The Gender Affirmative Model: What We Know and What We Aim to Learn

Beyond Discrete Categories: Studying Multiracial, Intersex, and Transgender Children Will Strengthen Basic Developmental Science

“…Turning to gender, until 2013 (3 years ago, as of this writing), transgender children were considered to have "gender identity disorder" and thus would have been included in the pathological sense of "atypical" according to common practice in both developmental psychology and psychiatry. Even now, although the diagnostic label "gender dysphoria" no longer carries the charged term "disorder," it still appears in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition and is still deemed by many in psychology and beyond to necessitate therapy to remove or reverse it (e.g., McHugh, 2014;Zucker, Wood, Singh, & Bradley, 2012), though this view too may be falling out of favor (Hidalgo et al, 2013).…”

“…We cautiously suggest that the answer is "yes." Most notably, several pediatricians and psychologists working in gender clinics have specifically stated a desire to know more about basic development among gender-diverse youth and a desire to collaborate more with researchers of basic gender development (e.g., Hidalgo et al, 2013). We focus here on two examples of how more knowledge about basic development in gender-diverse youth could influence clinical practice.…”

“…On the one hand, if these children will desist in their behaviors and identities anyway, some argue, why not try to make that behavior desist earlier (e.g., Meyer-Bahlburg, 2002) and therefore reduce anxiety and/or peer maltreatment that results from the gender nonconformity (Wilson, Griffin, & Wren, 2005)? On the other hand, if a gender-nonconforming child is highly likely to be a transgender adult, one might suggest providing familial (Hidalgo et al, 2013) and medical (de Vries, Steensma, Doreleijers, & Cohen-Kettenis, 2011) support, especially given that both have been linked to better mental health among transgender adults (e.g., de Vries et al, 2011;Hill, Menvielle, Sica, & Johnson, 2010;Olson, Durwood, DeMeules, & McLaughlin, 2016). Thus, increasing the ability to identify which children will (or will not) identify as transgender adults is of utmost importance.…”

Psychological and Medical Care of Gender Nonconforming Youth

“…16 Many children in this latter group explore gender at its margins in a developmental progression toward their later gay identity, at which point the gender nonconformity may dissipate or disappear. 8 For another group, the gender exploration or gender-related stress may emerge in adolescence, often with the onset of puberty as the trigger. 17 Thus, there is no consistent developmental trajectory, and it may be erroneous to mislabel any of these developmental progressions as "just a phase" when it is possible that they are not.…”

“…3 In recent years, an increasing number of multidisciplinary clinics have emerged in the United States that are dedicated to providing care to this population. [4][5][6][7][8] A challenge to all of these programs is that even with published clinical guidelines and standards of care, management of GN youth remains controversial, with a key factor being that these documents are based primarily on expert opinion rather than scientific data, given the paucity of outcomes data on the effects of mental health and medical interventions. An increasing number of GN youth are presenting for gendersensitive health services.…”