Skip to main content
SpringerLink
Log in

Is Gender Identity Disorder in Children a Mental Disorder?

  • Published:
Sex Roles Aims and scope Submit manuscript

Abstract

Empirical studies were evaluated to determine whether Gender Identity Disorder (GID) in children meets the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV, American Psychiatric Association, 1994) definitional criteria of mental disorder. Specifically, we examined whether GID in children is associated with (a) present distress; (b) present disability; (c) a significantly increased risk of suffering death, pain, disability, or an important loss of freedom; and if (d) GID represents dysfunction in the individual or is simply deviant behavior or a conflict between the individual and society. The evaluation indicates that children who experience a sense of inappropriateness in the culturally prescribed gender role of their sex but do not experience discomfort with their biological sex should not be considered to have GID. Because of flaws in the DSM-IV definition of mental disorder, and limitations of the current research base, there is insufficient evidence to make any conclusive statement regarding children who experience discomfort with their biological sex. The concluding recommendation is that, given current knowledge, the diagnostic category of GID in children in its current form should not appear in future editions of the DSM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Achenbach, T. M., & Edelbrock, C. (1981). Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. Monograph of the Society for Research in Child Development, 46(1, Serial No. 188).

  • Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213–232.

    Google Scholar 

  • Albers, S.M. (1998). The effect of gender-typed clothing on children's social judgements. Child Study Journal, 28, 137–159.

    Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.).Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (Rev. 3rd ed.).Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.).Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association Committee onGay, Lesbian, and Bisexual Issues of the Council on National Affairs. (1993). Position statement on homosexuality. American Journal of Psychiatry, 150, 686.

    Google Scholar 

  • Andison, C., & LeMare, L. (1999, April). Learning disabilities and peer victimization in schools. Poster presented at the biennial meeting of the Society for Research in Child Development, Albuquerque, NM.

  • Babinski, S., & Reyes, A. (1994). Identity formation in adolescence: Case study of gender identity disorder and treatment through an intermediate-care day hospital. Psychiatric Quarterly, 65, 121–133.

    Google Scholar 

  • Bailey, J. M., & Zucker, K. J. (1995). Childhood sex-typed behavior and sexual orientation: A conceptual analysis and quantitative review. Developmental Psychology, 31, 43–55.

    Google Scholar 

  • Bartlett, N. H. (2000). Aggression in early adolescence: The role of familial and dominancerelated characteristics in determining sex differences in bully/victim status. Manuscript in preparation, Concordia University, Montreal, Quebec.

    Google Scholar 

  • Bates, J. E., Bentler, P. M., & Thompson, S. K. (1973). Measurement of deviant gender development in boys. Child Development, 44, 591–598.

    Google Scholar 

  • Bates, J. E., Bentler, P. M., & Thompson, S. K. (1979). Gender-deviant boys compared with normal and clinical control boys. Journal of Abnormal Child Psychology, 7, 243–259.

    Google Scholar 

  • Bates, J. E., Skilbeck, W. M., Smith, K.V. R., & Bentler, P.M. (1974). Gender role abnormalities in boys: An analysis of clinical ratings. Journal of Abnormal Child Psychology, 2, 1–16.

    Google Scholar 

  • Bell, A. P., Weinberg, M. S., & Hammersmith, S. K. (1981). Sexual preference: Its development in men and women. Bloomington, IL: Indiana University Press.

    Google Scholar 

  • Bem, S. L. (1993). The lenses of gender: Transforming the debate on sexual inequality. New Haven: Yale University Press.

    Google Scholar 

  • Bentler, P. M., Rekers, G. A., & Rosen, A. C. (1979). Congruence of childhood sex-role identity and behavior disturbances. Child: Care, health and development, 5, 267–283.

    Google Scholar 

  • Bleiberg, E., Jackson, L., & Ross, J. L. (1986). Gender identity disorder and object loss. Journal of the American Academy of Child Psychiatry, 25, 58–67.

    Google Scholar 

  • Boivin, M., Dodge, K. A., & Coie, J. D. (1995). Individual-group behavioral similarity and peer status in experimental play groups of boys:The social misfit revisited. Journal ofPersonality and Social Psychology, 69, 269–279.

