Children who are persistently uncomfortable with their gender who display strong and consistent cross-gender behaviors may be experiencing a gender identity disorder (GID). According to the study, "Characteristics of Children and Adolescents with Gender Identity Disorder Referred to a Pediatric Medical Center," in the March 2012 Pediatrics (published online Feb. 20), gender-dysphoric children who do not receive medical treatment or counseling for GID can be at high-risk for certain behavioral and emotional problems, including psychiatric diagnoses. Of 97 patients younger than 21 years who met the criteria for GID, 44 percent had a prior history of psychiatric symptoms, 37 percent were taking psychotropic medications, and 21.6 percent had a history of self-mutilation and suicide attempts.
Study authors advocate for early evaluation of children exhibiting GID, but treatment with medications should not be started until they reach puberty. Pediatricians and parents should consult with experienced mental health professionals for children and adolescents experiencing gender-related issues. When patients are sufficiently physically mature to receive medical treatment, they should be referred to a medical specialist or program treating GID.
Editor's note: A related study, "Childhood Gender Nonconformity: A Risk Indicator for Childhood Abuse and Posttraumatic Stress in Youth," and commentary, "Gender Identity Disorder: An Emerging Problem for Pediatricians," will also appear in the March 2012 issue of Pediatrics.
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. (www.aap.org)