Primary school children 'battling gender identity problems'
A growing number of children are expressing gender identity issues to teachers in primary school, a leading support group has found.
With increased awareness and openness on the issue, the age of pupils now seeking help for 'gender dysphoria' is getting increasingly younger.
Transgender children can show signs of serious psychological distress, including self-harm and behavioural difficulties.
They may wish to transition - socially and sometimes medically - to their preferred gender.
Catherine Cross, family support and education officer for the Transgender Equality Network Ireland (TENI), says the majority of children who express gender identity concerns are in post-primary education.
"But we are seeing an increase in inquiries coming from primary schools," she added.
"I wouldn't describe pre-pubescent children as being transgender - but some children go against gender norms and stereotypes.
"They're expressing their gender as something else.
"It can be really challenging for parents because the kids are so young. It's often misunderstood by people who think it's something the family is encouraging... nobody really wants this; it's too difficult.
"While it's very dangerous to suppress a gender identity, it's also equally dangerous to encourage a different gender identity. My work involves keeping kids in school, and to ensure they're being supported.
"It's about parents and families finding that fine line between encouragement and discouragement."
She says the majority of parents struggle to accept that their child is battling with gender identity issues.
"Initially, most parents find it quite difficult, and it can be similar to grief.
"It's a complicated set of emotions they go through.
"There's crying, anger, denial and bargaining, as they try to navigate what is a difficult journey at times."
In certain cases, teenagers are given specialist drugs, known as 'puberty-blockers', which involve monthly hormone injections to halt the onset of puberty.
These slow the development of sex organs and body hair and delay other changes such as voice breaking.
She says a common misconception is that those with gender identity disorder will take the ultimate step and undergo sex-change surgery.
This procedure involves the reconstruction of genitalia to resemble that of the opposite sex.
"We're seeing less and less people feeling the need to make a medical intervention because society is more accepting of diversity.
"People feel more comfortable expressing their gender, and validate that, by using a different name or pronoun."
Meanwhile, new records obtained by the Sunday Independent show six patients have undergone sex-change operations abroad this year under a special State-funded scheme.
Gender reassignment surgery is not performed in Irish hospitals but it can be arranged in another country and funded by the HSE under the Treatment Abroad Scheme (TAS).
Data shows 74 public patients have availed of 'sex-change' surgery since 2015.
Forty patients travelled abroad for the treatment in 2015, while 28 availed of the scheme last year.
The process involves psychiatric assessment, counselling, hormonal therapy, and other procedures to alter the patient's appearance.
The cost of female-to-male operations is considerably higher than male-to-female procedures.
The average age of a patient in Ireland is 40 years old. Under-18s are not legally allowed to go under the knife for any form of gender reassignment surgery.