MWM, you beat me to it.
TPaul, you said,
Honestly, until a person is old enough to become sexually active and experienced they can not know if they are straight, bisexual or gay.
You would think so, but in fact it's not always the case. Friends of mine (male and female) whose sexual preference is for same-sex, have told me that they always knew. From my own knowledge of these people, "I always knew" may not have been from their earliest years but certainly well before they became sexually active. Both said they were attracted to same sex from their first attraction to anybody.
I remember having a crush on a same-sex teacher at school in my early teens but it was brief and I did not tell anybody. It worried me at the time. Plus at the same time I also had crushes on boys. I don't consider myself to be a lesbian but I have noted that I tend to be more aware of a 'vibe' from gay women. Not always and I wouldn't call it an attraction. And it's not simply strong women, either - my two best friends are both very capable, very strong women and neither is gay in the slightest. Nor do I get that vibe from them.
Gay male friends - some didn't know until after they married and had kids (that's what I call DENIAL!). Others knew before they hit puberty.
But this case - I think it's possibly very different.
First, I strongly urge you to get him thoroughly assessed by a neuropsychologist, looking at the behaviour and possible autism component. The sexual orientation/gender issues are, I'm convinced, entirely coincidental. Just as it's possible to have asthma and osteoarthritis, so it is possible to have two separate 'conditions' (if we classify the sexual stuff as a condition).
Whatever the sexual orientation/gender identity stuff is, medicine is now fairly much in agreement that it's in the brain. We know tat autism is also in the brain. However, I believe that is where the connection ends.
If 1% of the population is on the autism spectrum, and 1% of the population have gender identity dysmorphia, then the chance of having both (if the conditions are unrelated) is 1% x 1% or 1 in 10,000. Rare, but not impossible.
A person at husband's work is a dignosed Aspie and also has just finished the process of sex change from male to female. Actually, he's stopped short - he hasn't gone through with the full conversion to female, he has simply become neuter.
Sexual identity is often very complicated. We think in terms of male is male, female is female and that is it. And also that a male preferring other males as partners, is homosexual. But a male who considers himself to be a female in a male body, would not consider him/herself to be homosexual, but in reality having normal female desires.
Your child is 13. That is very young, to be already so very sure. So on top of the neuropsychologist for the autism-like features, you need to have the child seen by someone who is an expert in gender identity issues. Preferably someone balanced, not someone on a crusade (of either kind).
Interestingly we had a TV episode on this just a few days ago - a rival TV show to 60 Minutes (the same program that interviewed me and difficult child 3 a month ago, it hasn't aired yet) did a story on the world's youngest sex change case. It was a very well-balanced story, covering some very concerning questions, including "what if the person changes their minds?" They quoted research in Amsterdam, I believe it was (I'll post a link to the transcript for you) claiming that in fact anyone that determined doesn't change their minds. I'm not ready to believe that (until I read the reserch for myself) but if an impartial, careful psychiatrist really delves into the child's psyche, any underlying influences on the child tat could be responsible for such confusion should be identified and treated. For example, husband's co-worker - he had a very confused and damaging childhood, his mother was a man-hating nut case and taught her son that all men are sex-mad rapists - he couldn't accept that his maleness would make this even a possibility, so he the only way he could cope was to identify as female and also eliminate all maleness from his body. Was there also an innate component? Possibly, but there was a lot of confusion. However, after 20 years of constant psychiatric assessment and attempts to dissuade him, he has persisted in his path and claims to feel much more content now.
But I don't believe you can psychoanalyse away a gender identity issue that is innate.
I know this is an uncomfortable topic for some members - I'm sorry if what I'm writing here is confronting. But it is an issue I have studied (morbid fascination? Because I have friends who have issues in this spectrum?)
Whatever the real picture here - it is VITAL to properly identify the exact problems, learn the correct labels for what you describe (to avoid any confusion) and work on it piecemeal.
A few things to consider - I know I said that the possible autism needs to be considered as separate to the possible gender identity issues, but there is a possibility that some other aspects of the gender identity stuff could have some secondary psychological fallout which could be getting misdiagnosed as autism.
For example - a kid who insists on identifying with the opposite sex, is a kid who is gonig to be socially a misfit.
Autism trait No 1.
A kid who is insistent that he is misunderstood, that nobody understands him, that he MUST force the issue and live as he feels is being true to his innate nature - this is bordering on Obsessive Compulsive Disorder (OCD). ALso often an autism trait.
High-functioning autistic kids will also often obsess on their favourite topic. They find one thing (sometimes more) and that is their intense focus. It becomes the be all and end all to their living. For difficult child 3, it's computers and computer games. he's a walking encyclopedia, in his computing studies classes at school he getss almost full marks. If instead of computers, it was all things female (and wanting to live as a female) then yes, it could seem to be a gender identity issue.
I do beleive you are likely to be dealing with either separate conditions, or a really strong identification with himself as female, to such an intense degree that the resultant behavioural problems (because he's a kid trying to sort this out and even adults have problems with this) are making him seem to be mildly autistic.
In which case - I would be putting a priority of sorts onto the investigations.
1) see the gender identity specialistfirst, get an opinion on whether any of this could explain the other behaviour problems/possible autism-like manifestations.
THEN
2) See the neuropsychologist and especially ask for some understanding of everything that a possible hypothetical gender identity issue cannot explain. basically, give the neuropsychologist what is left and ask for an opinion.
On the Pervasive Developmental Disorder (PDD)/autism stuff, a lot of us here can help. But as a rule, we haven't had a lot to deal with concerning gender identity here. Some parents here have kids who have other problems as well as being gay. Again, unlikely to be a connection.
Here is the link I promised you - remember, sexual orientation and gender identity are very complex issues. Again, they're a spectrum. Still not well understood, still easy to get it wrong. A teenage kid goes through purgatory with developing sexuality; if they have any issues in this department, the psychological fallout is way more intense.
From the website, here is the blog of a father whose child was born male but is determined to have a sex change for an 18th birthday present.
http://au.tv.yahoo.com/sunday-night/blogs/article/-/article/6445663/a-father-39-s-story/
And here is the link to the site - there is a video link to the story of the youngest transexual in the world.
http://au.tv.yahoo.com/sunday-night/
I'm not saying your son is transexual - the issue is far more complex than that, or simple homosexuality. I can't tell you which it is. You need an expert to help you all through this. But I would urge you to see someone soon because something has to be done fast, from whichever angle you look at this.
If you believe this sort of thing is wrong and unnatural, the child needs help now.
If you believe this child is genuinely homosexual, then he needs help now in order to help him cope with the fallout of coming out.
If you believe this is a case of gender identity dysmorphia and you support the possibility of sex change, he needs help now to block puberty. This block is reversible at any time; but once male onset of puberty begins (deeper voice, wider shoulders, adams apple etc) it can't be undone by a sex change later in life. A later sex change would be far more obvious with the deeper voice, broder shoulders, adams apple etc.
And with all the stuff that is happening with him, YOU guys need help to cope with all the changes and the emotional fallout for you as parents.
This is very complex, you need help form a number of areas.
We can help with as much as we can.
Do let us know how you get on.
Marg