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Sex vs. Gender:  A Primer

The Basics

The screams of new life fill the delivery room amid the joyful emotion of new parents and medical staff.  The doctor then declares “It’s a boy!” or “It’s a girl!”  Everyone is happy because it is a new life and a promise of hope for the future.

From that moment on, the child’s life is loosely mapped out as to its social conditioning and upbringing.  The child has no say in this because in the binary gender model there are only two genders, male or female and each have their own unique sexual characteristics.  This definition of gender is controlled outwardly by sexual characteristic and in truth may be doing a great disservice; in fact to the transgender child it is or could be doing great harm.  The problem here is that no one can tell if the child is transgender or not.  That takes several years to emerge and it is the child who makes that declaration, not the parents, medical community, friends or family.  It is at this point that those close to the child can make the decision to support this declaration or not.

The other, and often catastrophic situation is: intersex. 


It is essential to recognize that the child has absolutely no frame of reference for gender or sexuality and as such must be taken seriously.  Children are not "gender confused" as some medical and psychological professionals claim, parents are gender confused.

I think that at this juncture it is well worth noting that transgender knows no boundaries of culture, sex, religion or socioeconomic condition.

If little Johnny declares he is a girl, or Suzy claims to be a boy, acknowledgement and recognition of this by the parent(s) is critical to the well being of the child.  Yes you can take the child to your paediatrician or family physician who will most likely state that it is just a phase and s/he will grow out of it.  But what if s/he doesn’t?

What if the doctor’s advice is to “correct” the child’s play behaviour is wrong?  For instance telling Suzy she must play with dolls instead of her brother’s trucks or Johnny’s play with dolls is wrong and substituting the dress up clothes with more male pursuits?  Is the child going to thrive or will s/he comply because of parental influence and thus “bury” those feelings?  This approach called Reparative or Conversion Therapy among other labels is NOT condoned by any psychiatric body for treatment of transgender health.  it is illegal in some jurisdictions.

I think that it is essential to note that the training most doctors receive, including those in the mental health fields about transgender is miserably inadequate, often amounting to little more than a few hours of lecture during medical school; if that.  Often medical texts are out of date and or out of step with current research so even that has to be questioned.  Simply put, the reasoning behind this is that transgender is not a commonly encountered situation; so it really doesn’t get the attention it needs.  It is left up to the mental health professionals who are not always equipped to deal with it either.

The problem with this thinking and rationalization is the impossibility of acquiring any kind of accurate statistics as to the number of transgender people as a percentage of the population at large.  Statistics vary wildly from as little as 0.1 percent to as large as 6 or seven percent.  These numbers can’t be trusted for a number of reasons yet to be discussed.  The overwhelming concept that this is largely a male situation is quickly falling by the wayside as increasing numbers of genetic women are now coming forward with their own claims of Gender Identity Disorder.

The Child

As I stated earlier, the child has no frame of reference about sex or gender.  That said, one cannot say that a three year old learned or chose this.  Did the parent teach it?  Of course not.  Did they learn it on television?  Of course they didn’t.  So where did they learn this?  The child didn’t learn it because transgender just is.  S/he only knows his or her feelings and nothing more.  Remember this is about the child, not the parents or medical community or any other societal influence.  The child’s feelings are what must be acknowledged and accepted; as hard as it may be.  The child doesn't need counselling; the parents do.

This is not to say that the child is definitely transgender, only that the indicators are there.  The child may very well “grow out of it”.  Still it requires a great deal of observation of the child before making any kind of assumptions or worse, premature diagnosis.  If this insistence about gender persists for an extended period of six months or more, then there are strong possibilities that the child is transgender.  Even at that, one cannot definitively draw any conclusions.  What does need to be done is to get the child to a psychiatrist or psychologist who is EXPERIENCED in dealing with transgender children.  More about this later.

Let’s suppose the parent(s) try to change the behaviour.  They “correct” the child’s behaviour at every turn either by coercion or worse through corporal punishment.  What is the effect on the child?

First of all the child is taught that his or her feelings are wrong.  Think about this for a moment.  It is wrong to feel like a girl if you are a boy.  It is wrong to play with the girls if you are a boy or it is wrong to go climb trees and play football if you are a girl.

Let's do some role play here.  Suppose someone in authority were to tell you your feelings are wrong?  If you were suddenly told that you are not your natural gender but the opposite gender.  You may not dress, act or socialize as the genetic male or female you are.  You cannot openly express those feelings or you will be punished through discrimination, or even violence?  Will the feelings of your natural gender go away? Of course they won’t because they are your feelings.  They are a part of your core.  Equally important is knowing that you are "faking" your feelings to suit others.

This is the situation most transgender people face every day of their lives.  They must live, learn and work behind a facade that masks the real person inside.

