CHILDREN as young as 14 are receiving sex change treatment on the NHS after revealing to their parents that they are confused about their sexuality.
They are among an estimated 600 girls and boys - some as young as seven - who suffer gender identity disorders in Britain, according to doctors and support groups.
The disclosure that a growing number of children are seeking treatment for the condition known as 'gender dysphoria' has prompted an intense debate among medical specialists. While some psychiatrists believe children should be helped to change sex early, others insist they should only take that decision after reaching sexual maturity.
Some children are offered help at school to change their first names and wear clothes designed for the opposite sex. They receive drugs to block the onset of puberty, followed by hormones to help develop the characteristics of their preferred gender.
The final step, taken after the child has reached 18, is the complex surgery required to provide the external reproductive organs of the other sex.
Russell Reid, a consultant psychiatrist at Hillingdon hospital, west London, believes children as young as 13 should be offered preliminary drug treatment to prevent puberty.
"It's not a crime to prescribe these drugs but you really have to know what you are doing," he said. "Changing the body to match the mind is increasingly the accepted way of doing things, but the medical professional has been dragging its feet."
Margaret Griffiths, who runs Mermaids, a support group for families of sex-change children, managed to get treatment for her son when he was 14. He had harboured doubts about his sexuality since he could not remember, but did not tell his parents until his early teens.
"We had problems with him not wanting to go to school and not being able to tell us what was wrong," said Griffiths. "By the time of the treatment his voice had begun to break a little bit, but it made an enormous difference. It took the pressure off, but I'm certain he would have done much better at school if he had been treated younger. Kids can be so nasty."
"We supported our child because he was suicidal over it. It was better to have a live daughter than a dead son. The treatment is controversial but parents have to live with the distress of their children and they want psychiatrists to stop being cautious about it."
She is campaigning to widen the availablity of treatment and receives up to eight inquiries a week from parents of children unhappy with their gender.
"One family has a child of seven who has wanted to be a girl since he was four," she said. "He exhibits all the signs of cross-gender behaviour."
Other affected young people say they have been left to suffer because some psychiatrists remain reluctant to treat them.
James Phillips, 11, was born a girl but has changed his name by deed poll. His school lets him play football with other boys and treats him as a male, but doctors insist he must go through puberty as a girl before they will consider hromone therapy or surgery. "I am a boy, I was born a boy trapped inside a girl's body, but the doctors won't even say when I can start treatment to be a boy," he said.
His mother, who recently agreed to refer to her child as "him", dreads the nightmare of his puberty and is powerless to help lessen the trauma.
"I'm convinced he's not going to change now," she said. "I am committed to his cause, and I want to help him live a normal life, but we don't know what to do."
The growing demand for treatment has led to the creation of a Royal College of Psychiatrists' working party to establish guidelines. The controversial draft proposals to be finalised this autumn urge the provision of "therapeutic intervention as early as possible in a child's life, and in some cases, altering secondarily the gender identity development".
Domenico Di Ceglie runs the gender identity development service at the Portman clinic in London where Griffith's son was treated, and led the group which produced the guidelines. He admitted that up to one in four of the teenagers who at 14 seem convinced of their desire to change sex will later change their minds. "They cannot be totally sure at that age. There's pressure to intervene because these patients are in no-man's-land. They find it very distressing and they need help in tolerating it," he said.
Names in this article have been changed to protect the identities of the children.
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