    Google Scholar 

  • Boivin, M., Hymel, S., & Bukowski, W. M. (1995). The roles of social withdrawal, peer rejection, and victimization by peers in predicting loneliness and depressed mood in childhood.Development and Psychopathology, 7, 765–785.

    Google Scholar 

  • Boulton, M. J., & Smith, P. K. (1994). Bully/victim problems in middle-school children: Stability, self-perceived competence, peer perceptions and peer acceptance. British Journal of Developmental Psychology, 12, 315–329.

    Google Scholar 

  • Bradley, S. J., & Zucker, K. J. (1990). Gender identity disorder and psychosexual problems in children and adolescents. Canadian Journal of Psychiatry, 35, 477–486.

    Google Scholar 

  • Bradley, S. J., & Zucker, K. J. (1997). Gender identity disorder: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 872–880.

    Google Scholar 

  • Browne, F.W. S. (1923). Studies in feminine inversion. Journal of Sexology and Psychoanalysis, 51–58.

  • Burke, P. (1996). Gender shock: Exploding the myths of male and female. New York: Anchor Books, Doubleday.

    Google Scholar 

  • Buss, D. M., Haselton, M. G., Shackelford, T. K., Bleske, A. L., & Wakefield, J. C. (1998). Adaptations, exaptations, and spandrels. American Psychologist, 53, 533–548.

    Google Scholar 

  • Carpenter, E. (1911). Love's coming-of-age. A series of papers on the relations of the sexes. New York: Mitchell Kennerley.

    Google Scholar 

  • Carter, D. B., & McCloskey, L. A. (1984). Peers and the maintenance of sex-typed behavior: Children's conceptions of cross-gender behavior in their peers. Social Cognition, 2, 294–314.

    Google Scholar 

  • Chauncey, G., Jr. (1989). From sexual inversion to homosexuality: The changing medical conceptualization of female “deviance.” In K. Peiss & C. Simmons (Eds.), Passion and power: Sexuality in history. Philadelphia: Temple University Press.

    Google Scholar 

  • Chazan, S. E. (1995). The simultaneous treatment of parent and child. New York: Basic Books.

    Google Scholar 

  • Claiborne, J.H. (1914). Hypertrichosis in women. Its relation to bisexuality (hermaphroditism): With remarks on bisexuality in animals, especially man. New York Medical Journal, 99, 1178–1184.

    Google Scholar 

  • Coates, S. (1990). Ontogenesis of boyhood gender identity disorder. Journal of the American Academy of Psychoanalysis, 18, 414–438.

    Google Scholar 

  • Coates, S., & Person, E. S. (1985). Extreme boyhood femininity: Isolated behavior or pervasive disorder? Journal of the American Academy of Child Psychiatry, 24, 702–709.

    Google Scholar 

  • Conaty, T., & Lobel, K. (1998, March). National Gay & Lesbian Task Force statement on gender identity disorder and transgender people. [On-line news service]. Retrieved May 1, 1998, from theWorldWideWeb: http://www.gendertalk.com/GTransgr/ngltfl.html

  • Connor, J. M., Serbin, L. A., & Ender, R. A. (1978). Responses of boys and girls to aggressive, assertive, and passive behaviors of male and female characters. Journal of Genetic Psychology, 133, 59–69.

    Google Scholar 

  • Craig, W.M. (1996,August). The relationship among bullying, victimization, depression, anxiety, and aggression in elementary school children. Paper presented at the 14th biennial meeting of the International Society for the Study of Behavioral Development, Quebec City, QC.

  • Dahl, E. K. (1988). Fantasies of gender. Psychoanalytic Study of the Child, 43, 351–365.

    Google Scholar 

  • D'Emilio, J., & Freedman, E. B. (1988). Intimate matters: A history of sexuality in America. New York: Harper & Row.

    Google Scholar 

  • Di Ceglie, D. (1995). Gender identity disorders in children and adolescents. British Journal of Hospital Medicine, 53, 251–256.

