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She first insisted she was a boy at the age of 2. "I am a boy" became a constant theme in struggles over clothing, bathing, swimming, eating, playing. Eventually, a psychologist diagnosed gender identity disorder. Now Tyler 's parents allow him to live as a boy, and the 5-year-old is reveling in his new identity. (The Post is using the name his parents would have given him if he had been born a boy to protect the family's identity outside their community, where their situation already is widely known.) (Whitney Shefte/The Washington Post)
Still, Jean wasn’t sure how he’d react to her suspicions that Kathryn might be transgender. She decided she wouldn’t voice them unless she was totally convinced herself.
She went back online and watched videos of parents talking about their realization that their child was transgender. They all described a variation of the conversation she’d had with Kathryn: “Why did you change me?” “God made a mistake with me.” “Something went wrong when I was in your belly.”
Many talked about their painful decision to allow their children to publicly transition to the opposite gender — a much tougher process for boys who wanted to be girls.
Some of what Jean heard was reassuring: Parents who took the plunge said their children’s behavior problems largely disappeared, schoolwork improved, happy kid smiles returned.
But some of what she heard was scary: children taking puberty blockers in elementary school and teens embarking on hormone therapy before they’d even finished high school.
All of it is a new and controversial phenomenon.
In the United States, children have been openly transitioning genders for probably less than a decade, said Jack Drescher, a New York psychiatrist who is a leader in the field of gender orientation. There is very little to go on, scientifically, to support that approach, and the very idea of labeling young children as transgender is shocking to many people.
But to others, it makes perfect sense.
“In children, gender solidifies at about 3 to 6,” explained Patrick Kelly, a psychiatrist with the division of child and adolescent psychiatry at Johns Hopkins Children’s Center.
That’s about the age when girls gravitate to girl things and boys to boy things. It’s when the parents who ban baby dolls or toy guns see their little girl swaddle and cradle a stuffed animal or watch in awe as their boy makes guttural, spitting Mack truck sounds while four-wheeling his toast over his eggs, then uses his string cheese as a sword.
And it’s the age when a child whose gender orientation is at odds with his or her biology begins expressing that disconnect — in Kathryn’s case, loudly.
The American Psychiatric Association has an official diagnosis for this: gender identity disorder in children.
Those who have it, according to the association’s Diagnostic and Statistical Manual of Mental Disorders, experience “a persistent and intense distress about assigned sex, together with a desire to be (or insistence that one is) of the other sex. There is a persistent preoccupation with the dress and activities of the opposite sex and repudiation of the individual’s own sex.”
And, it adds, “mere tomboyishness in girls or girlish behavior in boys is not sufficient” to warrant the diagnosis. It requires “a profound disturbance of the normal gender identity.”
The manual is being updated this year, and a task force that Drescher sits on is studying whether to remove the word “disorder” from the diagnosis and instead call the condition “gender incongruence.”
Whatever it’s called, it can’t always be solved by letting girls wear pants or boys wear dresses, psychiatrists say. Many of the kids have gender dysphoria, a persistent dislike of their bodies. They may shower with their clothes on, so they don’t have to see themselves. Or demand to know when their penises will grow in. Or, in extreme cases, try to cut their penises off.
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