Seven-year-old schoolgirl Maddi loves dancing, the colour pink and wearing dresses. But only a year ago Maddi was known to her friends and family as ‘Maddock’. She was born a boy.
She says she was “about three or four” years old when she first wanted to be a girl and wear dresses. Now aged seven, Maddi goes by her new name and has recently enrolled at school as a girl.
“I'm not getting called Maddock, I'm getting called Maddi. I'm not getting called a boy, I'm getting called a girl.”
Maddi tells Insight that she wanted to share her story on national television because “it doesn’t matter” if you were born a boy or a girl.
“I’m telling everyone it's alright to be born as a boy and want to be a girl, or be born as a girl and want to be a boy… It doesn't matter if you're a boy or a girl – it just matters about who you are.”
Every now and again he'll say something like,‘Oh, you've got boobies, I want boobies.'
Truly transgender or 'just a phase'?
Psychologists and psychiatrists say people are presenting as transgender at younger and younger ages. But some parents, like “Kate”, are finding it hard to determine whether their child is truly transgender or if it’s “just a phase”.
Kate says her six-year-old son is drawn to pink and glittery clothes and shoes. And he’s gone further. He’s told her he wants to cut off his penis and says he’s saving up money so he can buy breasts and a vagina.
“Every now and again he'll say something like ‘Oh, you've got boobies, I want boobies,'" she tells Insight.
“Sometimes I think to myself: is he tending towards that way? You know, on the feminine side – like into flowers and the pretty things – but he's still a boy? Or is he actually wanting to be a girl?
“I really haven't thought that much about taking him to see anybody because some days I think it's a phase.”
If a child is diagnosed with gender dysphoria and they are determined to transition into the other sex, they usually start their transition by taking puberty blockers.
In fact, it is now permissible for children to take puberty blockers to suppress sex hormones such as oestrogen or testosterone without needing court approval. In a landmark case in August this year, the Family Court ruled that since the effects of puberty blockers were reversible, the decision to start the treatment could be left to the parents.
If a child wants to continue their gender transition, they may take hormone changers, also known as hormone replacement therapy (HRT). These are administered so that a child’s secondary sexual characteristics (such as breasts or facial hair) align with their gender identity.
Because these changes are irreversible, children are generally not allowed to have HRT. But there are exceptions. For example, if the child is severely distressed or suicidal, the Family Court may allow them to take hormone changers, provided they have unanimous consent from their parents and doctors.
These children have rights, and they have a right to treatment that is appropriate and they have a right to happiness.
Too early to diagnose?
Plastic surgeon Peter Heartsch regularly performs gender reassignment surgery, and believes transgender children shouldn’t be allowed to undergo irreversible change.
“I think at this early age… we'd be very concerned that we do nothing which is in fact irreversible,” he tells Insight. “Because I don't know that you can establish the diagnosis, and I may be wrong, of transsexualism at this particular age.”
However psychiatrist Dr Fintan Harte says transgender children and their rights need to be respected.
“Certainly there's no medical or surgical interventions in this young age group, but it's guided by the child's distress. I think what we need to remember here is these children have rights, and they have a right to treatment that is appropriate and they have a right to happiness.”