Not conforming to gender is not a disorder, says group
September 27th, 2011
01:57 PM ET

Not conforming to gender is not a disorder, says group

People who do not conform to their gender roles or cultural expectations do not have a disorder, declared the health association for professionals who treat transgender patients.

The World Professional Association for Transgender Health, composed of doctors, psychologists and others professionals, updated its standard of care for the first time in 10 years and announced its revisions this week at its conference in Atlanta, Georgia.  This international group, called WPATH, meets every two years.

“People who don’t fit cultural expectations of what it means to be male or female are not inherently disordered,” said Eli Coleman, who chaired a committee to update the WPATH standard of care. “Society stigmatizes these individuals and we have prejudice and discrimination. This causes a lot of people distress.”

Transgender kids: Painful quest to be who they are

But some people have gender dysphoria, a condition in which they feel uncomfortable with their bodies because they don’t match their gender.  This causes mental distress that can be relieved by making changes to their appearance, body or hormones, Coleman said.  At other times, gender dysphoria does not need medical interventions.

“It’s not a lifetime diagnosis,” said Coleman, professor and director of Human Sexuality at the University of Minnesota Medical School.  “Some people learn that they can feel comfortable if they’re allowed to express their gender in some manner that doesn’t necessarily require hormonal or surgical sex requirements.”

WPATH also called reparative therapies – those that seek to change the person - “unethical.” Coleman likening them to treatments that were designed to turn gay people into heterosexuals.

“Treatment aimed at trying to change a person’s gender identity and expression to become more congruent with sex assigned at birth has been attempted in the past without success, particularly in the long term,” the guidelines stated.  “Such treatment is no longer considered ethical.”

Also another controversial issue around transgender health is when children should receive medical interventions.

Hormone treatments prevent children from experiencing puberty of their sex. Girls who feel more like boys take hormone-suppressing medications so they will not develop breasts and start menstruating. Boys who identify as girls can take blockers to avoid developing broad shoulders, deep voice and facial hair. The drugs put their puberty on pause, so they can figure out whether to transition gender.

The protocol is that hormonal interventions should not be given to a child until he or she has started puberty and has a documented history of gender dysphoria, Coleman said.  The guidelines do not state an age when it’s OK to start hormone-blockers, because puberty starts at different ages for all kids.

Here are the guidelines for hormone treatment for teens:

•        The teenager has a long-lasting pattern of gender nonconformity or gender dysphoria

•        Gender dysphoria emerged or worsened with the onset of puberty. Tanner Stages are predictable sequences of puberty.  Children should be at least be at Tanner Stage 2, in which boys will get enlarging scrotum and testes, and girls will see the signs of breast development.

•        Any co-existing psychological, medical, or social problems that could interfere with treatment have been addressed.

•        The teenager has given informed consent or parents or guardians have consented to treatment and support the individual.

The Endocrine Society also has recommendations - for endocrine specialists and also advises that hormone blockers start only after girls and boys show signs of physical changes confirmed by levels of estrogen and testosterone.

Hormone blockers are reversible, because once a child stops taking drugs,  natural puberty begins.

If a teen decides he or she wants to transition to the other gender, that individual can elect to receive either estrogen or testosterone.  The use of cross-gender hormones is partially irreversible and that decision should be made with the teenager, the family and the treatment team.

But irreversible interventions like gender reassignment surgery should be held off until adulthood, the group recommended.

soundoff (61 Responses)
  1. Thomas

    Our gender was determined before we were born into this earth life. We lived with Heavenly Father as spirit sons and daughters of God in Heaven, and while we lived with Him there, we were either a male or a female. Plain and simple.

    September 28, 2011 at 10:21 | Report abuse | Reply
    • LIsa

      Yah, but where was the talking Walnut during all this?

      September 28, 2011 at 10:51 | Report abuse |
    • lillian

      its not that simple and what you just wrote isn't what everyone believes.

      September 28, 2011 at 13:00 | Report abuse |
    • Mannee

      Boy, it sure is a good thing that we have a professional intellectual to respond as the first message on this message board. Thanks for those late, breaking facts. It must be nice to have everything all figured out for you so you don't have to think for yourself or challenge any of the pre-processed concepts some idiot church taught you about science.

      September 28, 2011 at 15:07 | Report abuse |
    • Tom, Tom, the Piper's Son

      Second that, Mannee.

      I wonder why some of these zealots feel so threatened by the idea that everything isn't black and white? That there are many shades of gray?

      Probably scares the cr&p out of them.

      September 28, 2011 at 20:51 | Report abuse |
    • Jimmyjessi

      But I have both genitalia and reproductive organs... what gender should I follow?!

      September 30, 2011 at 11:58 | Report abuse |
    • Alice

      If this happened, then I was a girl in the spirit world, because that is who I am. Then I look down and see a male body, and it confuses me, and disgusts me. Feeling like a girl but looking like a boy, now THAT is unnatural. Think of women who have their breasts removed due to cancer – and I accept that this may bring things up, I am sorry – but I never even had any. What's the difference between other women wearing fake breasts so they still feel like women, and me wearing fake breasts so that I may feel my gender without confusion?

      September 30, 2011 at 20:14 | Report abuse |
    • Jesse

      "There is neither Jew nor Greek, slave nor free, male nor female, for you are all one in Christ Jesus." - Galations 3:28

      October 4, 2011 at 12:21 | Report abuse |
    • teresa


      October 17, 2011 at 22:33 | Report abuse |
    • Katie

      Thomas, may I assume you are a Mormon? Having spent my formative years in the LDS Church, your statement sounds very familiar. However, it doesn't account for the fact that while Heavenly Father (IF he is out there) doesn't make mistakes, genetics DOES. In fact, genetic mistakes are common – whose to say that a spirit didn't wind up in the wrong body?

