at 816-305-0943 to schedule a confidential consultation for your child