Gender Identity and Preferences in Children with Variations in Sex Development

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.