Childhood Gender Identity ... Disorder? Developmental, Cultural, and Diagnostic Concerns

By Dragowski, Eliza A.; Scharron-del Rio, Maria R. et al. | Journal of Counseling and Development : JCD, Summer 2011 | Go to article overview

Childhood Gender Identity ... Disorder? Developmental, Cultural, and Diagnostic Concerns


Dragowski, Eliza A., Scharron-del Rio, Maria R., Sandigorsky, Amy L., Journal of Counseling and Development : JCD


Although fundamental to the way most of us experience ourselves and others, gender is rarely contemplated. Left unexplored, however, this complex concept often creates misconceptions and stereotypes, such as the belief that gender and sex are synonymous or that gender assigned at birth indicates a specific preference for toys, interests, clothes, and eventual erotic attraction. The aim of this article is to enhance counselor understanding of childhood gender identity development, to aid in assessment and diagnostic processes surrounding this matter. We review childhood gender identity in the context of developmental and cultural factors before considering the diagnosis of childhood gender identity disorder (GIDC), and we explore proposed changes to the diagnosis in the upcoming fifth revision of the Diagnostic and Statistical Manual of Mental Disorders.

Terms and Definitions

Misconceptions surrounding gender identity often begin with general confabulation of terms used to communicate about the issue. We thus begin this article with a review of terminology, aiming to define and disentangle biological sex, gender, and sexuality.

Biological Sex

Biological sex relates to one's anatomical and reproductive structures. It is determined by karyotype (a specific chromosomal complement, with 46 XY karyotype in typical males and 46 XX karyotype in typical females), gonads (testes and ovaries), external genitalia (scrotum and penis in typical males; labia and clitoris in typical females), and secondary sex differentiation at puberty (Pasterski, 2008). Most commonly, it follows a binary model assigned at birth based on the presence of external genitalia (Diamond, 2006). This model does not consider persons with disorders of sex development, whose sex chromosomes and genital structure(s) are considered to be incongruent (Pasterski, 2008).

Gender

Jacobs, Thomas, and Lang (1997) used the word gender to refer to "cultural rules, ideologies, and expected behaviors for individuals of diverse phenotypes and psychosocial characteristics" (p. 2). Gender identity relates to one's subjective sense of congruence with an attributed gender. Gender role is a public display of gender identity conveying societal schemes of how boys and girls should behave (Diamond, 2002; Stryker, 2008).

Transgender is an umbrella term referring to people who move away from the gender assigned to them at birth, thus violating societal conceptualizations of what it means to be a man or a woman (Stryker, 2008). Included in this category are transsexuals, people whose gender identity does not correspond to their physical body (Diamond, 2002). Transsexuals sometimes transform their physical body and often assume gender roles that are congruent with their experienced gender identity. According to Diamond (2002), the term transsexual best describes adults, not children who may meet criteria for gender identity disorder (GID). In this article, we interchangeably use the terms gender-variant and gender-nonconforming to describe children whose gender expression, gender role behavior, and/or gender identity do not conform to the traditional norms.

Sexuality/Sexual Orientation

The terms sexuality and sexual orientation refer to how and with whom people act on their affectionate, intimate, and erotic desires. In classifying sexuality, people tend to depend on the gender identity of the person to whom their desires are directed. Most commonly, to describe sexual orientation, we use the term heterosexual/straight to denote a person attracted to a member of another gender, homosexual/gay/lesbian to refer to an individual attracted to the member of the same gender, and bisexual to refer to a person attracted to a member of any gender (Diamond, 2002; Stryker, 2008).

What Does It All Mean?

Our cultural beliefs dictate that there are only two biological sexes corresponding to two genders. …

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