Childhood Gender Nonconformity and Identity Development Among a Diverse Transgender Community Sample in the United States

Abstract

Few studies have examined the association between childhood gender role nonconformity and markers of transgender identity development. We investigated the relationship between recalled childhood gender role nonconformity and identity development among a diverse sample of transgender and gender nonbinary (TGNB) individuals living in the United States. Using baseline data from a multi-site, longitudinal cohort study of U.S. transgender individuals (N=330), we evaluated whether recalled childhood gender nonconformity was associated with current gender identity, sexual orientation; age when they felt different, acknowledged being transgender to self and to others, changed gender roles, started hormones, and had surgery; minority stress, and mental health. 46.4% of TGNB participants were gender role nonconforming in childhood; no differences were found by sex assigned at birth. Gender nonconforming participants were more likely to identify as binary trans women or men, as heterosexual compared to participants who were gender conforming in childhood. Gender nonconforming participants reported an earlier age of feeling different and of acknowledging to themselves and to others that they were transgender. However, the two groups did not significantly differ in mean age of changing gender roles, starting hormones, and having gender-affirming surgery. In terms of minority stress, the gender nonconforming group reported lower levels of felt stigma, but no differences were found in enacted stigma. The two groups also did not differ in mental health. Childhood gender role nonconformity appears as an important variable affecting transgender identity development, particularly during adolescence and early adulthood. Our findings indicate that transgender and gender nonbinary individuals who were gender role nonconforming in childhood reached the initial milestones of awareness and disclosure at an earlier age. However, childhood gender nonconformity did not seem to affect the age of subsequent milestones of transition. To be more specific, the childhood gender nonconforming individuals have earlier first three milestones, but childhood conforming ones catch up during later three milestones. Clinicians should be aware that the awareness of gender nonconformity in childhood could be a predictor of different developmental paths of identity for the transgender population. Future research is needed to advance our understanding of different developmental trajectories of identity development, specific vulnerabilities, and resiliencies among transgender youth.