Not male, not female

What happens when your little boy shows up to play teatime dressed as his favorite Disney princess? Or Amita insists she should be called ‘Amit’ from now on?

By Dhara Thakar Meghani 

 

“Is it a boy or girl?” Expectant parents can almost never escape this question, and no birth announcement would be complete without mention of this vital information. A baby’s sex (physical and hormonal characteristics) typically informs the name chosen for the child, the color of his/her clothes, and the ideas that parents form about who this child may eventually become.

Children grow up learning about gender roles (the cultural set of behavioral expectations for women and men in a society) through their families and the surrounding culture, and can identify specific differences between boys and girls by the time they are four years old. In most cases, the gender with whom a person identifies is consistent with his/her sex.

So what happens when your little boy prefers to play with dolls and jewelry, and shows up to play teatime dressed as his favorite Disney princess? Or when your 6-year-old daughter Amita insists she is a boy and should be called ‘Amit’ from now on?

Are you more likely to think it is a phase he will outgrow; encourage and support his behavior; or try to talk her out of it? Might you initially wonder whether it is actually possible for a 6-year-old child to know whether she feels more like a boy or more like a girl?

According to the Diagnostic Statistical Manual for Mental Disorders (DSM-IV), children can be diagnosed with Gender Identity Disorder (GID) based on a set of criteria that include an emphatic, persistent identification with the other gender, rejection of their physical characteristics, and/or belief that they may grow up to have the physical characteristics of the other sex¹. Controversies exist regarding the use of the term “Disorder,” as many professionals do not classify confusion/rejection of gender identity as a pathological disturbance.

In fact, there is space in several cultures for gender fluidity and additional genders, which have not been adequately recognized in the DSM-IV. For example, hijras in South Asia are known as the “third sex,” and often see themselves as “not male, not female.”² Despite recognition of a gender that transcends the traditional male/female dichotomy, hijras are marginalized and rarely tolerated as functional members of society.

For South Asian parents, the notion that their child may be experiencing incongruence between sex and gender may be particularly troubling if the only other example they have encountered in their culture has been one that is quite extreme and outcast.

Even the most accepting of parents of children exhibiting gender deviant behavior may experience feelings of guilt, loss of the “child they always had in mind³,” and anger or disappointment in the child they actually have. These feelings may be amplified to disdain, disgust, and overt rejection among parents who are in denial their child might be different in a way they could never have imagined, and consequently, limit a parent’s capacity to love and accept the child unconditionally.

Emerging research indicates that children who exhibit GID or elements of GID may be at greater risk for psychological distress due to multiple reasons that include lack of support from their families, difficulty fitting in with peers, and in extreme cases, physical and/or emotional abuse from family members and/or peers4.

Children whose desire to be the other gender persists into adolescence may also experience feelings of depression and anxiety, particularly when their body transforms in a way that is completely discordant with their gender identity. Suicidal thoughts are also common among children whose families fail to understand and address the child’s gender identification in a way that supports their development into an individual who is comfortable in his/her own skin.

Among all the things a parent might have dreamed their child would be (smart, kind, a doctor, a football player), gender noncomforming, transgender, or transsexual would probably have never made it to the list. Accepting a child for who he/she is and wants to be can be one of the most challenging tasks of parenthood, particularly when these desires don’t match a parent’s aspirations and expectations for the child. And certainly, parents may fear their support and acceptance early on may be encouraging deviance from the norm that they might have been able to curb through discipline or rejection of gender nonconforming behavior.

However, there is growing evidence that gender identity is not a socially constructed phenomenon as is commonly thought³ . At the same time, there is little predictability in knowing whether children who exhibit gender fluidity early in life will identify as transgender or homosexual by adolescence and adulthood5; for some children, preferences for clothes, activities, and behavior that are generally associated with the opposite gender may truly be a phase.

The charge for parents then, is to have the patience, empathy, and courage to raise a child with enough love and attention to outlast the waves of confusion that result if and when their “boys will be girls, or girls will be boys.”³

Dhara Thakar Meghani recommends a touching NPR story that captures the experience of two 8-year old girls who were born boys. Make the topic of childhood GID come to life by hearing it for yourself here.

Notes:

¹Zucker, K. (2010). The DSM diagnostic criteria for Gender Identity Disorder in children. Archives of Sexual Behavior, 39, 477-498

²Meher, N. (2007). I am woman, hear me roar. Retrieved June 28, 2012, from http://nabihameher.wordpress.com/2007/06/08/hijras-%E2%80%93-the-third sex/

³Ehrensaft, D. (2011). Boys will be girls, girls will be boys: Children affect parents as parents affect children in gender nonconformity. Psychoanalytic Psychology, 28, 528-548

4Spack, N.P., et al. (2012). Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics, 129, 418-425

5Malpas, J. (2011). Between pink and blue: A multi-dimensional family approach to gender nonconforming children and their families. Family Process, 50, 453-470

 

 

 

 

 

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