Q: I have two sons, aged 5 years and 2 and a 1/2 years. Both are very outgoing, social, friendly and intelligent. Both like to wear dupattas and bindis. Is it some kind of abnormal behaviour? Whenever I see them doing it I scream at them but it is of very little use because they do it when I am not looking. I get very worried at times. Is it just a passing phase or should I take them to any psychiatrist?

A:Some amount of cross dressing in young age between 3 to 6 or 8 is not uncommon, but that is seen more often as being done by the parents. It is commonly a passing phase, but if it is persistent and specially done by the boys themselves, it may not be so. The psychiatric conditions for such cross dressing to continue into adult age are Transvestism and Transsexualism. Transvestism is merely the compulsive need that men or women have to dress like the other gender, and can be treated with some effort and does not cause much of disability in life except for getting into socially embarrassing situations occasionally. Transvestism often remains hidden and the persons concerned satisfy their urge to cross dress in private. Transsexualism is a more deep rooted and serious problem wherein there is a disconnect between the body and the mind. A biological male believes that he is actually a female trapped in a male body, and the mind does operate like a female, and so the gestures and many aspects of the lifestyle and mannerisms also are adopted for a female. This is called male to female transsexualism. The opposite is also possible where in a biological female has the mindset of a male. Some of these aspects of the different mindset can be made out at very early ages too, but mostly the cases of transsexualism are detected in adolescent age groups or even later. This is technically called Gender Identity Disorder since the persons own sense of identity is different from the biological reality. Cross dressing which is the only feature of Transvestism is one of the features of Transsexualism. Transsexualism is also often hidden for long periods if not entire lifetimes. The persons concerned keep suffering internally. Please also understand that Homosexuality (Gender Orientation Disorder) and True Hermaphroditism (Eunuchs) are different although often confused by the public. Please don't be alarmed about all this. I have gone into some detail here to explain the two related psychiatric disorders only so that you can understand both and make your judgement. It is quite possible that your sons are only going through the fairly common passing phase, although it also likely that you have been alert enough to pick up very early signs. It seems to me from your description that it is so. Your next logical question may well be so, what do I do about it? It is known that Transvestism can be modified by constant monitoring but it is not known if the same applies for Transsexualism. So, if a young boy or a girl demonstrates early signs of being a Transsexual, can checking him and monitoring him make a material difference in the long run, is not too well known. But since we don't know that, why not make that effort. If at all it so turns out that the suspicions are correct, and you realise that many years later, you would have missed the opportunity of having tried. I hope all this information and some suggestions help you in clarifying some aspects and deciding on the next course of action. You can certainly seek a psychiatry consultation or go to a Child Guidance Clinic in your city, but there is no easy way of knowing at this early age of your boys what is happening. All the same, no harm in seeking help in person. If all this information distresses you, please bear with that but it can only help to be well informed, right? I wish & hope that you will overcome your doubts and find a suitable solution.