The Associated Press (AP) is reporting that in one of three reports published today in the medical journal Pediatrics, Dr. Norman Spack of Children's Hospital of Boston, said doctors are seeing more and more children who believe they are born the wrong sex and who want help to change gender.
Spack's report claims a fourfold increase in the number of patients at his Gender Management Service clinic at Boston Hospital. His clinic, which opened in 2007, sees about 19 patients per year compared with only four per year treated for gender issues at the hospital since the late 1990s.
"If you open the doors, these are the kids who come. They're out there. They're in your practices," Spack said in an interview.
Even though occasionally pretending to be the opposite sex in young children is quite common, the children Spack treats are different in that they feel certain they were born with the wrong bodies. Some of these cases are given a psychiatric diagnosis of "gender identity disorder" (GID) but Spack questions that label. He claims emerging research shows that some of these people may have brain differences more similar to the opposite sex.
He also said that some estimates for the number of children who suffer with this condition could be as high as 1 in 10,000.
However, offering sex-changing treatment to children younger than 18 raises ethical concerns, and their parents' motives need to be closely examined, said Dr. Margaret Moon, a member of the American Academy of Pediatrics' bioethics committee. Some may just be uncomfortable with gender roles or some could be gay and are being coerced into treatment by their parents.
Whatever the case, it's harmful "to have an irreversible treatment too early," Moon said.
Transgender hormone treatments involve the use of monthly $1,000 injections of puberty-blocking drugs at the onset of puberty that will enable boys switching to girls to develop breasts and girls transitioning to boys to remain flat-chested. Because sex hormones in high doses have serious side affects such as blood clots and cancer when taken long term, sex change patients will require monitoring for the rest of their lives.
One of the reasons treatment is delayed until puberty is to give the child a chance to grow out of their longing to be the opposite sex; however, some doctors say withholding treatment could also be harmful because these children often resort to self-mutilation to try to change their anatomy.
This was the case with a now five year-old boy in the UK who became obsessed with the TV character Dora the Explorer and started dressing in girls' clothing. Little Zach Avery was only three at the time and thereafter refused to dress as a boy, going so far as trying to cut off his penis.
His parents took him to doctors and, after numerous consultations and observations, diagnosed him with GID, making him one of the youngest children in the UK to receive the diagnosis. Although he will not be able to get hormone treatment until puberty sets in, he's now wearing girls clothes and his primary school has even changed the childrens' toilets to gender-neutral in order to accommodate Zach.
Reports in the UK have revealed that the number of GID patients is growing in that country as well. One clinic reported that they had 97 referrals in 2010, 139 in 2011, and 165 thus far in 2012.
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