Does your 4-year-old son dress up in his big sister's tiaras and princess costumes?
Does your 3-year-old daughter hate dolls?
With celebrity gossip sites buzzing over Angelina Jolie's comment that her 4-year-old daughter, Shiloh, wants to be a boy, media reports spotlighting rare cases of transgender children and even children's books beginning to tackle the issue, concerned parents are sifting through a lot of contradictory information.
Childhood gender behavior varies a lot, experts say, and there is a wide range of reasons a boy may want long hair (maybe he identifies with his favorite sports star) or a girl may refuse to wear dresses (perhaps they're just not her style).
What's more challenging for parents is when a child consistently pursues a range of behaviors strongly associated with the opposite sex. A boy might play with Barbies, wear dresses, vehemently reject sports and say that he wants to be a girl. A girl might insist on playing only with boys, get a boy's haircut and express strong discomfort with her own body parts.
Often called gender variant or gender nonconforming, this pattern of behavior is still officially (and controversially) labeled childhood gender identity disorder by the American Psychiatric Association. Experts say no good data exist on how many children are affected.
Gender-variant behavior in children usually begins between ages 2 and 4, according to Ken Zucker, a psychologist and head of the Gender Identity Service at the Centre for Addiction and Mental Health in Toronto. The behavior is pronounced, broad in scope and continues over a lengthy period of time.
"We're not talking about transient, episodic behaviors," Zucker says. "Many children will engage in some cross-gender behavior or gender nonconforming behavior, but I think it's really the combination and the persistence that co-occurs with the child verbalizing the wish to be of the other sex that leads parents to want to get the opinion of the professional."
The outreach program for gender-variant children and their families at Children's National Medical Center in Washington, D.C, offers a free online brochure, "If you are concerned about your child's gender behaviors," with tips for choosing a therapist, among them:--Ask the therapist how he or she approaches gender variance.
-- Ask about their previous experience treating children with these issues.
-- Make sure that guidance and support for you and your spouse or partner is a major component of the therapy.
-- Be concerned if the sessions only involve your child, don't address parenting questions, or don't offer you ways to help your child and your family.
-- Be concerned if the therapist seems to focus on the child's behaviors as the problem rather than on helping the child cope with intolerance and prejudice.