Diane Ehrensaft, Ph.D., is a developmental psychologist and the director of mental health at the Child and Adolescent Gender Center in California. In May, she published a great article titled "We Trust Children to Know What Gender They Are - Until They Go Against the Norm." The article discusses gender identity development in transgender and gender non-conforming children and the approaches to facilitating healthy development. It's brilliant and brief and definitely worth a read:
Those of us who operate within the gender-affirmative model – abiding by the definition of gender health as the child’s opportunity to live in the gender that feels most authentic to them – have developed assessment processes based on the dictum that: “if you listen to the children, you will discover their gender. It is not for us to tell, but for them to say.”
This makes adults nervous, as we were always taught that gender was a bedrock, determined not by the child but by the assessment of the medical professionals delivering the baby: penis for a boy, vagina for a girl. It’s both earthshaking and extremely anxiety provoking to have that trope challenged by young voices who might say to us that we got it wrong. And if the child is wrong and we go along with them, we could make a mess of things by having them bounce back and forth between genders or take the wrong path.
Over the course of time, if we do not impose our own reactions and feelings on the children, like the ones above, and allow a space for their gender narrative to unfold, the gender they know themselves to be will come into clearer focus. From there we can give them the opportunity to transition to the gender that feels most authentic, followed later by the choice to use puberty blockers to put natal puberty on hold and later cross-sex hormones to bring their bodies into better sync with their psyche.
If we do not give them this opportunity, they may feel thwarted, frustrated, despondent, angry, deflated – feelings reflected in the symptoms correlated with being a gender-nonconforming or gender-dysphoric child. The root of these symptoms is not the child’s gender, but rather the environment’s negative reactions to the child’s gender.