STEVE INSKEEP, HOST:
The March issue of the medical journal, Pediatrics, features a striking editorial. It begins with the following sentence: A new pediatric problem is in town. That new problem, according to the editorial, is gender identity disorder in children. Pediatricians are apparently seeing more young patients who express an interest in changing their gender. NPR's Alix Spiegel reports.
ALIX SPIEGEL, BYLINE: Fifteen years ago, most pediatricians in America had never encountered the idea of gender identity disorder in children. But things change quickly.
DR. WALTER MEYER: We have had a lot of patients come to their doctors and say my boy child says they want to be a girl sometime or my girl child says they want to be a boy.
SPIEGEL: This is Walter Meyer, a child psychiatrist at the University of Texas Medical Branch, who wrote the editorial in Pediatrics.
Now, to be clear, it's not that Meyer is arguing that there's been an actual increase in the number of children who struggle with gender identity disorder. He says there've always been little boys who want to dress in dresses and little girls who can't stand them. It's just, he says, the social climate has changed.
MEYER: This behavior that used to be ignored by parents, they didn't use to come to my office at all, because I think the parents really accepted this as just normal exploration and ignored it.
SPIEGEL: Meyer says parents assumed that the little boy who played with dolls might grow up to be gay. But though some were desperately unhappy about that, it wasn't necessarily a medical issue. Then, according to Meyer, came the media.
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BARBARA WALTERS: From the moment we're born our gender identity is no secret.
SPIEGEL: This is a "20/20" episode about GID in children that aired in 2007. According to Meyer, GID in kids became a popular media subject about six years ago. And all of the coverage has really changed the way that parents interpret a certain set of behaviors that have always been present in children.
MEYER: Because of all the publicity around gender identity disorder, they now are worried that their child has something seriously wrong with them. So they bring that problem to their pediatrician.
SPIEGEL: Now, ideas about how to treat children with GID have been rapidly evolving. In the past, psychotherapists tried to force the child to accept their biological sex, but many psychotherapists now feel it's best to free the children, allow them to transition to living as the opposite sex. Some therapists encourage transition, even when kids are very small, as young as four. But Meyer says most experts think it's best to delay the decision.
MEYER: Most of us believe that the child should be allowed to explore the option, not encouraging either pathway.
SPIEGEL: So the editorial in Pediatrics, which appears alongside two GID studies, is an attempt to increase pediatrician awareness of treatment options, since kids are showing up in pediatric offices. But Lisa Schwartz, who researches how medical communication affects the use of medical treatments, says the editorial itself could have an impact on the number of children diagnosed and treated.
LISA SCHWARTZ: Increase in awareness, I think, can play out in two ways. I mean, it can help some people and I think it can hurt others.
SPIEGEL: It's possible that as more pediatricians become educated about GID, they will use that education to diagnosis and treat more patients. In most cases, that's fantastic, because kids desperately need help processing their experience. But...
SCHWARTZ: But it's clearly possible to cause harm by over diagnosing and over treating children who are either just transiently curious, experimenting or just different.
SPIEGEL: Almost no actual GID experts are very concerned about this however. They say GID is very far away from being over diagnosed. But what's clear is that our experience with GID in kids is changing.
Alix Spiegel, NPR News, Washington.
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