Preliminary development of a brief parent-report gender identity alignment/distress screener for children.

This research develops a brief, and preliminary, parent-report screener to assess gender identity alignment/distress in children. The increasing prevalence of children not identifying with their sex at birth, the length and outdated language of existing gender identity measures, and the need to assess gender identity among children (as opposed to adolescent/adult measures) motivate a screener. A survey containing 14 items from existing instruments was administered to a diverse set of 1110 parents of children ages 3-12. Exploratory and confirmatory factor analyses, followed by multiple indicators and multiple causes (MIMIC) modelling, were used to develop a 5-item, unidimensional screener that may assess gender identity alignment/distress. The screener may be suitable to identify children who experience misalignment between their gender and sex assigned at birth and parents or children for whom this misalignment causes distress. These families may benefit from additional resources and conversations between paediatric staff and children about their gender identity, including education for parents, and/or referrals for specialty care. Future research should further streamline and validate this preliminary screener, examine its convergence with gender identity and distress measures and explore including children's perspectives.