      February 27, 2013 at 16:11 | Report abuse |
  2. txwtch67

    er, what?

    September 28, 2011 at 10:47 | Report abuse | Reply
  3. giovino

    For those who've never questioned their gender, it seems incomprehensible that a 3 year old child can accurately evaluate their brain's gender. Apparently, you've got to experience this firsthand in order to comprehend the intensity of this sensation. Our lives and our perceptions are not constant, yet the one thing I am certain of is that I have always been male. Judging by the dialogue surrounding these recent articles, many people are of the opinion that these kids should not be given the hormone blockers, that they are unable to make such a decision until age 18. I suspect taking this route could actually harm their chances at leading a full life in their future appropriate gender. For example, if a teenage boy does not block his body's natural tendency to develop facial hair and a deeper voice, he must then fight that much harder to hide/overcome these traits for the remainder of his life. A teenage girl will eventually develop breasts that would be burdensome as this person transitions to become a male. In the case of transgendered children, having the option to delay puberty would be a true blessing. On a related topic, I believe surgical options should be withheld until the person is 18.

    In my particular case, a hormone blocker would have held back my breast development and menstruation, both of which triggered great stress and anxiety for this young man. Blocking my puberty would have given me some peace of mind that I was supported by the appropriate medical professionals, as well as understanding that I would be trusted to later address my gender through a more mature mindset. In other words, it would have provided a "light at the end of the tunnel" that would have been invaluable during those teenage years. As it was, I began transitioning to become male-bodied at age 19. Almost 15 years later, I am curious how my adolescent social experience and eventual physical transition would have been affected by an option to delay the onset of puberty. Ultimately, I am confident hormone blockers would have reduced the confusion and heartache experienced by myself and my family.

    September 28, 2011 at 10:47 | Report abuse | Reply
    • Marty brown

      I agree with you. I began the change to male as soon as I was 18. Then I got hormones soon after. And got male ID, so I was able to begin my new life as a male, attending school and a part-time job to learn a trade that would help me pay my doctor bills, I have never looked back. I was really screwed up and stressout when my breasts got huge (DD's) and when I started menstrating, it was torture for me.

      October 25, 2011 at 00:05 | Report abuse |
  4. Sy2502

    So not accepting the body you are born with, to the point of tampering with it or disfiguring and mutilating it is not a disorder? Wow, political correctness has gone nuts.

    September 28, 2011 at 13:34 | Report abuse | Reply
  5. The Professor

    What a freaking joke. Of COURSE this group is not going to suggest it's a disorder LMAO.

    Sorry, hate to burst your bubble, but willingly changing your gender is M-E-N-T-A-L .....say it slooow for me, I-L-L-N-E-S-S.

    Got it? Ok Class is dismissed.

    September 28, 2011 at 17:09 | Report abuse | Reply
    • Jay B.

      lol, no.

      September 28, 2011 at 17:16 | Report abuse |
    • Tom, Tom, the Piper's Son

      And you're a "professor" of what, exactly? English?

      Really, moron, just shut up now and stop making an idiot of yourself.

      September 28, 2011 at 20:04 | Report abuse |
    • Alice

      Really? Assuming you're male... if you had your penis chopped off and breast implants, would you then be a woman, would you then like make-up and perfume and dressing in prom dresses and squeeing? Or would you still like football and drinking beer? Let me tell you, if you can change the person you are just at the flip of a coin or a surgeon's knife; that's what I'd probably call a mental illness (it is actually, it's called multiple personality disorder). Myself, I just can't do male. Coz I'm not male. Simples. Whatever my genitals say to you (and if you think they speak to you then you really do have problems).

      September 30, 2011 at 20:18 | Report abuse |
  6. Rick

    What about people that want no gender? Not male, not female, nor hermaphrodite? But a non.

    September 28, 2011 at 22:55 | Report abuse | Reply
    • Henry

      Then they would be called "Jack-Offs" (south park joke)

      September 29, 2011 at 04:57 | Report abuse |
  7. Robert

    I love how Bible thumpers hate gays and transgenders but are okay with incest. Eve had to do her own children to create more humans, but they are okay with that.

    September 30, 2011 at 09:31 | Report abuse | Reply
  8. teresa


    October 17, 2011 at 22:34 | Report abuse | Reply
  9. cerrajerias

    Wonderful paintings! That is the type of information that are meant to be shared around the internet. Shame on the search engines for now not positioning this put up higher! Come on over and visit my site . Thanks =)

    June 4, 2012 at 03:20 | Report abuse | Reply
  10. gingerbeer

    We talk of child abuse the first thing we say is, THIS PERSON IS SICK, THE ACT IS SICK! But medical say these poor people are not sick. Whynot treat it as adiction but alwasys as a crime. Maybe theres a DNA mal function as all addictive desease. Fine a cure, ID the problem early sure wish we could help everyone with some type of help before it becomes a issue with no real happy ending.. Good luck and a happy life.

    February 27, 2013 at 12:13 | Report abuse | Reply
  11. Pedro Gonzalez

    Technically I was born caucasion, but ever since I can remember, I've liked black music and hair styles and especially black women. I've always just felt...black. And I've lived most of my entire life as a black person. But due to my blonde hair and blue eyes, I have been discriminated against and laughed at and unable to apply for minority status or claim discrimination. Some people claim I am transracialized, but the government will not recognize my status. Its really an unfair and cruel world for people like me.

    February 27, 2013 at 12:15 | Report abuse | Reply
    • Jimmie Hen

      Well go get a fake tan, some dark contact lenses, an afro wig and a penis enlargement surgery. I can guarantee you will feel like a new man. And black girls will be all over you.
      Good luck

      August 22, 2013 at 06:29 | Report abuse |
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