Gender is one of the central categories organizing children’s social world. Clear patterns of gender development have been well-documented among cisgender children (i.e., children who identify as a gender that is typically associated with their sex assigned at birth). We present a comprehensive study of gender development (e.g., gender identity and gender expression) in a cohort of 3- to 12-y-old transgender children (n = 317) who, in early childhood, are identifying and living as a gender different from their assigned sex. Four primary findings emerged. First, transgender children strongly identify as members of their current gender group and show gender-typed preferences and behaviors that are strongly associated with their current gender, not the gender typically associated with their sex assigned at birth. Second, transgender children’s gender identity (i.e., the gender they feel they are) and gender-typed preferences generally did not differ from 2 comparison groups: cisgender siblings (n = 189) and cisgender controls (n = 316). Third, transgender and cisgender children’s patterns of gender development showed coherence across measures. Finally, we observed minimal or no differences in gender identity or preferences as a function of how long transgender children had lived as their current gender. Our findings suggest that early sex assignment and parental rearing based on that sex assignment do not always define how a child identifies or expresses gender later.

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Control 49.94 (8.84) 11 (7.9) a These measures are normed such that the mean (SD) score of 50 (10) is the national average. Lower scores indicate lower depression or anxiety. b Clinical range defined as a score of Ն63, representing approximately 10% of a representative sample of youth in the age range on these measures.c When 2 parents provided responses for a given child, their scores were averaged.

The present survey study examined the attitudes of U.S. adults toward transgender children and adolescents, as well as their behavioral intentions, in two hypothetical scenarios involving gender variant youth. Participants recruited online (N = 281) reported generally favorable attitudes toward transgender minors, but expressed some hesitation to allow a transgender child to use the restroom aligned with their gender as opposed to their birth sex or to share a room with same gender peers on a school trip, possibly due to conflating gender identity with sexual orientation in these situations. Attitudes were less positive in respondents who reported a religious affiliation, conservative social political views, and stronger conformity to certain traditional gender norms-particularly in men. Even after controlling for these factors, stronger belief in environmental versus biological causes of transgender identity was linked to more negative attitudes. Participants' behavioral intentions were driven partly by their attitudes and causal attributions, but also by their age and, at least for women, personal connections to the transgender community. We discuss implications for the discourse surrounding transgender youth and the need for educating the public on the development of gender identity as well as the difference between gender identity and sexual orientation.

While considerable research has examined gender development in middle childhood, little longitudinal work has been conducted at this time to indicate whether, for example, youth who show more or less gender conformity at one point continue to do so later. The present study investigated the consistency of gender identity and preferences for gender-stereotypical toys, clothing, and same-gender peer preferences among groups of transgender youth (n = 158), their siblings (n = 79), and an unrelated group of cisgender youth (n = 128) from a mean age of 7.0 (range 3.0-10.9) to a mean age of 9.6 (range 5.1-12.0). Furthermore, 65.5% of the youth were girls, 69.7% were White, 72.8% grew up in households with an annual household income of $75,000 or more, and 89.9% of parents had a bachelor's degree or higher. Overall, we found a small-to-medium correlation over this 2.6-year span within each group, both across the composite of measures and most measures individually. Despite the moderate stability over time, we found a decrease in the composite and individual scores over this time span for girls and for transgender participants. Together these results suggested some stability in children's gender identity and preferences in middle childhood and that this was true regardless of whether the child's gender did or did not align with their sex assignment at birth.