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In response to growing demand from pediatricians and caregivers, the Canadian Paediatric Society released a guideline on Wednesday aimed at helping parents support children showing signs of questioning their own gender.

“Increasingly, our members – pediatricians – are telling us that they’re being approached by teens and parents with questions around gender and gender identity and sexual orientation,” said Mike Dickinson, president of the Canadian Paediatric Society. He said the guide represents a “missing piece” in the organization’s resources, and “will probably be the first of many more publications [on this topic] to come.”

The four-page document starts by clarifying such terms as gender identity – the gender one experiences one’s self to be – and gender expression – how someone presents gender to others through clothing, behaviour or a chosen name.

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“We wanted to make sure that everybody was talking the same language, and using terms that were accepted and appropriate,” Dr. Dickinson said.

Pediatricians developed the resource, available on the society’s website, with guidance from the support group Child, Youth and Family Committee of the Canadian Professional Association for Transgender Health.

The document guides parents through all stages of gender development, starting in the toddler years, when a child might try on different gender identities throughout the day, through to puberty, when some youth realize their gender identity is different from their assigned sex at birth.

The resource encourages parents to give children the freedom to express themselves, whether it’s a four-year-old boy who wears dresses, or a teenaged girl who hides her breasts.

“I think the message is that all children need to be loved and accepted and supported, regardless of their underlying gender identity, or their underlying sexual orientation,” Dr. Dickinson said.

Gender expression tends to be fluid in early childhood, he added. When a boy calls himself “she,” or a girl plays with trucks, “I think that can be a normal childhood phase.” Some children might end up with a different gender identity, “but the vast majority go through phases of experimentation and then settle with the gender they were assigned at birth.”

The main thing, he said, is to discourage parents from saying or doing things that might “make kids feel humiliated or ashamed or unworthy.”

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Recommendations on how to support children going through gender-identity issues are particularly crucial for families living in remote areas, who may lack access to specialists and resource centres, said Dr. Dickinson, a pediatrician in Miramichi, N.B. “We want to absolutely arm our more rural pediatricians with at least the basic skills.”

The guidelines were released the day after Ontario’s Conservative candidate Doug Ford promised to cancel the province’s progressive sex-education curriculum, which covers gender identity. Dr. Dickinson said the timing was a coincidence.

Children experimenting with gender identity may be at higher risk for becoming targets of bullying, or experiencing mental-health problems such as anxiety and depression, he explained. With better resources to offer support and understanding, “we can hopefully prevent those things from happening in the first place.”

Editor’s note: An earlier version of this story said guidance in the development of the guidelines was provided by Canadian Parents of Trans and Gender Diverse Kids and Gender Creative Kids Canada. In fact, it was the Child, Youth and Family Committee of the Canadian Professional Association for Transgender Health. This is a corrected version.
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