Aren't gender and sex the same thing?


People tend to use the terms “sex” and “gender” interchangeably. But, while connected, the two terms are not equivalent.

Sex and gender are different, and it is crucial to understand why.

“Sex” refers to the physiological differences between people who are assigned male, female, or intersex at birth. These differences include one's genitalia and chromosomal makeup. This assigned sex is called a person’s “natal sex.”

Gender, on the other hand, involves how a person identifies in terms of their "maleness," "femaleness" or "other." Unlike natal sex, gender is not made up of binary forms. Instead, gender is a broad spectrum. A person may identify at any point within this spectrum or outside of it entirely.

People may identify with a gender that is different from their natal sex or with none at all. These identities may include male, female, transgender, nonbinary or gender-neutral. There are many other ways in which a person may define their own gender.

Gender also exists as social constructs — as gender “roles” or “norms.” These are defined as the socially constructed roles, behaviors and attributes that a society considers appropriate for men and women.


What is a transgender child?

A transgender child is a young person who identifies with a gender that is different from their assigned sex. 

Transgender is an umbrella term for anyone whose gender does not align with their sex assigned at birth.

Cisgender is a term applied to people who are not transgender — people whose gender identity matches their assigned sex.

Aren't children too young and immature to know they are transgender?

No. Understanding of our gender comes to most of us fairly early in life. According to the American Academy of Pediatrics, “By age four, most children have a stable sense of their gender identity.” This core aspect of one’s identity comes from within each of us. Gender identity is an inherent aspect of a person’s make-up. Individuals do not choose their gender, nor can they be made to change it.

A new study published in the journal Pediatrics (released in May, 2022) found that the majority of transgender youth maintain their gender identity five years after their social transition during childhood.

How do you know if a child is transgender?

By early grade school, children may be able to express that their internal gender is different than the one they were assigned at birth. This is known as gender dysphoria.

Gender dysphoria is the distress someone feels when there is a difference between their gender identity and the anatomy of their body. People with gender dysphoria are called transgender.

Gender dysphoria is upsetting to children who experience it. It is not a phase and continues indefinitely.

Experts say children have diagnosable gender dysphoria if they have experienced significant distress about their gender for at least six months.

They also exhibit six or more of the following behaviors:

1. Expressing the desire to be the other gender or insisting that they are the other gender.

2. Strong preference for wearing clothes of the opposite gender.

3. Strong preference for make-believe play or fantasy play where they role-play the opposite gender.

4. Consistent preference for toys, games or activities typically preferred by the opposite gender.

5. Consistent rejection of toys, games and activities typically preferred by their assigned gender.

6. Primarily chooses playmates of the other gender.

7. Expresses dislike of their sexual anatomy.

8. Expresses a desire for physical sex characteristics of the opposite gender.

Isn't it possible that children are just going through a phase?

It is not unusual for kids to explore gender, especially when they are very young. Children like to play dress-up or engage in pretend play where they imagine themselves as someone of another gender. For many children, this behavior lasts for a short period of time (weeks to months).

For transgender kids, however, their feelings and behaviors are "persistent, insistent and consistent" over a long period of time (months to years). These three markers of behavior are usually tell-tale that you are raising a gender variant or transgender child.


Why is there such an increase in the number of transgender children in recent years? Has this become a trend?

No. Being Transgender is not a trend.

Historian Jules Gill-Peterson (as well as numerous other historians) documents the existence of transgender children in the United States dating back to the early 20th century (New York Times, 2021).

Society is becoming more educated on the evolution of gender, which has led to a greater understanding and acceptance of the spectrum of gender identities that exist.

This acceptance has helped young children to explore their authentic identities without feeling confined or shamed.

Also, parents are educating themselves and realizing that their children are happiest when supported as their authentic selves.

With the help of Gender Specialists and Psychologists, parents are becoming more comfrotable helping their children to navigate what it means to be non-binary or transgender.

Transgender children who do not have the support of their family have an attempted suicide rate close to 50%.

Parents are not willing to take the risk of losing a child to the depression and anxiety associated with gender dysphoria.

Source: Dr. Johanna Olson, Children's Hospital Los Angeles

Shouldn't parents wait until a child goes through puberty before they allow their child to transition?

If a transgender child is experiencing gender dysphoria (clinically significant distress or impairment related to a strong desire to be of another gender), the anticipation of puberty, or worse, the start of puberty can cause extreme anxiety, stress and depression.

With a close to 50% suicide rate due to extreme anxiety and depression, all major medical associations recommend that transgender youth pursue a social transition prior to puberty, and puberty blockers (if possible) at the onset of puberty.

Blocking puberty allows transgender children more time to experience life as the gender in which they identify and more time to prepare for any next steps for transition (hormone replacement and possible surgery); should they choose to pursue these options.

Source: National Library of Medicine

What are the primary challenges that transgender kids face while growing up?

Sometimes, the difference between a transgender child's assigned gender and their affirmed gender causes extreme distress called gender dysphoria. It’s important to note that being transgender is not a mental health disorder, and not all transgender people experience gender dysphoria.

But most do. They have a strong dislike of their sexual anatomy, a strong desire to be a different gender and a strong desire to be treated as that other gender to relieve their discomfort.

Many of them have anxiety or depression, which may be made worse by bullying, isolation from their peers or rejection by their families or community.

When they are unable to be accepted as the gender they feel they are; or are bullied or victimized, they are at high risk for depression and anxiety, as well as self-harm and suicidality.

The attempted suicide rate for transgender youth is close to 50%!

Why is there such a strong belief that there are only two genders?

The two gender identities most people are familiar with are boy and girl (or man and woman), and often people think that these are the only two gender identities. This idea that there are only two genders–and that each individual must be either one or the other–is called the “Gender Binary.”

However, throughout human history we know that many societies have seen, and continue to see, gender as a spectrum, and not limited to just two possibilities.

In addition to these two identities, other identities are now commonplace.

Youth and young adults today no longer feel bound by the gender binary, instead establishing a growing vocabulary for gender.

More than just a series of new words, however, this shift in language represents a far more nuanced understanding of the experience of gender itself.

Terms that communicate the broad range of experiences of non-binary people are particularly growing in number.

Genderqueer, a term that is used both as an identity and as an umbrella term for non-binary identities, is one example of a term for those who do not identify as exclusively masculine or feminine.

This evolution of language is exciting, but can also be confusing as new terms are created regularly, and since what a term means can vary from person to person. 

Source: Gender Spectrum

For further information on specific identities and what they commonly mean, please see Key Gender Terms.

How large is the transgender population?

According to the Williams Institute, 1.4 million adults identify as transgender in the United States. About 0.7% of adults 18-24 identify as transgender, and 0.5% of adults 65 and older identify as transgender.

This translates to approximately 149,750 transgender children between the ages of 13-17 in the United States in 2021.