“My grandson said he’s a girl when he was four years old. We are confused on how to respond. He was raised around women. Could it be he’s just confused? When he’s around men, he imitates them and seems more boy than girl, but he takes no interest whatsoever in trucks or cars but loves Barbies and kitchens. How do we know if this is just a phase or if he’s really a girl? We don’t want to feed his confusion but we don’t want to cause him discomfort with his identity either. What to do?”

Question submitted Anonymously
Answered by Irwin Krieger, Licensed Clinical Social Worker

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Irwin Says: 
When your grandson was born, a doctor determined he was male based on his external body parts. We therefore say that he was assigned male at birth. Gender identity is a child’s inner sense of being male, female, neither or both. Some children, such as your grandson, declare that they feel themselves to be of the gender that is opposite their assigned sex. This can happen as young as age 3 or 4. There is no indication that being raised around women, or any one particular life circumstance, causes a child’s gender identity to be different from their assigned sex.
Gender expression encompasses how the child presents gender to others, ranging from feminine to masculine. This includes clothes, manner and grooming as well as preferred toys, playmates and activities. It seems that your grandson’s gender expression so far is a blend of masculine and feminine, but he says his gender identity is female. It can be difficult for parents and grandparents to know what is best for a very young child who says he is a girl, rather than the boy they previously understood him to be. 
Gender identity in children may change as they mature through childhood into adolescence. Because of this, experts are divided on whether it is best to allow a child to live freely in their affirmed gender, or to encourage them to fit in as the boy or girl they seem to be based on their assigned sex. You may be worried that your grandchild will be stigmatized now for being gender-variant, and then doubly stigmatized should he eventually revert to his birth-assigned gender. 
To date, there is no way to be sure if this will turn out to be a temporary identity for your grandson, or one that persists into adolescence and adulthood. My view, and that of the group that espouses a gender affirmative approach, is that it is best to allow children to live in accordance with the gender that feels real and comfortable to them. The first step is to listen to what he is saying and respond in an accepting and supportive manner. Perhaps he just wants you to acknowledge that he identifies as female, for now. Ask him what he likes and dislikes about being a boy, or about being a girl. Notice if he responds with statements such as “I just am a girl,” which is more suggestive of female gender identity than statements about interests such as “I like to play with dolls.” In the latter case, he may just need your permission to be a boy with interests that we tend to associate with girls and often devalue for boys. Keep in mind that his sense of his self will be evolving all the time. 
At some point your grandchild may want to try out wearing girls’ clothes, or ask you to call him by a female name and use female pronouns. He may just ask to do this at home, or he may want to present as female in public. These steps can be difficult for parents and grandparents to accept. You may fear for your grandchild’s safety, or be uncomfortable with him presenting himself to others as female or as a very feminine boy. Should your grandchild make these requests, I recommend seeking support from a local organization and/or mental health clinician who specializes in gender identity. You can find these supports by looking at the links listed on my website: Helping Your Transgender Teen. Many of the resources listed there are for families with young children as well as teens.
In deciding how to proceed, you can be guided by your grandchild’s insistence on making a social transition (living in the affirmed gender), and his distress about conforming to everyone’s view of him as male. You will also have to address any safety concerns that arise, especially advocating for accepting and respectful inclusion of your grandchild at school. If your grandchild starts to identify fully as female, it will be important to her to be considered one of the girls at school by teachers and classmates. She will need all of her family members to honor her female identity, name and pronouns. You can read more about honoring a child’s preferred pronouns in another piece I wrote for My Kid Is Gay by clicking here
For most adults, our gender identity has always been consistent with our assigned sex. So most of us have not really considered what it would be like to feel different in this way. As a result, parents and grandparents may wonder if a child’s expression of a different gender identity is a sign of confusion. It is more helpful to think of this as a process of identity exploration. If your grandchild requests a social transition, view it as a way to gain more clarity about what feels right. If she is happy living as a girl, then you will know this is the best path for her at this time.

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Irwin Krieger, LCSW is a clinical social worker in private practice in New Haven, CT. A graduate of Yale with an MSW from the University of Connecticut, he has provided psychotherapy for LGBT individuals, couples and families for over 30 years. Since 2004, Irwin has been working extensively with transgender teens and young adults and their parents. He is the author of Helping Your Transgender Teen: A Guide for Parents.

You can find information about the book and an extensive list of resources for parents at: Helping Your Transgender Teen

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