Understanding Gender Identity in Children

As a parent, you may have questions about gender identity—what it means, how it develops, and how to support your child if they express gender in ways that differ from expectations. These conversations can feel complicated, but what your child needs most is your love and support.

This guide provides evidence-based information about gender identity development in children and practical guidance for parents navigating these topics.

Understanding Key Terms AAP

Clear definitions help us have productive conversations:

Sex assigned at birth:

• Typically based on physical anatomy at birth
• Recorded as male, female, or intersex
• Biological characteristic

Gender identity:

• A person's internal sense of their gender
• How someone feels inside about being male, female, both, or neither
• May or may not align with sex assigned at birth

Gender expression:

• How someone outwardly presents gender
• Clothing, hairstyle, mannerisms, interests
• Can vary across cultures and over time

Transgender:

• When gender identity differs from sex assigned at birth
• Not a choice or phase for most people
• Various terms used (trans, trans boy/girl, nonbinary)

Cisgender:

• When gender identity matches sex assigned at birth
• The experience of most people

Gender diverse/expansive:

• Umbrella term for gender expression or identity that differs from expectations
• May or may not indicate transgender identity

How Gender Identity Develops AAP

Gender identity develops over time, and children explore and express gender in various ways as they grow.

Early childhood (ages 2-4):

• Become aware of gender categories
• May express preferences for certain toys, clothes, activities
• May try on different gender expressions
• This exploration is normal and healthy

Preschool and early elementary (ages 4-7):

• Develop stronger sense of their own gender
• May express gender identity clearly and consistently
• Some children first express cross-gender identity at this age
• Often become more rigid about "boy things" and "girl things"

Middle childhood (ages 8-12):

• Gender identity typically becomes more stable
• May be more aware of social expectations and pressures
• Some children first express gender identity concerns at this age
• Puberty approaching may heighten gender-related feelings

Adolescence:

• Identity development intensifies (gender, plus overall identity)
• Puberty can be distressing for gender diverse youth
• May explore or solidify gender identity
• Social and romantic contexts become more significant

What's Typical Exploration vs. Something More AAP

Many children explore gender in ways that don't match stereotypes. This is normal and healthy.

Typical exploration includes:

• Boys playing with dolls or preferring pink
• Girls preferring "boy" activities or clothes
• Trying on different gender expressions
• Questioning gender stereotypes
• These explorations don't predict adult gender identity

Signs that may indicate deeper gender identity feelings:

• Persistent, consistent, insistent statements about their gender
• Strong discomfort with their body or assigned gender
• Distress (not just preference) about gendered expectations
• Statements sustained over time, not just occasional
• Social or emotional difficulties related to gender

The key questions:

• Is this consistent over time (not just a phase)?
• Is it insistent (not just preference)?
• Do they seem distressed about their gender (not just playful exploration)?

If you're unsure, a consultation with a gender-specialized mental health provider can help you understand your child's experience.

Supporting Your Child AAP

Regardless of whether your child is exploring gender or expressing a clear identity, your support matters enormously.

What helps all children:

• Unconditional love and acceptance
• Open, non-judgmental communication
• Freedom to explore interests without rigid gender expectations
• Assurance that your love isn't conditional on gender conformity
• Protection from bullying and discrimination

If your child is gender diverse:

• Listen to what they're telling you
• Use their preferred name and pronouns if asked
• Affirm their identity: "I love you and I'll support you"
• Educate yourself about gender diversity
• Find supportive resources and community
• Work with professionals if needed

What to avoid:

• Punishing gender expression
• Forcing gender conformity
• Shaming or ridiculing
• Dismissing their feelings: "It's just a phase"
• Expressing horror or rejection
• Keeping it secret as if it's shameful

Common Parent Questions

"What if it's just a phase?"
Some gender exploration is indeed a phase; for others, it's a persistent identity. Either way, the best approach is the same: support your child, listen to them, and let them guide you. If it's a phase, your support helped them explore safely. If it's not, your support is crucial for their well-being.

"Did I cause this?"
No. Gender identity isn't caused by parenting, trauma, or exposure to media. It develops as part of who a person is. Nothing you did or didn't do created your child's gender identity.

"Should I let my son wear dresses / my daughter cut her hair short?"
For most families, allowing children to express themselves authentically (within safety) is healthier than forcing conformity. Consider: What harm does it actually cause? Is my discomfort about what others think?

"When should we seek professional help?"

Consider consultation if:

• Your child expresses persistent distress about their gender
• They're experiencing anxiety, depression, or social difficulties related to gender
• You're unsure how to support them
• They're approaching puberty and gender concerns are increasing
• You want guidance on appropriate steps

Navigating Social Situations

Gender diverse expression can create social complexities. Here's how to navigate:

With family members:

• Educate them about supporting your child
• Set clear expectations about respectful behavior
• Limit contact if relatives are harmful
• Your child's well-being comes first

At school:

• Know your child's rights (varies by state/district)
• Communicate with teachers and administrators
• Advocate for inclusive policies
• Address bullying immediately
• Connect with school counselor

With peers:

• Help your child develop responses to questions
• Support their social connections
• Consider community groups for gender diverse youth
• Build resilience skills

Professional Support Options AAP

If your child is experiencing significant gender-related distress or you want guidance, professional support can help.

Mental health support:

• Gender-specialized therapists understand these issues
• Therapy helps children explore identity in a supportive environment
• Family therapy can help parents navigate
• Not about changing the child—about supporting well-being

Medical considerations:

• Before puberty, no medical interventions are typically recommended
• Support is social/psychological
• As puberty approaches, some families consider puberty blockers (fully reversible, buys time)
• Hormone therapy is typically for older adolescents
• Surgery is not performed on children
• All decisions should involve experienced professionals

Finding support:

• Ask your pediatrician for referrals
• LGBTQ+ organizations have provider directories
• Look for "gender-affirming" providers
• Trust your instincts about the right fit

Research on Outcomes AAP

Research shows that family support significantly impacts outcomes for gender diverse youth:

Family acceptance leads to:

• Better mental health
• Lower rates of depression and anxiety
• Lower risk of suicidal thoughts and attempts
• Better overall well-being
• Stronger family relationships

Family rejection is associated with:

• Higher rates of depression, anxiety
• Higher rates of substance use
• Higher rates of suicidal ideation and attempts
• Homelessness risk
• Poorer overall outcomes

The message is clear: your support matters enormously for your child's well-being.

Taking Care of Yourself

Parenting a gender diverse child can bring up complex feelings. Your feelings are valid, and you may need support too.

Common parent feelings:

• Confusion
• Grief for expected future
• Fear for child's safety and acceptance
• Uncertainty about what to do
• Pride in your child's courage

What helps:

• Connect with other parents of gender diverse children (support groups, online communities)
• Educate yourself through reputable sources
• Give yourself time to process
• Separate your feelings from your actions (you can feel uncertain while still being supportive)
• Seek your own therapy if needed

The Bottom Line

Your child's gender identity is one aspect of who they are. What they need most from you is love, acceptance, and support—the same things all children need.

Whether your child is exploring gender, expressing diversity, or identifying as transgender, your job remains the same:

• Listen to them
• Believe them
• Love them unconditionally
• Protect them from harm
• Support their well-being
• Get help when needed

Clara is here to help you navigate these conversations and support your child.