Understanding Gender Identity in the World of Global Nomad Families

Imagine your son beaming with joy about wearing his bright purple dress to Kindergarten, his first week in a new international school, in a very socially conservative region of the world.  Does your gut clench?   You aren’t alone if it does.  Even the most open-minded people understand that our world is still heavily gendered, and that there are consequences for kids who don’t play by the spoken and unspoken rules about how boys and girls “should” act.   There are also consequences for the parents of kids who behave in gender expansive ways, and it is the fear of the consequences for ourselves as parents and for our kids that lead lots of parents to worry and wonder quietly: “What is all this new gender stuff?” 

A gender expansive child is a child whose clothing, toy, game, and/or friend choices is different from what is expected of them based on the sex they were assigned at birth.  In a nutshell, their interests and tendencies expand beyond the limited “boys do this” and “girls do that” boxes.  

As you set out to read this, maybe you are a parent whose child is somewhat (or very) gender expansive. Maybe this doesn’t apply to your family at all. However, you know other families on this journey and you’d like to learn to be a good ally.  Maybe you are admittedly suspicious of this seemingly new trend, and you are uncomfortable with something that seems unnatural.   Statistically speaking, odds are very good that there are gender expansive and/or transgender children in your communities right now.  In this Part One of a Two-Part series I hope to shed some light on “this gender stuff.”

First, some definitions: 

Sex Assigned At Birth

The way the doctors labeled you (most often male or female) after a peek at your outwardly visible body parts.   

Gender Identity

Your internal, personal, heart-and-head-felt sense of how male, female, both or neither you are.  


Body parts (Sex assigned at birth) are aligned with their internal heart/head felt sense of gender (Gender Identity). 


Body parts (sex assigned at birth) are different from their internal felt sense of gender (gender identity)

Gender expression

How we express our internal felt sense of gender to the world.   

Parents often have questions as they begin to understand that body parts do not determine gender, and that gender is broader than two simple categories.  

Is it normal for kids to be curious and “try on” other gender identities?

  It is absolutely a healthy part of child development to explore a wide range of interests and clothing. Why else would preschools have such wonderful costume/dress-up sections?  But trying on clothes or finger nail polish or playing with toys (gender expression) usually associated with “the other gender” is not the same thing as trying on gender identities. We know from research and clinical experience that of the children who behave in gender expansive ways, some grow up to be cisgender, heterosexual adults.  Others grow up and identify as cisgender and gay, lesbian, bisexual or pansexual. Yet others grow up identify as non-binary or transgender (Ehrensaft, 2016). 

How will I know if my child is transgender?

As you can see above, just because your child is gender expansive in early childhood, it doesn’t mean that they will inevitably identify as a transgender child/teen. We know that many children whose body parts are different from their internal sense of gender feel increasing dysphoria (upset) as their body develops and/or as the world around them treats them as if they are their sex assigned at birth rather than in alignment with their felt sense of gender.

Children who are merely experimenting with gender expression (trying on clothes- wanting to be “like daddy”) generally do not experience upset when the world treats them as expected based on their sex assigned at birth.  Insistence, consistence, and persistence about their gender identity, as well as increasing discomfort when asked to behave or present in ways that match their sex assigned at birth can be indicators of an underlying gender identity journey.   Ultimately, though, there is no single sentence answer to this question.  If your child is persistent about their gender identity, and/or expresses upset consistently about being treated as their sex assigned at birth, it is recommended that a gender specialist and/or gender specialty clinic be consulted to help understand the child’s behavior and gender presentation. 

What is a gender specialist, and won’t they have an agenda?

A gender specialist is a professional with a mental health or a medical background who understands the complex nature of gender identity development and who has developed a specialization area in the assessment and support of gender expansive kids, teens and their families.  In some cases, gender specialists work in private practice, and in others, there are multi-disciplinary teams collaborating in medical centers.

An ethical responsible gender specialist’s only “agenda” will be to understand the child’s gender presentation in the context of their development. A gender specialist works with kids and families to clarify what kinds of support the child and their parents need while the whole family navigates the gender journey.  An ethical gender specialist will not steer the child or outcome in any certain direction and will help families understand gender, communicate with each other and make relevant decisions together (Keo-Meier, Ehrensaft 2018).   

How old does a child need to be to know they are transgender?  

Research and clinical practice suggest that by ages 3-4, most children can answer questions about their gender identity.  This may seem young, but I always encourage parents to try to remember the exact time they knew they were a boy or a girl.  Most of us say, “ I just knew.”  The same is true for many transgender kids.  At the same time, just because a child hasn’t been announcing it since preschool, doesn’t mean their preteen or teenage transgender identity isn’t real.  Preschool/Kindergarten is an age by which many children are articulating that they are on a gender journey.   It is also true that the onset of puberty is another time when preteens and teens report a clear sense that their changing/developing body parts are not in alignment with their internal felt sense of gender (Keo-Meyer, Ehrensaft 2018).  

Lately, everywhere I look there is more talk about transgender kids.  Its almost as if it is a fad.  Aren’t kids just using this as a form of rebellion?   

Parents almost always find a way to ask, “What causes” gender expansive behavior. The best answer is that gender identity is formed through a complex interaction of genetics, biology and social environment.   Although gender expression choices (clothing, hair, interests) can be influenced by peers, there is no indication that our internal gender identities can be changed or created by another’s influence.  

To suggest that gender identities are fads indicates that kids and teens simply choose to be transgender.  Data is beginning to suggest some brain and behavior connections related to gender, but it is too early discuss those trends clearly (Keo-Meier, Ehrensaft 2018). 

