Maternal Issues May Predispose Desire for Gender Change in Boys

SAN FRANCISCO – Boys who say they want to become girls may be trying to win a lost mother's love rather than expressing a true desire to switch gender, Judith Fingert Chused, M.D., said at the annual meeting of the American Psychoanalytic Association.

One of the most challenging psychotherapeutic dilemmas is treating young patients who believe they are “biologically incongruent” to their birth gender. Why? “Because the wish to be a different gender may have to do with something else that is going on,” said Dr. Chused of the department of psychiatry and behavioral sciences at George Washington University, Washington.

Although there is growing recognition that some people correctly identify themselves as being a different gender from a very early age, when it comes to children there is every reason to question such self-assessment, she said. In her practice, she has found that early maternal loss–between 12 and 24 months of age–and parent intolerance of aggressive behavior can underlie a boy's repeated assertion that he wants to be a girl.

Treatment of children needs to take into account the role of unconscious fantasies, which can be tough to discern in children, but this aspect may be particularly influential for those who express the wish to be a different gender, Dr. Chused stressed.

In her experience of treating several boys who said they wanted to be girls, she found that they had a universal longing to become like their mothers. “It was to try to find a way to be close to her, by becoming her themselves,” she suggested.

In the cases she has encountered, maternal deprivation seemed to go hand in hand with the expressed desire, although the loss of the mother occurred in different ways, she pointed out. Of course, she added, not all boys who have lost their mothers wish to change into girls, just as a male having feminine traits is not necessarily a sign of pathology.

Dr. Chused speculated that variations of maternal loss may be an underrecognized etiology for certain cases of gender identity disorder. In the panel discussion of the issue, she reiterated that concern, saying, “My sense from this [experience] and from reading the material on it, is that very few boys actually want to be a girl.”

In one case, she concluded that a boy had nothing more than a craving for maternal affection and that his mother had shown disdain for men. “This is different from wanting to be a girl. This is wanting to be loved,” she said. The reverse also seems to be true, according to the literature. When girls have mothers who don't like themselves as women, or who have a strong bias against their own gender, they may express the desire to be boys, believing that if they were male, they would be more acceptable to their parents, she said.

“The way I address such gender issues is to ask, 'Why is this child not comfortable with himself?' and to look at the whole individual within his environment–who is he or she,” she advised.

SAN FRANCISCO – Boys who say they want to become girls may be trying to win a lost mother's love rather than expressing a true desire to switch gender, Judith Fingert Chused, M.D., said at the annual meeting of the American Psychoanalytic Association.

One of the most challenging psychotherapeutic dilemmas is treating young patients who believe they are “biologically incongruent” to their birth gender. Why? “Because the wish to be a different gender may have to do with something else that is going on,” said Dr. Chused of the department of psychiatry and behavioral sciences at George Washington University, Washington.

Although there is growing recognition that some people correctly identify themselves as being a different gender from a very early age, when it comes to children there is every reason to question such self-assessment, she said. In her practice, she has found that early maternal loss–between 12 and 24 months of age–and parent intolerance of aggressive behavior can underlie a boy's repeated assertion that he wants to be a girl.

Treatment of children needs to take into account the role of unconscious fantasies, which can be tough to discern in children, but this aspect may be particularly influential for those who express the wish to be a different gender, Dr. Chused stressed.

In her experience of treating several boys who said they wanted to be girls, she found that they had a universal longing to become like their mothers. “It was to try to find a way to be close to her, by becoming her themselves,” she suggested.

In the cases she has encountered, maternal deprivation seemed to go hand in hand with the expressed desire, although the loss of the mother occurred in different ways, she pointed out. Of course, she added, not all boys who have lost their mothers wish to change into girls, just as a male having feminine traits is not necessarily a sign of pathology.

Dr. Chused speculated that variations of maternal loss may be an underrecognized etiology for certain cases of gender identity disorder. In the panel discussion of the issue, she reiterated that concern, saying, “My sense from this [experience] and from reading the material on it, is that very few boys actually want to be a girl.”

In one case, she concluded that a boy had nothing more than a craving for maternal affection and that his mother had shown disdain for men. “This is different from wanting to be a girl. This is wanting to be loved,” she said. The reverse also seems to be true, according to the literature. When girls have mothers who don't like themselves as women, or who have a strong bias against their own gender, they may express the desire to be boys, believing that if they were male, they would be more acceptable to their parents, she said.

“The way I address such gender issues is to ask, 'Why is this child not comfortable with himself?' and to look at the whole individual within his environment–who is he or she,” she advised.

SAN FRANCISCO – Boys who say they want to become girls may be trying to win a lost mother's love rather than expressing a true desire to switch gender, Judith Fingert Chused, M.D., said at the annual meeting of the American Psychoanalytic Association.

One of the most challenging psychotherapeutic dilemmas is treating young patients who believe they are “biologically incongruent” to their birth gender. Why? “Because the wish to be a different gender may have to do with something else that is going on,” said Dr. Chused of the department of psychiatry and behavioral sciences at George Washington University, Washington.

Although there is growing recognition that some people correctly identify themselves as being a different gender from a very early age, when it comes to children there is every reason to question such self-assessment, she said. In her practice, she has found that early maternal loss–between 12 and 24 months of age–and parent intolerance of aggressive behavior can underlie a boy's repeated assertion that he wants to be a girl.

Treatment of children needs to take into account the role of unconscious fantasies, which can be tough to discern in children, but this aspect may be particularly influential for those who express the wish to be a different gender, Dr. Chused stressed.

In her experience of treating several boys who said they wanted to be girls, she found that they had a universal longing to become like their mothers. “It was to try to find a way to be close to her, by becoming her themselves,” she suggested.

In the cases she has encountered, maternal deprivation seemed to go hand in hand with the expressed desire, although the loss of the mother occurred in different ways, she pointed out. Of course, she added, not all boys who have lost their mothers wish to change into girls, just as a male having feminine traits is not necessarily a sign of pathology.

Dr. Chused speculated that variations of maternal loss may be an underrecognized etiology for certain cases of gender identity disorder. In the panel discussion of the issue, she reiterated that concern, saying, “My sense from this [experience] and from reading the material on it, is that very few boys actually want to be a girl.”

In one case, she concluded that a boy had nothing more than a craving for maternal affection and that his mother had shown disdain for men. “This is different from wanting to be a girl. This is wanting to be loved,” she said. The reverse also seems to be true, according to the literature. When girls have mothers who don't like themselves as women, or who have a strong bias against their own gender, they may express the desire to be boys, believing that if they were male, they would be more acceptable to their parents, she said.

“The way I address such gender issues is to ask, 'Why is this child not comfortable with himself?' and to look at the whole individual within his environment–who is he or she,” she advised.