As parents, we often face complex questions about our children, and one of the most delicate concerns gender identity and, especially, gender dysphoria.
In a rapidly evolving world, where traditional concepts of masculinity and femininity are increasingly questioned, it’s natural to feel lost when our child expresses behaviors or feelings that don’t correspond to social expectations related to their assigned sex at birth.
Key Points
- Gender dysphoria is the significant distress caused by incongruence between assigned sex and perceived identity, different from normal identity exploration
- Many children show gender non-conforming behaviors without developing persistent dysphoria
- Recommended approach: “affirmative” method that supports identity exploration without forcing conformity, creating a safe and listening environment
- Professional intervention: consult specialists when there’s persistent distress, avoiding “reparative” therapies (ineffective and harmful)
- Age-based treatments: prepubertal children receive only psychological support; adolescents may consider puberty blockers after careful multidisciplinary evaluation
- A welcoming family environment significantly reduces bullying and mental health problems
Let’s start understanding more
Before delving into the nuances of our children’s experience, it’s important to clarify some key concepts.
- Gender identity represents the internal sense of being male, female, or something else, which may or may not correspond to the sex assigned at birth.
- Gender expression, instead, concerns how we externally manifest our identity through clothing, behaviors, and other forms of presentation.
The majority of people are cisgender, a term describing those whose gender identity aligns with their assigned sex at birth. However, some people experience what is defined as gender incongruence, namely a discrepancy between assigned sex and perceived gender identity.
It’s crucial to distinguish between:
- gender incongruence
- gender dysphoria
While the first simply describes a normal variation of human experience, dysphoria manifests when this incongruence causes significant distress or impairs the person’s daily functioning.
When incongruence becomes dender dysphoria
Gender dysphoria is not automatically present in all children who show behaviors non-conforming to gender expectations.
Many children go through phases where they prefer games, clothes, or activities typically associated with the opposite sex, and this is part of normal childhood development.
Dysphoria emerges when persistent and clinically significant distress manifests.
In children, this may include:
- insistence on saying they belong to the opposite sex
- strong preference for clothes of the opposite gender
- rejection of toys typical of their assigned sex
- marked aversion toward their own anatomy
It’s important to emphasize that the trajectory of children with gender incongruence cannot be predicted with certainty. Research shows contrasting results: some studies indicate that most children maintain their different gender identity into adolescence, while others suggest that only a minority continues to meet criteria for gender dysphoria in adulthood.
The affirmative approach: supporting without forcing
Facing these situations, the medical and psychological community has developed what is called “gender-affirmative approach”.
This model is based on the fundamental principle of supporting the child in their gender expression, avoiding attempts to force them to accept the gender role assigned at birth, which can be traumatic and counterproductive.
The affirmative approach doesn’t necessarily mean promoting immediate transition, but rather creating a safe space where the child can explore their identity without judgment. Let’s remember that what some desperately call gender education doesn’t exist.
This may include using preferred names and pronouns, freedom to express themselves through clothing and activities, and open and respectful dialogue about the child’s feelings.
For you parents, this means walking a delicate balance between support and patience, recognizing that your child’s identity might be fluid and evolving.
It’s not about making hasty decisions, but creating a family environment where your child feels safe expressing their authentic feelings.
When to seek professional support
If you notice persistent signs of gender-related distress in your child, it may be helpful to consult specialized professionals.
Professional evaluation considers various aspects:
- the child’s gender identity history
- presence of clinically significant distress
- medical and developmental history
- family and social context
Expert professionals can help you distinguish between normal identity exploration and dysphoria that might require specific interventions.
They can also support you in managing challenges the family might face, such as reactions from school or social environments.
It’s fundamental to choose professionals who adopt an evidence-based approach and don’t attempt to “convert” your child’s identity, even though it may happen that due to retrograde ideologies, not all professionals are reliable in this regard.
So-called reparative or conversion therapy not only is ineffective, but can be harmful and in many jurisdictions is considered unethical or illegal.
Treatment options and timing
For children in prepubertal age, treatment focuses primarily on psychological support and psychoeducation. No guidelines recommend hormonal or surgical interventions in this age group.
During adolescence, for young people with persistent dysphoria, more specific treatments may be considered.
Puberty-blocking medications, such as leuprolide, can be used to “pause” pubertal development, offering additional time for evaluation without permanent physical changes.
These interventions necessarily require thorough evaluations by expert multidisciplinary teams and, when appropriate, informed parental consent and adolescent assent.
It’s crucial that all decisions are made with full understanding of benefits, risks, and long-term implications, including those on future fertility.
The role of family and society
As parents, support is fundamental for your child’s wellbeing. Gender-diverse children and adolescents often face greater challenges, including higher rates of bullying, cyberbullying, social isolation, and mental health problems. A supportive family environment can make a significant difference in their psychological development.
At the same time, it’s important to recognize that your reactions and concerns are legitimate. Addressing these issues can generate anxiety, confusion, and stress in the family.
Research shows that, when adequately supported, transgender people can achieve levels of wellbeing and quality of life similar to those of the general population. Gender-affirming interventions, when appropriate and well-managed, can significantly alleviate dysphoria and improve mental health.
However, it’s important to maintain realistic expectations. The journey can be long and complex, and not all situations resolve linearly. Some young people may discover that their gender identity is more fluid than initially thought, while others may maintain a consistent direction toward transition.
We are with you
We at Parentalife are by your side throughout the entire parenting journey, from the fertile period, to pre-birth, to life with children.
We support you with guides, courses, and personalized consultations.
Remember, we are with you.
SOURCES
Boucher FJO, Chinnah TI. Gender Dysphoria: A Review Investigating the Relationship Between Genetic Influences and Brain Development. Adolesc Health Med Ther. 2020 Aug 5;11:89-99. doi: 10.2147/AHMT.S259168. PMID: 32801984; PMCID: PMC7415463.