Most parents of children who are gender expansive report that their children have been naturally drawn to their interests well before peer influence would have kicked in. Furthermore, research shows that gender expansive and transgender kids and teens are likely to be ostracized socially, and targeted for teasing (Pepper, Brill 2008), rather than heralded as Avant guard trendsetters.  Considering gender identity a choice also discounts the clear data related to gender dysphoria and the tremendous discomfort that preteen and teenage transgender youth often experience as they navigate their gender journeys.  

It just doesn’t seem “natural.”  

Actually, there is evidence in nature that gender diversity is naturally occurring in plants, animals and humans.  Gender identity variation can be viewed as another natural expression of science, genetics, biology and environment. 

Why is it happening so much more now?

There is evidence that for centuries, people in cultures around the world (Native American, Thai, Nepalese, Indian, Samoan, Hawaiian, various African tribes) demonstrated gender diversity and/or “two-spirit” concepts in which people were recognized to have a balance of male and female energies and to be respected for their related knowledge and skills (Brown, Mar 2018).   It is true that gender diversity has gotten more media attention in the past decade or so, but the concept of gender diversity is not new.

What is the connection between gender identity and sexual orientation?

The answer to this question is: There isn’t necessarily a connection.   It is important to understand that gender identity, gender expression and sexual orientation are three very different things that often get tangled when we speak about gender.  As noted earlier, although there are some gender expansive children who later identify as gay, there are also many gender expansive children who identify as heterosexual. 

Being transgender has nothing to do with to whom you are romantically and sexually attracted.   As someone once explained to me (in an admittedly oversimplified way) “Sexual orientation is whom you would like to go to bed WITH; Gender identity is whom you would like to go to bed AS.”   Those are two totally separate things.  The LGB and TQ communities have worked together to help advocate for one another and may fall under the same umbrella in organizations. But in reality your internal felt sense of gender is totally separate from your patterns in romantic attraction.   

I read somewhere that transgender kids have a lot of mental health problems. Is this true? 

It is true that many children and teens who are gender expansive experience greater levels of anxiety and depression than children who more easily land in our traditional gender boxes.  There is a social cost to pay for being different from others and behaving in ways that are unexpected for teachers, parents and other adults.  Most of the available research is related to gay children and teens and the statistics for them are startling.  Dr. Caitlin Ryan did research in 2010 that suggested thus. Without parent support, lesbian and gay teens are 8 times more likely to attempt suicide.  They are 6 times more likely to experience anxiety and depression.

They are 3 times more likely to develop a substance abuse problem.  Additionally, according to research, they struggle to imagine that they can have happy healthy lives as gay or lesbian young adults.    However, research suggests that with family support gay and lesbian teens are not at greater risk for mental health problems than other teens (Ryan, C., 2010,  Le, 2016, Travers, R., 2012, Wilson, 2016).  

Clinical experience suggests that gender expansive and transgender kids are at greater risk for mental health problems (anxiety, depression, attention concerns) especially if they do not have the support of their parents and community. It’s the alienation, judgment and questioning that takes it toll on a child’s wellness (Barrow, Apostle 2018).   In a nutshell, there is no clear evidence that gender identity concerns are always indicative of mental health concerns.    

Global Impacts

We find ourselves faced with learning new things. Also we understand there are a myriad of ways to honor others’ identities.  We are often challenged to rethink what we used to view as “normal” and we are skilled at respecting differences within and among people. 

Because of the above, global nomad parents have an advantage making sense of the shifting public dialogue about gender identity. Part Two of this series will specifically address how to support the gender expansive and transgender children in your lives.  There are fairly clear “do’s” and “don’ts” with the kids in our communities, and we will discuss them fully in Part Two. 


Barrow, K., Apostle, D., (2018).  Addressing Mental Health Conditions Often Experienced by Transgender and Gender Expansive Children.   The Gender Affirmative Model: An Interdisciplinary Approach to Supporting Transgender and Gender Expansive Children, pp. 71-84.

Brown, E., Mar, K., (2018) Culturally Responsive Practice With Children of Color.  The Gender Affirmative Model: An Interdisciplinary Approach to Supporting Transgender and Gender Expansive Children, pp. 55-70. 

Ehrensaft, D.  2016.  The Gender Creative Child: Pathways for Nurturing and Supporting Children Who Live Outside Gender Boxes. 

Keo-Meyer, C., Ehrensaft D., (Editors) The Gender Affirmative Model; An Interdisciplinary Approach to Supporting Transgender and Gender Expansive Children.  (2018). 

Pepper, R., Brill, S.  2008. The Transgender Child. A Handbook for Families and Professionals. 

Ryan, C, Rusell, ST, Huebner, D Diaz, R, Sanchez, J.  Family Acceptance in Adolescence and the Health of LGBT Young Adults. Journal of Psychiatric Child and Adolescent Nursing.  2010; 23(4): 205-213

Author Bio

Dr. Laura Anderson has been a licensed child and family psychologist for nearly twenty years. For most of her career, Dr. Anderson ‘s offices have been primarily based in school settings. She has worked in public, private, international and charter preschools, elementary, middle and high schools. Dr. Anderson has expertise in learning and behavioral assessments. She also has experience with emotional/behavioral interventions in classrooms. Dr. Anderson is currently based in Oakland California. She provides national and international training on a variety of child psychology topics.

Dr. Anderson is a founding member Parenting-in-the-Gap. This is a group under the umbrella of UCSF Mind-the-Gap. It focuses on training therapists to work with family of gender expansive youths. For both personal and professional reasons, Dr. Anderson is passionate about supporting global nomad gender expansive, non-binary, and transgender youth and their families.

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