Transgender Health

Season 14
Episode 1408

What does transgender mean?

Transgender is an umbrella term for persons whose gender identity, gender expression or behavior does not conform to that typically associated with the sex to which they were assigned at birth. Gender identity refers to a person’s internal sense of being male, female or something else; gender expression refers to the way a person communicates gender identity to others through behavior, clothing, hairstyles, voice or body characteristics. “Trans” is sometimes used as shorthand for “transgender.” While transgender is generally a good term to use, not everyone whose appearance or behavior is gender-nonconforming will identify as a transgender person. The ways that transgender people are talked about in popular culture, academia and science are constantly changing, particularly as individuals’ awareness, knowledge and openness about transgender people and their experiences grow.

Source: Human Rights Campaign

Gender Basics

Children are not born knowing what it means to be a boy or a girl; they learn it from their parents, older children and others around them. This learning process begins early. As soon as the doctor announces – based on observing the newborn’s external sex organs – “it’s a boy” or “it’s a girl,” the world around a child begins to teach these lessons. Whether it’s the sorting of blue clothes and pink clothes, “boys’ toys” and “girls’ toys” or telling young girls they’re “pretty” and boys they’re “strong.” It continues into puberty and adulthood as social expectations of masculine and feminine expression and behavior often become more rigid. But gender does not simply exist in those binary terms; gender is more of a spectrum, with all individuals expressing and identifying with varying degrees of both masculinity and femininity. Transgender people identify along this spectrum, but also identify as a gender that is different than the one they were assigned at birth.

Is My Child Transgender…

At some point, all children will engage in behavior associated with different genders – girls will play with trucks, boys will play with dolls, girls will hate wearing dresses and boys will insist on wearing them – and gender nonconforming behavior does not necessarily mean that a child is transgender. That said, sometimes it does – with some children identifying as another gender than the one they were assigned by the time they are toddlers.

The general rule for determining whether a child is transgender (rather than gender nonconforming or gender variant) is if the child is consistent, insistent, and persistent about their transgender identity. In other words, if your 4-year-old son wants to wear a dress or says he wants to be a girl once or twice, he probably is not transgender; but if your child who was assigned male at birth repeatedly insists over the course of several months that she is a girl, then she is probably transgender. Naturally, there are endless variations in the ways that children express themselves, so the best option if you think your child might be transgender is to consult a gender therapist.

…or is my child gay or lesbian?

Gender identity and sexual orientation are two different things. Being transgender is about an individual’s gender identity, while being gay is about an individual’s sexual orientation, which is our sexual or romantic attraction to people of the same gender, different genders, both or neither. While many children who go on to identify as lesbian, gay or bisexual express gender-expansive behaviors, whether they are transgender is about identity rather than attraction. Everyone possesses both a gender identity and a sexual orientation; in other words, a transgender person can also identify as gay, lesbian or bisexual.

What is “gender dysphoria”?

Gender dysphoria is the diagnosis typically given to a person whose assigned birth gender is not the same as the one with which they identify. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), the term – which recently replaced Gender Identity Disorder – “is intended to better characterize the experiences of affected children, adolescents, and adults.” To be clear, transgender identity is not a mental illness that can be cured with treatment. Rather, transgender people often experience a persistent and authentic disconnect between the sex assigned to them at birth and their internal sense of who they are. This disconnect is referred to by medical professionals as “gender dysphoria” because it can cause undue pain and distress in the lives of transgender people.

It isn’t just a phase and it’s not something you can change.

Sure, most children and teens go through “phases” – like only wearing all black, dying their hair, being obsessed with a certain band or asking to go by a nickname – but being transgender is not a phase, and trying to dismiss it as such can be harmful during a time when your child most needs support and validation.

Trying to change your child’s gender identity – either by denial, punishment, reparative therapy or any other tactic – is not only ineffective; it is dangerous and can do permanent damage to your child’s mental health. So-called “reparative” or “conversion” therapies, which are typically faith-based, have been uniformly condemned as psychologically harmful by the American Psychological Association, the American Medical Association, the American Psychiatric Association, and numerous similar professional organizations.

But my teenager just came out, shouldn’t they have known already?

While many transgender people say that they knew they were transgender as soon as they knew what “boys” and “girls” were, for many others, the journey to living openly as their affirmed gender is longer. For some, understanding their gender identity is a more complex process that lasts into their teens or adulthood, even seniors. Stigma, lack of knowledge and fear of rejection by family and peers often keep transgender people from coming out as children or teens. Sometimes a transgender person will come out as gay, lesbian, or bisexual before recognizing their gender identity or coming out as their true gender. No matter when your child comes out, knowing they have your support is critically important.

Simple Ways to Start Supporting Your Transgender Child

  • Always use the child’s preferred gender pronouns and preferred names.

  • Be your child’s advocate – call out transphobia when you see it and ask that others respect your child’s identity.

  • Educate yourself about the concerns facing transgender youth and adults.

  • Encourage your child to stand up for themselves when it is safe to do so.

  • Assure your child that they have your unconditional love and support.

Source: American Psychological Association

Medline Plus

Conduct an off-site search for transgender health from MedlinePlus.  These up-to-date search results are based on search terms specific to Second Opinion.

Resources

Center for Excellence for Transgender Health
The mission of the Center of Excellence for Transgender Health is to increase access to comprehensive, effective, and affirming health care services for trans communities.
GLAAD
GLAAD works through entertainment, news, and digital media to share stories from the LGBTQ community that accelerate acceptance.
World Professional Association for Transgender Health (WPATH)
WPATH mission to promote evidence based care, education, research, advocacy, public policy, and respect in transgender health.
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Panelists