Gender Dysphoria in Children
Gender dysphoria is described as the distress resulting from the mismatch between oneâ€s gender identity and the sex they were assigned at birth. The DSM 5 lists eight criteria for gender dysphoria in children. A child shows a strong desire to be the other gender, a strong preference for wearing clothes typical of the other gender, cross-gender roles, toys and play stereotypically engaged in by the opposite gender, and playmates of the other gender (Ristori & Steensma, 2016). Other criteria include a strong dislike and rejection of activities and games typical of the gender assigned at birth and oneâ€s sexual anatomy as well as a strong desire for the physical sexual characteristics that match a childâ€s gender identity (Bertolotto et al., 2015). Furthermore, the DSM 5 states that a child has to meet at least six of these criteria and that they must result in clinically significant distress or significant impairment of the childâ€s functioning in school, society, and other important areas of function.
Tonyâ€s symptoms show that he is experiencing gender dysphoria. The most appropriate approach to take is gender affirming treatment. Gender affirming care is a multidisciplinary approach to health intervention that involves various dimensions of mental, psychological, physical, and social health. One of the primary symptoms of gender dysphoria is significant amounts of distress that impairs the childâ€s ability to function at home, school, and in social situations (Hahn et al., 2019). To alleviate this distress, psychosocial interventions can be used to help the child and their caregivers and families to acclimatize to their gender identity (Kyriakou et al., 2020). Since Tony is not yet into adolescence, puberty blocking hormones can be delayed until he enters puberty. Thus, in the short term, the goal should be lessen Tonyâ€s distress, an objective to which gender affirming care is uniquely suited (Bonifacio et al., 2019). In the long term, as Tony enters puberty, a physical component will be added to the multidisciplinary team to address the issue of puberty blockers to give him more time to explore his options.
Bertolotto, M., Liguori, G., & Trombetta, C. (Eds.). (2015). Management of gender dysphoria: A multidisciplinary approach (1st ed. 2015). Springer Milanâ€¯: Imprint: Springer.
Bonifacio, J. H., Maser, C., Stadelman, K., & Palmert, M. (2019). Management of gender dysphoria in adolescents in primary care. Canadian Medical Association Journal, 191(3), E69â€“E75. https://doi.org/10.1503/cmaj.180672
Hahn, M., Sheran, N., Weber, S., Cohan, D., & Obedin-Maliver, J. (2019). Providing patient-centered perinatal care for transgender men and gender-diverse individuals: A collaborative multidisciplinary team approach. Obstetrics & Gynecology, 134(5), 959â€“963. https://doi.org/10.1097/AOG.0000000000003506
Kyriakou, A., Nicolaides, N. C., & Skordis, N. (2020). Current approach to the clinical care of adolescents with gender dysphoria. Acta Bio Medica Atenei Parmensis, 91(1), 165â€“175. https://doi.org/10.23750/abm.v91i1.9244
Ristori, J., & Steensma, T. D. (2016). Gender dysphoria in childhood. International Review of Psychiatry, 28(1), 13â€“20. https://doi.org/10.3109/09540261.2015.1115754
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Gender Dysphoria in Children