Children with Gender Identity Disorder (GID) show a strong preference for sex-typed behaviors more characteristic of the opposite sex and a rejection or avoidance of sex-typed behaviors more characteristic of one's own sex. There are also signs of distress and discomfort about one's status as a boy or a girl, including verbal expressions of dislike or disgust about one's genital anatomy.

The behaviors that characterize GID in children occur in concert, not in isolation. It is this behavioral patterning that is of clinical significance, and recognition of the patterning is extremely important in conducting a diagnostic assessment. the authors describe the case of a 6-year-old boy with GID. the clinical referral occurred 3 years after the onset of the condition, at the age of 6, when his parents begin to feel that the pattern of behavior was no longer a “phase” and worried about the implications of his symptoms in his academic and social life.

This case illustrates some of the problems of the diagnosis, assessment, associated psychopathologies, developmental trajectories and therapeutic strategies for childhood GID, including parental considerations.