Abstract
In this study the clinical management of young boys (average age 6) who are gender identity disordered and who present with genital self injurious behavior is discussed. It is argued that the symptom of genital mutilation is often missed because it is not asked for in the clinical interview. A review of the literature, and case history material, suggests that the symptom of genital self injurious behavior is only found among children who are gender dysphoric. Young boys who experience severe gender dysphoria also have a serious affective disorder which must be addressed. In order to address the clinical emergency and to assist the families in getting the necessary treatment for their children specific recommendations for interventions are made.
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