Abstract

Objective

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

Methods

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.

Results

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.

Conclusion

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.

What is already known on this topic? 

Gender development and relatedly, gender identity, are complex issues in the context of VSD. Children with VSD appear to experience higher gender identity discordance or gender dysphoria relative to the general population. However, few studies have studied gender development in children with VSD using contemporary measures and appropriate comparison groups.

What this study adds? 

This study of 78 children with VSD compared their gender development to that of a comparison sample of youth without VSD. Few differences between groups were observed, and youth in both groups reported a range of both gender stereotypic and diverse identities and preferences. Results have implications for VSD care.