The recent controversial laws in North Carolina and Mississippi have brought an issue into public debate I never thought would be discussed in my lifetime -- whether men dressed as women, who obviously have issues with sexuality, should be able to use women's bathrooms where there might be unaccompanied little girls.
I continue to be amazed at some of the decisions being made. It is clear there is a misunderstanding around the idea of transgender people. Somehow, people are forgetting that gender identity disorder -- the cause of transgender behavior -- is an illness.
There is no such thing as a woman being born in a man's body. We are born male or female. Some people, however, become confused early in childhood and choose to identify with the opposite sex parent. This, if untreated, can lead to gender identity disorder and transgender behavior as an adolescent and adult.
To understand how this happens, it is useful to remember that all children are initially taken care of by women. Consequently, the first person the child identifies with is their mother, whether the child is a boy or girl. Boys have to take the additional step of switching their gender identification to their fathers, which explains why gender identity disorder is more prevalent in boys than girls, and why sexual reassignment surgery is more prevalent in men then women.
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As the child's brain becomes more complex, he or she becomes aware of the differences between men and women and becomes fascinated with their father's greater size and particular version of power. This helps boys pull away from their mothers and identify with their fathers. It also causes some girls to envy and want to possess what men have.
Every one of us leaves childhood with both male and female identifications. The relative mix determines psychological gender identity. By the age of 5 or 6, the child has formed a set of fantasies that contain gender identification, sexual attraction and their own particular map to finding love as an adult. At the same age, the brain reorganizes, and the events that led up to the particular fantasies the child formed, as well as the fantasies themselves, are lost under a veil of repression and forgetfulness. What remains is a conviction of having "always felt this way."
Gender identity disorder is very treatable by psychological therapies if the child is 5 or less. It becomes more difficult to treat the older the child is. However, sexuality is more fluid than most people realize, and help is possible all through the lifespan without having to resort to castration and other forms of bodily mutilation. Pretending it is just a normal variation means people who could have been helped will not be and that valuable research will be not attempted.
Gender identity disorder is an illness like diabetes or asthma. We should look for treatments. We should not, however, break our social institutions to accommodate the underlying pathology.
Finally, if your child shows transgender behavior, get him or her help before they turn 5. It can make all the difference.
Dr. Jule P. Miller III, Biloxi child psychiatrist, can be contacted at firstname.lastname@example.org.