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Research Paper for WMST 200: Transgender Children

By Kerri Zuiker

There have always been transgender people, in every culture, in every country. Some have been celebrated for their differences, some have been harassed and persecuted, though with the growing awareness of gender and sexuality issues, this is starting to change. As these issues become more frequently discussed in everyday life, more and more transgender people are choosing to come out and live as the gender they feel themselves to be. In addition to adults, children are identifying as transgender or gender-variant in increasing numbers, and if they choose to, beginning the transition to the opposite sex at increasingly young ages. Lately, there has been more media coverage of this issue with specials such as Barbara Walters’ 20/20 special “My Secret Self: A Story of Transgender Children,” which offered a view of the lives of three transgender children, two younger transgender girls and one transgender teenage boy. Being transgender raises many different challenges for the child and his or her family, emotionally, physically, and socially within the child’s own family and in society in general.

Before exploring the challenges that transgender children must face, we need to understand the differences between gender, sex, and sexual orientation. In The Transgender Child, the authors say that there are three components of a person’s core identity. The first is gender identity, one’s “deep inner feeling of gender, regardless of anatomy.” (13) The second is style of behavior, which has to do with a person’s natural inclinations, expressions, and behavior patterns. The third is sexual orientation, which is who you are attracted to. “Gender variance may or may not be an indicator of a child’s later sexual orientation. Gender variance and sexual orientation are separate elements that are often interwoven.” (Brill, 33) These are all interrelated, but not interchangeable. In addition to having a transgender identity, people can also be categorized as gender fluid or gender variant. “Gender variance refers to behaviors and interests that fall outside what is considered normal for a person’s assigned biological sex.” (Brill, 5) While transgender children adamantly believe that they should be the opposite gender, gender-variant children may be perfectly comfortable in the gender associated with their birth sex, but they might not necessarily fit all of the typical behavior patterns associated with that particular gender. “Some kids are not typical boys or girls. They are also not transgender. They may like things that are thought of as boy’s things one day, and things that are considered girl’s things another. They may want to wear boy clothes one day and girl clothes the next. These kids may ever say they feel like a boy one day, and like a girl the next.” (Brill, 24) One parent of a gender-fluid child emphasizes the point that her son does not consider himself transgender, saying, “My child has always identified with girls and often likes to dress in girl’s clothes at home, but is quite clear that he is a boy and does not want to be identified as a girl.” (Brill, 25) It is important to keep these distinctions in mind when studying the experiences of transgender children.

“Transgender experience begins with the earliest moments of consciousness,” says Joan Roughgarden in Evolution’s Rainbow (264). From birth, children are exposed to gender associations and told to act a certain way, and if a child is transgender, they start to make this fact know very early on. Early childhood stages of transgender identity are laid out in The Transgender Child. “Gender identity emerges by age 2 to 3 and is influenced by biology and sociological factors… Amazingly, a transgender identity is often very clear by this age.” (61-62) At a very young age, children learn to differentiate between genders, and by the time they are four to six years old, they have learned to associate gender with specific behaviors. “By this age, many transgender children have been consistent and persistent in their cross-gender identity for several years. It starts to become glaringly apparent that this is not a stage.” (Brill, 63)

