Gender‐nonconforming (GN) children are often perceived less positively, which may harm their well‐being. We examined the development of such perceptions and an intervention to modify them. Chinese children’s appraisals were assessed using multiple measures (verbal responses, sharing, and rank order task) after viewing vignettes of gender‐conforming (GC) and GN hypothetical peers. In Study 1, children (N = 210; 4‐, 5‐, 8‐, and 9‐year‐olds) were less positive toward GN than GC peers, especially if they were older or if the peers were boys. In Study 2 (N = 211, 8‐ and 9‐year‐olds), showing children exemplars of GN peers who displayed positive and GC characteristics subsequently reduced bias against gender nonconformity. These findings inform strategies aimed at reducing bias against gender nonconformity.

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There is increasing interest regarding best practice for promoting well-being among gender-variant children. Social gender transition (e.g., name, pronoun, clothing changes) may benefit gender-variant children who desire to be of a gender that does not align with their birth-assigned sex. This study examined psychosocial challenges experienced by socially transitioned children and cisgender (i.e., birth-assigned sex and gender identity align) gender-variant children. Method: We used data from published samples of gender-variant children (N ϭ 266) reporting psychosocial well-being using the Child Behavior Checklist or similar measures. A statistical bootstrapping approach was used to control for birth-assigned sex, age, and degree of gender variance when comparing cisgender gender-variant (CGV) and socially transitioned children described as being supported in their gender identities. Within the CGV sample, we examined parental attitudes toward childhood gender variance, as well as correlations between these parental attitudes and peer relations with children's psychological well-being. Results: There was little evidence that psychosocial well-being varied in relation to gender transition status. Parents of CGV children were generally accepting of childhood gender variance, but only poor peer relations predicted lower psychological well-being among these children. Conclusion: Socially transitioned children appear to experience similar levels of psychosocial challenges as CGV children. While further research is needed to evaluate possible effects of childhood social gender transition on well-being, this study suggests experiences of psychosocial challenges among gender-variant children require monitoring irrespective of transition status, and relationships with peers may be especially important to consider.

No study to date has examined self-harm/suicidality in a community sample of children who express gender nonconformity (GNC). This parent-report study (N ϭ 1,923) examined self-harm/suicidality in a nonclinical community sample of 6-to 12-year-old children, including those who express marked GNC but do not have a gender dysphoria (GD) diagnosis. Child Behavior Checklist (CBCL) Items 18 ("Deliberately harms self or attempts suicide") and 91 ("Talks about killing self") measured self-harm/ suicidality. The Gender Identity Questionnaire for Children measured GNC, the CBCL measured peer relations and behavioral and emotional challenges, and the Child-Rearing Sex-Role Attitude Scale measured parents' gender-stereotypical attitudes toward child-rearing. Among children who expressed GNC most markedly, 9.1% had attempted suicide and/or self-harmed and 6.8% had suicidal ideation. These rates parallel those reported for children clinic-referred for GD. Across the sample, suicidal ideation, self-harm/suicide attempt, poor peer relations, and behavioral and emotional challenges were significantly positively correlated. Among children assigned female at birth, self-harm/suicide attempt was negatively correlated with gender-liberal parental attitudes. Binary logistic regressions showed some evidence that children who expressed GNC had higher suicidality/self-harm compared to children who were gender-conforming and did not have a mental health diagnosis; however, group effects were mostly accounted for when controlling for poor peer relations and behavioral and emotional challenges, with the latter being the strongest predictor of suicidal ideation and self-harm/suicide attempt. Thus, self-harm/ suicidality among gender-nonconforming children is likely greater in scope than previously recognized, and parental attitudes, peer relations, and behavioral and emotional challenges are important factors to consider. Public Significance StatementThis study is the first to demonstrate that the issue of suicidality/self-harm among gendernonconforming children from nonclinical, community populations is likely much greater in scope than has been previously recognized. Among children who expressed high levels of gender nonconformity, 9.1% had attempted suicide and/or self-harmed and 6.8% had suicidal ideation, which are similar to rates reported for children clinic-referred for gender dysphoria and highlights a need for awareness of this issue among individuals who regularly interact with children.