Should doctors perform sex change surgery on minors?

Feb 22, 2012 at 6:15 p.m. ET

A growing number of children, under the guidance of their supportive parents and doctors, are changing genders. New research estimates about one in 10,000 kids under the age of 18 believes they were born with the wrong body.

This condition was once considered as a psychological diagnosis. In the last few years, however, some doctors have embraced these patients, giving them sex-changing or puberty-delaying treatments.

Something isn't quite right

Kids dressing up as the opposite sex is normal playtime behavior, but for some it isn't just make believe. An 8-year-old girl shocked her parents when, at 18 months, she told them "I a boy" and has not wavered in that belief since, according to a report by the Associated Press. The family now refers to the child as a boy and is watching for the first signs of puberty so he can begin hormone treatment.

The mother explained that her son has a girl's anatomy but rejected that gender, refused to wear dresses and insisted on using a boy's name since preschool. The mother told the AP that accepting his identity has been difficult. Schools have refused to enroll him as a boy, and the family's pediatrician refused to go along with their request to treat him like a boy.

This situation is becoming more and more common. The number of hildren realizing they were born with the wrong gender is on the rise, according to medical professionals. Puberty-blocking drugs and hormone treatments -- and even in some cases, gender reassignment surgeries for children -- are no longer freakish folklore as in previous decades.

Once considered merely a psychological impediment

The condition is often labeled "gender identity disorder," when an individual rejects his or her birth sex and feels a strong identification with the opposite gender. The disorder affects an individual's self-image, and can impact the person's mannerisms, behavior and dress, according to Web MD.

Some doctors are now warning this label is misleading and the condition is not just psychological. Dr. Norman Spack, a specialist in transgenderism, warns ignoring a child's needs can create problems such as stress and self-mutilation. Spack authored article in the journal Pediatrics about children who insisted they were born with the wrong gender and opted for sex-changing treatments. He told the AP there is emerging research that suggests these children may have brain differences more similar to the opposite sex.

Treatments available

The article in Pediatrics noted that "the gender identity disorder population increased fourfold" and that two-thirds of patients were started on "cross-sex hormone therapy." The authors also argued that greater awareness and early medical intervention is needed.

The monthly dose of puberty-blocking injections costs about $1,000 a pop. The hormones delay puberty, giving children time to mature emotionally and delay the urgency of a permanent sex-change. Gender reassignment surgeries are done on a case-by-case situation by a handful of doctors. However, there have been some cases of breast-removal in girls as young as 16.

Read more on kids and gender

Talking to kids about gender roles
Canadian couple raising gender-less baby
Do chores have a gender?

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