1.     Rose is a 13-year-old girl who is being evaluated as part of

a family assessment; the primary patient is Rose’s 8-year-old brother who is demonstrating behavior of concern and is having a court-ordered evaluation. During the family assessment, it becomes apparent that Rose’s mother is very concerned that Rose is a tomboy. The mother, who is very elegant, is distressed by Rose’s persistent “tomboy” behavior and worries that Rose might become a lesbian, which would be “unacceptable” to the family. More detailed evaluation of Rose reveals that she is experiencing some sexual reflection. She excels at sports and has always preferred rough and tumble play, but she doesn’t see anything wrong with that. She thinks she is sexually attracted to one of her female teachers, and sometimes fantasizes about her. Rose just began menstruating 3 months ago, and while she has had a boyfriend at school, she is not sexually active in any way; they have kissed a few times, and she likes it, but she has no plans to take it any further. Otherwise Rose seems well adjusted, worries about her brother, and dismisses her mother’s concerns as “silly.” Which of the following statements best characterizes Rose?
A.
Rose should be evaluated for gender dysphoria as she meets the criteria of “strong preference for activities stereotypically engaged in by the other gender.”
B.
Rose is probably a lesbian and family therapy should include working with the mother to accept Rose’s sexual orientation.
C.
Rose may be a candidate for conversion therapy as her preferences are ambiguous at this point in her development.
D.
Rose does not appear to have concerns about her gender identity of sexuality and no further evaluation is indicated

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