What separates a young child who may be transgender from a kid with a vivid imagination? And what does gender identity have to do with sexual orientation? Your questions, answered.


To help recognize some of the signs that a child might be transgender, and to clear up some common misconceptions about trans kids, Parents spoke with Darlene Tando, a gender therapist in private practice in San Diego.

Girl on the inside
Credit: Aaron Tilley

Is It "Just a Phase" or Something More?

All children engage in imaginary play, particularly in the preschool years, when most kids are likely to try "opposite" gender toys. How can parents know if it's a phase or more significant?

Some kids are simply "gender nonconforming," unfettered by societal expectations of what are "girl" and "boy" playthings and pastimes, from toys to movies to activities. "These children have a lot of interests that are typically expected of the 'opposite' sex," says Tando. "But they don't have distress over identifying with the gender that matches their birth sex."

Kids who have gender dysphoria or who might be transgender, on the other hand, are in some or significant distress about their gender. Transgender kids can be:

Insistent: They insist they're not the gender that was assigned to them at birth, and they may repeatedly say they are, or wish they were, the opposite sex.

Consistent: They continue to express that they are or wish they were the opposite sex. They may continue to play or dress in the style of the opposite sex. Young children may even try to make their genitals "go away" by asking if they can get rid of them, pressing on them, or wearing leggings in the bath to conceal the sight of them.

Persistent: They can't be persuaded by others who "correct" them that their gender isn't what they believe or want.

That considered, there are some limitations to "insistent, consistent, persistent": "Children will modify their behavior if parents continue to correct them or express disapproval," says Tando. She also notes that some children by nature aren't particularly insistent about anything, especially if they're people pleasers. Her advice: Ask questions, and if you sense gender is a source of conflict, make it clear it's a topic your child is welcome to discuss with you. Then, seek a consultation with a gender therapist, preferably one with experience interviewing children.

Are Gender Identity and Sexual Orientation the Same Thing?

Many people mix up these two terms, but differentiating them is quite simple: Gender identity is the gender your brain identifies with—and not necessarily the gender you were assigned at birth. Sexual orientation is the gender you're attracted to.

Do children have a sexual orientation? "Not really, as children aren't sexual beings," says Tando. "However, children may begin to develop crushes in the elementary-school years, 'liking' someone of the same or different gender." What gender a transgender child eventually finds themself attracted to, however, is separate from their own identity.

To learn more about what it means to be transgender, visit these sites:

Originally published in the September 2015 issue of Parents magazine.

All content on this website, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

Parents Magazine