    Google Scholar 

  • Doering, R. W., Zucker, K. J., Bradley, S. J., & MacIntrye, R. B. (1989). Effects of neutral toys on sex-typed play in children with gender identity disorder. Journal of Abnormal Child Psychology, 17, 563–574.

    Google Scholar 

  • Dowrick, P. W. (1983). Video training of alternatives to cross-gender identity behaviors in a 4-year-old boy. Child and Family Behavior Therapy, 5, 59–65.

    Google Scholar 

  • Ellis, H. (1942). Sexual inversion. In Studies in the psychology of sex (Vol. 1.). New York: Random House.

    Google Scholar 

  • Epkins, C. C. (1996). Parent ratings of children's depression, anxiety, and aggression: A crosssample analysis of agreement and differences with child and teacher ratings. Journal of Clinical Psychology, 52, 599–608.

    Google Scholar 

  • Fagot, B. I. (1977). Consequences of moderate cross-gender behavior in preschool children. Child Development, 48, 902–907.

    Google Scholar 

  • Fagot, B. (1992). Review ofThe “Sissy Boy Syndrome” and the Development of Homosexuality. Archives of Sexual Behavior, 21, 327–332.

    Google Scholar 

  • Finegan, J. K., Zucker, K. J., Bradley, S. J., & Doering, R. W. (1982). Patterns of intellectual functioning and spatial ability in boys with gender identity disorder. Canadian Journal of Psychiatry, 27, 135–139.

    Google Scholar 

  • Gilmore, K. (1995). Gender identity disorder in a girl: Insights from adoption. Journal of the American Psychoanalytic Association, 43, 39–59.

    Google Scholar 

  • Goddard, R., & Tuber, S. (1989). Boyhood separation anxiety disorder: Thought disorder and object relations psychopathology as manifested in Rorschach imagery. Journal of Personality Assessment, 53, 239–252.

    Google Scholar 

  • Gonsiorek, J.C. (1991).The empirical basis for the demise of the illness model of homosexuality.In J.C. Gonsiorek & J.D. Weinrich (Eds.). Homosexuality: Research implications for public policy. London: Sage.

    Google Scholar 

  • Gould, S. J., & Vrba, E. S. (1982). Exaptations: A missing term in the science of form. Paleobiology, 8, 4–15.

    Google Scholar 

  • Green, R. (1974). Sexual identity conflict in children and adults. New York: Basic Books.

    Google Scholar 

  • Green, R. (1975). The significance of feminine behaviour in boys. Journal of Child Psychology and Psychiatry, 16, 341–344.

    Google Scholar 

  • Green, R. (1976). One-hundred ten feminine and masculine boys: Behavioral contrasts and demographic similarities. Archives of Sexual Behavior, 5, 425–446.

    Google Scholar 

  • Green, R. (1985). Gender identity disorder and later sexual orientation: Follow-up of 78 males. American Journal of Psychiatry, 142, 339–341.

    Google Scholar 

  • Green, R. (1987). The “Sissy Boy Syndrome” and the development of homosexuality. New Haven, CT: Yale University Press.

    Google Scholar 

  • Green, R. (1994). Sexual problems and therapies: A quarter century of developments and changes. In A. S. Rossi (Ed.), Sexuality across the life course (pp. 341–361). Chicago: The University of Chicago Press.

    Google Scholar 

  • Green, R. (1995). Gender identity disorder in children. In G. O. Gabbard (Ed.). Treatments of psychiatric disorders (Vol. 2).Washington: American Psychiatric Press.

    Google Scholar 

  • Green, R., Newman, L. E., & Stoller, R. J. (1972). Treatment of boyhood “transsexualism”: An interim report of four years' experience. Archives of General Psychiatry, 26, 213–217.

    Google Scholar 

  • Green, R., Williams, K., & Goodman, M. (1982). Ninety-nine “tomboys” and “non-tomboys”: Behavioral contrasts and demographic similarities. Archives of Sexual Behavior, 11, 247–266.

