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Gender Identity Disorder (GID) of childhood is a very rare syndrome, first classified in DSM-III, characterized by a persistent and determined wish to be the opposite gender coupled with an intense dislike of one's own gender. Boys with the syndrome are referred for clinical evaluation far more frequently than girls by a ratio of approximately 5 to 1 (Zucker and Green, 1992). The onset of the disorder almost invariably occurs during the ages of 2 to 4, and once established, it is surprisingly stable and usually proves refractory to all but the most intensive psychodynamic and family interventions. Extensive biomedical research has failed to document any chromosomal or hormonal abnormalities associated with the disorder.
Typical is the case of Colin, a 3-year-old boy reported in detail elsewhere (Coates, Friedman, and Wolfe, 1991). Colin had frequently dressed in his mother's clothes since the age of 2. He was intensely interested in jewelry and makeup and would spend long periods of time cross-dressed in front of a mirror. He had a strong preference for stereotypical feminine activities, such as playing with dolls, and he