Transgender youth

Transgender youth are children and adolescents who identify as transgender and/or transsexual. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, and because most doctors are reluctant to provide medical treatments to them, transgender youth face different challenges related to their condition when compared to adults. Transgender conditions manifest at different times in life in different individuals. In most cases of gender identity disorder (GID), the condition is often apparent in early childhood, when such a child may express behavior incongruent with and dissatisfaction related to his, or her assigned gender. However, many of these children experience rejection as a result of their differences and quickly attempt to repress them. Therefore, people who see these children regularly may be unaware that they are unhappy as members of their assigned gender.

According to the DSM-IV, most children diagnosed with gender identity disorder will establish an identity as a member of their assigned sex in adolescence or adulthood. However, it is known that many transgender and transsexual youth retain their trans identity in adulthood and the factual accuracy of the DSM, in regard to this matter, has been questioned.

Coming out
In many parts of the world, transgender and transsexualism are not widely accepted by the public. Therefore, transgender youths may feel that they need to remain in the closet until they feel that it is safe and appropriate to reveal their gender identity to their parents and other family members and friends. This is probably justifiable, as parents usually have a great deal of influence in their children's lives, and many parents will react negatively to such news. However, some parents are very supportive when such news is broken to them. It may be impossible to predict a parent's reaction to such news, and the process is fraught with tension for many transsexual youths. Additionally, reactions of parents to transsexual children can change over time. For example, parents who initially reacted with negativity and hostility may eventually come around to support their transgender children. And parents who were initially supportive may later develop hostility toward their child's gender identity.

Transgender youths potentially face many hardships in obtaining medical treatment for their condition. Psychiatrists and endocrinologists are generally reluctant to provide hormone therapy to youths under 16, and obtaining sex reassignment surgery prior to the age of 18 is almost impossible in most countries. However, the latest revision of the Harry Benjamin Standards of Care has addressed the needs of transgender children. Currently, the SOC allows for medications for prevention of puberty to be prescribed to these children as soon as the first signs of puberty become apparent.

Puberty
Puberty is a very difficult time for almost all transsexual youth, and many other transgender youth as well. Puberty is often considered to be a difficult time for everyone in many ways. But unlike their peers, who may be excited about bodily changes and thrilled with growing up, transsexual youth are appalled by the changes that take place. While their peers may seem to be happy about going through puberty, the changes that they are experiencing do not feel right. The androgyny of childhood is lost at this time, and transsexual youths see changes in their bodies that make them very uncomfortable and put them through considerable agony.

In addition, many physicians insist that adolescents go through the puberty associated with their chromosomal sex before they prescribe hormones that could have prevented the feminization or masculinization of a transsexual man or transsexual woman, respectively. Because of this, transsexual people must often undergo expensive, risky, time-consuming, and painful procedures to reverse pubertal changes that could have been prevented with early intervention. Additionally, some pubertal changes, like the widening of a young transman's pelvic bone, or the broadening of a young transwoman's shoulders, can never be corrected. During puberty, some young transwomen attempt to perform castration on themselves, but often, they are not successful, and self-castration is generally considered to be dangerous. However, as stated above, the Standards of Care now authorize, and an increasing number of physicians are willing to prescribe hormone blockers to trans children in order to prevent puberty.

Ensuring the child's security
In recent years, some transgender children have received counseling and, in some cases, medical treatment for their condition, as well as the ability to change their gender role. In some countries, schools are working to accommodate gender identity and expression by eliminating traditional gendered activities.

Families with a young child who may identify as a member of "the opposite" sex and who chooses to alter his or her gender role through dress or behaviors may respect their child's decision, and sometimes, may decide to relocate the child to another area in order to afford the young person the best opportunity to live in their desired gender role among a novel set of peers and community. This helps protect trans children from peer rejection, bullying, and harassment.

Families who choose to continue living with such a child within an intolerant community which has had previous experience with the child as a member of his/her assigned sex, may face challenging issues. Gwen Araujo of Newark, California was a young person who was living as female, when she had been assigned to the male gender at birth. When her trans status was revealed at a party she attended, she became the victim of violent crimes that resulted in her death. Thankfully the Araujo case is an extreme one, however parents should be aware of the social implications of their transgender child living in an unsafe environment.

The film Ma Vie en Rose (My Life in Pink) (1997) by Alain Berliner depicts a similar scenario. Ludovic is a young child who is assigned male but who lives as a girl and tries to make others agree with her identification. Ludovic's "gender play" incurs conflict within the family and prejudice from the neighbors; in the end, the family had to relocate to a new community.

The 1999 documentary film Creature, directed by Parris Patton tells the story of Stacey "Hollywood" Dean, a young transsexual woman who grew up in rural North Carolina. It follows her over four years and includes interviews with her conservative Christian parents.

The decision to relocate, however, depends on the social environment and the handling of the situation by caregivers and other adults. There were cases in which no need was felt to relocate, particularly in Western Europe.

Australia
The Australian Socio-legal foundations for transgender youth were only recently established. Foundations were formed with the case 2004 Fam CA 297 ("Re Alex"). Re Alex examined the rights of a 13 year old born female to take hormonal treatment to facilitate “becoming” male. The courts gave the alias of Alex to protect [him]. Debate emerged over if it was the body or the mind that required treatment. Throughout the case a variety of views were expressed, this article attempts to cover a representative variety of the views.

Human Rights and Equal Opportunity Commission (HREOC)
HREOC gave a submission of three principles. First, the right of a child to live with a transgender identity. Second, that it is in a child’s best interest to have that right respected and last that identity should not be limited to medical or surgical definitions.

Mr Flemming
Flemming put forward argument that if Alex was granted treatment it would follow that if someone deemed themself to be a horse would society then be required to allow treatment to become a horse. This argument reduces the issues at hand to the level of the absurd and has been criticized by Sandor (2004) as insensitive.

Associate Professor Jeffreys
Jeffreys, a Political Science at the University of Melbourne argument discredits Flemming’s argument. Jeffreys argues that Gender Identity Dysphoria is a “fossil” and that there should be no correlation between body shape and right behaviour.

Senior Law Lecturer Millbank
Millbank from Sydney University supported Jeffreys’ argument. Millbank argued that male roles are not fixed, a community in South Africa as an example. The community in question allows families without sons to give the oldest female the role traditionally assigned to the male. This means [s]he will marry and take on traditional functions of the male.

Catholic Spokesman Mr Campbell
Campbell argued along a similar line to Flemming. This is unsurprising given Flemming and Campbell share close ties to the Catholic Church. Campbell claims that for a large number of people this is just a “stage” and will pass. Consistent with his argument he recommends psychotherapy treatment.

Outcomes
Recent research has shown that in carefully selected patients, people who transition young suffer few ill effects, and maintain a higher level of functioning than before transition. Additionally, results of treatment are considered better when it is offered at an earlier age.