    Google Scholar 

  • Haber, C. H. (1991). The psychoanalytic treatment of a preschool boy with a gender identity disorder. Journal of the American Psychoanalytic Association, 39, 107–129.

    Google Scholar 

  • Handwerk, M. L., Larzelere, R. E., Soper, S. H., & Friman, P. C. (1999). Parent and child discrepancies in reporting severity of problem behaviors in three out-of-home settings. Psychological Assessment, 11, 14–23.

    Google Scholar 

  • Harry Benjamin International Gender Dysphoria Association (1998). The standards of care for gender identity disorders (Version 5). Retrieved August 28, 2000, from theWorldWide Web: http://www.hbigda.org/soc.html

  • Harry, J. (1982).Gay children grownup: Gender culture and gender deviance.NewYork: Praeger.

    Google Scholar 

  • Hart, M., Roback, H., Tittler, B., Wetz, L., Walston, B., & McKee, E. (1978). Psychological adjustment of nonpatient homosexuals: Critical review of the research literature. Journal of Clinical Psychiatry, 39, 604–608.

    Google Scholar 

  • Hay, W. M., Barlow, D. H., & Hay, L. R. (1981). Treatment of stereotypic cross-gender motor behavior using covert modeling in a boy with gender identity confusion. Journal of Consulting and Clinical Psychology, 49, 388–394.

    Google Scholar 

  • Hemmer, J.D., & Kleiber, D.A. (1981). Tomboys and sissies: Androgynous children? Sex Roles, 7, 1205–1212.

    Google Scholar 

  • Herdt, G. (Ed.). (1994). Third sex, third gender: Beyond sexual dimorphism in culture and history. New York: Zone Books.

    Google Scholar 

  • Herman, S. P. (1983). Gender identity disorder in a five-year-old boy. TheYale Journal of Biology and Medicine, 56, 15–22.

    Google Scholar 

  • Honingmann, J. J. (1964). The Kaska Indians: An ethnographic reconstruction. New Haven: Yale University Press.

    Google Scholar 

  • Huddleston, E. N., & Rust, J. O. (1994). A comparison of child and parent ratings of depression and anxiety in clinically referred children. Research Communications in Psychology, Psychiatry, and Behavior, 19, 101–112.

    Google Scholar 

  • Kazdin, A. E., Colbus, D., & Rodgers, A. (1986). Assessment of depression and diagnosis of depressive disorder among psychiatrically disturbed children. Journal of Abnormal Child Psychology, 14, 499–515.

    Google Scholar 

  • Kovacs, D. M., Parker, J.G., & Hoffman, L.W. (1996). Behavioral, affective, and social correlates of involvement in cross-sex friendship in elementary school. Child Development, 67, 2269–2286.

    Google Scholar 

  • Krafft-Ebing, R. von (1893). Psychopathia Sexualis, with especial reference to contrary sexual instinct: A medico-legal study (7th ed.). Philadelphia: F. A. Davis.

    Google Scholar 

  • Kupersmidt, J. B., Coie, J. D., & Dodge, K. A. (1990). The role of poor peer relationships in the development of disorder. In S. R. Asher & J. D. Coie (Eds.). Peer rejection in childhood. Cambridge: Cambridge University Press.

    Google Scholar 

  • Lagerspetz, K. M., Bjorkqvist, K., Berts, M., & King, E. (1982). Group aggression among school children in three schools. Scandinavian Journal of Psychology, 23, 45–52.

    Google Scholar 

  • Lamb, M. E., Easterbrooks, M. A., & Holden, G. W. (1980). Reinforcement and punishment among preschoolers: Characteristics, effects, and correlates. Child Development, 51, 1230–1236.

    Google Scholar 

  • Langlois, J. H., & Downs, A. C. (1980). Mothers, fathers, and peers as socialization agents of sex-typed play behaviors in young children. Child Development, 51, 1217–1247.

    Google Scholar 

  • Lilienfeld, S. O., & Marino, L. (1995). Mental disorder as a Roschian concept: A critique of Wakefield's “harmful dysfunction” analysis. Journal of Abnormal Psychology, 104, 411–420.

