When Do Children Develop Their Gender Identity?

Exploring gender identity and sexuality is part of every child’s healthy development, says Linda Hawkins, PhD, MSEd, LPC, Co-director of the Gender and Sexuality Development Clinic at Children's Hospital of Philadelphia (CHOP). The clinic offers medical and psychosocial assessments and support for transgender and gender expansive children and youth.

“Gender exploration is like any other exploration,” Hawkins says. “It’s like trying on different clothes. Children try on all sorts of things, hats, boots, you name it, they’ll try it on and see if they like it personally and see if they like the response they get from people.”

A child begins to have an innate sense of their gender identity between ages 3 and 5. Around this time, they also start to pick up on the subtle and not-so-subtle gender expectations in their family, their daycare, their church and their community.

For some children and youth, the gender expectations that are connected to the sex they were assigned at birth don’t match or fit. Some children and youth will clearly identify that their gender is actually the opposite of the sex they were assigned at birth, indicating a transgender identity. Other children and youth may feel more in the middle when it comes to gender expectations, indicating a gender expansive identity.

These children and youth might feel different, alone, misunderstood or unsupported, which can result in negative physical and emotional outcomes. Experiencing body changes that don’t fit with or are the opposite of a child’s gender can be equally distressing. These children can experience distress, low self-esteem, anxiety, depression and suicidal thoughts. In addition, stress about where to go to the bathroom at school can lead to disordered eating and gastrointestinal issues.

How parents can support their child

Hawkins’ advice to parents of children who indicate a transgender or gender expansive identity is:

1. Family acceptance is the best medicine. “When you have a loving, supportive family and caring adults who can help children accept themselves, almost all of these potentially disastrous health outcomes completely wash away,” says Hawkins. “The especially nice thing I like to highlight about parent and family acceptance as the best medicine is that there is no co-pay and you can’t overdose on it.”
2. Become an educated ally. Some key educational/support resources Hawkins recommends for parents are:
   • Gender Spectrum
   • Human Rights Campaign
   • Equality Pennsylvania
3. Connect with a community. You aren’t alone. There is support to be found among other families who are also raising transgender and gender expansive children. A good place to start is your local PFLAG group. 

If you believe your child is exploring their gender identity, you may have additional questions about how to best support your child. Visit the Gender Clinic website for more information or email us at genderclinic@email.chop.edu.