Gender Identity Disorder: An Emerging Problem for Pediatricians

Abstract

* Abbreviations: GID — : gender identity disorder PTSD — : posttraumatic stress disorder A new pediatric problem is in town. In this issue of Pediatrics there are 2 articles1,2 concerning gender identity disorder (GID). There has been an explosion of public interest in recent years and concern about children who show an interest in changing their gender. This, of course, brings more inquiries to the pediatrician about what to do. Cross-gender behavior in children has been known for many years. Even in the Child Behavior Check List3 developed by Achenbach in the 1970s there are 2 gender questions for parents to complete. Mothers reported that 2% to 4% of boys and 5% to 10% of girls of a nonclinical sample between the ages of 4 and 18 behaved as the opposite gender from time to time. Less frequently, these mothers reported that their children wished to be the opposite gender. Using the Youth Self Report,4 5% to 13% of teenage boys and 20% to 26% of teenage girls of a nonclinical sample reported cross-gender behavior. Two percent to 5% of boys and 15% to 16% of girls reported sometimes desiring to be the opposite gender. In spite of this relatively high rate of cross-gender behavior, very few patients have presented for evaluation and treatment even in countries such as the Netherlands where there is a well-established formal program for treatment.5 The prevalence there is of the order of 0.01% (1 in 10 000–30 000). Therefore, a lot of children seem to be experimenting with cross-gender behavior, but very few … Address correspondence to Walter J. Meyer III, MD, Department of Psychiatry and Behavior Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0193. E-mail: wmeyer{at}utmb.edu