Launched in 2005, WellesleyWeston Magazine is a quarterly publication tailored to Wellesley and Weston residents and edited to enrich the experience of living in two of Massachusetts' most desirable communities.
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Once a child has identified as transgender, many experts advocate for a social transition — which involves changing names, pronoun use, clothing, and hairstyle, for example — as soon as possible. Proponents of this approach argue that social transition can improve function in children who are intensely gender dysphoric and can 'test the waters'; that is, giving the child a completely reversible way to explore life in the other gender before committing to any medical interventions (see side- bar on page 96). There is some evidence that once they have socially transitioned, children with intense gender dysphoria often show marked improvement in behavior and mood. Dr. Carswell agrees, though with the caveat that this is a personal decision, and the environment of the child needs to be considered. "Early social transition is the right thing to do when there is parental support and when the child's safety can be ensured." If there is any con- cern about significant bullying or safety, she sometimes recommends that the child continue to present as cisgender (non-transgender) at school, and as transgender at home. Anxiety and depression rates are higher in the transgender popu- lation than in the general population. Reassuringly, a recent study showed that transgender children who are allowed to socially transition repeated idiom further clarifies it: "Sexual orientation is whom you go to bed with. Gender identity is who you go to bed as." One hallmark of a child who may be transgender is persistence, insis- tence, and consistency. It is common for children to act in cross-gender play — for example, choosing dress, toys, or play that are typical for the opposite of their natal gender. Referred to as "gender noncomforming" behavior, this does not necessarily mean a child is transgender. In other words, if a four-year-old boy wants to wear a dress or says he wants to be a girl once or twice, he probably is not transgender; but if a boy repeat- edly insists, for months or years, that he is a girl, then he is more likely to be transgender. Dr. Jeremi Carswell is a pediatric endocrinologist and the director of the Gender Management Service (GeMS) at Boston Children's Hospital. The age at which a child becomes aware that he or she may be transgen- der varies. "We see kids as young as three whose parents may have ques- tions about gender nonconforming behavior, and we see other kids who present after puberty." She notes that a significant percentage of children who exhibit gender nonconformity at younger ages will ultimately not be transgender. Carswell says, "The strength of a child's words and degree of their conviction can be indicative of whether they are truly transgender." n GENDER IDENTITY: An individual's internal sense of feeling male, female, neither, or some combination of both. n NATAL OR BIRTH-ASSIGNED SEX: The gender assigned at birth according to external genitalia or chromosomes. n GENDER EXPRESSION : How gender is presented to the outside world (e.g., feminine, masculine, androgynous). Gender expression does not necessarily correlate with birth-assigned sex or gender identity. n "TRANSGENDER" (SOMETIMES ABBREVIATED AS "TRANS"): Term used to describe a person whose gender identity does not match the biological sex they were assigned at birth. "Transgender" is used as an adjective ("transgender people"), not a noun ("transgenders"). TRANSGENDER MALE/TRANSMALE: Female to male. Person with a masculine gender identity who was assigned a female sex at birth. TRANSGENDER FEMALE/TRANSFEMALE: Male to female. Person with a feminine gender identity who was assigned a male sex at birth. n CISGENDER (SOMETIMES ABBREVIATED AS "CIS"): Term used to describe a person whose gender identity matches the biological sex they were assigned at birth. n GENDER NONCONFORMING: A person whose gender expression is per- ceived as being inconsistent with cultural normals for that gender. (e.g., a boy preferring feminine clothes or playing with toys intended for girls would be gender nonconforming.) A person whose gender expression is consistent with cultural norms expected for that gender (e.g., girls playing with Barbie dolls) would be gender conforming. n GENDER DYSPHORIA: Pyschosocial distress that may occur when gender identity and birth-assigned sex are not completely congruent. n SEXUAL ORIENTATION: A person's feeling of attraction toward other people: heterosexual, homosexual, or bisexual. Sexual orientation is entirely separate from gender identity, but it is often confused with it. The sexual orientation of transgender people is based upon their identified gender (e.g., a transgender man who is attracted to other men might identify as a gay man; a transgender woman who is attracted to other women might identify as a lesbian). n TRANSSEXUAL: Older, clinical term that has fallen out of favor. Historically, it was used to refer to transgender people who sought medical or surgical interventions for gender affirmation. Gender Identity, Sex, and Expression 94 Transitions W e l l e s l e y W e s t o n M a g a z i n e | s u m m e r 2 0 1 7