Developmental Trajectories among Gender Dysphoric Children

InterVarsity Press Academic and the Christian Association for Psychological Studies are set to publish a new book I wrote with Erica S. N. Tan titled, Sexuality & Sex Therapy: A Comprehensive Christian Appraisal. I am hearing it will be out in April.

After four foundational chapters offering theological, sociocultural, biological, and clinical perspectives on sexuality, we discuss several sexual dysfunctions, the paraphilias, sexual addiction, and other clinical presentations. Here is an excerpt from the chapter on Gender Dysphoria.

What we are discussing is onset and course. Specifically, we are discussing a study of children who persist and desist in their experience of Gender Dysphoria:

Although there is relatively little research on gender dysphoria as compared to many other sexual concerns, there has been some preliminary research (Steensmaet et al., 2010) on possible developmental trajectories among those who persist (in their experience of gender dysphoria) and those who desist (or who do not continue to experience gender incongruence).

When these two groups are compared, it is interesting to note that there are apparent differences in underlying motives in cross-identification, as well as differences in responses to changes at puberty. In considering motives for cross-identification, one persister shared the following: “In childhood (and still), I had the feeling that I was born as a boy. I did not ‘want’ to be a girl. To myself I ‘was’ a boy, I felt insulted if people treated me as a girl. Of course I ‘knew’ I was a girl, but still, in my view I was not” (Steensmaet et al., 2010, p. 6). In contrast to this, a desister shared this: “I knew very well that I was a girl, but one who wished to be a boy. In childhood I liked the boys better, the girls were always niggling [petty, nagging]. I was tough and wanted to be as tough as the boys” (p. 6).

When the researchers looked at the different responses to puberty, they noted the strong reaction against these changes among those who persisted with their gender incongruence. One persister shared the following: “It was terrible, I constantly wanted to know whether I was already in puberty or not. … I really did not want to have breasts, I felt like, if they would grow, I would remove them myself. I absolutely did not want them!” (Steensmaet et al., 2010, p. 8).

Again, in contrast, a desister shared this: “Before puberty, I disliked the thought of getting breasts. I did not want them to grow. But when they actually started to grow, I was glad they did. I really loved looking like a girl, so I was glad my body became more feminine” (Steensmaet et al., 2010, p. 12).

Keep in mind that both groups engaged in some cross-identification at a young age, about 6 or 7 years old. However, Steensma et al (2010) reported that for those who desisted—whose gender dysphoria abated over time—that change occurred at between 10-13 years of age, whereas the gender dysphoria seemed to increase for those who were called persisters.

The persisiters would go on to disclose and make a plan for some kind of transition between the ages of 10-13 years old, while those who desisted tended to identify with their birth sex at age 13 and older.

Although I have provided clinical services and consultations in the area of gender dysphoria and have conducted research involving transgender Christians, I have not written that much about it. I enjoyed the opportunity to work on this chapter with Erica and to reflect further on gender identity and gender dysphoria from a Christian worldview.