This early understanding of one’s identity is true in the case of Jazz, a six-year-old transgender girl who was featured on the 20/20 special on transgender children. At the time the special aired, Jazz was in kindergarten, and was ‘one of the youngest known cases of an early transition from male to female.” From a very young age, Jazz made it clear that she possessed a female identity. “At only 15 months, he would unsnap his onesies to make it look like a dress. When his parents praised Jazz as a "good boy," he would correct them, saying he was a good girl.” (Goldberg) As Jazz grew older and entered preschool still desperate to be seen as a girl, her parents realized that this was not something that would go away. “A phase is called a phase because it is just that,” Renee, Jazz’s mother said. “It ends. And this is not ending. This is just getting stronger.” As transgender children become more adamant that their gender does not correspond with their birth sex, families either learn to adapt and accept their child as he or she is, or they try to convince the child that they are the gender associated with their birth sex. Many people advocate accepting the child for who he or she is, and not trying to change them to fit with the gender they are “supposed” to be. “If there is any cure for children or youth with gender-identity issues, it can be found in the key words acceptance, androgyny, compromise, and communication. It is important for parents to recognize that all children need to be accepted for what they are, not for what others believe they should be.” (Israel, 200) The authors of The Transgender Child recommend that children who are transgender have contact with other transgender or gender-variant people. “All of this may require making contact with the closest metropolitan area’s gay community center, or an LGBT resource center that is part of a college or university. …Families might want to attend a gathering like the annual Gender Spectrum Youth and Family Conference so they can meet other teens and adults who find themselves all across the gender spectrum.” (Brill, 30) This contact with other people like them help children to not feel so isolated, and assure them that there are other people who have similar feelings about their gender identity. Of course, not all parents are able to be accepting of their children right away. “Given long-held beliefs about gender and immense pressure from society, it is easy to understand why conflict commonly occurs among family members when faced with a child or teen who is significantly gender-nonconforming or transgender.” (Brill, 41) Many parents will go through stages of grief, as though their child has died. “Intense and varying periods of denial, sadness, anger, and mourning are common in dealing with and accepting this new emerging identity. (Brill, 47) Jazz’s mother went through these sorts of feelings as she tried to accept her daughter for who she was, saying, "I mourn the loss of the idea of my son. I see pictures and the video, and that child's gone. But there's a wonderful person now that's with us."

It is not always easy to accept a gender-variant or transgender child for who he or she is, but the attempt must be made. “If the child has a cross-gender identity, it won’t change just because the parents don’t accept it. However, with clear communications of parental rejection, over time the child’s cross-gender identity may go underground and become internalized with shame.” (Brill, 16) Parents often believe that their child may just be acting out when they express gender-variant tendencies. (Brill, 77) They may also fear the responses of other people when they are told about their children, which can lead to the parent wanting to keep silent about the child’s gender identity. This only damages the child “by teaching them to split off a core part of their identity.” (Brill, 84) There is also the feeling among some parents that if they keep their children away from other gender-variant children or adults, “their child might go back to being ‘normal.’ …The unfortunate thing is that by removing or forbidding contact with other people whom your child can relate to, you are only isolating them further.” (Brill, 80) When transgender children hear this sort of negative backlash about their gender identity, they internalize feelings of shame, and their self-esteem and feelings of self-worth are undermined. By blaming a child for their gender-variant identity, “your child hears that there is something wrong with who they are and that it is their fault. They hear that they are to blame and deserve to be treated with disrespect. Some people can better understand the injustice of this when they realize how similar it is to blaming a woman for being raped.” (Brill, 81) The best thing for the well-being of the child is to let them be who they are, and learn to accept the fact that are not, and may never be, gender typical.

However, not all parents and doctors working with transgender children are as willing to let the children become the gender they identify with. Some doctors use therapy similar to the conversion therapy used on gay and lesbian people to change their behavior back to heterosexual, “natural” behavior. Dr. Joseph Nicolosi, one of the proponents of this kind of therapy and author of A Parent’s Guide to Preventing Homosexuality, believes that transgender children can be taught to conform to their birth sex instead of identifying with the opposite gender. He appeared on an episode of the Dr. Phil show as one of the doctors on a two-sided debate about a mother’s decision to let her transgender daughter live full-time as a female. Nicolosi explained some of the techniques they would use to encourage the child to identify as male. “We would involve the father more. We would encourage a bonding between the father and the son. We would discourage — not to shame the child — but to discourage the feminine interests, really build up his boy identity, make him feel good as a boy, and get Mother out of her over-enmeshment with the boy.” In the same sort of style as Nicolosi, Dr. Ken Zucker tries to “make the child comfortable with the sex he or she was born with” if they are younger than ten years old. (Spiegel) In the case of Bradley, a young boy who identified as female, Zucker explained to Bradley’s parents that their parenting style would have to undergo a dramatic change. “Bradley would no longer be allowed to spend time with girls. He would no longer be allowed to play with girlish toys or pretend that he was a female character. Zucker said that all of these activities were dangerous to a kid with gender identity disorder. He explained that unless Carol and her husband helped the child to change his behavior, as Bradley grew older, he likely would be rejected by both peer groups.” (Spiegel)

