Transgender or Not? A Helpful Quiz

Updated: Oct 10, 2019

According to the American School Counselors Association (ASCA), the American Academy of Pediatrics (AAP), GLSEN (formerly the Gay, Lesbian, & Straight Education Network), the Human Rights Campaign Foundation (HRC), the National Educators Association (NEA), and Planned Parenthood, transition affirmation is the only acceptable treatment for a child who expresses a disconnect between his or her physical body and his or her inner sense of what sex s/he actually is. Affirmation includes social transition as well as hormone therapy and possibly sex reassignment surgery.

Hopefully this short quiz will aid in everyone’s ability to recognize who ought to transition and who perhaps should not, in case it isn’t clear enough from the directives of the above organizations.

1. A six-year-old girl is brutally raped by two men in a public restroom while her brother, who is with her, is not. Later that year she announces that she is really a boy and wants to transition to living as such.

a. This child is transgender and should be affirmed in transition.

b. This child is coping with the assault she survived by deducing that girls can be raped while boys cannot, so therefore it is safer to be a boy.

Answer: b. Erin Brewer’s story illuminates the shortsightedness of the affirmation-only approach to gender dysphoria. When this happened to her in the early 1970’s, Erin’s school counselor prompted her parents to help Erin accept her biological sex through talk therapy, by encouraging her to present as a girl, and by introducing her to strong, positive female role models. Today Erin is a wife and mother, confident in who she is as a woman, and appalled that were she a gender dysphoric child today, “experts” like those above would usher her into hormone therapy and medical sterilization.

2. A five-year-old boy, whose younger sister was born with profoundly special needs, insists that he is really a girl.

a. This child is transgender and should be affirmed in transition.

b. This child interpreted the sudden and overwhelming shift in his parents’ attention from him to his newborn sister as evidence that they prefer girls to boys.

Answer: b. “Andy” was brought to Dr. Michelle Cretella when he suddenly announced that he wanted to be the other sex. She referred the family to a therapist. During one session the boy revealed that he wanted to be a girl so his parents would love him again. He misinterpreted the amount of attention required from his parents by his sister’s special needs as a preference for daughters over sons. The counselor was able to help the boy understand that his parents’ love had not changed, only the circumstances of having a special-needs child in the house had caused a change in their relationship. The boy returned to accepting his biological sex and his parents were alerted to his need for more of their attention.

3. An autistic twelve-year-old girl announces to her parents, out of the blue, that she is transgender, and specifically non-binary.

a. This child is transgender and should be affirmed in transition.

b. This child is struggling with puberty, body dysmorphia, and social relationships.

Answer: Likely b. High-functioning autistic children tend to be highly intelligent, but behind the curve on social and emotional development. They often experience sensory discomforts and may not develop sexual/romantic interests until later than their neurotypical peers. That a large segment of adolescents who express gender dysphoria have underlying neurological diagnoses like autism, depression, or obsessive-compulsive disorder should not surprise, given the social and emotional issues that often accompany these disorders. While peers are developing interests in the opposite sex and experimenting with flirting and relationships, autistic adolescents and teens may feel threatened by unwanted sexual attention, confused by these subtle and complex social cues, and abnormal by comparison. The transgender narrative offers a convenient yet ultimately unhealthy coping mechanism for dealing with with one’s developing sexuality.

Let’s try two more.

4. An eighteen-month-old girl pulls the barrette out of her hair.

a. This child is indicating dissatisfaction with the trappings of femaleness, is expressing her gender preference as male, and should be affirmed in transition.

b. This child is behaving like a child.

According to Diane Ehrensaft, a leading gender therapist at the Child & Adolescent Gender Center of the University of California San Francisco, a toddler who pulls a barrette out of her hair is expressing a transgender identity. One wonders what Ehrensaft might say about the cognitive intentions of a toddler who pulls off her shoes, mittens, or diaper.

5. A four-year-old boy living with three older sisters and his divorced mother claims that he is really a girl, and expresses happiness when allowed to grow out his hair and dress in girls’ clothing.

a. This child is transgender and should be affirmed in transition.

b. This child looks up to his older sisters and mother, has no in-home male role models, and may believe that to insure his place in the family tribe it would be better to be female.

This one may not be so cut-and-dried. But isn’t that a good enough reason to look a little deeper into the “why” of this child’s assertion? Which is ultimately better for a child, to be chemically and/or surgically castrated and require pharmaceutical interventions for the rest of his life, or to be helped toward acceptance of his functioning, natural body as it is?

The transgender, medical, and pharmaceutical industries have political and financial incentives to funnel children into life-long medicalization. Parents, educators, and mental health care communities must recognize the harms that are being perpetrated on today’s children, and be more concerned with children’s health and future well-being than with toeing the party line, staying on the good side of the culture, or protecting their own interests.

If even one of the above scenarios strikes you as a questionable reason to transition a child to the opposite sex, then it’s time to step up and say so. Children depend on adults for protection, wisdom, and guidance. We must start doing our jobs and demand that our schools, ASCA, the AAP, GLSEN, the HRC, the NEA, and Planned Parenthood do the same.

For further reading: If Your Child Says S/he's Transgender