Gender discussions in the media have left many parents and children asking questions. Whether you are wondering if your child could be struggling with various feelings related to gender — or your child has a transgender classmate — it’s best to have an understanding of gender identity disorder (GID).
In the past there have been specific definitions regarding gender roles, but society is beginning to accept a broader view. Women firefighters, male nurses and more dads working from home while their wives pursue careers are part of today’s reality and have changed some people’s perception.
We raise our children to embrace their curiosity regarding roles. Kids like to explore their environments when it comes to their attire, hairstyles and toys. Allowing your children to explore different options is healthy and vital to their development.
Knowing the difference between gender identity and gender expression is important. Gender identity is innermost feelings of being male, female or neither, whereas gender expression is showing masculinity or femininity in the way you act, dress, behave and interact. GID is a medical term given to individuals who identify with a gender inconsistent with their birth sex.
Some gender-specific behaviors can be influenced by with whom a child spends the most time. This can have an impact on gender expression, but by no means can it affect gender identity. A six-year-old girl who spends the majority of her time with her dad hunting, fishing and wearing camouflage but has always consistently said she is a girl shows no red flags for GID. Rather, she is expressing normal behavior.
However, a six-year-old girl who wants her hair shaven and to play football because she insists she is a boy and has shown male tendencies since age three may be experiencing GID.
Well-child visits are a good opportunity for parents to discuss any concerns or questions they might have regarding their child’s gender identity with the healthcare provider. The provider can help distinguish between normal and GID behaviors.
During the preadolescence stage (ages 8 to 12) all kids should have a good understanding of their gender identity, and most will express the gender consistent with their sexual organs. If your child — into the preadolescence stage — continues to identify his gender inconsistent with his sexual organs, seeking professional counseling would be appropriate.
Preferably you would schedule your child with a trained gender-disorder psychologist, but if one is not available in your area, ask local counselors or psychologists if they feel comfortable caring for your child. They can give insight into whether your child is transitioning through “just a stage” or actually has GID. Once that is determined, a plan can be created for the next steps — such as social transition, consulting with a gender-disorder-trained provider to discuss future medical transition, joining support groups in the community while sorting out feelings.
When receiving confirmation that your child has GID, you might have a sea of emotions, which are completely normal. Whether you have happy emotions, feel angry and hostile or are in denial, consider seeking counseling to help you cope as a parent.
Social transition — defined as when a person begins to live as the gender identified with rather than the gender associated with biological sex — can be a difficult time for both the child and the family. This can include changes in attire, hairstyle and name. During the first few days or even weeks of a social transition, it might be beneficial to go to a place where your child it not known in order to explore feelings while living in the different gender without the added stress of social stigma from peers, teachers and other community members.
Medical transition can include puberty blockers and cross-sex hormones (testosterone or estrogen), but this treatment is not initiated until your child has been through extensive psychological counseling and evaluation. Before this step, your child’s provider should explain the potential health risks associated with cross-sex hormones and have you and your child consent to treatment.
Your transgender child will not have an easy road ahead. Transgender kids are at increased risk for bullying, sexual assault and discrimination from peers, teachers and even some family members. Because of this stress, your child needs support and unconditional love more than ever. Many resources exist to help parents handle the child’s school setting (dressing room, bathroom, bullying), inform family members of the child’s transition (especially siblings) and find parental support groups. Having a support system is vital to the entire process.
Educate your kids about transgender people in society. They need to hear from you that being kind and respectful is a top priority in life, and that discrimination of any kind is unacceptable. Help them care for not only their closest friends and family, but people outside their inner circle: the new kind in class, the child sitting by himself at the lunch table, a member of the community in a time of need.
As teachers like to say: Kindness is contagious. You can help to create an anti-bullying policy at your child’s school or help to promote an existing policy by speaking to the school counselor and other parents.
Every child deserves to be loved, live a happy and fulfilling life and grow up to have a family and successful career, regardless of sexual orientation, gender expression or gender identity. You can make a difference in the lives of your kids with GID so they flourish. You may not understand the reason for certain feelings, but you can still help them. Be positive, supportive voice that can make a difference in your child’s life and in the lives of other children and families.
Dr. Katie Erdlitz, DNP, CRNP, CPNP-PC, currently works as an assistant professor at the University of South Alabama and as a PNP at a private clinic. She is an active member of NAPNAP and currently serves on the Conference Planning Committee. Dr. Erdlitz is also continuing education and membership chair of NAPNAP’s Alabama chapter.