Guilt, Shame and Fear:  The Terrible Trio

So how does the child react?  S/he will hide those feelings and that will cause stress.  Why should the child suffer stress because of his or her feelings?  As a result of their “wrong” feelings the child will hide them and begin to erect barriers to obscure the real person inside.  Still those feelings will never go away and they learn to be ashamed of the feelings because they have been told they are wrong.  At the other extreme they will act out and even express suicidal ideation.  If you think your child's gender association and desire to die outweghs your prejudices, you need to walk away.  Someone who truly loves your child will be happy to parent them properly.

This is the first learned response to being transgender.  Guilt.  What child as young as three years of age deserves to be burdened with guilt over their feelings?

Regardless of the guilt feelings that are now learned, the child is still compelled to act on those feelings so they hide and when they feel safe, they will act on them.  The little boy will play dress up and the little girl will play football.

This effectively sets up the second condition of the trio, shame.  The child has learned their feelings are wrong but must act on them and when they do they feel shame for having to hide their feelings and actions.  Consider the confusion the young child will experience during this time.

Finally they learn fear.  This is fear of discovery.  The child wants to avoid ridicule, disappointment by others and so the circle of Guilt, Shame and Fear is set to potentially create a life of misery that can include psychological and/or physical problems.

It is difficult to imagine the devastating effects this cycle can have on the normal and healthy development of the child.

I can’t think of any better way to spend a childhood; or a life; can you?  I can because I lived through the suppression.


To this point we have been primarily dealing with the child transsexual.  Still there is far more to this than the transsexual.  Not all transgendered people are transsexual and of those who do identify this way, only a small number of them will actually pursue transition but more about that later.

At the onset of puberty another group of transgender people commonly emerge, the Cross Dressers.  The cross dresser is compelled to dress in clothing of the opposite sex for a variety of reasons but again it comes down to feelings.  It is not a choice, nor is it a sexual abnormality despite the fact that with raging, out of control pubescent hormones, there is a strong sexual element to this cross dressing.  This behaviour wanes as the cross dresser ages but for those who do not, they are classified as Transvestic Fetishists.  TV’s are not generally considered to be part of the transgender population because their cross dressing is sexual not gender in nature.

Of course at this time there are not only massive physical changes but also social changes.  These are particularly difficult for either the transsexual or cross dresser.  Often the socialization is retarded by the transgender person because of their belief that there is something wrong with them.  They have learned that their feelings are wrong and they further invalidate them in order to appear normal to their peers.

Please try to remember that the transgender person’s feelings are that their gender is misaligned with their natural sex.  Johnny still feels like a girl but don’t forget that raging testosterone in his body.  He also likes girls; a lot.  He sees girls in a new light, as more than just a girl but as an ideal, a goddess for lack of a better description.  He is so enamoured he is even further driven to emulate the female gender.  The cross dresser has emerged in full force but s/he is also confused about sexuality because his or her interest is in the opposite sex yet their feelings are that they belong to that sex/gender to some degree.

For the transsexual this is a time of massive upheaval because their sex prevents them from joining in the socializing of their natural gender.  This frequently results in the youth being ostracized and thus being prevented for becoming socialized.  Additionally they hate their bodies and this adds to the accumulating stresses they are feeling.  The transsexual youth is at extremely high risk during this period of growth.  These risks include mental coping that can result in anxiety, depression and even suicide.

It is also during this time that most identified child transsexuals discard that diagnosis.  Statistically about 25% of all identified child transsexuals go through their teen years with that identity intact.  Still, it does require parents to assure the child will have normal growth and development within the circumstances of having an identified child transsexual.  DO NOT try to change the behaviour because of the statistics.  Let the child choose his or her own path.


Young Adulthood

With the trials of the teen years behind them, the transgendered person now is moving on to college, careers and families.  Huge mistakes are often made during this time by both the CD and TS person.

They are of the opinion that they can fight this, and if they take macho careers and marry and have families that they will be cured.  Wrong.  The first mistake is that they often see their being transgendered as a problem.  It can be problematic for a relationship and often is.

What has changed though is the sexual element to cross dressing.  It is on the wane and for the TS it is mostly gone.  This is not to say that all transsexuals are now asexual, that would be a lie.  What occurs is their feelings are now more internalized and the sexual element to their gender expression is irrelevant.  In other words, crossdressing offers a "relief" in psychological not physical terms.  To both the CD and the TS this is often mistaken as an element that they can control their problem.

Inevitably the transgender person is discovered by their partner and a host of other problems emerge that can and frequently do result in breakdown of the family.  This is tragic because it can be avoided and with excellent communication between partners, it can be saved and even made stronger.  The real key is to avoid any such discoveries by coming out to a potential partner early in the relationship.


The transgender person has no choice in being transgendered and additionally is frequently the victim of societal discrimination.  The truth of sex and gender is that there is no correlation that can be definitively identified to relate them as being co dependant.

The concepts of sex and gender cause great amounts of stress on the transgendered person further adding to mental stresses incurred while growing up.  This places the transgender person at risk for other psychological problems that are created as a result of being transgendered.

NEXT:  What Causes it?


This site was last updated 09/16/15