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My body is wrong'Should teenagers who believe they are transgender be helped to changesex? And if so, what about the four-year-olds who feel the same way? VivGroskop 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), amother of two who lives in the south of England. "But from agethree we knew something was wrong. She was very introverted,isolated. When she started school at four she came home and saidshe was a freak. It seemed a strange word for a four-year-old touse. She was always quite a sad little person."Sarah's daughter was born and grew up as a boy. Now 19, she isfar happier in a woman's body as a post-operative transsexual. Ittook two years for the family to get used to calling her "she". Hermother says her daughter experienced her childhood as mentaltorture, especially during puberty. "Looking back, we could neverfind any tape in the house. It was because she was taping hergenitals 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 crazybecause she knew in her head that she was a girl."One day, when her daughter was 14, Sarah walked in on her in herbedroom. "She was there in front of the mirror with her genitalstucked away. She was very embarrassed. I said, 'I don't knowwhat'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: "Ihad watched programmes on transgender, I'm very interested inpeople, it's part of who I am to find out about these things ... Butyou never imagine it's going to happen to you."Sarah sought help from her GP - who laughed. Eventually, herdaughter got a referral to the one London clinic that deals withgender identity disorder in children and adolescents. But obtainingtreatment on the NHS in her daughter's mid-teens was slow anddifficult. Several suicide attempts followed and the familyremortgaged their house to pay for private hormone treatment.Once Sarah's daughter was 18, they also paid for an operationabroad.AdvertisementThe plight of children with gender identity disorder has madeheadlines this year. In February an inquest was held into the deathof Cameron McWilliams, a 10-year-old boy from Doncaster, whohanged himself. The court heard that he had asked permission towear makeup and girls' underwear. "It was apparent he wasunhappy and said he wanted to be a girl," his mother said. "He didlike girls' things." Later the same month Lawrence King, 15, fromOxnard, California, who described himself as "gender non-conforming" and was a victim of school bullying, was shot to deathin a science laboratory by another pupil.Internationally, there is controversy over medical treatments thatcould be used to help children in this situation. In May, Dr NormanSpack, the US's leading authority on "gender-confused" childrenand a paediatric endocrinologist at the Children's Hospital inBoston, revealed on US National Public Radio that he has at least10 paediatric transgendered patients who are receiving puberty-blocking hormone treatment. He says that the procedures allowchildren to buy time to make a decision about gender reassignmentsurgery. Once they have gone through puberty - and fullydeveloped the body of the gender they don't want - it is much moredifficult.
Awareness of transgender children is growing. Earlier this year abook called TheTransgenderChild: A Handbook for Families andProfessionals (Cleis Press) was published. "Thousands of familiesface raising children who step outside the pink or blue box," saysthe blurb.But their stories rarely cross into the mainstream because familiesdon't want their children to be identified. Even adult transsexualsrisk ridicule (and sometimes physical abuse) when talking abouttheir past. The Oprah Winfrey Show first featured an 11-year-oldgirl who wanted surgery to become a boy in 2004. Last year, a verycute six-year-old girl, Jazz, appeared on the Barbara Walters showin 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 tobe. She and her parents appeared on television under assumednames. "We'll say things like, 'You're special. God made youspecial.' Because there aren't very many little girls out there thathave a penis," said her mother Renee. They were comfortable withidentifying their child as transgender.AdvertisementGenderissues can appear as young as four (although the parents ofthe aforementioned Jazz insist that their son made it clear hewanted to wear a dress from the age of 18 months). "It usuallybecomes more evident when they go to school," says SimonaGiordano, a senior lecturer in ethics and psychiatry at theUniversity of Manchester who is conducting an international studyinto gender identity in children. "There have been reported cases ofkids who won't drink for the duration of the school day so that theydon't have to go to the toilet, and who don't want to sleep in abedroom with their peers."In Britain, there is only one place where children who feel this waycan be treated: the Gender Identity Development Service at theTavistock and Portman NHS Foundation Trust in London, run by DrDomenico di Ceglie, author of a 1998 ground-breaking study ontransgender children, A Stranger in My Own Body: Atypical GenderIdentity Development and MentalHealth(Carnac). He becameaware of the needs of the children with gender-identity issues whenworking as a child psychiatrist in Croydon in the 1980s. His