One issue that is both important and frustrating to me is what to do with children who show “cross gender behaviour”. For example, little Timmy is five years old. He wants to play with dolls, wear dresses, and keep his hair long. That may be all or he may go even further and insist that he is a girl named Tina. Most of his friends are likely girls, though that very much depends on location (where I grew up we weren’t split into boys vs girls).
There are two schools of thought on how to handle little Timmy. On the far left side you have people (like Dr. Norman Spack) who believe that Timmy should transition completely to live as Tina. Dr. Spack believes that Timmy will grow up to be a transwoman, therefore early social transition is the best treatment option. Once Tina hits 10 or so he will likely place her on hormone blockers to prevent male puberty from taking place.
Then you have the far right side. Dr. Kenneth Zucker advocates a treatment plan that is the exact opposite of Dr. Spack’s. Rather than having Timmy transition, Zucker would have Timmy’s parents insist that he is a healthy little boy. His dolls would be taken, along with his dresses and pink bedsheets. He would have his hair cut and be instructed in how to play with other little boys. His parents would continue to find “boy” activities for him to participate in until they found one that worked. If Timmy continues to want dolls and “girl” things into puberty then — and only then — would Dr. Zucker consider treatment. By this point Timmy would be too old for hormone blockers, but he would be just barely old enough to start hormone replacement therapy, the standard treatment plan for adult MtF transexuals.
I dislike both of these options. The reasons for disliking the Zucker method are rather obvious, he essentially advocates reparative therapy for small children. However, most transpeople believe that Spack’s method is ideal. I am one of the few exceptions. Why? Because upwards of 75% of children with cross-gender behaviour grow up to be cisgendered (non-trans) adults. Most of them are gay men/lesbians, but at the end of the day they don’t feel the need to transition.
By fully transitioning children before they’ve ever hit puberty we are essentially creating transpeople. I can’t support that. Not because I believe transpeople shouldn’t exist (I obviously like my existence), but because it will mean life is infinitely more difficult for those children than it has to be.
Instead I take a more moderate approach. Timmy wants to wear dresses? Let him wear dresses. Why shouldn’t he? He can play with dolls, keep his hair long, even be called Tina if he really wants. I’d prefer a more gender neutral nickname, but hey, I knew a kid who insisted on being called Skydawn Velociraptor at one point. School isn’t likely to be a huge problem simply because I plan on homeschooling, but if I wasn’t I’d spend large amounts of time trying to find the best school for Timmy/Tina. One where the staff is open to letting him play and dress however he likes (provided it’s school appropriate, of course) and will shut down any bullying as quickly as possible. Essentially I’d like him to go to a school like the ones I grew up in.
I’d also be sure that Timmy was raised in a household where transpeople were made a reality through books, tv shows, anything I could find. He would know that some girls grow up to be men and some boys grow up to be women and I don’t care which he is as long as he’s happy. (Obviously gay-themed books would already be included simply because he’d have two daddies.) It is important that he have the words to describe what he’s feeling in case he does grow up to be trans.
At some point puberty will begin to peek up over the horizon. This is an incredibly important time for children who may be trans. Why? It’s when most children with cross-gender identification either revert to their birth gender or become adamant about transition. It’s also when those of us who had no concept of gender in our pre-puberty years begin to realise that something is wrong. Hormones are shifting, dating is becoming more than just an idea, and sex is everywhere. This is the time that is most difficult if you haven’t already prescribed to either the Zucker or Spack method of raising cross-gender children.
At around 10 (closer to 8 or 9 for female children) I’d start watching Timmy/Tina very closely. Does he still like pink and glitter and play with girls instead of boys? Is he excited about puberty? Afraid of it? With any luck we’d have developed a close enough relationship by this point for me to be able to ask things like “do you want to be a man or a woman when you grow up?” (I realise that’s an odd question for most parents, but if you have children with cross-gender behaviour it’s a question you need to get used to.) If there is any sign that Tina/Timmy might hurt himself due to displeasure with his body that would be the time for me to load him into the car and get him to a doctor that will prescribe hormone blockers. I do not play around with self harm, even if he later decides to be Timmy (or, I suppose, Tim by that point) at least he is alive to make the decision.
If there’s no indication that Timmy is displeased with his body then I’d let it go a little longer. Let’s say a year (with, of course, more careful watching). Then reevaluate. Still mostly girl friends, but no longer wearing dresses? Ambivalent about puberty? Alright, repeat for another year. At some point it will become obvious that Timmy is either Timmy or Tina. If I’m not fully sure I’d do this amazing thing called asking. Since he’d been raised to understand what transpeople are he would know what I’m asking about and be able to answer.
It’s not as clear cut an approach as either Zucker or Spack’s methods. It requires more observation, more intensive care, and more ambivalence about where your child is going to end up than either of those. It requires the belief that little boys can wear dresses and little girls can be cowboys. If you are at all afraid of your child growing up to be a drag queen it’s not likely to be an approach that works for you. However, it’s also the most child driven approach I’ve been able to find. It’s the only one that allows the child to make decisions based solely on how they feel rather than how society thinks boys and girls should act. It’s not perfect, there are always going to be influences from other people, but in my opinion it’s better than forcing a child into a mold at an early age.