The origins of Gender Identity Disorder (GID) are complex and multi-factorial.  They are described in this chapter www.childhealing.com/articles/ genderidentitydisorder.php.  GID is the most common childhood precursor to transsexual issues.  The primary emotional conflict in these children is the failure of the child to identify with and accept the goodness of one's masculinity or femininity.

Some young male children who lack eye-hand coordination and, are not confident playing sports, don't join male peers in athletic activities because of fear of being rejected. Such rejection can be subtle in that boys who are not proficient in sports may not be invited to join in team play, a major form of male bonding in childhood, simply because they can't help the team. The fear of rejection however, often leads them to turn to girls for friendship. For some this leads to over identification with these friends and the development of feminine traits in speech and in mannerisms. Symptoms of effeminacy and strong identification with females can intensify eventually leading to the development of a gender identify disorder. (See Gender Identity Disorder article at www.narth.com.)   Also, the absence of a father-role model in the home can contribute in some males to identity confusion.

A less common cause of GID is seen in males who have powerful artistic and creative gifts that lead to a strong attraction to the beauty in the female world and to an identification with femininity. This artistic response can begin early in childhood and can lead to a desire to be female. In rare cases, a parent wanting a child to be of the opposite sex and dresses and treats a boy as a female or a girl as a male. In addition some boys act in a feminine manner because they perceive their fathers as giving preferential treatment to an older sister. By acting like a sister they unconsciously hope to gain more attention and acceptance from the father.

In addition, a poor body image in a male as a result of being overly thin, small in stature or a lack of musculature can contribute to a profound sense of insecurity in one's masculinity, self-rejection or self-hatred in a culture obsessed with the body and a failure to appreciate the goodness of one's masculinity.  The developmental faliure in appreciating the goodness in one's masculinity lead to an identification with femininity. Cognitive distortions can then develop and include thinking that my body is inadequate and not truly masculine and that I would be happier with a female body.

GID in young girls can develop the desire to please a parent as well as the lack of acceptance by same sex peers. This results in low self-esteem and later self-hatred. Failure to attach securely to and to identify with the mother can be another factor. These young girls have no support to, or for other reasons, fail to to embrace the goodness of their femininity. Young females who don't identify with their femininity, are "tom boys" and are overly involved in athletic activities can be difficult to identify in a culture which is so supportive of their involvement with sports.

In addition in a culture in which young females are influenced to think that their femininity is determined primarily by their bodies, girls can develop a negative view of themselves if their bodies don't fit the cultural model of being thin. Then, a lack of acceptance by female peers and a hatred of one's body and ultimately of one's femininity can develop. Some of these females meet the criteria for a Body Dysmorphic Disorder.

Drs. Zucker and Bradley in their textbook on GID report that 80% of children with this disorder experience a resolution of their symptoms.  Zucker and Bradley's research also demonstrates serious emotional conflicts in the majority of the mothers of these children.

The Catholic Medical Association has information available on understanding children who have difficulty embracing the goodness of their masculinity or femininity and the desire for cross dressing at www.narth.com/docs/ CMApressrelease.pdf.  

Transsexual issues

Several articles on the transsexual issues, the desire for sex change surgery (www.narth.com/docs/desiresch.html, www.mercatornet.com/articles/view/ vile_bodies_and_quack_remedies) can be helpful in ministry to families with this conflict.  Dr. Paul Mc Hugh, the former chair person of psychiatry at John Hopkins, has written an excellent article on his study of transsexual surgery there on how he worked to bring to an end this surgery at Hopkins.

Based on his research findings as result of studying these patients before and after surgery Dr. Paul Mc Hugh stated: “I concluded that Hopkins was fundamentally cooperating with a mental illness. We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia." He added, “As for the adults who came to us claiming to have discovered their "true" sexual identity and to have heard about sex-change operations, we psychiatrists have been distracted from studying the causes and natures of their mental misdirections by preparing them for surgery and for a life in the other sex. We have wasted scientific and technical resources and damaged our professional credibility by collaborating with madness rather than trying to study, cure, and ultimately prevent it.”

An article in the National Catholic Bio ethics Quarterly, Spring 2009, The Psychopathology of "Sex Reassignment" Surgery, assesses the medical, psychological and ethical appropriateness of sexual reassignment surgery.  Sexual reassignment surgery (SRS) violates basic medical and ethical principles and is therefore not ethically or medically appropriate. (1) SRS mutilates a healthy, non-diseased body. To perform surgery on a healthy body involves unnecessary risks; therefore, SRS violates the principle primum non nocere, "first, do no harm." (2) Candidates for SRS may believe that they are trapped in the bodies of the wrong sex and therefore desire or, more accurately, demand SRS; however, this belief is generated by a disordered perception of self. Such a fixed, irrational belief is appropriately described as a delusion. SRS, therefore, is a "category mistake", it offers a surgical solution for psychological problems such as a failure to accept the goodness of one's masculinity or femininity, lack of secure attachment relationships in childhood with same-sex peers or a parent, self-rejection, untreated gender identity disorder, addiction to masturbation and fantasy, poor body image, excessive anger, and severe psychopathology in a parent. (3) SRS does not accomplish what it claims to accomplish. It does not change a person's sex; therefore, it provides no true benefit. (4) SRS is a "permanent," effectively unchangeable, and often unsatisfying surgical attempt to change what may be only a temporary (i.e., psychotherapeutically changeable) psychological/psychiatric condition. www.ncbcenter.com.

At the very least, health professionals who deal with these individuals and their families should evaluate the part of strong anger with oneself and others, self-pity, childhood trauma, addiction to masturbation and fantasy, envy play and parental emotional conflicts in the development of these conflicts.  These persons also should be evaluated for both borderline or narcissistic personality disorders.

In December 2008 Pope Benedict expressed his views about gender, “That which is often expressed and understood by the term Gender, results finally in the self-emancipation of man from creation and from the Creator. Man wishes to act alone and to dispose ever and exclusively of that alone which concerns him. But in this way he is living contrary to the truth, he is living contrary to the Spirit Creator.  The tropical forests are deserving, yes, of our protection, but man merits no less than the creature, in which there is written a message which does not mean a contradiction of our liberty, but its condition,” Pope Benedict, December 22, 2008.