XVII Harry Benjamin International Gender Dysphoria Association Symposium
31 October - 4 November 2001, Galveston, Texas, U.S.A.

Current Views on the Management of Gender Identity Disorder in Young People

DI CEGLIE, DOMENICO U.K.
E-mail: gidu@tavi-port.demon.co.uk

In this presentation I will describe a model of management of gender identity disorders in children and adolescents, which is based on a staged approach.

Stage 1 of the process for children and adolescents involves the therapeutic exploration of the nature of their atypical gender identity organization. I will outline how "a psychotherapeutic stance" can be used to explore the nature and characteristics of such an organization, as well as to alleviate the associated psychological and social difficulties which these children and adolescents often present. The therapeutic aims in this phase of the work will be described. Stage 2 includes wholly reversible interventions. These involve the use of hypothalamic blockers that suppress the production of estrogen and testosterone. Stage 3 includes partial reversible interventions, such as hormonal treatment that masculinizes or feminizes the body. Stage 4, to be considered in adulthood, includes irreversible interventions such as surgical procedures.

The paper puts forward the view that these interventions are best carried out within an integrated, comprehensive, multi-disciplinary assessment and treatment program. The involvement in this process of the social network, such as the school, will also be considered. The value of this model of management will be discussed with special reference to the crucial function of engaging the group of children and teenagers and their families with the service and provide a containing framework for, at times, painful and unbearable experiences, particularly during adolescence.