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I’m a Pediatrician. Here’s What I Did When a Little Boy Patient Said He Was a Girl.

“Congratulations, it’s a boy!” Or, “Congratulations, it’s a girl!”

As a pediatrician for nearly 20 years, that’s how many of my patient relationships began. Our bodies declare our sex.

Sex vs. Identity

Biological sex is not assigned. Sex is determined at conception by our DNA and is stamped into every cell of our bodies. Human sexuality is binary. You either have a normal Y chromosome, and develop into a male, or you don’t, and you will develop into a female. There are at least 6,500 genetic differences between men and women. Hormones and surgery cannot change this.

An identity is not biological, it is psychological. It has to do with thinking and feeling. Thoughts and feelings are not biologically hardwired. Our thinking and feeling may be factually right or factually wrong.

If I walk into my doctor’s office today and say, “Hi, I’m Margaret Thatcher,” my physician will say I am delusional and give me an anti-psychotic. Yet, if instead, I walked in and said, “I’m a man,” he would say, “Congratulations, you’re transgender.”

If I were to say, “Doc, I am suicidal because I’m an amputee trapped in a normal body, please cut off my leg,” I will be diagnosed with body identity integrity disorder. But if I walk into that doctor’s office and say, “I am a man, sign me up for a double mastectomy,” my physician will. See, if you want to cut off a leg or an arm you’re mentally ill, but if you want to cut off healthy breasts or a penis, you’re transgender.

‘No One is Born Transgender’

No one is born transgender. If gender identity were hardwired in the brain before birth, identical twins would have the same gender identity 100 percent of the time. But they don’t.

I had one patient we’ll call Andy. Between the ages of 3 and 5, he increasingly played with girls and “girl toys” and said he was a girl. I referred the parents and Andy to a therapist. Sometimes mental illness of a parent or abuse of the child are factors, but more commonly, the child has misperceived family dynamics and internalized a false belief.

Read more at The Stream. 

 

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