In opposition to this style of therapy, Dr. Diane Ehrensaft says, “If we allow people to unfold and give them the freedom to be who they really are, we engender health. And if we try and constrict it, or bend the twig, we engender poor mental health.” (Spiegel) Dr. Ehrensaft does not believe in trying to modify a child’s behavior, as she believes it to be “coercive therapy” that is more harmful than helpful to the child. If transgendered children are allowed to continue to present themselves as the gender they identify with, eventually they may start the transitioning process from one sex to the other. Deborah Rudacille in The Riddle of Gender says, “Increasing numbers of young people are identifying as gender-variant, and are transitioning at far younger ages.” (Rudacille, 224) There are several different ways to go through the transition process, and there is not set timeline for when these transitions have to occur. Many parents with younger transgender children wish for their children to begin the transition process early, in order to avoid the inevitable changes that will occur during puberty. “It is common for children to resist the body changes of puberty. …However, for a child who is transgender, these changes can be a harbinger of depression, self-neglect, and self-destructive behaviors.” (Brill, 65) Parents of transgender children can delay the onset of puberty by administering GnRH inhibitors, or “blockers”, which “shut down the newly awakened adolescent hormonal surges and effectively stop a child’s pubertal development.” (Brill, 204-205) These puberty blockers have not been used for long in the US, but “the Dutch have had much success using them in this fashion.” (Brill, 205) It is also important to consider the permanent changes that will occur should a child be allowed to go through puberty without being on hormone blockers. “If you choose not to administer these medicines to delay puberty in your transgender child,” the authors of The Transgender Child say, you are dramatically increasing the likelihood of future surgeries for your child. This may be especially true for biological males, since the effects of testosterone on structural development are more permanent than those of estrogen.” (207)

After a child takes GnRH inhibitors through puberty, they may then consider the use of cross-hormones in order to visibly change the appearance of their bodies to be more in line with that of the gender they wish to present themselves as. If GnRH blockers have been used through puberty, no transgender surgeries except for genital reconstruction will be needed. “This is a compelling argument, in and of itself, for the use of puberty blockers.” (Brill, 220)

As stated in The Transgender Child, “No one knows how common transgender children are. Some gender specialists say that one in 500 children is significantly gender-variant or transgender. …Older studies, based only on statistics of postoperative transsexual men, say that the number is closer to 1 in 20,000.” (Brill, 2) No matter what the numbers are, these children should be accepted for who they are and the adults they will become, regardless of whether their gender and their biological sex are connected. As scientists study gender further, it is becoming more commonly accepted that gender is a spectrum. “Today, gender can no longer really be considered a two-option category. That form of thinking is outdated. It can be compared to trying to view the world in distinct racial categories without an understanding that an ever-growing percentage of the population is beautifully multi-ethnic.” (Brill, xiv) In order to understand and accept transgender people, we must also realize that no one is entirely one gender or the other, and all of these associations with gender are created by a society that also has the ability to change their meaning.


Brill, Stephanie and Rachel Pepper. The Transgender Child: A Handbook for Families and Professionals. San Francisco, California: Cleis Press, Inc., 2008.

Goldberg, Alan B. and Joneil Adriano. “’I’m a Girl’ – Understanding Transgender Children: Parents of a Transgender 6-Year-Old Girl Support Her Choice.” ABC News. April 27, 2007. ABC News Internet Ventures. April, 24, 2009. http://abcnews.go.com/2020/story?id=3088298

Israel, Gianna E., and Donald E. Tarver II, M.D. Transgender Care: Recommended Guidelines, Practical Information and Personal Accounts. Philadelphia: Temple University Press, 1997.

“Little Boy Lost.” Dr. Phil.com. 2009. Peteski Productions, Inc. April 24, 2009. http://www.drphil.com/slideshows/slideshow/4899/?id=4899&slide=2&showID=1201&preview=&versionID=

Roughgarden, Joan. Evolution’s Rainbow: Diversity, Gender, and Sexuality in Nature and People. Berkeley and Los Angeles, California: University of California Press, 2004.

Rudacille, Deborah. The Riddle of Gender: Science, Activism, and Transgender Rights. New York: Pantheon Books, 2005.

Spiegel, Alix. “Two Families Grapple with Sons’ Gender Preferences: Psychologists Take Radically Different Approaches in Therapy.” NPR. May 7, 2008. NPR. April 24, 2009. http://www.npr.org/templates/story/story.php?storyId=90247842

Kerri Zuiker – April, 2009.