Gender Development

All children and youth will have different journeys and timelines for when and how they disclose their gender identity and expression. Research helps us understand how gender develops for children and youth.

Theories of gender development

Traditional theories of child and youth gender development focus on cognitive and social aspects of development: 

  • Cognitive theories focus on how children make sense of gender as they move through different stages of development. 
  • Social theories centre around how people learn about gender through observation, modelling, and social interactions that reward or discourage certain gendered behaviours. 
  • Some scientists are also studying in utero hormones and the brains of trans individuals to explore biological explanations of trans gender development. 

Currently, there are no definitive answers about why some people are trans and others are cisgender. But, researchers use, test and refine theories about gender development to help us better understand the experiences of gender creative children and trans and gender diverse youth.

What do we know?

Most children have a strong sense of their gender identity by the time they are four years old, according to the Canadian Pediatric Society's guide on gender development in children.

Young children may even be able to express that their gender and sex are different. As children approach school age, they may become increasingly consistent and persistent about their gender identities. But, it is normal for children to express their gender in different ways. All children and youth will have different gender journeys with varying timelines for when and how they decide to disclose their gender identity and expression.

Despite growing awareness, much of society today promotes the idea that there are only boys and girls, and that gender and sex assigned at birth should be the same. 

If children feel pressure from the outside world and from families to conform to gender norms, a child may meet the expectations of their environment, such as by changing their outward expressions of gender. For some children, the pressure to conform to gender expectations causes high levels of distress. Resilient children conform to their sex assigned at birth while finding creative ways to hold on to their gender identity in private. 

Later on, given the language, space, and support they need, these children may be able to express their gender identity how they wish.

Diversity of gender creative children

Each child is unique. Their gender is also unique. It involves two important parts: identity and expression. The distinction between these is important for understanding what children are telling us about their gender.

  • First, some children clearly have a gender identity that is not the same as the sex assigned to them at birth. They are persistent, consistent, and insistent about the gender they know themselves to be. These children may be frustrated with their bodies or think that God made a mistake by giving them the body they have. Nature plays a very strong role in driving both identity and expressions. These children are likely to have a consistent trans identity over time.
  • Second, there are children who explore gender expression in ways that go against social norms. However, they still identify with their sex assigned at birth. These children are telling us that gender roles and norms don't fit for them, and they need to express themselves differently. Nature, nurture, and culture are all at work here. Later on they may identify as gay or queer, and their gender expressions may or may not continue to be gender non-conforming.
  • The third group of children are creative in their identities and expressions of gender. This group can be considered non-binary. They have an identity that doesn't fit with boy or girl. They may or may not be unhappy with some aspects of their bodies. Their expressions of gender are often a creative mix, and they may continue with this creativity throughout their lives.

All of these gender selves are healthy. None need to be fixed or changed. Gender health comes from being able to freely identify and express the authentic gender self. Paying attention to what children tell us about their identity and through their expressions can help us to learn how to best support them.

The gender affirmative model of care

Gender-affirming care is important for promoting gender health in children and youth. There is a growing body of evidence that supporting child and youth gender identity supports mental health1. Trying to change a child's behaviour or not allowing them to express their gender freely may lead to feelings of shame and depression2

The gender affirmative model consists of these ideas3,4:
  • Gender variations are not disorders.
  • Gender variations are healthy expressions.
  • Gender presentations are diverse and varied across cultures.
  • Gender involves an interweaving of nature, nurture and culture.
  • A person's gender may be binary, non-binary, fluid, or multiple.
  • Distress connected to gender most often stems from negative reactions from the outside world.
Understanding that gender is complex and gender diversity5 is a natural part of human diversity is important in learning how to support a gender creative child or trans youth. 

  1. Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), 1–8.  
  2. Wallace, R., & Russell, H. (2013). Attachment and shame in gender-nonconforming children and their families: Toward a theoretical framework for evaluating clinical interventions. International Journal of Transgenderism, 14(3), 113–126. 
  3. Ehrensaft, D. (2016). The gender creative child: Pathways for nurturing and supporting children who live outside gender boxes. The Experiment.
  4. Hidalgo, M. A., Ehrensaft, D., Tishelman, A. C., Clark, L. F., Garofalo, R., Rosenthal, S. M., Spack, N. P., & Olson, J. (2013). The gender affirmative model: What we know and what we aim to learn. Human Development, 56(5), 285–290. 
  5. Vincent, B., & Manzano, A. (2017). History and cultural diversity. In C. Richards, W. P. Bouman, & M.-J. Barker (Eds.), Genderqueer and non-binary genders (pp. 11–30). Palgrave MacMillan.

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