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Dianna Kenny PhD

Gender development is a complex process; it involves an interplay of genes, gonadal hormones, cognitive, language, and socioemotional development, the child’s socialization history, and culture. 

Gender identity includes: 

  • the individual's conviction that s/he is male or female; and
  • a social sex-role, which is the enactment of socially and culturally appropriate displays of femininity and masculinity.[1]

Cognitive processes in gender development

Psychologically, the development of gender concepts follows the same stages as those in the development of object and person constancy. Jean Piaget and colleagues identified four stages of cognitive development based on the different ways that children of different ages and cognitive capacity construct reality.[2] In the first stage (i.e., sensorimotor stage from birth to ~18 months), the infant interacts with the world via his/her senses and motor activity. Through repeated experiences of the physical world, the infant gradually develops schemas or organized patterns of behaviour, which gradually cohere into more complex, higher-order schemas. A process of adaptation then occurs that allows information to be assimilated into the new schema or to be accommodated if new knowledge replaces old, less appropriate schemas for the new object. Feedback from the environment determines which schemas are maintained and elaborated and which fade into disuse. In this process, combinations of visual, auditory, tactile, olfactory, and motor representations of objects are combined to form more complex, complete, and permanent representations of objects (and people) in the real world 

A critical skill acquired at the end of the sensorimotor period is object permanence, defined as the understanding that objects (and people) continue to exist when out of sight. Object permanence is necessary for more complex schema development and for memory. Absence or poorly developed object or person permanence explains the lack of distress in infants in the first few months of life when mother leaves, and the capacity of other caregivers to attend to the child’s needs without protest from the infant. When object permanence is complete, infants understand that their mothers are unique and continue to exist when out of sight, hence their distress when she is absent. Interestingly, babies with secure attachments to their mothers develop person permanence at a younger age than object permanence.[3]

Following Piaget, Kohlberg and Maccoby[4] proposed that the development of gender constancy (i.e., the notion of the permanence of categorical sex) is a necessary precursor to conformity with culturally defined gender norms; in other words, gender cognitions precede gendered behaviour (i.e., “I am a boy; therefore I want to behave like a boy”). According to this cognitive-developmental theory, there are three stages in the acquisition of gender constancy: 

  • identification of one’s own and others’ sex, that is, basic gender identity and labelling;
  • gender stability/gender permanence (i.e., gender remains stable over time); and
  • gender constancy (i.e., gender is a fixed characteristic that is not altered by superficial transformations in appearance or activities). 

As children develop their concept of gender, they initially focus on the perceptual properties of a person (e.g., the person’s name, long or short hair, pink or blue clothes) and act as if these properties are the defining characteristics of that person. They cannot conserve or retain a person’s basic gender identity when outward characteristics change. In other words, they are perceptually bound - they define the concepts of “male” and “female” in terms of outward appearance such as hair, clothing, toys etc rather than in terms of the person’s genitalia or biological sex. Here is an example:

A mother of a three-year-old was visiting with her friend who had just given birth to a son. The child was watching the mother bathe the baby. Mother asked her, “Is this baby a boy or a girl?” to which the child replied, “I don’t know. It hasn’t got any clothes on.”

Some children older than three years continue to have difficulty conserving sex across perceptual transformations and these difficulties may continue up to the age of seven. This is developmentally normal. Even when preschool children do show gender constancy, it is unlikely that they understand its biological basis, a phenomenon called pseudo-constancy.[5] Pseudo-constant children provide correct judgements of gender but with incorrect explanations as to their judgement, while children with true constancy offer both correct judgements and explanations. Pseudo-constancy is a transitional process leading to the attainment of true constancy.

Once gender constancy (i.e., consistency and stability of the concept) is achieved, children display lower levels of rigidity or gender stereotypy in gender-based behaviour and become more flexible in their reactions to culturally derived gender norm violations. This generally occurs around five years of age, although children with gender dysphoria are slower to develop gender constancy and engage in less sex-typical behaviour compared with children who can accurately self-label their gender.[6] Thus, gender constancy becomes an organizing principle for children’s gender beliefs and to some extent, behaviours. Part of the gender development process is the attainment of a sense of the importance of and contentedness with one’s gender. Gender typing, a process whereby the child selectively attends to gender cues, same-sex models, same-sex activities,  and clothing is a function of increasing age and emerging constancy.[7] 

Social processes in gender development

In addition to cognitive factors, social factors[8],[9] are influential in the development of gender concepts. Kagan[10]argued that social sex-roles i.e., gender “typical” behaviours are acquired by:

  • children wanting approval
  • adult caretakers giving children approval for developing stereotypic male or female behaviour; and
  • males learning to behave like boys and females like girls. 

