What if Your Child is “Gender Confused”?

“Speaking as a mother and a Catholic, I consider it evil. ... To disrupt the core identity of young children in this way desecrates the image of God within them.”

Jazz Jennings, a teenage boy who has gained fame for presenting himself as a female on his YouTube channel, rides in the 2016 NYC Pride parade.
Jazz Jennings, a teenage boy who has gained fame for presenting himself as a female on his YouTube channel, rides in the 2016 NYC Pride parade. (photo: Photo: Steven Pisano, CC BY 2.0, via Wikimedia Commons)

Introducing young children to the concept of transgenderism is not benign. And if you think it’s not happening, consider that public libraries (using taxpayer dollars) in New York, Boston and San Francisco have hosted “drag queen story hours” for preschoolers. And have you heard about the Orthodox Jewish primary school in Britain threatened with closure after government inspectors determined it was in violation of the law for not teaching about transgenderism?

Did you know there are books written for children to teach them about transgenderism? Introducing Teddy, for ages 3-6, is about a teddy bear named Thomas who reveals to his friend that he’s really Tilly. And I Am Jazz is a picture book for children ages 4-8 which tells the true story of a boy who transitioned to being a transgender girl.

Dr. Michelle Cretella is a pediatrician, a Catholic mother of four, and president of the American College of Pediatricians. I interviewed her recently on the subject of transgenderism and children.


What would you say to a parent who told you her pre-pubescent child thinks he or she is the wrong gender?

First I would try and clarify the language. It’s important for parents and children to understand that our genes, our DNA, determines our sex. We’re talking about two things here: biological sex – which cannot be changed and is hardwired by DNA, and we’re talking about gender identity – which is about how we feel and think about our biological sex. It’s necessary to make that distinction because gender identity is not hardwired. It’s also important for parents to understand that all children develop an awareness about their biological sex and a gender identity over time. Unborn children, for example, can distinguish between their mother’s voice and their father’s voice. By four months of age, infants can distinguish between male and female faces, and by the age of 6 months, infants can readily discriminate both faces and voices by sex.

The next critical step in gender identity formation requires attaching to the same-sex parent, and then having the opportunity to develop healthy same-sex peer relationships. Usually by the time children are 3 years old they know the difference between a man and a woman, a boy and a girl. Most of them can say correctly, “I am a girl,” or “I am a boy.” It’s also important to understand that even though children know what sex they are by that age, they do not understand that sex is permanent. Normal children may actually believe that if a man dresses like a woman, he is a woman. The idea of the permanence of biological sex doesn’t form in a child’s cognitive development until age 7.

So as pediatricians, when we’re dealing with very young children, we should reassure parents that their children’s cognitive development is such that they don’t fully understand that sex is a permanent thing, and they’re probably going through a phase, trying on different identities. We need to reassure children, for example, that “You are a boy and mommy and daddy love the boy you are.” Likewise for a girl.  The same-sex parent is key. Positive interactions with the same-sex parent are what help children grasp what it means for them to be a boy or a girl.

It takes up until age 7 for many children to think “I was born a boy, I am a boy. If I put on a dress that doesn’t make me a girl, it just makes me a boy in a dress.”


What if a parent heard all this but still believed they should be “affirming” the child’s perceived gender identity?

I would tell them it’s wrong to encourage a lie. We know that no one is born transgender. We know that is a myth. Sadly it’s being promoted by a lot of medical professionals, the media and educators. But it’s not true. If we reinforce this lie we’re actually encouraging the child to develop a fixed false belief; and a “fixed false belief” is the definition of a delusion. We’re making the child believe something that is not true about himself. And if the delusion is reinforced, the child will eventually be put on hormones that make him or her sterile, that harm bones, harm brain development, and increase the risk for stroke, diabetes and cancer over his lifetime.

This is a massive uncontrolled social experiment going on with our children right now. We know that in the years prior to promoting the gender transition of young children the vast majority of them, up to 95% of cases, would identify as their biological sex once they passed through puberty.


Are there consequences to introducing the concept of transgenderism to kids in situations like drag queen story hours and by reading books about it?

Most parents with little children are going to be confronted by this at some point, whether it’s in their public libraries, preschool or K-12 schools, just by virtue of the books that could be read to them. What is dangerous is that these young children are just developing the awareness of the fact that they are a boy or a girl. And it’s not until age 7 that most realize that is who they are and that sex doesn’t change. It’s dangerous because when you give young children fantasy picture books like this it indoctrinates them into thinking that their sex is all external. A preschool boy, for example, may think “The boy Teddy bear became a girl when he turned his bow tie into a barrette. I can do that, too.” Children will come to believe that their sex is whatever they think they want it to be. This is dangerous from a psychological point of view. It’s disrupting the natural process of gender identity formation.

Speaking as a mother and a Catholic, I consider it evil. If children cannot learn to trust the reality of their own bodies, how will they have the capacity to evaluate any other part of reality? To disrupt the core identity of young children in this way desecrates the image of God within them.


How common is it for children to be confused about their sex?

Prior to 2013 most physicians and therapists treated it as a clear-cut disorder and it was estimated that less than 1% of children would present with gender identity confusion or disorder. The United Kingdom has seen a 930% increase in the number of children referred to gender clinics in the last six years, including some as young as 3 and 4. There have been astronomical increases around the world, including in the US and Canada. And it makes sense because we’re bombarded by the lies in social media, on TV, in newspapers and magazines, and in schools. As much as activists say people are born this way, we know that if that were the case, we wouldn’t be seeing such a huge increase just from an affirming environment. This is a social phenomenon.


So parents are more prone to rush their kids to the doctor?

Absolutely, especially because so many of the so-called experts in education and medicine are saying parents must affirm their children’s mistaken belief and get them on hormone blockers or they’ll kill themselves. And that’s a false dichotomy. But parents often believe the choice is between having a trans child or a dead child.

There is a proportion of children with this problem who come from dysfunctional families and/or abusive families. And those things can be missed by a doctor or therapist, even under the best circumstances. But now with gender confusion essentially normalized, these cases may be missed entirely.


So there is a connection between family dysfunction and gender dysphoria?

Yes. In the psychiatric literature it is well documented that many families with gender confused children have family dysfunction. Examples include an overbearing mother, distant father, severe depression in the mother, anger management problems in the father, and divorce. Divorce is a factor particularly with teenage girls who did not have gender confusion previously. As an example, you have a divorce situation in which the mom was very beaten down physically, emotionally, or both. And dad is very aggressive. The daughter will perceive being female as being weak and unlovable. Subconsciously she wants to be strong, safe and loved, so her subconscious mind defends itself by believing she is a man. Her subconscious mind has learned that men are strong and don’t get hurt. If she is a man, she is not like her mother. She may say to herself subconsciously, “I’m strong like my dad. This is how I’m going to survive. This is how I will be loved.” Obviously this is not conscious, but it may come out in long term therapy. So the psychiatric literature confirms that family dysfunction can play a role in gender confused children.

In my next blog Dr. Cretella will answer questions about what the future is like for children who are “affirmed” as transgender. You can read more about transgenderism and children on the ACPeds website.