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How do I know if my five-year-old is gay?

The question: My five-year-old son loves to play dress-up and always steals his older sister's dolls. I'm fed up with hearing everyone else's uninformed opinions. Is there anything a doctor can do to assess his sexuality or gender identity at his age?

The answer: One frustrating aspect of parenthood is the constant barrage of unsolicited advice about how you should raise your child. I can only imagine how particularly annoying it would be to have friends and strangers weigh in on the issue of your child's sexuality.

We still have a lot to learn about what influences a person's sexuality and gender preference. For example, some experts believe that the more older brothers a male child has, the more likely that child's eventual gender preference will be non-heterosexual. Go figure. The best we can say at this point is that final gender preference is likely affected by both genetic and environmental factors. A "gay gene" has never been identified. As such, there are no tests that your doctor could perform that would indicate your child's ultimate gender preference.

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I am reassured by children who engage in creative role-playing at this age. This can include pretending to be different characters, genders, professions and even make-believe creatures. I believe this is a sign of a normal, healthy, creative young mind. When I encounter parents in my clinic who are anxious about their child's ultimate gender preference, I provide reassurance. We know that children will ultimately develop their own unique personality and, along with that, a gender preference. While most often this is a heterosexual preference, some will naturally develop a non-heterosexual preference.

Parental influence seems to play a negligible role in this process. We are now entering an age when there are increasing numbers of children raised by gay or lesbian parents. The American Academy of Pediatrics believes such children have outcomes socially, emotionally and sexually that are no different from children raised by heterosexual parents. Having a stable, nurturing home environment appears to be more important than parental sexual orientation.

Perhaps most importantly, parents should not be afraid to discuss sexuality with their children. Discussing sexuality can start at an early age by using proper names for body parts and introducing concepts like "good touch, bad touch." As children mature, more detailed concepts of anatomy and intercourse can be broached. In my experience, children want to be well informed about sexuality and prefer to learn about this subject from their parents, rather than other sources. Being honest, supportive and open-minded can never be a bad thing, regardless of your child's gender preference.

Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.

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