    Google Scholar 

  • Loeb, L. R. (1992). Analysis of the transference neurosis in a child with transsexual symptoms. Journal of the American Psychoanalytic Association, 40, 587–605.

    Google Scholar 

  • Loeb, L., & Shane, M. (1982). The resolution of a transsexual wish in a five-year-old boy. Journal of the American Psychoanalytic Association, 10, 419–434.

    Google Scholar 

  • Lothstein, L. M. (1992). Clinical management of gender dysphoria in young boys: Genital mutilation and DSM IV implications. Journal of Psychology and Human Sexuality, 5, 87–106.

    Google Scholar 

  • Lowenstein, L. E. (1978). The bullied and non-bullied child. Bulletin of the British Psychological Society, 31, 316–318.

    Google Scholar 

  • Martlew, M., & Hodson, J. (1991). Children with mild learning difficulties in an integrated and in a special school: Comparisons of behaviour, teasing and teachers' attitudes. British Journal of Educational Psychology, 61, 355–369.

    Google Scholar 

  • Menvielle, E. J. (1998). Gender identity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 37,243, 244.

    Google Scholar 

  • Meyer, J. K., & Dupkin, C. (1985). Gender disturbance in children: An interim clinical report. Bulletin of the Menninger Clinic, 49, 236–269.

    Google Scholar 

  • Money, J., & Lehne, G. K. (1993). Gender-identity disorders. In R. T. Ammerman, C. G. Last, & M. Hersen (Eds.), Handbook of prescriptive treatments for children and adolescents (pp. 240–253). Boston. Allyn and Bacon.

    Google Scholar 

  • Money, J., & Russo, A. J. (1979). Homosexual outcome of discordant gender identity/role: Longitudinal follow-up. Journal of Pediatric Psychology, 4, 29–41.

    Google Scholar 

  • Morin, S. F., & Schultz, S. J. (1978). The gay movement and the rights of children. Journal of Social Issues, 34, 137–148.

    Google Scholar 

  • Nanda, S. (1990). Neither man nor woman: The Hijras of India. Belmont, CA: Wadsworth.

    Google Scholar 

  • Nanda, S. (2000). Gender diversity: Cross-cultural variations. Prospect Heights, IL: Waveland.

    Google Scholar 

  • Neisen, J. (1992). Gender identity disorder of childhood: By whose standard and for what purpose? A response to Rekers and Morey. Journal of Psychology and Human Sexuality, 5, 65–67.

    Google Scholar 

  • Newman, L. E. (1976). Treatment for the parents of feminine boys. American Journal of Psychiatry, 133, 683–687.

    Google Scholar 

  • Nordyke, N. S., Baer, D. M., Etzel, B.C., & LeBlanc, J.M. (1977). Implications of the stereotyping and modification of sex role. Journal of Applied Behavior Analysis, 10, 553–557.

    Google Scholar 

  • O'Connell, P., Sedighdeilami, F., Peplar, D. J., Craig, W., Connolly, J., Atlas, R., Smith, C., & Charach, A. (1997, April). Prevalence of bullying and victimization among Canadian elementary and middle school children. Poster presented at the biennial meeting of the Society for Research in Child Development,Washington, DC.

  • Olweus, D. (1993). Bullying at school: What we know and what we can do. Oxford: Blackwell.

    Google Scholar 

  • Perry, D. G., Kusel, S. J., & Perry, L. C. (1988). Victims of peer aggression. Developmental Psychology, 24, 807–814.

    Google Scholar 

  • Phillips, G., & Over, R. (1992). Adult sexual orientation in relation to memories of childhood gender conforming and gender nonconforming behaviors. Archives of Sexual Behavior, 21, 543–558.

    Google Scholar 

  • Pilkington, N. W., & D'Augelli, A. R. (1995). Victimization of lesbian, gay, and bisexual youth in community settings. Journal of Community Psychology, 23, 34–56.

    Google Scholar 

  • Pleak, R. R., Meyer-Bahlburg, H. F. L., O'Brien, J.D., Bowen, H. A., & Morganstein, A. (1989). Cross-gender behavior and psychopathology in boy psychiatric outpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 385–393.

