Work

Social and biological factors related to gender expression in 3-year-old children

Year: 2025

Type: article

Abstract: Background: Gender identity (GI) is the unified and persistent self-perception on the male-female spectrum, and its acquisition is a multifactorial process. GI is generally consolidated around ages 3-4 years. The gender identity questionnaire for children (GIQC) aims to assess GI in both clinical and non-clinical populations. The aim of the research is to evaluate GI in relation to social and biological factors. Methods: Single-center, prospective birth-cohort study enrolling those born at term, appropriate for gestational age. The GIQC was administered to the parents at age 3. The scoring was performed through the original coding scheme and the new coding scheme for the non-clinical group based on three scales: female typical behavior (FTB), male typical behavior (MTB), and cross-gender (CG). Anthropometrics, anogenital distances, and urinary hormone assessment were performed at birth, 3, 6 and 36 months. Results: 86 children (males 53) participated. FTB, MTB, and CG scores differed significantly according to sex: boys (3.28 ± 0.59) scored higher than girls (2.45 ± 0.44) on MTB, while girls (3.41 ± 0.75) scored higher than boys (1.92 ± 0.61) on FTB. Girls (4.14 ± 0.64) scored higher than boys (3.66 ± 0.88) on the CG scale. Within the whole sample, the FTB scale showed a moderate negative correlation with MTB (r: -0.464, P < 0.01) and a positive one with CG (r: 0.377, P < 0.001) in the female population. Correlations exist between MTB and ano-scrotal distance (AGD-AS) in males, and between MTB and ano-clitoral distance (AGD-AC) in females. Conclusion: Our findings confirm that by age 3, most children express differentiated sex-typed behavior according to the sex assigned at birth. In addition, androgenization appears to play a role in GI development in males.

Source: Endocrine Connections

DOI: 10.1530/ec-25-0289