What Would You Do? Helping Transgender Children

Gender can be a confusing issue for children, both before and during puberty. It's a significantly more complex issue when a child may be transgender. A clinic in Boston is hoping to help these children figure themselves out, though their experimental new approach is not without its critics.

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To Be Young and Transgender

As many as one in 1,000 children are born believing their biological sex doesn't match their true gender. While physically one gender, these children may behave, speak and dress as the opposite gender. A transgender boy, for example, may choose to wear dresses, play with dolls and engage in other traditionally feminine activities.

This behavior can have devastating effects. Transgender children are often relentlessly bullied at school. They may be made to feel ashamed and embarrassed. For some, that includes confusion or hostility from family members. It's no surprise that transgender youth are more likely than their peers to commit suicide.

A Progressive Approach

Since 2007, a clinic at Children's Hospital in Boston has attempted to help transgender children. Children as young as seven can seek treatment, which solves what had been a major problem with transgender treatment. Previously, most transgender individuals sought gender reassignment surgery as adults. Yet after puberty, the physical changes of the body are complete. That means that post-surgery transgender adults have difficulty being accepted as their new gender.

The clinic in Boston offers hormone treatment that delays the onset of puberty for pre-pubescent children. This delays the normal development of gender characterization until a later age. The goal of this delay is to allow the child to reach an age, which is typically around 16, when a decision can be made about surgery.

Controversy and Critics

Offering medical services to transgender children is controversial. Critics of the Boston clinic note that the hormones used on children to delay puberty have major consequences. For example, estrogen treatments heighten the risk for breast cancer later in life. Infertility may also be an inescapable result of the treatments. There are also more immediate side effects, including spasms and the discharge of bloody mucus from the nose.

Furthermore, critics note that diagnosing a child as transgender is not an exact science. Approximately four out of five children with gender confusion no longer consider themselves transgender as adults. Therefore, putting such a great deal of power in the hands of young children may be asking them to make too big of a decision about their lives too early.

Undeterred, the team behind the clinic in Boston is trying to further refine their practice. This begins with a rigorous initial screening and diagnostic process. Their goal is to identify those children who are not just confused, but are truly transgender. When they're successful, which they report occurs with the vast majority of their patients, they change lives for the better.

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