For years, there's been debate about whether transgenderism has a medical explanation. Could something be causing it?
Dr. Jill Jacobson, a pediatric endocrinologist at Children's Mercy, currently has 36 transgender children in her care. She's done clinical research showing increased androgens could be a factor for female to male trans children (female to male means they have a female body but identify and feel like they are a boy).
"We started measuring androgen levels in the patients themselves and we're finding high androgen levels in 73 percent of them," said Jacobson.
Androgens are any substance, like testosterone or androsterone, which promotes male characteristics. She says of the kids she's studied, 56 percent have elevated levels of testosterone specifically. The number of people being diagnosed with gender dysphoria is increasing by at least 15 percent yearly, said Jacobson.
Gender dysphoria is now considered an endocrine condition, she said.
"When we are able to explain that to families, it's sometimes helpful to them to understand how the child is feeling," Jacobson explained. "And helpful to them to explain to other family members -- who might not be as accepting -- that there might actually be a biological basis for some of these feelings."
Jacobson said they have not found any increased levels of hormones in male to female patients.
She said this is all fairly new territory because the Endocrine Society only recently came out with guidelines for using puberty blockers. Once the diagnosis is established, hormonal therapies are considered.
She said they are starting a Multidisciplinary Clinic in September called Gender Pathway Services (GPS) for the 2nd Thursday of every month. There will be more information released at a later date.
Commonly used terminology
Twenty years ago, a person struggling with gender dysphoria had very few resources. Google didn't exist and few talked about it.
But it was about that long ago that Caroline Gibbs met a group of transgender people who were on a mission to educate counselors.
She listened; ended up becoming friends with some of the people she met, and has made it her life's mission to help people with transgenderism.
Gibbs founded The Transgender Institute in Kansas City. She is a counselor specializing in help with gender identity and transition assistance.
Gibbs explains some terminology within the transgender community:
- FTM (female to male)
"If we have a female bodied person whose gender identity - that is the sense inside and the situation chemically and genetically in the brain - is saying to them that they are not that gender. That gender identity is their real gender. So if we have sombody who is female-bodied with the gender identity of male, then that's an F for female, T for to, Male. So FTM and we call that person also a transman," said Gibbs.
- MTF (male to female)
"If we go from the other direction. A male-bodied person who identifies as a woman inside, then again, it's M for male, t for to, then F for female..."
Gibbs gives these notes to help people understand transgenderism in children.
- Stages of Gender Variance: Age-specific milestones for gender development
1-1/2 to 3 years old
- Clothes and toys have gender
- Look for same-sex models on how to act when (GI) gender identity (internal) is established
- TG ID is very clear
3 to 4 years old
- Keen sense of gender GI
- Aware of anatomical differences
- Established gender roles - what boys and girls, men and women do
- Gender segregation starts
- Use language to express differences: "I am a boy" "I will grow up to be a girl"
4 to 6 years old
- Use gender scripts -- gender associated with specific behaviors (i.e. makeup for girls, trucks for boys)
- Gender variance clearly emerges
- Wants clothes of other gender
- Becomes apparent not a stage
5 to 7 years old
- Gender stability -- gender won't change. Fixed for life
- If forced to limit expression - suicidal ideation, mutilation, behavioral problems, especially at school
9 to 12 years old (puberty)
- GI continues to stabilize
- Pubertal changes begin -- gender Dysphoria emerges more strongly
- Family recognizes Gender Variance
- Depression, self-neglect, self-destructive
- Therapy can be very useful
12 to 18 years old
- Third most common time for emergence
- Realize going through "wrong puberty"
- Social withdrawal, depression
- Urgency of communication of gender id