gender identity disorder in children facts

gender identity disorder in children facts Gender Identity Disorder (GID) in the DSM-IV (American Psychiatric
Association [APA], 1994) classification system refers to a strong identification
with and preference for the gender role characteristics of the other sex. This is expressed through play, behaviour and verbal statements of a desire to be the other sex. Most young children receiving this diagnosis correctly label their own sex but have a desire to be the other sex. This desire may be articulated as
early as two or three years of age. Children may intensely dislike their own
genitals and refuse to wear typical male or female clothes. This disorder occurs in children with normal anatomical/chromosomal sex.
As a diagnostic category, GID remains a focus of much contemporary debate.
Polarised views abound and essentially revolve around issues of nature versus nurture in the creation of gender identity. In biological determinist models, gender
identity is seen as founded in prenatal brain development in response to
hormonal exposure (Swaab & Fliers, 1985), and largely determines gender role development. In sociocultural models, gender identity is seen as a complex internalisation of cultural systems of meaning and subject to variation across
cultures and historical periods (Mead, 1949). Biological models see GID as a
brain development disorder largely uninfluenced by socialisation.
These very different models lead to different understandings of gender
dysphoria and opposing views regarding intervention.
Biological determinist models of gender identity disorder
Biological models, in simplified terms, see GID as the result of abnormal brain sex differentiation, with subsequent gender development occurring along predetermined lines and in conflict with the assigned gender role. Sex, and in
particular ‘brain-sex’, is seen as the foundation of gender in its social and
cultural forms. Intervention for GID then becomes a matter of either changing
gender identity to fit the body, or using sex-modifying procedures to align the
body with the sense of subjective gender. Given the determining nature of brain processes, the latter approach of aligning the body with the person’s sense of
gender is favoured. Paradoxically, it also follows from this approach that intersex infants with ambiguous external genitalia should not automatically be assigned to a particular sex (usually female), as their prenatal sexual differentiation will
influence gender identity in the same way. There have been several intersex
individuals unhappy in their assigned gender role and their experiences are used to discredit a purely social constructionist account of gender identity
development (Butler, 1990).
In this binary model, where there are two sexes and two genders, gender
should conform to sex and ‘normality’ is defined as congruence between sexual anatomy and gender identity. To be gendered in opposition to sex is to have a disorder, despite the fact that sex and gender are analytically distinct. Biological
accounts suggest that biological treatments should be the major approach.
Sociocultural models of gender identity disorder
Constructionists argue that gender is not the result of essential biological sexual difference, but rather gender is an elaborate social construct within which biology is interpreted. Gender is seen as causally prior to biological sex differences (Colapinto, 2000). These accounts emphasise the social practices that
reinforce a particular culture’s gender categorisation and see nothing intrinsic
and fixed about a binary gender system. At their most extreme, these accounts
argue that ‘gender dysphoria’ is the response of an individual who does not
conform to defined gender role and that GID is a psychiatric label used to
pathologise those experiences of gender non-conformity. While an individual
with gender dysphoria may suffer distress, social discrimination and secondary
emotional problems, it is argued that sociocultural change and the dismantling
of rigid gender categories is the level of needed intervention rather than
individual ‘treatment’ for a ‘disorder’.
Social constructionists may not see the role for individual intervention and
argue for much more social flexibility in the interpretation of gender. In practice,
the majority of parents of an intersex infant support some intervention and find
it difficult to raise their infant when uncertain about gender. Factors such as the
family’s tolerance of this uncertainty, the ‘degree’ of difference in the child’s
appearance and the family’s beliefs about gender should be taken into account in
decision making.