Gender dysphoria, how to recognise it in children

What is gender identity? Gender dysphoria is a very specific condition: «It refers to a strong sense of discomfort regarding one’s gender assigned at birth». Hence, Dr. Damiana Massara, psychologist and psychotherapist at the ASL To5 shared some of her vast knowledge and experience on the subject, especially how gender dysphoria manifests in children. Massara, who began her career in the 80s at the Sexology Clinic of the Mauriziano Hospital in Turin, she founded, along with other colleagues, the National Observatory of Gender Identity, an association that brings together people and professionals within the sphere of gender identity.

Gender dysphoria in children

This discomfort, in children, manifests itself through specific behaviours and requests, like wanting to wear clothes tipically used by the opposite gender or clearly stating their conviction they would change physically once they’re older. The doctor underlines how it’s not simple changes in behaviour that can lead to this diagnosis, however, it’s a permanent and central aspect of a child’s identity.

According to Massara, «When discussin gender dysphoria in children, we’re looking for clear-cut signs». It’s important to not confuse these manifestations with temporary variations of gender stereotypes. Gender dysphoria is a matter of identity and not a simple preference towards activities of clothing tipically associated with the other gender.

The crucial role parents play

Children with gender dysphoria itself. Reactions from parents, teachers and society can significantly impact the child’s wellbeing. «The problem with gender dysphoria is how these people are treated». Massara emphasised the importance of the family’s support: «Parents play a crucial role in communicating to children that they are accepted». 

The psychotherapist underscores how gender is a complex construct, tied to psycho-bio-social factors, and in no way can be influenced by education or parental expectations. «Parents cannot influence a child’s identity, the perception and construction of our identities is a complex process». 

Social impact and support

Dr. Massara also discussed the importance of a positive social environment, in order to prevent psychological discomfort in children with gender dysphoria. «Being able to express oneself without being stigmatised, without judgement, in a safe environment makes these kids stronger». 

The doctor highlighted how the fact some members of society are still having trouble accepting people with gender dysphoria can have dire consequences, leading often to suicide attempts or other self-harming behaviour.

If the child’s experiences and identity can be integrated within the family, there is no need to turn to a specialist. In the case this isn’t possible or there are some difficulties, then specialists can help: «Specialists can tell when a child is suffering, they can help with the transition from a social point of view, afterwards, as puberty approaches, they can start to consider whether or not to use hormone blockers».

The evolution of “gender”

According to Doctor Massara, the concept of gender is changing within our society. «If a man chooses today to wear an earring, nobody bats an eye, things would have been much different in my dad’s time». However, there is still much to be done, especially among adults who have a harder time accepting this new perspective. The Doctor expresses admiration for the new generations who are revolutionising the concept of gender identity: «I am convinced that gender is fluid, non-binary, and individualised. This is the revolution young people are bringing to the world».