Gender Identity and Preferences in Children with Variations in Sex Development

To assess gender-typed preferences and gender identity in children with and without variations in sex developments (VSDs).

In this cross-sectional study, 78 children with VSDs (ages 3-12; mean age = 7 years; 55% White, non-Hispanic) recruited through specialty clinics in the United States and 78 children without VSDs (ages 3-13; mean age = 7 years; 55% White, Non-Hispanic) recruited through university-based community databases completed assessments of gender-typed toy, clothing and peer preferences, continuous and categorical measures of gender identity, and perceived similarity to boys and to girls.

Generally, children with and without VSDs did not differ in their gender development on 5 of 7 measures for each gender group. Children raised as girls who had VSDs had more masculine toy preferences, t(84.89) = 3.421; p = 0.001; d = 0.698, and viewed themselves as more similar to boys, t(67.43) = 2.994; p = 0.004; d = 0.648, than comparison children raised as girls. Boys with VSDs selected more masculine toys (t(55.17) = 2.413; p = 0.019; d = 0.623), and responded in a more-masculine way on the continuous gender identity measure (t(38.40) = 2.364; p = 0.023; d = 0.621), than did boys in the community comparison sample, though these effects, unlike the effects amongst girls, were not robust against corrections for multiple comparisons.

During early and mid-childhood, VSDs were not strongly associated with differences in gender development. Future longitudinal research on the gender development of youth with VSDs is necessary, particularly as they mature into adolescence.