So due to all the fearmongering and panic being created regarding acceptance of transgender children, I decided to write this up with the intent of hopefully helping people understand the difference between care for trans children vs care for trans adolescents (generally puberty to 18) and adults. There is a lot of misinformation due to the fact that many people assume that the care for children as young as 3 is the same as what would be done for someone who is in their late 30s, which is due to the fact that when gender is discussed the focus is almost always on transition and not on the other aspects.
REMINDER: GENDER DYSPHORIA IS NOT A REQUIREMENT FOR BEING TRANSGENDER PER THE WHO AND THE DSM-V! If you want to look at the DSM-V you can view it online here, the section on Gender Dysphoria starts on page 451: https://bit.ly/2ESzk0Y
People generally start to figure out their gender between toddler stages and puberty, though gender can and does fluctuate so not everyone who is trans will “realize” it at a young age. In most cases for children who are transgender, the only time medical intervention is done is when the child is experiencing gender dysphoria due to their gender. If gender dysphoria is not present, the focus is on gender expansive education for the family and community, societal aspects to allow the child to fit with their gender as best as possible, and acceptance of the child and their identity.
One thing to remember is that gender does fluctuate and a child who is working on figuring out their gender can at some point either go “back” to being the gender they were assigned at birth, or they can persist with their gender incongruence (being transgender). The DSM-V specifically discusses this in reference to young children specifically with Gender Dysphoria (the rates of persistence may be higher but as they don’t include non-dysphoric children we cannot know for sure). I discuss this in my article “Breaking Down Point 5 of Gender Ideology Hurts Kids” on my own website if you want to read more about it.
“Rates of persistence of gender dysphoria from childhood into adolescence or adulthood vary. In natal males, persistence has ranged from 2.2% to 30%. In natal females, persistence has ranged from 12% to 50%.” (Pg 455)
So let’s move on to the criteria, shall we?
The criteria for transgender care for children is for the most part focused on education, support, and observation. A child with a gender incongruence (a gender different from the one they were assigned) would be observed by their family and medical practitioners for signs of distress due to the incongruence that might require intervention in the form of therapy or education of those around the child on being supportive.
REMINDER: GD is NOT required for being trans, and it is SPECIFICALLY stated within the DSM-V, “Gender dysphoria refers to the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender. Although not all individuals will experience distress as a result of such incongruence, many are distressed if the desired physical interventions by means of hormones and/or surgery are not available.
For Gender Dysphoria (specifically GDIC) to be diagnosed in a trans child, they have to meet 6 out of 8 criteria as well as have been dealing with the issue/distress for more than 6 months. For the specific criteria and breakdowns you can check out this link: http://www.ifge.org/302.6_Gender_Identity_Disorder_in_Children
No medical procedures such as pills, surgeries, or the like are performed on young children.
The education is for the most part focused around the parents, family, and social interactions involving the child, and are on things such as how to be supportive as they try to figure it out, how to ensure their needs are being met, and how to shut down problems from outside sources (such as bullying, misgendering, and people refusing to treat the child with respect due to their gender).
Around the time the child reaches puberty age the criteria change to focus on adolescent and later adult care, and they may be put on puberty blockers if they are dealing with gender dysphoria due to physical symptoms, or if the doctor, adolescent, and family agree that holding off puberty would be the best course of action while the adolescent continues to work on hammering out their gender. These blockers are reversible and are used in cisgender children who have conditions such as precocious puberty so they are not a new practice.
The EARLIEST that hormone therapy can begin is in their mid to late teens, and this is done on a case by case basis and under strict medical supervision only after determining the mental/physical/psychological/emotional state of the adolescent and if they are a good candidate for HRT.
Surgeries are rarely if ever done, and only due to either a medical need, or the adolescent has reached the state of adulthood and has qualified for the surgery (such as an 18 year old or above).
Hopefully this breakdown regarding the treatment of transgender children and the breakdown of GDIC if they have it helps to remove the stress/fear of children being put on hormones, having surgeries, or any other massively life altering procedures at a young age.