Doctor on the Side

I began residency on a particularly interesting note: a rotation through “Developmental and Behavioral Pediatrics.”  Between spending time evaluating kids for autism, adjusting ADHD medications, and rating prematurely born toddlers’ developmental milestone achievements, I was assigned the task of preparing a presentation regarding a topic of my choosing.  My topic was to represent ANY aspect of child development—be it normal or abnormal—and I would end my rotation by leading an interactive discussion with the behavioral/developmental pediatricians and fellows at my residency program.

My topic selection came easily, as I chose something I have always been interested in: the poorly understood, but developmentally normal circumstance of “gender variance.”  What is that, you say?  Gender variance is a person’s naturally persistent pattern of preferences and behaviors characterized as typical of the opposite gender.  When I learned that one of the doctors at my program conveniently is a national expert on childhood gender variance, I JUMPED on the opportunity to be mentored by her.  The rest of my month, as you can probably anticipate, was faaaaaaabulouuuus!!!

With this project, I dove into the issue of differentiating “sex” from “gender,” and exploring society’s role in archaically defining “what is masculine” from “what is feminine.”  By reading through case reports of children as young as one and two years of age with preferences deviating from society’s expected “norm,” I confirmed my suspicion that gender variance is as naturally present from birth as is dark or pale skin.  I learned that kindergarteners will not ridicule a boy who likes Barbies or a girl who dresses up as Batman unless they have learned intolerance from their parents.  I learned that—regardless of gender variance or gender typicality—the happiest, strongest, most resilient, and most successful children are those who are unconditionally accepted, loved, and supported.  I was exposed to the terrible reality that the constant, undeserved marginalization experienced by the gender variant population places them at an unforgivably high risk for severe secondary psychopathology (anxiety, depression, suicide).  And gender variant children present to our developmental/behavioral clinic not because they need fixing, but because their parents and families need a whole lot of educating.

I also learned about “The Sissy Duckling” by Harvey Fierstein, a WONDERFUL children’s book that you need to click here and buy RIGHT NOW.  Come on, it’s like $7.99!  It is beautifully written and illustrated (and that is coming from someone who both reads, and draws!).  The story is creative, funny, applicable to everyday life, and educational to child and adult alike.  More importantly, sharing such stories with our kids/nieces/nephews/students/patients/everybody is the first step we can take as a society to spread the message of love, equality, and embracing differences.  After all, kids only do, say, and think as they learn from adults, perpetuating a cycle that can just as easily uplift as it can destroy.

So lets wake up and smell the 21st century coffee, people!  It’s time to get educated, practice tolerance, and do our part in promoting love, acceptance and understanding.  Opt for uplifting.

Resources for kids, teens, and families:

• Children’s National Gender and Sexuality Psychosocial Programs
• Parents, Friends and Families of Lesbians and Gays (PFLAG)
• Trans Youth Family Allies
• GenderSpectrum.Org
• Trans Youth Equality Foundation
• Gay, Lesbian, and Straight Education Network (GLSEN)

Sweet books for kids and early teens!

• My Princess Boy
• The Sissy Duckling
• It’s Perfectly Normal

Books for young adults and parents:

• Not Like Other Boys
• Gender Born, Gender Made
• Sissies & Tomboys

And of course, the powerpoint presentation of the hour ↓

An Unexpected Chief Complaint: Addressing gender variance in pediatric primary care

My talk was awesome, and I could not have hoped for the response to my topic to be more positive, or for the dialogue that ensued between the developmental/behavioral docs and I to have been any more fascinating.  My project mentor recently offered me the opportunity to conduct a prospective study of gender variant children with her, and I accepted.

“An Unexpected Chief Complaint: Addressing gender variance in pediatric primary care” may be used for personal, public, and educational purposes with permission from the author.  Please let me know!  I would love to hear from you.

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