Does a child's gender remain the same after a certain age or might it change as they get older?
There is evidence that many transgender children experience incongruence between their experienced and their assigned gender early in life (Steensma et al, 2013). At GIDS, about 15-25% of our referrals are for children aged under 12. Often these children do not identify with stereotypical behaviours and preferences of their assigned gender peers, and sometimes strongly dislike their physical sex characteristics.
In the majority of cases these feelings seem to discontinue either before, or early in, puberty (Steensma et al, 2013). In some children, however, gender dysphoric feelings will intensify during adolescence expressed by an aversion of their bodies in the context of secondary sex characteristics developing.
Across all studies approximately 16% continue with their gender identification (Steensma et al, 2013). The way gender identity develops and how gender identification is expressed seems to be influenced by biological, environmental and psychological factors (De Cuypere et al., 2013; de Vries et. al., 2014; Steensma & Cohen-Kettenis 2015).
Young people indicated that the period from 10 and 13 years to be most crucial in their feelings related to gender dysphoria. For both, the young people who continued having these feelings and for those where the feelings of gender dysphoria became less prominent, three main factors seem to have had an impact on their gender identity development. Firstly, the changes in social environment (gender roles and expectations become more distinct during this period of their life); secondly, the effects of a changing body through puberty; and thirdly the experience of romantic feelings and falling in love (Steensma et al, 2011).
The majority of our referrals at GIDS are adolescents who first presented with gender dysphoria or cross-gender identification at, or after, the onset of puberty. Traditionally, evidence has suggested that those who present to the service after puberty are more likely to continue to request service input for their gender in the long term (Steensma et. al., 2013; GIDS Audit: Retrospective Look at Cases Closed at GIDS, presented at WPATH 2016). However, we see a more diverse profile of young people presenting after puberty (e.g. Kaltiala-Heino et al, 2015), so it is unknown whether this is still the case.
Gender questioning children who do not continue with a cross-gender identification may be more likely to later identify as gay or lesbian than non-gender-questioning children (Drescher, 2013; Wallien & Cohen Kettenis, 2008).