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Transgender youth: providing medical treatment for a misunderstood population.

Article Excerpt
IT IS ANOTHER ONE OF THOSE TIMES in the history of progressive health care. Time to embrace another group of individuals who deserve health care and yet have been marginalized up until this point. An underserved, unrecognized, and much deserving segment of the population. This time it is children--transgender children and teens.

Because of society's lack of awareness of a simple, yet complex part of human identity--gender--transgender children and teens are deeply misunderstood. This lack of understanding feeds family and societal rejection and stigmatization, which unfortunately too often leads to sexual and physical violence directed towards transgender children. A known, or recognizably transgender person is frequently a target for discrimination and violence. The shame and rejection felt by these children in turn leads to self-harming behaviors, increased drug use, homelessness, HIV/AIDS infection, depression, and suicide. One-third (33.2%) of transgender youth have attempted suicide. (1)

Although it is unknown how many children and teens are truly transgender, medical professionals and others who care for children are finally paying attention to this minority group. Doctors in the United States, the Netherlands, the United Kingdom and elsewhere in Europe now agree that early treatment of transgender children can change--and even save--lives. In order to understand what kinds of treatments are needed for transgender children and youth, it is important to understand what a transgender child is, what treatments are available, and how these treatments can help.

WHAT IS TRANSGENDER?

Transgender people have existed throughout all times and in all cultures. Being transgender is not a mental illness but is, rather, a normal variation of human development. There is nothing wrong with transgender children--the problem lies with the way we understand gender.

Common understanding of gender is based on the premises that there are two genders, and that gender and biological anatomy are synonymous. Each of these premises is incorrect. In fact, a minority of the population experience themselves as either a blend of genders or no gender at all. For most people, gender is static. For some, however, it is fluid or changes over time. Likewise, one's biological anatomy determines one's biological sex. One's internal sense of gender, however, is not determined by biological anatomy but is a different spectra of formative identity altogether. Taken together, biological sex and gender identity create a person's sense of "self". Because it is most common for biological sex and gender identity to align in a predictable pattern, the two separate aspects of "self" have become conflated. In order to understand and serve transgender people, however, it is essential to recognize and distinguish these separate parts of self.

In other words, although it is most common that people with female anatomy identity as girls, a small percentage do not. Of those who do not feel they are girls, some identify as a blend of genders, some as neither gender, and some identity as boys. A female-bodied person who identifies consistently and persistently over time as a boy is a transgender boy. Likewise, although most male-bodied people identify as boys, a small percentage...

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