Paul is a nine-year-old pariah. Schoolmates taunt him, and even his own family has begun to reject him. His offense: he insists on dressing up in his mother's clothes and playing dolls with his sister rather than joining his brother in outdoor games. His lot is not a happy one, but it is common enough among the patients at a unique psychiatric clinic at U.C.L.A., the Gender Identity Research Treatment Program.
Begun in 1967 by Psychiatrist Richard Green, 37, to study homosexuality, the program's current enrollment includes 50 boys between the ages of 4% and ten. All the youngsters are overtly effeminate: many walk with a mince, talk with a lisp and want to be girls. Left untreated, Green believes that most of them would grow up to be homosexuals, if not candidates for transsexual operations. By studying and treating them through adulthood, Green hopes not only to discover why they became effeminate but also to help them handle the hostility they generate among their peers and families, and perhaps make it possible for some of them to grow into heterosexual relationships.
Unlike tomboyish girls, a few of whom Green has also studied, "sissy" boys are quickly marked out for social rejection. All the little boys at the clinic have suffered harassment; one seven-year-old had his shirt ripped off by classmates who wanted to see if he had female breasts. To ease a boy's anxiety about being a misfit, Green concentrates on changing his behavior through weekly therapy. Under the direction of a male therapist, the patients are divided into small groups and encouraged to assume traditional male roles in their play.
Point System. One result is that the boys often react to one another just the way their outside peers react to them. A five-year-old with a passion for dolls teased a fellow patient who picked up a doll, saying, "That's sissy stuff." Because many of the youngsters seem unaware of the way they appear to others, they are shown videotapes of themselves mincing down the hall.
Another major therapeutic focus, however, is on the children's parents. Green counsels them to criticize consistently their child's effeminate habits and encourage him to play with boys neither unaggressive nor overly so. He sometimes has the parents use a complicated point system: five points might be awarded for taking the role of father in playing house, for example, five subtracted for wearing a dress. The tally may be kept on a blackboard, and, when a positive total of, say, 30 is reached, the boy will be rewarded with a trip to Disneyland. Conversely, enough demerits might result in the loss of television privileges. The aim of this stern regimen is to prod the boys into masculinity through rewards and penalties.