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  • Friday, June 17, 2016

    June 19, 2016 8:00 AM - June 19, 2016 6:00 PM

    • Jun Koh, MD, PhD ;
    • Yasuo Kawabata, M.A. ;
    • Nanako Saito, M.A. ;
    • Mai Yoshikawa, M.A.


    Several groups, notably including Green (1987) and Steensma (2013), have reported on clinical cases of children with gender dysphoria. Green reported that for only one person out of 44, gender dysphoria conditions had not persisted, and Steensma reported 37% of adolescents were identified as persisters. Thus, with children, gender-diverse conditions do not necessarily persist. On the other hand, gender diverse children have been known to experience a variety of maladaptive issues. Interviews were conducted to investigate the current state of gender-diverse children in Japan and presented in the Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific, which was summarized in 2015. Such a series of case reports of children with gender diversity in Japan has not been previously collected to our knowledge.

    Materials and Methods

    We have supported 33 children with gender-diverse conditions under the age of 15 (mean age 11.6 ± 3.9) from September 2003 to December 2014 (18 trans girls, mean age 9.1 ± 4.3, 15 trans boys, mean age 13.9 ± 4.3) seen in the gender clinic at Osaka Medical College.


    All the children wanted to be dealt with as the gender of their choice while in school. Regarding problematic behavior, truancy was observed in 13 children (9 trans boys, 4 trans girls) while 6 children (5 trans boys, 1 trans girl) showed self-injury. In order to reduce the problematic behavior, we negotiated with teachers to accept them as children with their desired gender at school. All of the children seen in our clinic returned back to school as a result of treating them as their desired gender. Of the six children who admitted to self-injurious behavior, three of them were from single-mother households. Two mothers had been patients at psychiatric clinics, and one mother had severely limited Japanese language communication skills, and one of the fathers completely denied his child's desired gender identity. These parents were not fully understanding their children's distress. After health care workers (psychiatrist, clinical psychotherapist, nurse, and psychiatric social worker) provided support and cooperation and the schools accepted their desired gender identities, the self-injurious behavior of all of the children subsided.


    For these children with gender dysphoria, diagnosis of gender identity disorder was not required in most cases. These findings suggest that a medical diagnosis of gender identity disorders is not necessary for improving school situations. We should concentrate on modifying social environments in order to support the children by affirming their desired gender.

    Category: Mental Health, Psychology, and Psychiatry