The nature of the relationship between the child and the adult caretaker who is modelling the desired behaviour is important. The adult model must:

  • be perceived by the child as nurturing
  • have resources desired by the child; and 
  • be perceived by the child on some objective basis to be similar to the model. 

The emergence of awareness of sex differences and the display of gender-typical behaviour and preferences occurs primarily within groups after the early gender socialization experiences of infants and toddlers that occurs in families. Developmental Intergroup Theory[11] is one model that explicates the powerful social psychological processes that operate to create group-based adherence to dimensions of social categorization such as race, religion, politics, sexual orientation, and gender. It appears from research in this area that similar social learning processes operate in learning about gender as those that involve other intergroup or categorization experiences. With respect to gender, mothers' and fathers' behaviours are better predictors of children's gender-role attitudes than parents' gender ideology.[12]

Thus, the perception of being male or female is both an individual and a group process in that children, during the course of developing a gender identity, assign themselves to a categorical group membership that asserts new, and reinforces existing gender beliefs and attitudes through modelling and imitation of same-sexed peers and adults. When gendered behaviour is the salient characteristic being observed, children imitate same-sex adults more than same-aged peers, highlighting the importance of same-sex adults as early gender role models. 

On any given day, children are exposed to numerous people exhibiting a variety of behaviors. What they encode as gender normative, however, are those behaviors exhibited most frequently and consistently by multiple members of each gender category[13] (p. 1929). 

Children as a young as three- to four-years of age can self-categorize along the dimension of gender and can adapt their behaviour via imitation according to the social context in which it occurs.

Group processes are critical. For example, according to social learning theory,  children are rewarded for gendered behaviour and this consolidates the cognition, “I must be a boy/girl.”[14] Parents encourage and reinforce sex-typical play in their children from a young age.[15] A strong association has been found between amount of encouragement and level of sex-typical play in normally developing children.[16] By three years of age, children show marked preference for same-sex playmates and these preferences persist independently of parental involvement, even increasing when adults are not present.  

As same-sex imitation increases, cross-sex avoidance heightens, possibly because gender constancy has not yet been fully attained. “Self-categorization in terms of a social identity maximizes both differences between one's in-group and an out-group and similarities between oneself and other in-group members”11 (p. 1929). 

The impact of families on gender identity development

“Parents are critical mediators of the experiences of their gender variant children…”[17] (p. 123), as indeed are siblings, peers, and the wider ecological context in which children grow and learn.

Individual differences in children’s gender role development emerge as a result of both structural (e.g., family parental constellation – single parent, lesbian/gay, heterosexual) and process factors (e.g., beliefs and attitudes, gender-related behaviours, division of paid and unpaid labour) in families. It is important to disentangle family structure variables (i.e., parental sexual orientation) from family process variables (i.e., attitudes and behaviours). Research has identified family process variables to be more strongly associated with children’s gender development than family structure variables.[18]

Research on children reared by heterosexual parents indicates that individual differences in gender development covaries with differences in parental attitudes and practices. For example, when parents hold more conservative attitudes about gender-related issues, and when they divide household labour along traditional, gender-specialized lines, their children are likely to label their own gender as well as that of others earlier than children of more egalitarian parents. Those children who learn gender labels earlier are also likely to have more extensive knowledge of gender role stereotypes, and more traditional gender-related preferences and behaviours. However, during the preschool period, even children of more liberal parents often report strong same sex-typed preferences like children with more conservative parents.[19]

Studies in the developmental psychology literature about factors that influence gender development in traditional families[20],[21],[22] can inform and guide research into families with a transgender child. These include the interpersonal quality of parent-child[23] and sibling relationships[24], and parental gender attitudes and behaviours[25],[26].   One study of traditional families found that preadolescent children who are anxiously attached or who had a preoccupied form of insecure attachment to their mothers experienced lower gender contentedness and fewer gender-typical feelings compared with securely attached children[27].

A study of sibling effects on gender development and identification found that boys and girls with same-sexed older siblings were more sex-typed than same-aged, same-sexed singleton children, who, in turn, were more sex-typed than children with opposite-sex siblings. Having an older brother was associated with more masculine behaviours in both younger male and female siblings25.  In a three-year longitudinal study of first-born sibling influences on second-born children, McHale et al20 reported that elder siblings influenced the gender role attitudes and behaviours in their younger siblings, but that parents exerted more influence over gender role in first-borns compared with second-born siblings. These findings raise interesting questions, for example, whether an abusive elder brother may figure disproportionately in the family constellations of later-born sisters who eventually transition from female-to-male. 

