Joining the discussion is Dr. Dan Siegel, professor and clinical psychiatrist at UCLA School of Medicine and director for the Center for Human Development. Dr. Siegel says he works with many families going through what Melissa and Tim are experiencing.
"The basic thing we need to realize is there is something called a gender identity, which isn't the same as the genitals you have," Dr. Siegel says. "So your genes determine whether you have male genitals or female genitals, but the exposure to the fetus' brain as it develops in the womb, we think, determines the identity. And it's on a spectrum, so you could be feeling fully male or fully female, or somewhere in between, and in your case, the child we're talking about, she feels that her brain " she even said it on the video " got an identity as a female even though her genitals are male, and that makes total sense when you understand the biology of how it develops."
"So you're saying how you're born is defined on different levels," Dr. Phil says.
"Exactly, because how you're born with your genitals doesn't necessarily correspond with your brain's development," he says. "You should accept the child for how they are born, I totally agree with that, but in the inside, when you look at the brain, it isn't as black and white as are you a female or male as the genitals would show."
[AD]"But if it's a brain identity, why does such a small percentage actually become transgender adults as were children?" Dr. Phil asks.
"Here's my thought about that: Our society makes roles that are so black and white because that's what our genitals are, but our brains are on a wide spectrum," Dr. Siegel says. "So that 80 percent of the people who are cross-gendered that you're referring to, those are probably people who were somewhere in the middle, and they said, â€˜Hey, I may have feminine desires in classical senses, like I enjoy being sensitive, and I enjoy thinking about the internal world, not just being aggressive,' but those are the people who say, â€˜I can stay a male, and I am a male, and I'll find my identity that way.'"
Glenn Stanton is a research fellow with the Christian-based organization, Focus on the Family. He studies gender as a social phenomenon and is currently working on a book that deals with the importance of gender and parenting. He says people are not born this way and parents are responsible for guiding their children into the gender they were born with.
"What we find is that kids start out as kids," Glenn says. "They don't know. Most little boys have never been a man before. Most little girls have never been a woman before. They need help figuring these things out, and it's a job of the parent to come in, as you did, with such a loving heart and care for your child, but to guide them and direct them. The children are not in the driver's seat. They're not the ones who are at the age and the maturity to be able to make these kinds of decisions, so we need to help them move in the right direction."
"So you disagree with what Dr. Siegel is saying, because you talk about 'born as,' but what Dr. Siegel is saying is that it's defined by the brain as well as the external genitalia. How do you respond to that?" Dr. Phil asks.
"I'm actually agreeing with him in a way that there is a spectrum, but there are very few real Pats in the world, where we just don't know what they are," Glenn says, referring to the gender-neutral character named Pat on Saturday Night Live. "We always identify with either a boy or a girl, we can always determine OK, that's girl behavior or boy behavior. For my little boy wanting to go to art museums, for me wanting to go to art museums, is that feminine behavior? For you being interested in ballet, is that a feminine behavior? No. It could be done in a very masculine way."
"Are you saying these parents are wrong?" Dr. Phil asks.
Glenn speaks to Melissa. "From what I understand, you've taken an entry level psychology course in college, you gave your child a test on the Internet about what it means to be transgendered, and your child mimics, really, as I see it, some very adult concepts that she got from somewhere, and so I'm wondering who's leading and who's following?"
[AD]"Your idea of thinking " what ends up happening to these transgendered children, is they grow up depressed, they grow up suicidal, they get into drugs, into prostitution, and it's wrong," Melissa argues. "What he's stating is actual fact, it's scientific fact. Where are your facts?"
"There are plenty of facts. I mean, Dr. Kagan at Harvard, who has looked at this issue for a long time, 40 years longer than anybody else, he says what parents need to do with these gender-confused kids is be very directive with them, and be the parent," Glenn says.
"Every time we tried to say, â€˜You know what? You were born a boy, so you have to dress this way. You cannot wear these clothes to school. You cannot wear these clothes at home. You cannot wear these barrettes,' he was becoming more depressed," Melissa says.
"A 3-year-old child, they don't know what they think at this point," Glenn says. "Or they have very strong opinions about who they are. When I was that age, I wanted to be a horse!"
"Have you not seen the statistics? Have you not seen the statistics on transgendered children and adults? Have you not read the statistics on what happens to these children when you don't back them up, and you don't love them, and support them and be an advocate for them?" Melissa asks.
Dr. Phil addresses her question. "Well, what you're talking about is the fact that the suicide rate with transgendered children is two to three times higher than normal, and they do report a fairly high incidence of anxiety, depression, feelings of isolation, but what that comes from, whether it comes from being in a different role, or not being supported in that different role, is less clear," he says. "Do you have enough confidence in your position that you would consider hormone therapy to develop female breasts and body type and style in your child?"
"Yes," she says. "She keeps asking me, 'When I become a teenager, am I going to be like my brother and be all full of hair?' And I said, â€˜Well, you are brothers, so yeah, you probably are,' and she just started sobbing and said, â€˜No, I don't want to look like that.'"
[AD]Dr. Phil turns to Dr. Siegel. "There are some clinics in the country that are highly controversial that will give children hormones that will suppress the one set of sexual characteristics and enhance another. Would you be comfortable in recommending that sort of thing with an 8-year-old or at all?"
"Coming before puberty, you'd want to really address this issue with clinicians who think deeply about the reality of the biology of this, not just belief systems that you're hearing about," he says.
At the end of the show, Dr. Phil tells Melissa and Tim, "I really hope you don't consider hormone therapy at this point, but you continue to let this evolve. That would be a wrong, wrong, wrong thing to do in my opinion."