When Aidan Key was a little girl, he didn’t realize he had gender identity issues. He simply knew something was off.
“I didn’t necessarily become aware that I was trapped in the wrong body,” says the 49-year-old Bellingham, Wash., native who had gender reassignment surgery at the age of 33. “I became aware that people didn’t perceive me as I felt myself to be. It was just odd to me to have to wear a dress the first day of kindergarten. It didn’t make sense.”
Today, Key might have received counseling — and perhaps even puberty blocking drugs — at one of a handful of U.S. clinics designed to help adolescents with what’s now called gender identity disorder or GID. The psychological diagnosis is used to describe a male or female who feels a strong identification with the opposite sex and experiences considerable distress because of their actual sex (the word “disorder” refers to the distress the person feels, not the fact that they identify with another gender).
According to reports published Monday in the medical journal Pediatrics, a small but growing number of teens and even younger children who think they were born the wrong sex are now getting support from parents and from doctors who give them treatments that could eventually help them change their sex.
Some estimates say about 1 in 10,000 children may have GID, Dr. Norman Spack, author of one of three reports published Monday and director of one of the nation’s first gender identity medical clinics, at Children’s Hospital Boston told the Associated Press. And that number does appear to be on the rise, experts say.
The number of people treated at Spack’s Gender Management Service clinic, also known as GeMS, which was the focus of a study, increased fourfold between January 1998 and February 2010. The clinic now averages about 19 patients each year, compared with about four per year treated for gender issues at the hospital in the late 1990s.
While many children can take part in nonconforming gender activities without issue — little boys playing princess, for instance — those with GID can experience a host of psychological problems, especially with the onset of puberty.
“It’s devastating to them,” says Dr. Scott Leibowitz, a child and adolescent psychiatrist at GeMS clinic in Boston.
Those who don’t get support in the form of counseling or medical treatment can be at high risk for behavior and emotional problems, the study found. Of the 97 patients younger than 21 years old in the study who met the criteria for GID, 44.3 percent had a history of significant psychiatric problems, including 20.6 percent who reported self-mutilation and 9.3 percent who attempted suicide. The youngest in the study was age 4.
Laura Edwards-Leeper, a psychologist specializing in youth gender issues at Seattle’s Children’s Hospital and co-author of the Pediatrics study, says at her hospital, “more and more people are banging down the doors to get in. I’m guessing in part this is due to media attention and people becoming a bit more accepting about it. Parents are becoming more open to the possibility and willing to get help for their kids.”
Unfortunately, some parents who seek help for their child through traditional channels – such as the family pediatrician – can come away feeling judged.
“I’ve heard many, many stories of adults and families being turned away with a stern lecture about their parenting or their choices,” says Key, director of Gender Diversity, an education, support and training organization committed to increasing awareness about gender variations. “It can often be viewed as a moral issue.”
Support from parents doesn’t always exist either, says Key. ”The response varies so much,” he says. “Some parents will tell the kids ‘No, you’re really a boy. No, those are girl toys. You don’t want that.’ They try to get the child not to engage in these activities because they know it’s not accepted by society, they know the child will be teased. I try to think they have the best intentions.”
Sometimes, the response of parents — or others — can be quite damaging. A related study of childhood abuse in the current issue of Pediatrics found gender nonconformity before age 11 was a risk indicator for physical, sexual, and psychological abuse in childhood as well as probable PTSD.
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By Diane Mapes