Whether they have DSDs or not, as they mature, all children go through a process of development in terms of their gender identities and sexuality. We will talk about this in depth below, because parents of children with DSDs have told us that honestly answering your child’s questions about gender and sexuality issues is a great way to help your child and to build a loving, trusting relationship with him or her.

Many parents of children with DSDs have a whole set of worries that a lot of other parents do not have, and they have them right from the moment the DSD is noticed. They worry that the child has been assigned the “wrong” gender or that the child may turn out to be gay. Parents of children with DSDs tell us that they spend a lot of energy watching their children play and interact with others, trying to notice whether the child’s behavior is “girlish” or “boyish.” When they see their children acting like the “opposite” gender, or they see their children acting “gay,” they often wonder if the DSD (or a “wrong” gender assignment) is the cause of what they are seeing. Sometimes seeing their children behave “different” in this way will bring up strong emotions for parents, including sometimes a sense of guilt, fear, shame, or anger.

So do DSDs cause some children to act and feel different than most people in terms of gender and sexual orientation? We are not sure. The truth is, even though scientists have attempted to find out why people end up with the gender identities and sexual orientations they do, the origins of gender identity and sexual orientation remain somewhat of a mystery for all of us. Do our gender identities and sexual orientations come mostly from our biology? Mostly from the way we are raised and our cultures? Or a combination of all that? The answer may be different for different people. And, although the causes of gender identity and sexual orientation may be important to scientists, this probably is not the most important issue to you. What is most important to you is your child’s happiness and well-being. In terms of your child’s gender identity and sexual orientation, it is very important to love and support your children over the years as they come to understand and express who they are.

What we do know for sure, from talking with parents of children with DSDs, is that these parents are a lot more likely to notice and take seriously the “gendered” behavior of their children. But when you are noticing these things, consider that maybe you’re just reacting more strongly to what lots of other kids also express, because you’ve been “put on alert” by knowing your child has a DSD. Parents who have been through this suggest that you try not to spend too much energy “keeping score” of the “gendered” behaviors of your child, because if you do, it is hard to accept your child for who she is. And you definitely should not conclude that, just because your child sometimes acts like the “opposite” gender or seems to be attracted to people of the same gender, you have his or her gender assignment wrong. Just because a boy is somewhat girlish does not mean he should have been raised as a girl. Just because a girl is attracted to other girls does not mean she should have been raised as a boy.

If you talk with adults with DSDs, you will find that the majority of them do not think they were raised in the “wrong” gender. So it is statistically very unlikely your child will change the gender to which he or she was assigned. Adults with DSDs do remember feeling hurt when their parents rejected them or felt ashamed of them because they were different from the average in terms of their gender identities or sexual orientations. Again, what that teaches us is that parental love and honest acceptance are the main things children with DSDs want and need.

The following sections walk you through different stages of children’s lives and help you think about how to be supportive of your child.