    Google Scholar 

  • Pruett, K. D., & Dahl, K. (1982). Psychotherapy of gender identity conflict in young boys. Journal of the American Academy of Child Psychiatry, 21, 65–70.

    Google Scholar 

  • Reber, A. S. (1985). The Penguin dictionary of psychology. London: Penguin Books.

    Google Scholar 

  • Rekers, G. A. (1979). Sex-role behavior change: Intrasubject studies of boyhood gender disturbance. The Journal of Psychology, 103, 255–269. Retrieved March 14, 1999, from the WorldWideWeb: http//www.leaderu.com/jhs/rekers.html

    Google Scholar 

  • Rekers, G.A. (1982). Growing up straight: What every family should knowabout homosexuality. Chicago: Moody Press.

    Google Scholar 

  • Rekers, G. A. (1986). Inadequate sex role differentiation in childhood: The family and gender identity disorders. Journal of Family and Culture, 2, 8–37.

    Google Scholar 

  • Rekers, G. A. (1991). Psychological foundations for rearing masculine boys and feminine girls. In W. Grudem & J. Piper (Eds.), Recovering biblical manhood and womanhood:Aresponse to evangelical feminism (pp. 292–311).Wheaton, IL: Crossway. Retrieved August 26, 1999, from theWorldWideWeb: http://www.leaderu.com/orgs/cbmw/rbmw/chapter17.html

    Google Scholar 

  • Rekers, G. A., Bentler, P. M., Rosen, A. C., & Lovaas, O. I. (1977). Child gender disturbances: A clinical rationale for intervention. Psychotherapy: Theory, research and practice, 14, 2–11.

    Google Scholar 

  • Rekers, G. A., & Lovaas, O. I. (1974). Behavioral treatment of deviant sex-role behaviors in a male child. Journal of Applied Behavior Analysis, 7, 173–190.

    Google Scholar 

  • Rekers, G. A., Lovaas, O. I., & Low, B. (1974). The behavioral treatment of a “transsexual” preadolescent boy. Journal of Abnormal Child Psychology, 2, 99–116.

    Google Scholar 

  • Rekers, G. A., & Mead, S. (1979). Early intervention for female sexual identity disturbance: Self-monitoring of play behavior. Journal of Abnormal Child Psychology, 7, 405–423.

    Google Scholar 

  • Remafedi, G. (1987). Male homosexuality. The adolescent's perspective. Pediatrics, 79, 326–337.

    Google Scholar 

  • Richardson, J. (1996). Setting limits on gender health. Harvard Review of Psychiatry, 4, 49–53.

    Google Scholar 

  • Richardson, J. (1999). Response: Finding the disorder in gender identity disorder. Harvard Review of Psychiatry, 7, 43–50.

    Google Scholar 

  • Rivers,W. C. (1920). A new male homosexual trait (?). Alienist and Neurologist, 41, 22–27.

    Google Scholar 

  • Rofes, E. E. (1993–94). Making our schools safe for sissies. High School Journal, 77, 37–40.

    Google Scholar 

  • Rosen, A. C., Rekers, G. A., & Bentler, P.M. (1978). Ethical issues in the treatment of children. Journal of Social Issues, 34, 122–135.

    Google Scholar 

  • Sack, W. H. (1985). Gender identity conflict in young boys following divorce. Journal of Divorce, 9, 47–59.

    Google Scholar 

  • Scholinski, D. (1998). The last time I wore a dress. New York: Riverhead Books.

    Google Scholar 

  • Scientific Proceedings—Panel Reports. (1993). Gender Identity Disorder in boys. M. A. Silverman (Chair). Journal of the American Psychoanalytic Association, 4, 729–742.

    Google Scholar 

  • Seil, D. (1996). Transsexuals: The boundaries of sexual identity and gender. In R. P. Cabaj & T. S. Stein (Eds.), Textbook of homosexuality and mental health (pp. 743–762).Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Skilbeck, W. M., Bates, J. E., & Bentler, P.M. (1975). Human figure drawings of gender-problem and school-problem boys. Journal of Abnormal Child Psychology, 3, 191–199.

