my girl is 9 years old and she keeps insisting that she is a boy.  she
wants to be reffered as a boy.  its been going on for the last 2 years
and i cannot find any material about that.  All i get is sex changes
surgeories that happens when the child is borne with no real sexual
identity.  but she is definatly a girl from the phisical side.  al i
am trying to find out is some research on girls who claim they are
boys at that age, and what are the options and what can i do about
it...

Hi Leeron,

I first want to tell you that your little girl does *not* necessarily
have *any* disease and/or problem at all. It is *normal* for 9 year
old girls (who have yet to undergo puberty) to 'pretend' to be what
they are not. She may simply not like to wear dresses and sees this as
a way to only wear pants--or, she may derive pleasure from watching
you squirm when she says, "I'm a boy!". Labelling your daughter with a
'name' for the condition (if indeed one exists) is NOT in the best
interests of your child: although having a 'name' for it may help you
with dealing with her protests.

Having said that, I will give you the information you requested.

The DSM-IV (Diagnostic and Statistical Manual of Mental Disorder) is a
book published by the American Psychiatric Association which
categorizes and explains mental disorders. Again, YOUR DAUGHTER MOST
LIKELY HAS NO 'DISORDER' AT ALL!!! IT IS IMPERATIVE FOR YOU TO
UNDERSTAND THIS!!

Section 302.6 "Gender Identity Disorder In Children - NOS" (NOS means
"Not otherwise specified") is the category that would apply to your
daughter IF she was diagnosed with a mental disorder. Basically, what
this diagnosis (I'll use "Dx" to shorten the word in the future) talks
about is a desire for cross-gender identification. To be diagnosed
with this condition, four (or more) of the following must be met:

"(1) Repeatedly stated desire to be, or insistence that he or she is,
the other sex
(2) ...in girls, insistence on wearing only stereotypical masculine
clothing
(3) strong and persistent preferences for cross-sex roles in
make-believe play or persistent fantasies of being the other sex
(4) intense desire to participate in the stereotypical games and
pastimes of the other sex
(5) strong preference for playmates of the other sex.

Also, there must be persistent discomfort with her sex and/or sense of
inappropriateness in the gender role of that sex. For example, in
girls, "...rejection of urinating in a sitting position, assertion
that she has or will grow a penis, or assertion that she does not want
to grow breasts or menstruate, or marked aversion towards normative
feminine clothing." (DSM-IV, 1994).

However, the DSM is founded on the principal that there is more to
mental disorder than a diagnosis of a mental disorder. What I mean by
that is that there are five "Axis" that must be viewed together to
arrive at a Dx. What I just gave you was Axis I information. Axis II,
IV and V probably don't pertain to this discussion (this is a
judgement call from my education and experience). Axis III however
probably DOES pertain.

Axis III is "General Medical Conditions". What I mean by this is: are
you sure your daughter isn't really a son? Have you had genetic
testing done? A physician examine her external and internal genitals
to confirm that she is indeed biologically female? You can NOT be
diagnosed with an Axis I disorder if there is a contributory Axis III
disorder. That means, she has NOTHING wrong with her if her problem is
that she "should" be male--but her genitals are incorrect. This DOES
happen.

What I would suggest to you is to speak to your doctor. Your doctor is
the only one that can decide whether or not your daughter has a
problem: or, if this is something she will quickly outgrow at puberty.

Your options for treating your child is limited: but, easily obtained.
Speak to your doctor -- and if necessary, ask for a referral to a
Pediatrician and/or Psychiatrist (if the Pediatrician says that there
is no physical issues to be considered). Quite frankly, I'd guess that
this should disappear at about the same time as she begins to undergo
puberty and becomes fascinated with boys. That's small comfort to you
now, but, in another 2 years, this will probably be
"water-under-the-bridge".

You should also consider obtaining a genetic test to confirm that you
daughter has no Y chromosomes -- and two X chromosomes. (The
chromosomal makeup of a normal girl.) If she DOES have a Y chromosome,
then she is a boy. The Y chromosome - by its mere presence,
NECESSARILY indicates the subject is male. The lack of a Y NECESSARILY
indicated that the subject is NOT male.

I hope this helps in your understanding of your daughter. What I've
provided to you is from the DSM-IV (available at your local library
and/or at: http://www.psychologynet.org/dsm.html  [this link does not
include the majority of the information I've given to you however])
and from my own knowledge and educational background in Psychology.

If you'd like any part of this clarified, please ask for clarification
prior to rating this answer.

Thanks!

Legolas-ga

---

Clarification of Answer by legolas-ga on 25 Nov 2002 09:41 PST

Taking your daughter to the doctor is a great first-step to
resolution. Please understand, that while there is probably nothing
wrong--other than jealousy/etc--it is possible that there is a
problem. The odds of it actually being a problem however is very
small. More than likely you will want to investigate a genetic test
for your daughter. You'll want to ask your doctor for the name of a
lab capable of doing DNA testing near you. DNA tests aren't cheap
though. The price will also vary be the service requested (what they
are looking for in the DNA) and where you live.

