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Gender Dysphoria in Children

Back in January, we wrote about gender dysphoria, a situation in which a person feels uncomfortable with or distressed about the gender of birth, preferring to live as the opposite gender. (Gender dysphoria is sometimes called “gender identity disorder” and a common adjective is “transgender.”) Our post discussed ways that adults manage their gender identity.

Some decide to live as their desired gender. For example, a man may dress as a woman or ask others to use his preferred female name. Others undergo cross-sex hormone therapy to suppress the secondary sex characteristics of their biological gender and promote the characteristics of their preferred gender. Some choose to have gender-reassignment surgery (a “sex change operation”), which could involve removing or creating breasts and genitalia.

But what happens when children feel they’ve been born in the wrong gender?

It’s unclear just how many children feel this way. And it’s not a situation that is openly discussed that often.

Gender dysphoria in children presents challenges to families. Today, we’ll discuss these briefly.

Challenges for Children

Transgender children are usually very clear about which gender they’re meant to be. They know which gender feels “right” to them.

But “right” is sometimes difficult to assert in a world that expects them to look and act according to their biological gender. If they have been living as their biological gender for several years and decide to start living as the opposite gender, they may find the following:

·         Unacceptance. Transgender children may find that their friends don’t understand where they’re coming from. Some parents may no longer allow their children to play with a transgender child. In addition, some sports teams and school clubs might not allow the child to participate as the desired gender. For example, a biological girl who wants to be a boy may still be expected to wear a traditional girl’s bathing suit on the swim team.

·         Frustration with their biology. A biological boy who wants to be a girl might be distressed when the voice deepens or when facial hair appears. A biological girl who wishes to be a boy may find menstruation especially upsetting.

·         Bullying. Transgender children are often teased, ridiculed, or bullied.

·         Anxiety and depression. Not surprisingly, all of the above can contribute to overwhelming anxiety and depression. Counseling is recommended for many transgender children.

Challenges for Parents and Guardians

Parents and guardians of transgender children are often faced with difficult questions:

·         Should I let my child live as the preferred gender? If so, what is the best way to do this? And when should it happen?

·         How can I explain this to our other children, our extended family, our friends, and our community? How can I help them understand?

·         What will happen at school? Will my child be accepted? Will teachers and administrators be accommodating?

·         Will my child be teased or bullied? How can I help him or her cope if it happens?

·         What will happen when my child reaches puberty?

·         Should we consider “puberty blockers”? These are special medications that suppress the changes of puberty. Many parents see puberty blockers as a way of buying time as the child makes decisions about gender identity. Puberty blockers are reversible. If they are stopped, the child will go through the puberty of the biological gender.

·         Should we consider hormonal treatment later on? (Older children might take hormones to facilitate their gender transition.)

·         What if my child wants gender-reassignment surgery?

·         While I love my child, I feel a sense of loss for my biological son or daughter. Is this normal? How can I work through these feelings?

·         Will my child decide to “go back” to his or her biological gender? If so, what happens then?

What Should Families Do?

Every child is different and every family goes on its own journey. Still, if you feel that your child might be transgender, there are some steps you can take:

·         Talk to your pediatrician. He or she can help you assess your child’s behavior, guide you on next steps, and refer you to appropriate professionals, such as therapists or endocrinologists.

·         Talk to other families with transgender children. Look for support groups either in person or online. Talking to others who share your experience can help you cope with situations like loneliness, bullying, school policies, and helping siblings adjust. Other families can also suggest helpful resources, such as websites, DVDs, or print materials that can help you learn more.

·         Most of all, support your child. Make sure your child knows that he or she is loved, respected, and safe. If you think your child is experiencing anxiety or depression, be sure to seek professional help.

Your Turn

Have you had any experiences with a transgender child? What happened? Feel free to tell us your story in the comments.

Print this article or view it as a PDF file here: Gender Dysphoria in Children


American Academy of Pediatrics

“Gender Identity and Gender Confusion In Children”

(Last updated: May 11, 2013)

Gender Spectrum

“Frequently Asked Questions”

The Kansas City Star

Adler, Eric

“ ‘I am a girl’: Transgender children face a society slow to accept them”

(February 8, 2014)

New York

Green, Jesse


(May 27, 2012)

Spiegel, Alix

“More Children Struggle With Gender Identity Disorder”

(February 21, 2012)

Sexual Medicine Society of North America

“Gender Dysphoria”

(January 22, 2014)

The Washington Post

Dvorak, Petula

“Transgender at five”

(May 19, 2012)