• Gender dysphoria — the feeling of one’s emotional and psychological identity to be opposite to one’s biological sex — can be present in children as young as five to six years of age, says Dr Shekhar Seshadri, psychiatrist and professor of the Department of Child and Adolescent Psychiatry in NIMHANS, Bengaluru. “It also depends on the kind of gender roles that they get socialised in,” he adds.
  • “Among children reporting gender dysphoria, it normalises in a portion of them. But in the remaining too, among those who show opposite gender play, not all of them necessarily have a trans identity, they might just identify as homosexual as adults,” he says, pointing to the World Professional Association for Transgender Health guidelines.
  • According to WPATH’s Standard of Care book, in most children, gender dysphoria will disappear before, or early in, puberty. However, in some children these feelings will intensify and body aversion will develop or increase as they become adolescents and their secondary sex characteristics develop.
  • “Data from one study suggest that more extreme gender nonconformity in childhood is associated with persistence of gender dysphoria into late adolescence and early adulthood. Yet many adolescents and adults presenting with gender dysphoria do not report a history of childhood gender-nonconforming behaviors. Therefore, it may come as a surprise to others (parents, other family members, friends, and community members) when a youth’s gender dysphoria first becomes evident in adolescence,” it says. The book goes on to explain how mental health experts can aid the family and the adolescent in the transitioning process.
  • Dr Seshadhri says that for those teenagers with a trans identity, it is generally required for them to have at least two years of real time experience of living notion the gender they were born in, but in the gender they feel aligned to. “We extrapolate from that, and see if there are stable patterns. Sometimes parents might bring in a child saying they have already observed gender distress in them for four years at home. We have to take that evidence into account as well,” he says.
  • Agreeing that acceptance and awareness is slowly percolating into the fabric of civil society he says, “There are many youngsters who don’t want to be bound in the binary, as it is limiting in terms of understanding the range of human sexuality.”