Chicago — A small but growing number of teens and even younger children who think they were born the wrong sex are getting support from parents and from doctors who give them sex-changing treatments, according to reports in the medical journal Pediatrics.
It’s an issue that raises ethical questions, and some experts urge caution in treating children with puberty-blocking drugs and hormones.
An 8-year-old second-grader in Los Angeles is a typical patient. Born a girl, the child announced at 18 months, “I a boy” and has stuck with that belief. The family was shocked but now refers to the child as a boy and is watching for the first signs of puberty to begin treatment, his mother told The Associated Press.
Pediatricians need to know these kids exist and deserve treatment, said Dr. Norman Spack, author of one of three reports published today and director of one of the nation’s first gender identity medical clinics, at Children’s Hospital Boston.
“If you open the doors, these are the kids who come. They’re out there. They’re in your practices,” Spack said in an interview.
Switching gender roles and occasionally pretending to be the opposite sex is common in young children. But these kids are different. They feel certain they were born with the wrong bodies.
Some are labeled with “gender identity disorder,” a psychiatric diagnosis. But Spack is among doctors who think that’s a misnomer. Emerging research suggests they may have brain differences more similar to the opposite sex.
Spack said by some estimates, 1 in 10,000 children have the condition.
Offering sex-changing treatment to kids younger than 18 raises ethical concerns, and their parents’ motives need to be closely examined, said Dr. Margaret Moon, a member of the American Academy of Pediatrics’ bioethics committee. She was not involved in any of the reports.
Some kids may get a psychiatric diagnosis when they are just hugely uncomfortable with narrowly defined gender roles; or some may be gay and are coerced into treatment by parents more comfortable with a sex change than having a homosexual child, said Moon, who teaches at the Johns Hopkins Berman Institute of Bioethics.
It’s harmful “to have an irreversible treatment too early,” Moon said.
Doctors who provide the treatment say withholding it would be more harmful.
These children sometimes resort to self-mutilation to try to change their anatomy; the other two journal reports note that some face verbal and physical abuse and are prone to stress, depression and suicide attempts. Spack said those problems typically disappear in kids who’ve had treatment and are allowed to live as the opposite sex.
Comments
Ragingbear 1 year, 3 months ago
Gotta love how you get one or two cases and these editors try and make it look like there are hundreds of thousands like this. Gender re-assignment is a long, drawn out process requiring therapy and time. Usually no less than a year, but usually more than two.
webmocker 1 year, 3 months ago
Ragingbear (anonymous) says… Gotta love how you get one or two cases and these editors try and make it look like there are hundreds of thousands like this.
"Spack said by some estimates, 1 in 10,000 children have the condition."
Ragingbear 1 year, 2 months ago
Estimate: See "Wild guess" in most cases.
number3of5 1 year, 3 months ago
Just a bunch of rubbish. Some doctor wants to get rich exploiting childhood fantasies. I know, I wished that I had been born a boy until I was 11 years old. Now I am so happy that I am a woman, married for 51+ years with 5 children, 12 grandchildren and 15 greatgrands with another on the way........
Paul R. Getto 1 year, 3 months ago
3or5: Wouldn't call it rubbish (see below.) This is something we share with all our mammalian brothers, sisters and cousins and is nothing to dismiss. I am glad you had no 'fantasies' while young. For those in this condition, it can be a nightmare for the child and the family. Listen and learn: http://www.isna.org/faq/frequency Below we provide a summary of statistics drawn from an article by Brown University researcher Anne Fausto-Sterling.2 The basis for that article was an extensive review of the medical literature from 1955 to 1998 aimed at producing numeric estimates for the frequency of sex variations. Note that the frequency of some of these conditions, such as congenital adrenal hyperplasia, differs for different populations. These statistics are approximations.
Not XX and not XY one in 1,666 births Klinefelter (XXY) one in 1,000 births Androgen insensitivity syndrome one in 13,000 births Partial androgen insensitivity syndrome one in 130,000 births Classical congenital adrenal hyperplasia one in 13,000 births Late onset adrenal hyperplasia one in 66 individuals Vaginal agenesis one in 6,000 births Ovotestes one in 83,000 births Idiopathic (no discernable medical cause) one in 110,000 births Iatrogenic (caused by medical treatment, for instance progestin administered to pregnant mother) no estimate 5 alpha reductase deficiency no estimate Mixed gonadal dysgenesis no estimate Complete gonadal dysgenesis one in 150,000 births Hypospadias (urethral opening in perineum or along penile shaft) one in 2,000 births Hypospadias (urethral opening between corona and tip of glans penis) one in 770 births
Total number of people whose bodies differ from standard male or female one in 100 births Total number of people receiving surgery to “normalize” genital appearance one or two in 1,000 births
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