abstract art blue close up
Photo by Tim Mossholder on Pexels.com

My pediatrician asked us to fill out a developmental assessment for my three-year old child a few months ago. We made it a game, so we were having fun. What is your name? Where is your nose? Where is your elbow? Can you stand on one foot? Can you jump from here to there? Can you draw a line like this? Can you draw a circle? Can you put these beads on a string? Can you stack blocks in a bridge? My daughter thought this was all very silly and we were laughing together. And then we got to a question that made me pause:

“Using these exact words, ask your child, “Are you a boy or a girl?” Does your child answer correctly?”

Umm…well, she says that she’s a girl, but gender is an innate internal attribute. Gender is who you are. How can you be wrong when you tell me who you are? She is correct when she tells me that she is a girl, but it would also be correct if she answered that she was a boy, or neither, or both.

It probably wasn’t ill-intentioned (and it was a form that our doctor printed and not one that she created), but it’s a bad question. It lacks inclusivity and it assumes all children are cisgender (their sex assigned at birth is the same as their gender identity). I’m not even sure what development milestone this is trying to check either. Are you asking if my child can distinguish sex? Are you asking if my child identifies with their sex assigned at birth? Are you you trying to identify children that may be transgender (sex assigned at birth differs from gender identity) to be able to provide their parents support and guidance? Or, are you forgetting that transgender and gender nonconforming children are out there?

The active hostility towards transgender individuals in our society is obviously harmful and dangerous, but there is also damage from all of the situations and forms and interactions that neglect being transgender. An entire childhood or an entire lifetime of being told that you are “incorrect” or that your reality isn’t real is legitimately harmful. It might seem like this is too early to worry about this, but it’s not. It matters even when you are three.

Most children begin to identify strongly with a gender around age three. Identifying with a gender really isn’t about what our children are interested in or what clothing they like.  It is about who they are. It’s saying “I am a girl” rather than wanting to wear a dress or play with dolls. Teaching our children that that gender identity and sex assigned at birth aren’t always the same is important. We have been intentional with how we talk about this in our family since our kids were babies. For cisgender children, this helps them grow up to be better allies. For transgender children, this helps affirm what they are experiencing. Telling a child that they are a boy when they know they are a girl must be as confusing to them as trying to convince them that the sky is red when they can see that it is blue. Some people worry that affirming a child’s gender identity and supporting a social transition (changing pronouns, changing clothing, names, etc.) causes the child to change their gender identity That’s not the case, though. Recent research suggests that social transitions do not change the strength of gender identity. Dr Kristina Olson and her research group from the University of Washington studied three groups of children: 85 cisgender children, 84 transgender children that had socially transitioned, and 85 gender-nonconforming children that had not socially transitioned. There was no difference in the strength of gender identities between the groups. For example – girls who were cisgender and had always lived as girls, transgender girls that had socially transitioned and were living as girls, and transgender girls that had not socially transitioned and were living as boys all identified as girls with the same strength. Social transition did not change the strength of gender identity. It was always there. A strong gender identity leads to social transition not the other way around.

Research also shows that there are big benefits of affirming and supporting a child’s gender identity. There are some heartbreaking statistics related to mental health issues in the transgender community. 41% of transgender individuals have reported a suicide attempt and those numbers are even higher, at 57%, for individuals that experienced rejection from their family and friends.  This is devastating. The good news, though, is that transgender children that have socially transitioned in a loving and supportive home do not show higher rates of depression and have only slightly higher rates of anxiety relative to population averages. Family support and affirmation of gender identity at an early age seems to be extremely important in protecting transgender children from mental health problems and risks of suicide that can otherwise be common. These types of mental health issues seem less related to being transgender and more related to having to live a life that obstructs your gender expression – things like being told that you are incorrect about your gender.

All of this research combines to suggest that when a child’s gender identity is strong (think consistent, persistent, and insistent) we should affirm their gender identity rather than question it.

So, coming back to that assessment question. “Does your child answer correctly?” Yes. The answer is always yes.

Tomorrow is Transgender Visibility Day. It’s a day to raise awareness, offer support, and bring visibility. We should be doing this every day, but especially today we step up and speak out as allies. We remind our transgender community members that we see you and celebrate you –  even when forms and assessments and government policies leave you out.