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My body is wrong'Should teenagers who believe they are transgender be helped to change sex? And if so, what about the four-year-olds who feel the same way? Viv Groskop meets the parents and doctors in favour of interventionViv GroskopThursday 14 August 200800.01BSTView more sharing optionsShares2'She was our first child," recalls Sarah (not her real name), a mother of two who lives in the south of England. "But from age three we knew something was wrong. She was very introverted, isolated. When she started school at four she came home and said she was a freak. It seemed a strange word for a four-year-old to use. She was always quite a sad little person."Sarah's daughter was born and grew up as a boy. Now 19, she is far happier in a woman's body as a post-operative transsexual. It took two years for the family to get used to calling her "she". Her mother says her daughter experienced her childhood as mental torture, especially during puberty. "Looking back, we could never find any tape in the house. It was because she was taping her genitals up every day. She said to us later that she thought it wouldall go right for her at puberty, that her willy would drop off and shewould grow breasts. She said she was going completely crazy because she knew in her head that she was a girl."One day, when her daughter was 14, Sarah walked in on her in her bedroom. "She was there in front of the mirror with her genitals tucked away. She was very embarrassed. I said, 'I don't know what's happening here but if you want to talk to me, you can.'
About 10 minutes later she came and lay on the bed next to me andsaid, 'I want to be a girl. I'm not a boy. My body is wrong. Everything is wrong.'" For Sarah, this was more than shocking: "I had watched programmes on transgender, I'm very interested in people, it's part of who I am to find out about these things ... But you never imagine it's going to happen to you."Sarah sought help from her GP - who laughed. Eventually, her daughter got a referral to the one London clinic that deals with gender identity disorder in children and adolescents. But obtaining treatment on the NHS in her daughter's mid-teens was slow and difficult. Several suicide attempts followed and the family remortgaged their house to pay for private hormone treatment. Once Sarah's daughter was 18, they also paid for an operation abroad.AdvertisementThe plight of children with gender identity disorder has made headlines this year. In February an inquest was held into the death of Cameron McWilliams, a 10-year-old boy from Doncaster, who hanged himself. The court heard that he had asked permission to wear makeup and girls' underwear. "It was apparent he was unhappy and said he wanted to be a girl," his mother said. "He did like girls' things." Later the same month Lawrence King, 15, from Oxnard, California, who described himself as "gender non-conforming" and was a victim of school bullying, was shot to death in a science laboratory by another pupil.Internationally, there is controversy over medical treatments that could be used to help children in this situation. In May, Dr Norman Spack, the US's leading authority on "gender-confused" children and a paediatric endocrinologist at the Children's Hospital in Boston, revealed on US National Public Radio that he has at least 10 paediatric transgendered patients who are receiving puberty-blocking hormone treatment. He says that the procedures allow children to buy time to make a decision about gender reassignmentsurgery. Once they have gone through puberty - and fully developed the body of the gender they don't want - it is much more difficult.
Awareness of transgender children is growing. Earlier this year a book called TheTransgenderChild: A Handbook for Families and Professionals (Cleis Press) was published. "Thousands of families face raising children who step outside the pink or blue box," says the blurb.But their stories rarely cross into the mainstream because families don't want their children to be identified. Even adult transsexuals risk ridicule (and sometimes physical abuse) when talking about their past. The Oprah Winfrey Show first featured an 11-year-old girl who wanted surgery to become a boy in 2004. Last year, a very cute six-year-old girl, Jazz, appeared on the Barbara Walters show in the US. She had been born as a boy but she identified so stronglyas a girl that her parents decided to let her be who she wanted to be. She and her parents appeared on television under assumed names. "We'll say things like, 'You're special. God made you special.' Because there aren't very many little girls out there that have a penis," said her mother Renee. They were comfortable with identifying their child as transgender.AdvertisementGenderissues can appear as young as four (although the parents ofthe aforementioned Jazz insist that their son made it clear he wanted to wear a dress from the age of 18 months). "It usually becomes more evident when they go to school," says Simona Giordano, a senior lecturer in ethics and psychiatry at the University of Manchester who is conducting an international study into gender identity in children. "There have been reported cases ofkids who won't drink for the duration of the school day so that they don't have to go to the toilet, and who don't want to sleep in a bedroom with their peers."In Britain, there is only one place where children who feel this way can be treated: the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust in London, run by DrDomenico di Ceglie, author of a 1998 ground-breaking study on transgender children, A Stranger in My Own Body: Atypical GenderIdentity Development and MentalHealth(Carnac). He became aware of the needs of the children with gender-identity issues whenworking as a child psychiatrist in Croydon in the 1980s. His
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