In the past, the major difficulty with gender identity issues was that they were perceived as rare conditions and people who had them were therefore isolated and affected by being misunderstood. The transgendered were repressed, persecuted or not taken seriously, and consequently suffered with loneliness and depression.

A boy may have said he felt he was really a girl, but as such a thing was so little heard of he would not be believed and would learn to keep that subjective experience secret and suffer accordingly. The internet has made transgenderism in children more widely known, which makes it easier for it to be accepted and, hopefully, more normal. But as the recent spate of sensationalist news stories about young children with the condition show, we, as a culture, have work to do: "normality" needs to widen its net.

When raising any child, gender dysphoric or not, upbringing should not be about whether to oppress or indulge children, as it too often is. Ideally the carers of a gender dysphoric child should neither be punitive nor overly enthusiastic, as both of these responses would be judgmental. A judgment is a bit like a full stop and, once reached, further exploration tends to cease. Instead, adults need to honour children's subjective experience. They should endeavour to understand and validate a child's feelings.

Validation teaches children to be able to empathise with others' subjective experience too, thus learning to accept that how one person feels may be different to how another does. Whether a child thinks he is Batman or identifies as female despite having male genitalia, his experience should be honoured. We usually assume that he will grow out of being Batman but we cannot assume that he will grow out of wanting to be a girl, although he may well do. This is because it may be difficult to ascertain whether wanting to be a girl is merely a passing game, or something that won't leave him. It may come with one or more of the many preconditions that can cause gender dysphoria. These preconditions can be grouped into hormonal, social or environmental factors, and may exist in any combination.

Nor can we immediately ascertain how deep such influences have gone. The child is unlikely to be able to give you reasons for why he prefers to be a girl than a boy. His feelings, though possibly strong, are inchoate and are probably not yet ready to be processed into words that form a sophisticated argument. They might never be. The difficulties that even many adult transsexuals have in putting the experience of gender dysphoria into words has me guessing that its causes may be pre-verbal whether they are environmental or biological. However intelligent they are, adult transsexuals often say, "I'm a woman trapped in a man's body", or the reverse if they are female-to-male transsexuals. This cliche tends to get repeated because it is a hard thing for which to find different or more specific words.

It is difficult for many of us to imagine what it is like to feel trapped in a body that seems to be of the wrong gender. It is so far from common subjective experience of being that a first reaction is often to think that gender dysphoria is a choice and one that must only be made as an adult. But it is not a choice, it is a condition. And in some cases it is so definite that the gender dysphoric person wants to change their body.

It may be that their lives will be made easier if hormone treatments are started just before puberty. But for parents faced with this prospect, they should be aware it is not a decision made in isolation. There is guidance and help from specialist psychiatrists and psychologists about whether this way of proceeding is advisable for any particular child. Although the phenomenon of young children believing they are gender dysphoric may seem new as the popular media has just got hold of it, a book like Gender Identity Disorder and Psychosexual Problems in Children and Adolescents by Kenneth Zucker and Susan Bradley shows there is long-term research and experience in this field.

It may be daunting for a parent to adjust to a new gender identity for their child or to think that their child may, later in life, put themselves through painful surgery to change their external appearance in order to feel more comfortable.

My suggestion would be not to get carried away by fears of the future and to stay in the present, doing what makes the child most comfortable now. If a person is understood and accepted by their family of origin, they tend to know how to be accepted in the wider world now and later on.

Much psychological distress comes from not having our own subjective experience of ourselves understood by another person. The tyranny of what is generally perceived to be normal causes some of us to feel abnormal. The abnormality has little to do with an individual's subjective experience of herself and more to do with what other people think she should feel and how she should behave.

Sometimes I think we ask the wrong questions. Instead of asking why a boy thinks he ought to be a girl, we should ask what is it about our culture that we cannot allow that person to conduct him or herself sensitively and spontaneously in the world without recourse to our having to pathologise them. What is wrong with us that we feel unable to endorse the experience as it is?

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