Kids will more easily pass as the opposite gender, and require less drastic treatment later, if drug treatment starts early, Spack said. For example, boys switching to girls will develop breasts and girls transitioning to boys will be flat-chested if puberty is blocked and sex-hormones started soon enough, Spack said.
Sex hormones, especially in high doses when used long-term, can have serious side effects, including blood clots and cancer. Spack said he uses low, safer doses but that patients should be monitored.
Gender-reassignment surgery, which may include removing or creating penises, is only done by a handful of U.S. doctors, on patients at least 18 years old, Spack said. His clinic has worked with local surgeons who've done breast removal surgery on girls at age 16, but that surgery can be relatively minor, or avoided, if puberty is halted in time, he said.
The mother of the Los Angeles 8-year-old says he's eager to begin treatment.
When the child was told he could get shots to block breast development, "he was so excited," the mother said.
He also knows he'll eventually be taking testosterone shots for life but surgery right now is uncertain.
The child attends a public school where classmates don't know he is biologically a girl. For that reason, his mother requested anonymity.
She said she explained about having a girl's anatomy but he rejected that, refused to wear dresses, and has insisted on using a boy's name since preschool.
The mother first thought it was a phase, then that her child might be a lesbian, and sought a therapist's help to confirm her suspicion. That's when she first heard the term "gender identity disorder" and learned it's often not something kids outgrow.
Accepting his identity has been difficult for both parents, the woman said. Private schools refused to enroll him as a boy, and the family's pediatrician refused to go along with their request to treat him like a boy. They found a physician who would, Dr. Jo Olson, medical director of a transgender clinic at Children's Hospital Los Angeles.
Olson said the journal reports should help persuade more doctors to offer these kids sex-changing treatment or refer them to specialists who will.
"It would be so nice to move this out of the world of mental health, and into the medical world," Olson said.
Endocrine Society: http://www.endo-society.org
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