To say that a child “presents as transgender” sounds clinical but it’s really just ideological framing.
First, the metaphor of “presenting” connotes a black box that yields up data about its internal state independent of environmental factors. But of course, the beliefs of the adults in the child’s life are always a confounding variable. Parents who are enthusiastic believers in “gender,” who think that “gender” is socially constructed, who are vocal supporters of the politics of “gender,” who rush to interpret any “gender nonconforming” behavior as evidence of “transgenderism,” etc., obviously affect the child’s conception of his or her sex. The metaphor of “presenting” conveniently directs the attention away from this reality. The child is almost certainly picking up on cues and expectations from the parents. In which case, garbage in, garbage out. Add the assessment of an ideologically committed “gender” therapist, and it’s even less clear what’s actually going on with the child.
Second, the idea that a child “presents as transgender” rests on an interlocking set of pure suppositions. It is supposed that there exists such a thing as a person’s “gender,” that “gender” is something that exists entirely independent of the chromosomal arrangements in the person’s body that determine sex, and that “gender” so construed determines sex.
But no one can point to the child’s “gender” apart from what the child is “presenting as.” And that’s obviously circular. What is “gender?” A thing the child “presents as.” How do we know it’s real? Because the child “presents as” it. By that definition “gender” is indistinguishable from delusion.
This epistemic circularity shows that “gender” is a question-begging ideological concept. It rests on the assumption that there is something other than biological reality that determines whether a person is male or female (or, in more radical versions of the theory, one of an infinite number of other possible “genders”). The actual reality of “gender” is simply assumed as the defining element of the ideological framework by which we are to understand what the child is “presenting as.”