    Google Scholar 

  • Slee, P. T. (1995). Peer victimization and its relationship to depression among Australian primary school students. Personality and Individual Differences, 18, 57–62.

    Google Scholar 

  • Spitzer, R. L., & Endicott, J. (1978). Medical and mental disorder: Proposed definition and criteria. In Critical issues in psychiatric diagnosis (pp. 15–39). New York: Raven Press.

    Google Scholar 

  • Sroufe, L. A., Bennett, C., Englund, M., & Urban, J. (1993). The significance of gender boundaries in preadolescence: Contemporary correlates and antecedents of boundary violation and maintenance. Child Development, 64, 455–466.

    Google Scholar 

  • Stoller, R. J. (1975). Sex and gender: Vol. 2. The transsexual experiment. London: Hogarth Press.

    Google Scholar 

  • Sugar, M. (1995). A clinical approach to childhood gender identity disorder. American Journal of Psychotherapy, 49, 260–281.

    Google Scholar 

  • Thompson, D., Whitney, I., & Smith, P. K. (1994). Bullying of children with special needs in mainstream schools. Support for Learning, 9, 103–106.

    Google Scholar 

  • Trumbach, R. (1994). London's Sapphists: From three sexes to four genders in the making of modern culture. In G. Herdt (Ed.), Third sex, third gender: Beyond sexual dimorphism in culture and history (pp. 111–136). New York: Zone Books.

    Google Scholar 

  • Tuber, S., & Coates, S. (1985). Interpersonal phenomena in the Rorscachs of extremely feminine boys. Psychoanalytic Psychology, 2, 251–265.

    Google Scholar 

  • Tuber, S., & Coates, S. (1989). Indices of psychopathology in the Rorschachs of boys with severe gender identity disorder:Acomparison with normal control subjects. Journal ofPersonality Assessment, 53, 100–112.

    Google Scholar 

  • Wakefield, J.C. (1992a). Disorder as harmful dysfunction:Aconceptual critique of DSM-III-R's definition of mental disorder. Psychological Review, 99, 232–247.

    Google Scholar 

  • Wakefield, J. C. (1992b). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47, 373–388.

    Google Scholar 

  • Wakefield, J. C. (1993). Limits of operationalization:Acritique of Spitzer and Endicott's (1978) proposed operational criteria for mental disorder. Journal of Abnormal Psychology, 102, 160–172.

    Google Scholar 

  • Wakefield, J. C. (1997). Diagnosing DSM—IV—Part 1: DSM—IV and the concept of disorder. Behaviour Research and Therapy, 35, 633–649.

    Google Scholar 

  • Walker, P. L., & Cook, D. C. (1998). Brief communication: Gender and sex: Vive la difference. American Journal of Physical Anthropology, 106, 255–259.

    Google Scholar 

  • Williams, M. (1999). The association between weight and appearance-related teasing, body esteem, and eating behaviours in children and adolescents. Manuscript in preparation, Concordia University, Montreal, QC.

    Google Scholar 

  • Williams, W. L. (1992). The spirit and the flesh: Sexual diversity in American Indian culture. Boston: Beacon Press.

    Google Scholar 

  • Wilson, K. K., & Hammond, B. E. (1996). Myth, stereotype, and cross-gender identity in the DSM-IV. Poster presented at the Association for Women in Psychology, 21st Annual Feminist Psychology Conference, Portland, OR.

  • Winkler, R. C. (1977). What types of sex-role behavior should behavior modifiers promote? Journal of Applied Behavior Analysis, 10, 549–552.

    Google Scholar 

  • Wright, J. C., Giammarino, M., & Parad, H.W. (1986). Social status in small groups: Individualgroup similarity and the social “misfit.” Journal of Personality and Social Psychology, 50, 523–536.

    Google Scholar 

  • Yude, C., Goodman, R., & McConachie, H. (1998). Peer problems of children with hemiplegia in mainstream primary schools. Journal of Child Psychology and Psychiatry and Allied Disciplines, 39, 533–541.

