Another approach to the treatment of boys with GID has involved group therapy. Green and Fuller (1973) reported on the group treatment of seven boys (age range 4-9 years). Each of these boys was reported to be aware, in varying degree, “of the reason for his inclusion in the group.” Weekly sessions were held in a recreational area with a male therapist who verbally reinforced the boys for nonfeminine, socially competent behaviors and verbally admonished them for feminine behaviors. At these sessions, the boys themselves often criticized one another for feminine behaviors. It was reported that both parental narratives and behavioral ratings of the boys indicated “change on a variety of parameters” concerned with cross-gender identification. Detailed analyses were not, however, available.
Meyer-Bahlburg (1993) also emphasized the role of the peer group in facilitating behavioral change. The main strategy in Meyer-Bahlburg’s treatment protocol was to have the parents of boys with GID arrange consistent “play dates” for their sons with other boys. Many boys with GID avoid boys as playmates and are often anxious about involvement in rough-and-tumble play. If the parents of such boys are able to find other boys whom their sons do not experience as too threatening, those boys could serve as role models for the development of more gender-typical play and activities. Meyer-Bahlburg indicated that this approach appeared effective in reducing cross-gender behavior after a short time and that the boys were able to develop successfully the friendships they formed in this way. Unfortunately, detailed information was lacking.
Bates et al. (1975) employed group therapy with gender-problem boys who were mainly between the ages of 8 and 13 years. Their program emphasized the encouragement of masculine behavior and general social skills. In contrast to the approach of Green and Fuller (1973), feminine behavior was not explicitly discouraged. Both modeling by the therapists and more structured behavior modification techniques were used. Concurrent with the children’s group, the parents also met in groups, with one of the main goals being to work on ways to improve the father-son relationship. Although systematic data were not recorded, Bates et al. (1975) felt that the boys showed “recognizable improvement…both in terms of social skills development and in the development of masculine interests and abilities” (p. 154). Parent and verbal reports indicated similar changes in the neighborhood and at school, including “less interest in cross-dressing, doll play, and imitating females.”
Revision date: June 11, 2011
Last revised: by Jorge P. Ribeiro, MD