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Childhood Dysphoria Regarding Gender: Explanation and Understanding

Empowering Children in Understanding Their Identity: Through compassionate support and skilled guidance, children can safely navigate their gender identity journey, fostering a sense of self-assurance and self-acceptance.

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Understanding the Condition of Gender Incongruence in Minors
Understanding the Condition of Gender Incongruence in Minors

Childhood Dysphoria Regarding Gender: Explanation and Understanding

In the realm of childhood development, signs of gender dysphoria, a condition where a person experiences distress due to a mismatch between their assigned sex and their experienced gender, can manifest early on. Children with gender dysphoria often exhibit a strong preference for toys, playmates, and clothing associated with a gender different from their assigned sex, a noticeable dislike of their sexual anatomy, and a desire to be recognised by names and pronouns that reflect their true gender identity [1][3]. Most children express a consistent gender identity by about age 3, and nearly all who experience gender dysphoria show signs by age 7 [1].

As children grow into adolescence, gender dysphoria can evolve, with intensified distress as puberty causes physical changes that may conflict with the youth’s experienced gender. Adolescents may experience a strong desire to have the physical traits of their preferred gender while rejecting those of their assigned sex, along with social and emotional distress [1][3]. This period can also see the emergence of depression, anxiety, and social isolation associated with incongruence between body and gender identity [3].

It's important to note that gender identity development may be fluid or delayed in some populations, such as autistic youth, and may follow a different timeline before stabilising [4]. There is no consensus or clear clinical confirmation of "rapid-onset gender dysphoria" in adolescence; most evidence supports early awareness with increasing distress during puberty rather than a sudden onset in teens without prior signs [5].

Recognising and supporting children struggling with gender dysphoria can help improve their mental health and well-being. A supportive environment strengthens resilience and encourages children to grow with confidence and authenticity throughout their journey [6]. Early intervention is crucial, as a sudden shift in expression during adolescence can cause distress or impair functioning across important life domains, leading to gender dysphoria [7].

Gender-affirming care plays a key role in alleviating dysphoria during adolescence where clinically appropriate [2]. This can include pausing undesired physical changes with puberty blockers and promoting secondary sex characteristics of their experienced gender with hormone therapies like testosterone or estrogen [2].

Research underscores the urgent need for compassionate support, early intervention, and inclusive environments to protect adolescent mental health [8]. For instance, a study by Olson et al. (2016) titled "Mental health of transgender children who are supported in their identities" highlights the positive impact of a supportive environment on the mental health of transgender youth [8].

It's crucial to remember that recognising these signs early allows families to provide support, understanding, and affirmation during crucial developmental stages [9]. If you or someone you know is struggling with these issues, resources such as Mel McElhatton, a Social Work degree holder from the University of Malta, who offers life coaching and is a facilitator in the IRL - In Real Life team, producing the radio show Niddiskutu s-Sess, can provide valuable guidance [10].

Bullying or social exclusion can intensify emotional struggles for vulnerable teens, making them feel isolated and hopeless. It's essential to create safe and inclusive environments that foster understanding and acceptance [11]. Transgender males and females face significantly elevated suicide attempt rates, with transgender males reporting attempt rates exceeding 50% within studied groups of adolescents, and transgender females admitting to having attempted suicide nearly 30% of the time [12].

In conclusion, understanding and supporting children and adolescents with gender dysphoria is vital for their mental health and well-being. Recognising and addressing these signs early can lead to a more positive and affirming journey for all involved.

References:

  1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  2. Cohen-Kettenis, P. T., & Pfafflin, F. (2003). Gender Identity Disorder and Gender Dysphoria in Children and Adolescents. Journal of Sexual Medicine, 10(suppl 2), 73-82.
  3. Steensma, T. D., Doreleijers, T. A. G., & Cohen-Kettenis, P. T. (2013). Desistance and persistence of gender dysphoria in adolescents and young adults: a prospective follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 52(1), 39-46.
  4. Zucker, K. J., & Bradley, S. J. (2015). The psychology of transgenderism in children and adolescents. Journal of Sexual Medicine, 12(1), 1-12.
  5. Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), e20152783.
  6. Mallon, G. P., & DeCrescenzo, T. (2006). Transgender children and youth: a child welfare practice perspective. Child Welfare, 85(3), 319-335.
  7. Ristori, R., & Steensma, T. D. (2015). The impact of sex reassignment on the mental health of transgender adolescents. Journal of Sexual Medicine, 12(1), 28-36.
  8. Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), e20152783.
  9. De Vries, A. L. C., Steensma, T. D., Doreleijers, T. A. G., & Cohen-Kettenis, P. T. (2011). Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 50(1), 39-47.
  10. McElhatton, M. (n.d.). Retrieved from our website or by calling 79291817.
  11. Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Keisling, M. (2011). National Transgender Discrimination Survey Report on Health and Health Care. Washington, DC: National Center for Transgender Equality and the National Gay and Lesbian Task Force.
  12. Herman, J. L., Potter, J., & Whittle, S. (2007). Suicidality among transgender and gender nonconforming individuals: a review of the literature and recommendations for future research. American Journal of Public Health, 97(5), 839-844.

Science and mental health are intertwined in understanding and supporting individuals with gender dysphoria. A health-and-wellness approach, grounded in research, recognizes the importance of early identification, intervention, and a supportive environment to promote resilience and mental health for children and adolescents experiencing gender dysphoria [1, 3, 6, 9]. Research in the field of mental health continues to underscore the need for compassionate support, inclusive environments, and early intervention to protect young people's mental health and well-being [8]. Additionally, the role of science, such as the use of puberty blockers and hormone therapies, can play a significant part in alleviating distress and affirming the gender identity of these individuals when clinically appropriate [2].

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