Consulting in an affirmative way towards children and young people
Cross-gender play and other expressions of gender variance in childhood are normal aspects of human development. However, parents may consult GPs when a child is expressing unhappiness, distress and anxiety around their gender identity.
If a young child is articulating their gender feelings, it is important not to be dismissive.
Be alert to the possibility that trans children may express gender-related distress in the form of challenging behaviours, truancy, attention deficiency, social anxiety, and through self-injury.
As a rule of thumb, while a child’s self-expression might well change over time, the only way to avoid damaging their well-being is to embrace their identification and how they navigate the gendered world in the moment.
In this scenario, Jodie’s mum is already supporting her child with a partial change of social gender role, including a name and pronoun change, and some subtle shifts to the way she dresses to make her feel more comfortable. It is likely that the local school will be engaged in supporting this process, but levels of inclusivity and engagement can vary.
A formal change of medical record has not been requested, but it would be appropriate to suggest putting a note on the system so that Jodie can be called by her preferred name and not misgendered (using a form of address that does not reflect the gender with which a person identifies). It is vital to use the name and pronoun requested, and not to pathologize this process by adding diagnostic read codes to the notes. Most certainly a change of social gender role does not need prior approval from a gender identity specialist.
Lastly, do not make gender identity the primary focus if this is not why a patient comes to see you. Naturally it would be helpful to check to see if the family want help with signposting for support, but in this scenario, Jodie has an URTI and asthma exacerbation.