I wish you the best.

Legolas-ga

leeron,

I am curious as to whether you have any sons, or only daughters. This
could have an effect on why your daughter behaves this way.

aceresearcher

First, I must say that I appreciate the interest and the concern.  It
is so personal and I am really surprised at the service.  Thank you. 
I have a son 4  years old and I have a feeling she is jealous because
we keep saying how great he is all the time and I know that she feels
not as good.  I am trying to give her as much compliments as I give
him, but she is a very very smart and sensitive girl and she knows
that I am trying with her.  by the way all the five symptoms that you
mentioned are very much like my daughter.  I am taking her to the
doctor for a physical exam.  we are taking her to see a psychiatric
and he said that it is jealousy but last week they were playing Noah
and the Ark and they needed to get in the Ark and she started crying
because she didn't want to get in with a boy because she is a boy...
So that made it a little more scary for me, and it seem more than just
a puberty issue.... I am very scared and I don't know how to deal with
such a thing.  I hope that it will pass but I have a feeling that its
more than meets the eye...(please forgive my English, its not my first
language). Again thank you for your help... if you can tell me more I
will be happy to hear your advice.
Leeron

leeron,

First of all, you do not need to apologize for your English; you write
quite well (better, in fact, than many for whom English is their
native language!).

It is entirely possible that your daughter is experiencing the
unfortunate results of a genetic "hiccup", where, despite her female
physiology, to her, both mentally and physically, she perceives
herself to be a boy. When interviewed as adults, people with similar
genetic makeup say simply "I knew from an early age that I was
supposed to be a girl, not a boy", or "I always knew that I was a boy
in a girl's body".

If this is indeed the basis for your daughter's issues, there are
certainly things that can be done when she gets older to help her find
her own path, whatever it may be. And if and when that time comes,
remember that what is MOST important is her happiness, not whether she
conforms to a societal ideal that might find a gender realignment
shocking or embarrassing.

While this has to be very scary and bewildering for you as a parent,
if this is truly her situation, one of the worst things you could do
for her is to try to "force her into the mold" of a girl. It's really
important for you to get her a counselor -- hopefully, one who has
experience dealing with gender identity issues in both children and
adults -- as soon as possible, to try and determine if this is what is
happening.

On the other hand, what is happening may have a much simpler
explanation. Many cultures have traditionally placed a much greater
value and importance on men and their role in society, versus that of
women. Most of these cultures still have this mindset, anywhere from a
small to a very large degree. If your culture is one where the
importance of males is still much more pre-eminent than that of
females, it is quite likely that your daughter has noticed this.

It is quite common for a first child to feel shunted aside when a
second child comes along. Your daughter was the sole recipient of love
and attention for 5 years before her little brother was born. All of a
sudden, everyone was wanting to hold and cuddle him, making remarks
about how cute he was, etc., and she may very well have felt pushed
into the background.

When you say "I am trying to give her as much compliments as I give
him, but she is a very very smart and sensitive girl and she knows
that I am trying with her", are you saying that you have to work
harder at telling her how great she is because deep down, you don't
really feel that she is quite as important when compared to her
brother? If so, she will almost certainly be able to sense that.

Does your son get to do certain things that your daughter never got to
do when she was the same age, such as sports or other activities? If
so, you can be sure that she has noticed this. Deciding that she is
going to be a boy instead of a girl may very well be her way of trying
to get equal treatment.

While you are finding a counselor and getting treatment for your
daughter, one of the best things you can do for her is to treat BOTH
your children as gender-neutrally as possible. Avoid the "pink is for
girls, blue is for boys; dolls are for girls, sports are for boys"
stereotype that still seems to be somewhat common here in the United
States. Make it clear that NO activity is reserved either just for
boys or just for girls. Let her know that you believe that she can
become ANYTHING she wants to be, whether that is an Astronaut, an
Engineer, a Teacher, a Fashion Designer, or a Wife and Mother -- and
that you will actively help her to achieve her goal, whatever she
decides that may be.

Make a conscious effort not to do extra things for your son that you
have never done for your daughter; at the very least, if you are going
to do such things for your son, be sure that you do them now for your
daughter as well.

I know that you and your daughter are experiencing a difficult time
right now; but by seeking professional assistance now and dealing with
the situation up front, you are doing exactly the right thing to bring
peace and happiness, both to you and your daughter, farther down the
road.

All my Best Wishes,

aceresearcher

Thank you very much for your help.  I want my daughter to be happy
with whomever she is.  I dont' care what she is as long as she knows
it. I will help her to know who she is and I will support her.  Its
not going to be easy but i will do my best.  I am taking her to a new
psychologist and also to the doctor.  Thanks for everything.
Leeron