Dr. Henry Paul, MD

Psychiatrist, Author and Educator


May 12th, 2015

“People who have gender dysphoria feel strongly that they are not the gender they physically appear to be.

For example, a person who has a penis and all other physical traits of a male might feel instead that he is actually a female. That person would have an intense desire to have a female body and to be accepted by others as a female. Or, someone with the physical characteristics of a female would feel her true identity is male.

Feeling that your body does not reflect your true gender can cause severe distress, anxiety, and depression. “Dysphoria” is a feeling of dissatisfaction, anxiety, and restlessness. With gender dysphoria, the discomfort with your male or female body can be so intense that it can interfere with the way you function in normal life, for instance at school or work or during social activities.” (WEDMD, 2015)

Gender dysphoria is another term for Gender Identity Disorder. Whether-or-not young children who express transgender issues can really be believed is a hotly debated issue right now. Is this ever just a phase? How do you respond when your toddler daughter’s first sentence is that she’s a boy and she says it over-and-over, day-after-day? What do you do when your three-year-old son insists on wearing nail polish like mommy, and a dress to pre-school?

21423515_sHow young is too young to know? In March 2015, a Medscape study looked at the usual patterns for development of gender identity. According to the study, “Several studies by Milton Diamond of the University of Hawaii indicate that gender development reaches a critical point during childhood, after which it becomes extremely difficult to modify in most individuals. While there may be a number of children who do not clearly fit into a neat binary model of gender in which the polar extremes of behavior are reserved for those with clear sex and gender congruence, it is increasingly clear that gender identity is at the very least an intrinsic characteristic that emerges during early development.”

For parents, dealing with a child’s gender identity issues can be overwhelming. It also brings on a flood of questions. What causes it? What treatment will help? What should parents do or not do?

The first thing is not to panic. Love your child. Talk with your child’s pediatrician and seek out a child psychiatrist, if necessary. Many very young children express gender dysphoria and turn out not to be transgender when older. Thus, it is considered risky to support any permanent changes (name, gender reassignment surgery,etc.) until a child is older.  Also, with gender identity there are usually underlying conditions, known as co-morbidities, which need to be addressed. These co-morbidities include such things as depression, anxiety and suicidal tendencies. Remember, that supportive parenting practices are key to strengthening a child’s self-esteem. Listen, learn and keep the communication open. Those are the first steps!

This blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

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