Teenagers

If the feelings of gender dysphoria are still present by the time your child is a teenager or young adult, it is likely that they are not simply going through a phase or a stage of development.

If you are a teenager whose feelings of gender dysphoria started in childhood, you may now have a much clearer sense of your gender identity and the way you want to deal with it.

The ways that gender dysphoria affects teenagers is different to the way that it affects children.  If you are a teenager or adult with gender dysphoria, you may feel:

• without doubt that your gender identity is at odds with your biological sex
• comfortable only when in the gender role of your preferred gender identity
• a strong desire to hide or be rid of the physical signs of your sex, such as breasts, body hair and muscle definition
• a strong dislike for and a strong desire to change or be rid of the genitalia of your biological sex

These feelings can often be very difficult to deal with and, as a result, many individuals with gender dysphoria may experience depression or suicidal feelings.  If you feel this way, do see your GP as soon as possible.  They will be able to provide help and support.

PUBERTY

For young people who feel strong and persistent discomfort about their gender, puberty is often a very difficult time.  The physical changes that occur at puberty can increase feelings of unhappiness about their body or their gender.

If a child is strongly identifying with the opposite gender, it’s best to get help before puberty begins, and if the feelings of gender discomfort persist to the extent that your son or daughter wants to live full-time in the opposite gender, careful preparation needs to be made with the school and any clubs or groups that your child attends.

WHAT CAN I DO TO HELP?

As a parent you may feel worried or uncomfortable, but this is not unusual and you are not alone.  Gender identity is no-one’s fault, but young people can worry about telling you how they feel, or worry that your love for them will change.  Continue to reassure your them that you love them, and that nothing will change that.  However you may feel regarding the non-conforming behaviour, be relaxed about it and do not make an issue of it.  This will help them by not making him/her feel judged or rejected when they are, after all, just being who they are.

It is however, important to seek help if the young person/teenager identifies very strongly with the opposite gender, especially if it is to the point where it’s causing distress to the individual and family.

Signs of distress in a young person or teenager can include self-harm, destructive behaviour and depression, which is why early help is always advisable.

The route to help and advice will vary from family to family, and individual to individual.  To begin with, see a GP if you think you/your teenage child have gender dysphoria.   Select a GP with whom you will feel most comfortable.  The next step is usually a referral to CAMHS (the Child and Adolescent Mental Health Service), where psychological help will be offered to your child. This may involve working with the whole family, and sometimes with schools as well.  CAMHS is for under 18’s only, and if, after assessment, they deem it appropriate, your son/daughter could then be referred to the Regional Service for Gender Variant Children and Transgender Adolescents.  This service is part of the CAMHS within the Belfast Health and Social Care Trust and can only be accessed by referral from the generic CAMHS Teams in the various Trusts.

There are strict criteria for diagnosing gender dysphoria, which differ for children and adults.  Due to the fact that gender dysphoria is so complex, specialists tend to make a diagnosis based on each individual, rather than just on the criteria.

The traditional criteria for diagnosing gender dysphoria in teenagers and young adults are described below.

CRITERIA FOR TEENAGERS AND YOUNG ADULTS

To be diagnosed with gender dysphoria, a teenager should:

• feel persistently and strongly that they are the wrong sex and feel a strong identification with the opposite sex
• feel discomfort in their sex and its gender role and strongly dislike and wish to be rid of the physical characteristics of their sex, such as breasts, facial and body hair and genitalia
• not have a condition that causes them to display physical attributes of the opposite sex (although this is being increasingly questioned)
• experience long-term anxiety, distress and impairment in social and occupational areas of life due to their condition

ASSESSMENT

As well as these criteria, a diagnosis of gender dysphoria will depend on a full and highly personalised assessment of your teenager’s gender identity and preferred gender role.

Your specialist will assess their gender development in earlier childhood and puberty. They will also carry out psychological assessments to assess the level of cross-gender identification.

Counselling should also be offered, as well as details of support groups to help you cope with the condition.