Although definitions may vary in the literature and in clinical discussion, some core concepts are defined here.
Gender identity refers to one’s internally perceived gender, regardless of chromosomal constitution, gonadal/hormonal secretions, or genitalia. Most children develop a stable gender identity that is concordant with their biology at about the age of 3 years. This process is probably driven by biological determinants, but environmental or psychosocial factors may also play a role.
Gender role refers to culturally underwritten masculine and feminine behaviors, attitudes, and personality traits that are partly biologically driven and partly shaped by the environment. This is often noticeable as early as age 2 or 3 years, although in some children there can be flexibility until age 5 or later.
Transgender youth identify with or express a gender identity that differs from the one that corresponds to the person’s sex at birth. This definition does not capture the complexity of an individual’s experience. Transgender youth may share issues and experiences addressed in this article; however, this group is not discussed here because of the need to understand them as a distinct population. References to literature that specifically addresses this population and the topic of gender dysphoria in children and adolescents appear at the end of this article.
Sexual orientation is the predominance of erotic feelings, thoughts, and fantasies one has for members of one’s sex, or both sexes. Savin-Williams and Diamond2 posit that sexual orientation exists along a continuum; a multitude of expressions are possible over a person’s life span. Sexual orientation may not be within conscious control. It may shift along a bisexual continuum for some and for others remain fixed.
Sexual identity describes one’s broader feelings towards one’s gender and sexual attractions. It describes how one consciously labels one’s sexuality.
Resources for Parents and Adolescents
Parents, Families and Friends of Lesbians and Gays (PFLAG) is a support, education, and advocacy organization that promotes the health and well-being of sexual minorities in more than 400 communities: www.pflag.org.
Gay-Straight Alliances (GSA) are student organizations that are intended to provide a safe and supportive environment for sexual minorities. The goal of most, if not all, GSAs is to make schools welcoming to all students regardless of sexual orientation and gender identity: www.gsanetwork.org.
Gay, Lesbian, and Straight Education Network (GLSEN) strives to ensure that each member of every school community is valued and respected regardless of sexual orientation or gender identity/expression: www.glsen.org.
ThinkB4YouSpeak.com is a Web site created by GLSEN that promotes education on the potentially negative impacts of language and bullying on sexual minorities: www.ThinkB4YouSpeak.com
Gender Spectrum Education and Training provides education, resources, and training to create a more gender-sensitive and supportive environment for all people, including gender-variant and transgender youth: www.genderspectrum.org.
The Family Acceptance Project is a community research, intervention, and education initiative to study the impact of family acceptance and rejection on the health, mental health, and well-being of sexual minority youth: www.familyproject.sfsu.edu.