Rather Than Just “Male” or “Female,” Gender Identities Span a Spectrum-
While some children and adolescents identify exclusively as male or female, others feel their gender lies somewhere between. Gender identity is a result of a complex interaction of influences including biological, social and cultural factors. Many individuals are transgender, affirming a gender other than the one they were assigned at birth. They can struggle because their feelings and behavior are out of sync with societal expectations for their assigned gender.
Children of all ages may have gender questions and face challenges that may require help from schools, parents, families and clinicians.
Years ago, our clinic saw a higher proportion of younger children and their families coming in with questions about gender, but now we are seeing more adolescents. We also are seeing a greater number of adolescents who were assigned a female gender at birth but who identify as male (and relatively fewer adolescents who were assigned a male gender at birth). We don’t yet know what accounts for these changes; we are hoping to look at the demographics of patients from our clinic in a more systematic way to come up with answers.
Gender Development Is Complicated: It Impacts Each Child Differently
Each child has a unique story. Some children are able to articulate even at a very young age that they identify with a gender other than the one they were assigned at birth. Some children who are very young just can’t put their feelings into words. Other kids may come to understand their gender identity more gradually. As they reach puberty and become more developmentally sophisticated, they are often more able to identify specifically as gender nonconforming or transgender.
Our approach to children varies depending on their age and developmental stage. For example, in the majority of pre-pubertal children with gender nonconforming feelings and behaviors, these experiences will not persist into adulthood. However, some children will go on to become transgender or gender nonconforming adults.
Once puberty begins, gender nonconformity is much more likely to persist. There are many terms and labels for gender identity and it can take time for adolescents to find the right words to describe themselves. We stay “open” to what the teen is telling us, and try not to put any of them ‘in a box’ prematurely. We let the kids describe who they are, and how they are starting to understand their identities.
I can’t emphasize enough that maintaining an open line of communication with kids is extremely important – and so is patience. What they say the first time may be only a part of what they actually feel – and it may take time for their true feelings to manifest themselves.
For parents and children, reaching out for professional support, including from mental health professionals, can be very helpful. That’s one of the reasons we provide a group therapy program for kids and a parent support group. There is nothing better than hearing from other parents who have faced the same issues and asked the same questions.
Gender Nonconforming, Transgender and Mental Health
If a child identifies as gender nonconforming or transgender, that doesn’t mean the child has a mental health problem. However, there is a higher risk for depression, anxiety, and even suicide. A supportive family and school environment is the best protection. Bullying at school is a known risk factor for poor mental health so it is imperative to engage schools so kids get the support they need.
Some kids who have gender issues worry what the future may hold for them. With proper support, counseling and care, it can be very bright indeed.