Gender Identity Disorder in Childhood: Inconclusive Advice to Parents (Essay‪)‬

For purposes of this essay, let's invent a contemporary American child named William Lee. William is five years old and, as far as anyone can tell, his body is that of a typical male. But William has long acted in a fashion more typical of girls: he likes to play with "girl" toys like Barbie dolls and My Little Pony; he strongly prefers playing with girls to playing with boys; and he likes to dress up like a conventionally pretty woman, in pumps and dresses, with jewelry and make-up. He increasingly insists he is really a girl and indicates a belief--or a desperate hope--that he will grow up to be a woman. He wants to be called "Julie" and to go to school as Julie. He exhibits what psychologists call gender dysphoria. This stresses out his parents; it is not easy to have a child who challenges social norms, especially norms about gender. If William's parents are not living in a media-free universe, they will know that there are two basic models of thought about what they should do. One, which I'll call the therapeutic model, maintains that William is showing all the signs of gender identity disorder (GID) and that he should be treated by a mental health professional. Or rather, his family should be treated by mental health professionals because, according to the typical contemporary therapeutic perspective, William needs--and lacks--a family that is functioning well psychologically and emotionally. If his mother is depressed or clingy, if his father is physically or emotionally absent, if his parents' marriage is a stressful mess, William is going to keep suffering from gender role confusion, and secondarily from the anger, shame, disappointment, anxiety, and guilt that his parents may exhibit in response. Although the therapeutic model does not point to a single cause of GID, it does see familial dysfunction as an aggravating factor in virtually all cases.