A third spectrum is gender expression, a pattern of behaviors that typically “belong” to males or females in your community. It is heavily, if not altogether, culturally defined, and often situation-specific. Acting aggressively and speaking confrontationally in some circumstances may be “unfeminine,” but in a context of threat to her children might be “normal mama bear” behavior. You can see that studying the incidence of this gets very squishy very fast. In recent decades, the blurring of strict gender roles has made this spectrum more open for everybody, but generally more so for women than men.

Many childhood development experts consider some degree of gender-variant play normal for children. (1) When it comes to pretend, gender seems like a small stretch. Some kids’ games could be described as species-variant (“let’s be ponies”), age-variant (“I’ll be the mommy and you be the little baby”), planet-variant (“let’s go to the moon”), geologic-era-variant (“let’s be dinosaurs”), and of course, reality-variant (cartoon, magical and other characters). Some kids occasionally play at being a different gender, but for others it’s a recurring theme.

So why does frequent or consistent gender-variant play and behaviors cause concern? Parents wonder what conclusions to draw for the future, and protectively fear their child may be teased or worse in the present.

What does it mean for the future? Most studies are small, and tend to focus on the children who exhibit the most gender-variant behaviors.

A small study of boys found that three-quarters of the “feminine boys” were homosexual or bisexual using the Kinsey scale, compared to none of the boys in the “masculine” control group. (2) A longitudinal study followed 54 children who had been referred to a Dutch clinic for Gender Identity Dysphoria over 10 years, and found that “Most children with gender dysphoria will not remain gender dysphoric after puberty…. With regard to sexual orientation, the most likely outcome of childhood GID is homosexuality or bisexuality.” In their sample, almost all of those whose gender dysphoria persisted through adolescence identified as non-heterosexual, while all the girls and half the boys whose GID diminished with adolescence identified as heterosexual. (3)

An older but larger study found that 5-13% of boys and 20-26% of girls (ages 12-18) reported their own behavior as sometimes cross-gender; significant subsets reported sometimes wanting to be a different gender. (4)  These rates are far higher than the rates of biologically intersex and transgender people, and noticeably higher than estimates of non-heterosexuality.

But for many parents of kids with “nonconforming” gender behavior, the important challenge is separating concern about sexual orientation (maybe to be revealed soon, maybe in the future) from concern about teasing, manipulation and bullying right now. For young kids, the peers in and out of the dressup corner aren’t thinking about sexual activity, even if they use “that’s so gay” as a taunt. They are, in the words of a Japanese proverb, hammering the nail that sticks up. A parent has no influence on whoever it turns out little Michael-as-Glinda or Kayla-as-Batman will be attracted to a decade from now, but quite a lot of influence on how s/he feels about today’s play and the playmates reactions. More about this is in “Bias: Blatent and Latent” (coming soon).

For older kids, the verbal and physical hammering is real much too often.    GLSEN (Gay, Lesbian and Straight Educators’ Network) has been conducting well-regarded broad-scale research into the social climate of schools for LGBT youth since 1999. Comparing the results from 2001 and 2011 (latest available), it’s remarkable how little has changed.

Sadly, although it’s becoming slightly less acceptable to say “that’s so gay,” “fag” and “dyke,”  it’s still ok in too many schools to taunt or slam into lockers someone whose behavior doesn’t match what you think a person of their gender should do. Interestingly, in this same time period the number of LGBT teens who reported hearing sexist remarks frequently or often also fell (85% to 71%) but the number who heard racist remarks frequently or often rose (35% to 42%). (5)

1. Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington (DC): National Academies Press (US); 2011. 4, page 2 Childhood/Adolescence. Available from: http://www.ncbi.nlm.nih.gov/books/NBK64808/

2. Green R: The “Sissy Boy Syndrome” and the Development of Homosexuality. New Haven, CT, Yale University Press,  1987, as reported in Kenneth J. Zucker, PhD; Susan J. Bradley, MD: Gender Identity and Psychosexual Disorders, FOCUS. 2005;3:598-617.

3. Wallien MS, Cohen-Kettenis PT “Psychosexual outcome of gender-dysphoric children”, J Am Acad Child Adolesc Psychiatry. 2008 Dec;47(12):1413-23.

4. Achenbach T M & Edelbrock C, Manual for the Youth Self-Report and Profile. Burlington VT : U of VT Dept for Psychiatry; 1987, as reported by W J Meyer III  in his commentary in Pediatrics Vol 129 #3” March 2012, p 571.

5. GLSEN, National Schools Climate Survey 2011 and National Schools Climate Survey 2001.