The relationship between childhood gender nonconformity (GNC) and a child's future gender identity is complex and a subject of ongoing longitudinal research.
- Jun 30
- 3 min read
Updated: Jul 2
Cassandra Williamson
30 June 2025, Monday
Based on the scientific evidence, here is an analysis of the relationship between childhood gender nonconformity and the likelihood of developing a transgender identity.
The relationship between childhood gender nonconformity (GNC) and a child's future gender identity is complex and a subject of ongoing longitudinal research.1 While some gender-nonconforming children do grow up to be transgender, scientific evidence indicates this is not the most common outcome. For a majority of these children, particularly for boys, significant gender nonconformity is a stronger predictor of a future gay or bisexual sexual orientation than it is of a persistent transgender identity.3
Persistence and Desistance of Gender Dysphoria
To understand the developmental pathways of gender-nonconforming children, it is crucial to distinguish between GNC as a broad pattern of behavior (e.g., "tomboyism" in girls or "effeminate" interests in boys) and the clinical diagnosis of gender dysphoria, which involves a marked and persistent incongruence between one's experienced gender and assigned sex that causes significant distress.5
Longitudinal studies that have followed children clinically referred for gender dysphoria have identified two primary outcomes:
Persistence: A minority of children with gender dysphoria continue to experience this incongruence into adolescence and adulthood, ultimately identifying as transgender.6
Desistance: The majority of children in these studies—often cited as around 80-88%—experience "desistance," meaning their gender dysphoria subsides and they do not grow up to be transgender.6 For this larger group, the most common outcome is a cisgender (non-transgender) identity and a homosexual (gay or lesbian) or bisexual sexual orientation.4
It is important to note that this body of research on desistance has faced criticism for methodological issues, including how participants were recruited and how "desistance" was defined, with some studies conflating gender nonconformity with gender dysphoria.7 Nonetheless, the finding that childhood GNC is more often a precursor to a non-heterosexual orientation than a transgender identity is a consistent theme in the literature.3
Predictors of a Transgender Identity
Researchers have worked to identify factors that might distinguish children whose gender identity is likely to persist from those whose dysphoria is likely to desist. The key differentiator is not simply the presence of gender-nonconforming behavior, but the nature and intensity of the child's internal sense of self.6
According to the American Academy of Pediatrics and other experts, a transgender identity in childhood is characterized by feelings and assertions that are consistent, insistent, and persistent over time.11 Specific factors that are more predictive of a child being transgender include:
Intensity and Nature of Identification: Children who persist in a transgender identity often do not just wish they were the other gender but have a strong and adamant belief that they are the other gender.4 Their identification is more cognitive and affective, reporting that their internal feelings do not match their physical body.6
Social Transition: Children who show stronger cross-sex identification and preferences are more likely to socially transition (i.e., change their name, pronouns, and clothing to align with their gender identity).12 One study found that 94% of children who had socially transitioned continued to identify as transgender five years later.13
Discomfort with Anatomy: A strong dislike of one's sexual anatomy or a desire for the sex characteristics of the other gender is a key diagnostic criterion for gender dysphoria and is more common in children who persist in a transgender identity.4
In contrast, many forms of gender nonconformity, such as a girl being a "tomboy," are very common and are not strong predictors of a future transgender identity.14 While many lesbians recall being tomboys, the vast majority of tomboys grow up to be heterosexual and cisgender women.14
The Professional Consensus: A Gender-Affirming Approach
Given the different potential outcomes for gender-nonconforming children, major medical organizations like the American Academy of Pediatrics (AAP) and the American Psychological Association (APA) advocate for a "gender-affirming" approach.15 This model advises parents, caregivers, and clinicians to listen to and respect the child's expressed identity in the present moment, rather than trying to predict or change their future identity.15
The focus of this approach is on creating a supportive and non-judgmental environment that promotes the child's overall well-being and resilience.15 Family support is a critical factor in ensuring positive mental health outcomes for all gender-diverse youth, regardless of whether they ultimately identify as transgender, gay, lesbian, bisexual, or heterosexual.4
The Path Forward
Join me each weekday at 6 PM Eastern or 3 PM Pacific as I explore and analyze the days news and opinions.
Midday with Cassandra Williamson
On weekdays, usually around 1 PM Eastern.
[The timing is flexible since, as the caregiver for my mom, brother, and sister, my schedule is influenced by their appointments, needs, and situation.]
Programming is available on Social Media.
Comments