In this section

Gender issues

The term "gender identity" refers to a child's inner sense of oneself and self-concept, in terms of gender. This may or may not conform to a child's biological sex. It is normal for young children to express wanting to be the opposite sex, or for young children to believe people can change into the opposite sex easily.

For some children, the desire to be the opposite sex only increases with age, and they do not "grow out" of these feelings. Gender dysphoria is a strong and persistent cross-gender identification that persists in children for over 6 months. Children and adolescents with gender dysphoria repeatedly state, desire to be, or insist that they are the other sex.

Other signs parents may notice include:

  • LGBTQ flagIn boys, preference for cross-dressing or wearing female attire; in girls, insistence on wearing only stereotypical masculine clothing
  • Strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex
  • Strong rejection of toys/games typically played by one's sex.
  • Intense desire to participate in the stereotypical games and pastimes of the other sex
  • Strong preference for playmates of the other sex
  • Strong dislike of one's sexual anatomy
  • Strong desire for the primary (e.g., penis, vagina) or secondary (e.g., menstruation) sex characteristics of the other gender

Gender nonconforming children and adolescents are exploring, questioning, or asserting their gender identity expressions. They may challenge the current dominant cultural values of what it means to be male or female. Some children and teens who are gender non-conforming may identify themselves using terms such as gender fluid, pangender, agender, third gender, polygender, or omnigender.

The term "transgender" is a broad term describing any person who is gender-variant. People who are transgender feel like they're living inside the "wrong" body. Between 3-5% of the population fall under this category. Being transgender is not the same thing as being gay. Being transgender is about gender identity — the way people see themselves and the gender they identify with. Being gay or lesbian is about sexual orientation — the gender someone is attracted to.

At Children's Wisconsin, we work with children and adolescents who may be struggling with a range of issues, including gender dysphoria, transgender, and/or gender nonconforming. In addition to individual psychotherapy, we also offer group counseling, a parent support group, and serve as a liaison to schools. Hormone suppression and hormone affirming therapy are also options, in conjunction with the Gender Health Clinic in Endocrinology.

Transgender flag

Why is this a concern?

Children and adolescents who are struggling with issues around gender may need support. At times, they may feel depressed, isolated, misunderstood, or anxious. Counseling can be beneficial in helping them sort out their feelings.

How are gender concerns diagnosed/evaluated?

Currently, we have psychologists who work with children and adolescents with a range of gender concerns. Typically, a clinical interview is completed with the child and the family and treatment goals are established.

Treatment offers hope

With young children, sometimes observation and guidance is all that is needed. For older children and adolescents, individual and group psychotherapy are available, in addition to a parent support group. Hormone suppression and hormone affirming therapy are also options, in conjunction with the Gender Care clinic in Endocrinology. The best place to start with concerns is by contacting the Psychiatry and Behavioral Medicine Center.

When to seek

In very young children, gender nonconformity is very normal and not a concern. As your child gets older, if symptoms of gender dysphoria are present you may want to seek professional help. The focus will be on ways to support your child and your family. Since gender identity is not a choice, trying to "force" a child to change his or her gender identity is not helpful and can lead to problems.

Long-term outlook for transgender individuals

Some transgender individuals decide to physically change their bodies — through surgery or taking hormones — to match the gender they identify with. Physically becoming the opposite gender can be a long, complicated, and expensive process. Other individuals are comfortable keeping their physical anatomy but dress as the gender they identify with. Some aren't sure what they want yet, and may be trying to sort this out.


Need help?

Need someone to talk to? Crisis mental healthcare hotlines are available in English or Español.

Find a mental health provider

Looking to find a mental health provider? Learn more about our specialists.

Contact us

To make an appointment, call the Psychiatry and behavioral medicine program.

(414) 266-2932

For new referrals or new patient appointments, please call (414) 266-3339.

Help is available immediately if your family is experiencing a mental health crisis.