The current prospective study examined the clinical characteristics of children (including adolescents) presenting to a newly established, multidisciplinary Gender Service in New South Wales, Australia, along with the challenges that clinicians faced in providing clinical services to these patients and their families. We found that the clinical characteristics of the children presenting to our service were comparable to those described by other paediatric clinics: a slight preponderance of biological females to males and high levels of distress and comorbid mental health disorders. While previous studies of children have highlighted high rates of abuse, bullying, discrimination, victimization, and family rejection or lack of family support in a general way—often under an umbrella heading of “abuse and victimization experiences” (p326) (Chew et al., 2020)—the results from our study, including the developmental stories told by the children and their families, highlight that many of these experiences have occurred within the family setting itself. That is, our results highlight that many of the ACEs reported by the children and families—family conflict, bullying, parental mental illness, financial stress, maltreatment, and a breakdown of the family system—occur within the family system itself and that the ACEs reflect a long-standing history of relational stress and a chronic disruption of what are normally comfortable and nurturing attachments.
Our study found that the children and families who came to the clinic had clear, preformed expectations: most often, children and families wanted a diagnosis of gender dysphoria to be provided or confirmed, together with referral to endocrinology services to pursue medical treatment of gender dysphoria. . . . It was our impression that these expectations had been shaped by the dominant sociopolitical discourse—the gender affirmative model. It will be interesting to track the expectations of children and families in the years to come as sociopolitical discourses become more varied and diverse and as the voices are heard of both those who have done well and those who not done well via the medical pathway.
Source: Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service – Kasia Kozlowska, Georgia McClure, Catherine Chudleigh, Ann M Maguire, Danielle Gessler, Stephen Scher, Geoffrey R Ambler, 2021