    Google Scholar 

  • Zucker, K. J. (1982). Childhood gender disturbance: Diagnostic issues. Journal of the American Academy of Child Psychiatry, 21, 274–280.

    Google Scholar 

  • Zucker, K. J. (1985). Cross-gender-identified children. In B.W. Steiner (Ed.), Gender dysphoria. Development, research, management (pp. 75–174). New York: Plenum Press.

    Google Scholar 

  • Zucker, K. J. (1990). Psychosocial and erotic development in cross-gender-identified children.Canadian Journal of Psychiatry, 35, 487–495.

    Google Scholar 

  • Zucker, K. J. (1999). Commentary on Richardson's (1996) “Setting limits on gender health.” Havard Review of Psychiatry, 7, 37–42.

    Google Scholar 

  • Zucker, K. J. (2000). Gender identity disorder. In A. Sameroff, M. Lewis, & S.M. Miller (Eds.), Handbook of developmental psychopathology (2nd ed., pp. 671–686). New York: Kluwer Academic/Plenum Publishers.

    Google Scholar 

  • Zucker, K. J., & Bradley, S. J. (1995). Gender identity disorder and psychosexual problems in children and adolescents. New York: The Guilford Press.

    Google Scholar 

  • Zucker, K. J., Bradley, S. J., & Lowry Sullivan, C. B. (1996). Traits of separation anxiety in boys with gender identity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 791–798.

    Google Scholar 

  • Zucker, K. J., Bradley, S. J., & Sanikhani, M. (1997). Sex differences in referral rates of children with gender identity disorder: Some hypotheses. Journal of Abnormal Child Psychology, 25, 217–227.

    Google Scholar 

  • Zucker, K. J., Finegan, J. K., Doering, R.W., & Bradley, S. J. (1984). Two subgroups of genderproblem children. Archives of Sexual Behavior, 13, 27–39.

    Google Scholar 

  • Zucker, K. J., & Green, R. (1991). Gender identity and psychosexual disorders. In J. M. Wiener (Ed.), Textbook of child and adolescent psychiatry (pp. 452–467). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Zucker, K. J., & Green, R. (1992). Psychosexual disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 33, 107–151.

    Google Scholar 

  • Zucker, K. J., & Green, R. (1993). Psychological and familial aspects of gender identity disorder. Child and Adolescent Psychiatric Clinics of North America, 2, 513–542.

    Google Scholar 

  • Zucker, K. J., Green, R., Bradley, S. J., Williams, K., Rebach, H. M., & Hood, J. E. (1998). Gender identity disorder of childhood: Diagnostic issues. In T. A. Widiger, A. J. Frances, H. A. Pincus, R. Ross, M. B. First, W. Davis, & M. Kline (Eds.), DSM-IV Sourcebook (Vol. 4).Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Zucker, K. J., Wilson-Smith, D. N., Kurita, J. A., & Stern, A. (1995). Children's appraisals of sex-typed behavior in their peers. Sex Roles, 33, 703–725.

    Google Scholar 

  • Zuger, B. (1978). Effeminate behavior present in boys from childhood: 10 additional years of follow-up. Comprehensive Psychiatry, 19, 363–369.

    Google Scholar 

  • Zuger, B. (1984). Early effeminate behavior in boys: Outcome and significance for homosexuality. The Journal of Nervous and Mental Disease, 172, 90–97.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Concordia University, Montréal, Québec, Canada

    Nancy H. Bartlett & William M. Bukowski

  2. University of Lethbridge, Lethbridge, Alberta, Canada

    Paul L. Vasey

Authors
  1. Nancy H. Bartlett
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul L. Vasey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William M. Bukowski
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bartlett, N.H., Vasey, P.L. & Bukowski, W.M. Is Gender Identity Disorder in Children a Mental Disorder?. Sex Roles 43, 753–785 (2000). https://doi.org/10.1023/A:1011004431889

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1011004431889

Keywords

Search

Navigation