Problems with binary gender discourse: Using context to promote flexibility and connection in gender identity

Abstract

Western society recognises male and female sex from physiological attributes, such as genitals and chromosomes. 'Gender' is the social and cultural expectation of how males and females should think, behave and how they should be treated by others (Diamond, 2002). Some children and adolescents experience distress, marginalization, and abuse associated with their gender identifications, preferences and behaviours, which are inconsistent with those expected of their biological sex. Often their families and society find gender non-conformity at best difficult, at worst offensive, distressing and intolerable. There is increasing focus on how mental health professionals work with difference in gender and sexual identity and recent publications highlight the shift from pathologizing transgender to a more 'identity-based' perspective, focussing more on the stigmatizing affects of the environment and the impact on the individual (Bockting, 2009). This article describes the challenges of binary gender discourse for young people and their wider contexts and considers how clinicians may more helpfully respond to avoid unhelpful binaries and so keep the young person in mind. The therapeutic aims of the UK Gender Identity Development Service (GIDS) for children and young people are considered and examples of our work provided.

Internalizing and Externalizing Behaviors in a Group of Young People with Gender Dysphoria

“…As described by Wiseman and Davidson (2011), the context someone finds themself in very much influences their identity and sense of self. When an individual experiences prejudice and is being marginalized by society, their sense of self can be damaged and difficult feelings about themselves can arise (Wiseman & Davidson, 2011).…”

Understanding the Experience of Parents of Pre-pubescent Children with Gender Identity Issues

“…Holding a position of uncertainty appeared too difficult for these parents, and binary positions appeared to offer more comfort. As Wiseman and Davidson (2011) suggest "a binary discourse of sex and gender provides concrete predictability where there may be a great deal of uncertainty and fluidity, both temporal and contextual" (p3).…”

The aging population: Imperative to uncouple sex and gender to establish “gender equal” health care

“…However, medical teaching has long reinforced the gender binary, labeling individuals with non-conforming gender identities and non-conforming physical anatomies as "abnormal" [1]. The same was formerly true about sexual preferences: the heterosexual-as-the norm and homosexual-as-abnormal were once what the medical community recognized with regard to sexual orientation.…”