Last updated on August 4th, 2017 at 08:30 pm
Some children and adolescents identify as transgender or gender nonconforming. The term transgender is used as a broad umbrella term to describe people whose gender identity—their internal sense of being female, male, or some other gender—does not line up with their sex assigned at birth. The term gender nonconforming is similarly used to describe gender identities or gender expressions that do not fit in with societal expectations for the child’s sex assigned at birth. Being transgender or gender nonconforming is not a psychological disorder.
What is Gender Dysphoria?
Gender dysphoria is a diagnosis that is included in the DSM-5. This diagnosis is used to describe the persistent clinically-significant distress and impairment that some transgender or gender nonconforming youth may experience due to the incongruence between their gender identity/expression and their sex assigned at birth. Children and adolescents who experience gender dysphoria may be particularly distressed by certain parts of their body, typically primary or secondary sex characteristics.
Effective Therapies for Gender Dysphoria
Currently, there are no psychological interventions that have been shown to reduce gender dysphoria. Therapies that aim to change a child or adolescent’s gender identity are considered unethical. However, transgender and gender nonconforming youth may benefit from seeing a therapist, who can help them cope with stressful experiences that they may face. Transgender and gender nonconforming youth may encounter family rejection, stigma, discrimination, or even interpersonal violence due to their gender identity or expression. These negative experiences may lead to anxiety, depression, or suicidal thoughts and behaviors. It is very important that parents and families of transgender and gender nonconforming youth support and affirm their identity—for example, by using their preferred name and pronouns—as family acceptance is a strong protective factor against negative mental health outcomes.
The World Professional Association for Transgender Health has published standards of care (WPATH SOC version 7) that all physical and mental health care providers should use when treating transgender and gender nonconforming youth. The WPATH SOC-7 outlines several gender-affirmative interventions that can help reduce youth’s gender dysphoria. Children and adolescents may choose to socially transition to live in their affirmed gender by changing their name, the pronouns they use, or their appearance (e.g., clothing, hairstyle). Secondly, some young adolescents may decide with their parents and doctors to take medications to suppress their pubertal development. This reversible medical intervention halts the development of physical characteristics that may be distressing for transgender and gender nonconforming youth (e.g., facial hair, breasts, deepening voice). Lastly, older adolescents—typically around age 16—may be eligible for gender-affirmative hormone therapy. Hormone therapy involves taking either estrogen or testosterone, which leads to significant physical changes that help transgender and gender nonconforming youths’ body match their gender identity. Some of these physical changes are permanent, though others may revert if youth stop hormone therapy. Surgical interventions are generally not recommended until age 18, except under certain circumstances.