January 20, 2017
Caring for transgender youth
Dr. Joey Bonifacio is Staff Paediatrician and Clinical Lead of the Transgender Youth Clinic at SickKids and Assistant Professor in the Department of Paediatrics at the University of Toronto.
The BBC documentary, Transgender Kids: Who Knows Best? has resulted in more controversy regarding gender dysphoria in children and adolescents. Our culture, most likely stemming from the media’ presentation of this topic, has forced us into two camps— those that oppose children identifying as transgender and those that do not. My belief, however, is the use of this perspective is the true disservice to these children and youth.
Many people will look for statistics and point out that youth may “desist” and return to their assigned gender later on in life. They are correct. From the few studies we have, this is likely the majority when it comes to younger children. But others will use the same studies and point out that many “persist” and say we have to make sure to protect these vulnerable youth. They are equally correct too. But when we fail to recognize both perspectives and use problematic analogies then we are at a standstill and these children and adolescents do not receive the care and help they need.
Those that question transitioning may also point out other reasons for a child having gender dysphoria. They may highlight associations between gender dysphoria and other conditions such as autism. Are there higher rates of autism spectrum disorder in those who have gender dysphoria compared to those without gender dysphoria? The few studies that have investigated this association do suggest this and I have seen many children and teens with both autism and gender dysphoria. But does having autism spectrum disorder negate one being transgender? Of course not. But it does add another layer to how the child and we understand this young person’s identity and figure out what is the best way to help both the child and their family.
We have to remember that decisions such as this are always done in a thoughtful manner and involves informing the youth and family of the different trajectories that may take place regarding the child’s gender. Regardless of one’s perspective, however, the ultimate goal is the same: a happy and healthy child of sound body and mind.