Diane Ehrensaft: The Gender Creative Child

The term cross-sex hormones is commonly used to refer to the estrogen or testosterone that transgender youth take to align their bodies to their affirmed gender. Some people prefer to use the medical term hormone replacement therapy , which in no way implies that anyone has crossed any sex lines but instead indicates that this person just needs an addition of hormones to solidify their affirmed gender. HRT as a term has its own set of problems, since so many of us—particularly ciswomen of a certain age—associate hormone replacement therapy with the plight of menopausal women in the early twenty-first century, who were told for many years of the benefits of such treatment and then warned that those very treatments might be causing them physical harm. To avoid this terminology conundrum, I have opted to simply use the term hormones whenever possible to refer to the treatment that allows a youth to receive hormones in alignment with their affirmed gender identity.

Nanette Asimov, “Mills College Spells Out What It Means to Be Female,” San Francisco Chronicle , August 20, 2014, A1, A10.

Michelle Goldberg, “What Is a Woman?,” American Chronicles, The New Yorker , August 4, 2014, 24–28.

Ruth Padawer, “Sisterhood Is Complicated,” The New York Times Magazine , October 19, 2014, 34–39, 48, 50.

See Stephanie Brill and Rachel Pepper, The Transgender Child (San Francisco: Cleis Press, 2008); Diane Ehrensaft, Gender Born, Gender Made (New York: The Experiment, 2011); and Jake Pyne, Rainbow Health Ontario Fact Sheet, 2012.

BBC News India, “India Court Recognises Transgender People as Third Gender,” April 15, 2014, bbc.com.

D. W. Winnicott, Playing and Reality (London: Tavistock, 1971).

See Genny Beemyn and Susan Rankin, The Lives of Transgender People (New York: Columbia University Press, 2011).

V. Pasterski et al., “Increased Cross-Gender Identification Independent of Gender Role Behavior in Girls with Congenital Adrenal Hyperplasia: Results from a Standardized Assessment of 4- to 11-Year-Old Children,” Archives of Sexual Behavior , published online September 20, 2014.

Two major articles about androgens and gender: P. T. Cohen-Kettenis, “Gender Change in 46,XY Persons with 5alphareductase-2 Deficiency and 17beta-hydroxysteroid dehydrogenase-3 Deficiency,” Archives of Sexual Behavior 34 (2005): 399–410; H. F. Meyer-Bahlburg, “Gender Identity Outcome in Female-Raised 46,XY Persons with Penile Agenesis, Cloacal Exstrophy of the Bladder, or Penile Ablation,” Archives of Sexual Behavior 34 (2005): 423–38.

Stephen M. Rosenthal, “Approach to the Patient: Transgender Youth: Endocrine Considerations,” Journal of Clinical Endocrinology and Metabolism (2014), 1–11, jcem.endojournals.org. See p. 3 for the cited quote.

As a sample of my perusal, one might take a look at Jerome Kagan, The Growth of the Child (New York: W. W. Norton, 1978); Herbert Ginsburg and Sylvia Offer, Piaget’s Theory of Intellectual Development: An Introduction (Englewood Cliffs, NJ: Prentice-Hall, Inc., 1969); Jean Piaget, Plays, Dreams, and Imitation in Childhood (New York: W. W. Norton, 1962); Erik Erikson, Identity, Youth, and Crisis (New York: W. W. Norton, 1968).

The World Professional Association for Transgender Health (WPATH), Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, Version 7 (2011), 17, wpath.org.

The Brothers Grimm, “The Frog Prince,” in Grimms Fairy Tales (New York: Crown Publishers, 1973), 17.

Candace Waldron, My Daughter, He: Transitioning with Our Transgender Children (Rockport, MA: Stone Circle Press, 2014), 47.

E. B. White, Stuart Little (New York: Harper Trophy, 1945), 9.

Genny Beemyn and Susan Rankin, The Lives of Transgender People (New York: Columbia University Press, 2011).

Thomas D. Steensma et al., “Factors Associated with Desistence and Persistence of Childhood Gender Dysphoria: A Quantitative Follow-up Study,” Journal of the American Academy of Child and Adolescent Psychiatry 52, no. 6 (2013): 582–90.

Hoffman and Hoffman, Jacob’s New Dress .

Richard Green, The “Sissy Boy” Syndrome and the Development of Homosexuality (New Haven, CT: Yale University Press, 1987).

GenderQueer Revolution, “About,” facebook.com.

Some people may recall fruit being used as pejorative term for any boy or man who appeared effeminate. This is, of course, not what I am referring to here. In the spirit of the queer movement, I am appropriating the word fruit with pride, as our own gender affirmative term, in relation to apples and oranges, to acknowledge and celebrate the mélange of gender that defies gender boxes in both identity and expressions.

Wikipedia, “Genderqueer,” en.wikipedia.org, January 5, 2015.

Suzanne Leigh, “Getting Beyond Male and Female,” San Francisco Chronicle , February 12, 2014, D1, D2.

GenderQueer Revolution.

Eric Erikson, Childhood and Society (New York: W. W. Norton, 1963).

Jennifer Carr, Be Who You Are (Bloomington, IN: AuthorHouse, 2010).

39. Mx. Nathan Tamar Pautz, “On Not Judging a Book by Its Cover,” in Trans Bodies, Trans Selves: A Resource for the Transgender Community , ed. Laura Erickson-Schroth (New York: Oxford University Press, 2014), 97.

WPATH, Standards of Care , 26.

For more information, see Alexander Thomas, Stella Chess, and Herbert G. Birch, Temperament and Behavior Disorders in Children (New York: New York University Press, 1968); and Stella Chess and Alexander Thomas, Temperament (New York: Routledge, 1996).

See Annelou L. C. de Vries et al., “Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents,” Journal of Autism and Developmental Disorders 40 (2010): 930–36, published online January 22, 2010; Doug P. VanderLaan et al., “Do Children with Gender Dysphoria Have Intense/Obsessional Interests?,” Journal of Sex Research 52, no. 2 (2015), 213–19; and a review by Kyle Simon, cofounder of the Autism Family Center, “Is There a Link Between Autism and Gender Dysphoria?,” Huffington Post Gay Voices , September 13, 2013, huffingtonpost.com.

See Avgi Saketopoulou, “Minding the Gap: Intersections Between Gender, Race, and Class in Work with Gender Variant Children,” Psychoanalytic Dialogues 21 (2011): 192–209; and Mark Gevisser, “Self-Made Man,” Granta 129: Fate, Autumn 2014, granta.com, for further discussion of the need to hold the tension between the old and the new.