Katie Wears Y-fronts

We all want our daughters to be strong and brave and our sons sensitive and caring. But when - if at all - does "girlish" behaviour in a boy or "boyishness" in a girl become a problem? And whose problem is it anyway?

Tom is eight, and has been playing with dolls since he was old enough to hold one. A quiet child, he shuns the football brigade at playtime in favour of playing and talking to girls, and the one or two other boys who don't like rough and tumble. At home, he still loves playing imaginative games with dolls and animal toys. Sometimes he and his younger sister dress up in sparkly swirly costumes, festoon themselves with their mother's necklaces and paint their faces with make-up.

Tom will never win a popularity contest among his peers. Because he's friends with all the girls, the boys will have nothing to do with him. At home, his parents love and accept him for the rather eccentric child he is, providing him with a range of experiences, like camping, swimming and music lessons, like all good parents do.

Do they worry about his gender identity? "Not at all," says his father Philip. "Tom knows he's a boy and that he's a bit different from other boys, but he's secure and happy being who he is."

Tom is a very lucky child. Many parents would find his behaviour difficult to deal with, says Dr Domenico Di Ceglie, consultant child psychiatrist and director of the Gender Identity Development Clinic at the Portman Clinic in London. Gender is, he says, a psycho-social construct. "You can't dissociate what the child is feeling from what parents feel and from what society's views of conventional behaviour are.""

While Tom's behaviour is different to that of most boys of his age, it would only become a problem if it were part of a larger picture." When a child's behaviour occurs purely in the context of role play and the child retains its identity in the role, it's perfectly normal. It's when children say they want to be the other sex and cross-dress and avoid play stereotypically associated with their own sex, prefer friends of the opposite sex and dislike their bodies that they and their families need to be listened to professionally."

When Jacky Miller heard what her daughter was feeling, she knew she had to take action. Almost from birth, her daughter Katie preferred a "boyish" lifestyle. Jacky has a photograph of her Katie, now nine, taken just before her second birthday. In it, she's sitting in the middle of her smiling family, scowling. Why? Because of the dress she's wearing. She hated wearing dresses.

Shortly after the photo was taken, Katie insisted on having all her curls cut into a short crop. She only played with boys and when they'd come over, she'd always manage to get them to part with their Y-fronts. She even wrote to Father Christmas begging for some.

By the time she started school at four, Katie was wearing boys' school trousers, had adopted a streetwise strut and would only play Barbies with her older sisters if she could be Ken. But she far preferred guns, trains and cars.

Looking back, Jacky says that she didn't yet think that Katie's behaviour was anything to worry about because she was such a popular, happy child. "Even when her friends would sometimes call her 'him', it didn't really worry me."

The crunch only came when, aged seven, Katie told her mum that she wanted to change her name to Dennis, that she felt like a boy inside and that if she ever grew breasts she'd cut them off with a knife or "pop them with pins". It was then that Jacky knew they needed help. "I realised this was more than just being a tomboy," she says. "I felt I couldn't risk not intervening."

A child psychiatrist confirmed that Katie needed specialist help and referred her to the Gender Identity Development Unit. There, Katie and family saw a clinical social worker, a member of the multi-disciplinary team who agreed that she appeared to have a gender identity problem. During five visits, Katie, her sisters and parents talked about how they felt.

Often Katie would sit on the floor playing with blocks or drawing as the rest of the family vented their views. "My oldest daughter would say, 'Oh mum, you're making a big deal out of it. She's quirky and odd but she's fine.' And my middle daughter said things like, 'She'll be whatever she'll be. All you need is love.' After a couple of times, they didn't come any more."

Katie herself was open about how she felt and said that she didn't think she had a problem.

During that time, the Portman Clinic suggested that Jacky contact Mermaids, a family support group for children and adolescents with gender identity problems. She and Katie went a few times but Jacky found that her daughter's boyish behaviour became exaggerated during and after the visits. "I didn't think that was what Katie needed. It clarified to me that she wasn't like the other children there who had genuine gender identity problems. For her, it wasn't all-consuming."

That was a year ago. Today, Katie appears to have forgotten all about Dennis, has let her hair grow out and has a new friend who happens to be a girly sort of girl. She has even worn dresses.

So what was it all about? Jacky doesn't know and neither does she understand why Katie was the way she was. "I've often asked myself if I encouraged this on some level. I don't think so. At first I was delighted to have a girl who wanted to play with cars instead of dolls. I was a feminist mum. But it clearly was something else and when people would say to me, 'Oh yeah, I was a tomboy when I was young', I'd think, 'This is different.' The fact is that for the first nine years of her life, she wanted to be a boy."

Some names have been changed. The Gender Identity Development Unit sees children up to the age of 18 and their families. Write to them at: The Gender Identity Development Unit, Portman Clinic, Tavistock and Portman NHS Trust, 8 Fitzjohns Avenue, London NW3 5NA. Tel: 020-7794 8262. Email: GIDU@Tavi-Port.demon.co.uk. Mermaids' helpline: 070-71 22 5895. Email

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