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Gender Identity


George R. Brown

, MD, East Tennessee State University

Last full review/revision Apr 2021| Content last modified Apr 2021
Click here for the Professional Version

Various terms are used to talk about sex and gender:

For most people, gender identity is consistent with their anatomic (birth) sex and their gender role (as when a man has an inner sense of masculinity and publicly acts in masculine ways).

Did You Know...

  • Many young boys go through a phase of playing with girls' toys.

Gender identity is well-established by early childhood (18 to 24 months of age). During childhood, boys come to know they are boys, and girls come to know they are girls. Children sometimes prefer activities considered by many in their society to be more appropriate for the other sex (called gender-nonconforming behavior). For example, young girls may like to play baseball and wrestle. Young boys may play with dolls and prefer cooking to sports or to rough types of play. Usually, this behavior is part of normal development. It does not mean that children have a gender identity problem as long as they identify themselves as and are comfortable with being their birth sex. Most boys who prefer activities considered more appropriate for girls do not have a gender identity problem when they grow up. However, many of those who consistently prefer these activities are more likely to be homosexual or bisexual as adults.

Children born with ambiguous genitals Defects of the genitals can involve the penis, scrotum, or testes (testicles) in boys and the vagina and labia in girls. Sometimes the genitals are ambiguous, that is, not clearly female or... read more usually do not have a gender identity problem if they are decisively reared as one sex or the other, even if they are raised in the gender role that is opposite to their biologic sex. Whether genital surgery is appropriate for children and infants with visibly ambiguous genitals is controversial.

Sometimes people feel that their gender identity and their anatomic sex do not match. Sometimes this feeling of mismatch causes significant distress and/or impairs the ability to function. In such cases, the condition is called gender dysphoria Gender Dysphoria Gender dysphoria involves a strong, persistent feeling that a person's anatomic sex does not match their inner sense of self as masculine, feminine, mixed, neutral, or something else (gender... read more . People with gender dysphoria may need to be evaluated by a health care practitioner.

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