Childhood maltreatment is frequently found in the medical histories of gender dysphoric individuals, with one study reporting that 25 percent of a sample of 109 adult male-to-female transgender persons disclosed child maltreatment[28], with more serious maltreatment being associated with higher body dissatisfaction.


The role of biological factors in gender identity development

Biological factors also make a significant contribution to gender identity development and gender dysphoria.  These include (i) genetic factors as evinced, for example, by higher concordance of transgenderism among monozygotic compared with dizygotic twins[29]; (ii) neuroanatomical factors related to the sexual differentiation of the genitals and the brain[30]; (iii) developmental disorders, in particular autism spectrum disorder[31],29; (iv) neuropsychiatric morbidity[32]; and (v) endocrine factors[33].

Recent research in both humans and primates shows that sexually dimorphic toy preferences reflect basic neurobiological differences between boys and girls that precede social or cognitive influences.[34] Children’s gendered selections of playmates, toys, and activities can be traced to the influence of biological factors, in particular, prenatal exposure to testosterone that occurs via testicular development, which in turn is determined by the presence of the Y chromosome.[35]

These sex differences in children’s play commence very early, before gender development and sexual orientation.[36]Studies with nonhuman primates, who have not been affected by gendered socialization processes or gender identification, confirm sex differences in novel toy selection (e.g., males prefer wheeled toys, females prefer plush toys, dolls) observed in young children.[37] In both monkeys and children, males are more rigid in their toy selections than females. However, girls who have been exposed to abnormally high levels of testosterone, such as those with congenital adrenal hyperplasia (CAH),[38] and those whose mothers took androgenic progestins during pregnancy show increased male-typical play and toy selection.[39] Further, levels of testosterone in the blood or amniotic fluid of pregnant women are associated with the degree of male-typical behaviour demonstrated by their children.[40]  As well as sex-nontypical behaviour in childhood, women with CAH evince lower heterosexual orientation, diminished identification with female gender, and higher preference to live as a man in adulthood, despite having been raised as girls. CAH women are 600 times more likely than women in the general population to experience severe gender dysphoria.21

Some personality characteristics such as empathy (higher in females) and aggression (higher in males) are also associated with prenatal testosterone exposure.[41] Hormonal surges in sex hormones (testosterone for boys, and oestrogen for girls) soon after birth may also affect gender development. Those children who have absent or reduced hormonal surges such as boys with hypogonadism and girls with Turner’s syndrome show differential deficits in developments normally associated with their assigned sex.[42]

Biological factors other than testosterone can also affect gender development. For example, newborns can generally be assessed along nine dimensions of infant temperament - activity level, distractibility, intensity, regularity, sensory threshold, approach/withdrawal, adaptability, persistence, and mood.[43]  Zucker and colleagues[44] offer a highly cogent example of how infant temperament can interact with gender development processes to cause confusion about gender identity in young people. Activity level, a sex-dimorphic trait that tends to be higher in boys, is associated with higher physical energy expenditure, one form of which is rough-and-tumble play. Activity level is lower in boys and higher in girls with gender identity disorder (GID) – an inversion of levels that occur in children without GID. Boys low in activity level might find the behaviour of girls more compatible with their temperament, leading them to affiliate with girls, which may direct their toy and play interests towards those typical of girls. This process, if continued, may lead to the development of female gender identity and later to gender confusion and/or dysphoria. This process may be interrupted if boys with low activity level meet and befriend other boys with similar activity levels (e.g., boys who prefer reading and playing chess rather than playing body contact sports). Meeting like, same-gendered minds may make it possible for such boys to expand their previously-held, somewhat rigid views about the nature of boys, thus allowing them to view themselves as a subset of all males, rather than as females “trapped in the wrong body.” 


Gender development is a multifaceted process involving genetic, biological, cognitive, and social factors. These factors are not monoliths acting independently. Rather, they form a complex set of interactions that influence gender development, perhaps in different ways for different children. Detailed examination of the child’s life including their primary caregivers, family constellation and peer relationships needs to be undertaken to understand the complex issues associated with gender development and its pathologies. Gender dysphoria might be better understood as a relational process rather than an inherent property of the individual[45]. Illuminating the interactional dynamics[46] in which young children assert that they are transgender may elucidate the complex interplay of cognitive, social and biological factors at play. 


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