GENDER DYSPHORIA
While patience, support and careful listening to the child are the best “medicine” for a child exploring gender, children who clearly describe a transgender identity may require more active care. Many transgender children experience gender dysphoria — defined by the World Professional Association for Transgender Health as “discomfort or distress that is caused by a discrepancy between a person’s gender identity and their sex assigned at birth,” including their physical sex characteristics and the associated gender role.14 Gender dysphoria ranges from manageable to debilitating, causing problems with school performance and social interactions. Symptoms can include anxiety, depression, self-harm and suicidality.15
Depending on the child’s age and signs of distress, “gender-affirmative” counseling or therapy can help manage gender dysphoria. However, in many cases, the remedy for dysphoria is gender transition: taking steps to affirm the gender that feels comfortable and authentic to the child. It is important to understand that, for children who have not reached puberty, gender transition involves no medical interventions at all: it consists of social changes like name, pronoun and gender expression.
While acceptance and affirmation at home can help a great deal, children do not grow up in a vacuum, so even children with supportive families may experience dysphoria. Nonetheless, families and doctors of transgender children often report that the gender transition process is transformative — even life-saving. Often, parents and clinicians describe remarkable improvements in the child’s psychological well-being.16