Despite increasing tolerance for nontraditional gender roles in many countries, it is important to identify problems for which gender-dysphoric children and adolescents may need help. Building on previous research that employed the CBCL to identify such problems in parents’ reports, Steensma et al. (2014) compared TRF scores obtained by 728 children (ages <12 years) and adolescents (ages >12 years who were being served by clinical centers for gender dysphoria in Toronto and Amsterdam. In both countries, adolescents obtained higher problem scores than children, and boys obtained higher Internalizing and peer problems scores than girls, compared to norms for the participants’ age and gender.

For both genders in both age ranges, problem scores were higher for the Canadian than the Dutch sample. By far the strongest predictor of TRF Total Problems scores was the sum of teachers’ ratings on the TRF items Doesn’t get along with other pupilsGets teased a lot, and Not liked by other pupils, with the scores for these items omitted from the Total Problems score. The authors concluded that, because poor peer relations apparently contribute to other problems reported by teachers, it is “important to provide training for teachers and other school personnel regarding the clinical needs of children and adolescents with gender dysphoria, including techniques to reduce social ostracism and isolation in the school environment, which would be an important adjunct to therapeutic care provided in a clinical setting” (p. 646).

Reference: Steensma, T.D., Zucker, K.J., Kreukels, B.P.C., VanderLaan, D.P., Wood, H., Fuentes, A., & Cohen-Kettenis, P.T. (2014). Behavioral and emotional problems on the Teacher’s Report Form: A cross-national, cross-clinical comparative analysis of gender dysphoric children and adolescents. Journal of Abnormal Child Psychology, 42, 635-647.