ESPE Abstracts

Background: Gender identity (GI) is the unified and persistent self-perception on the male-female spectrum, and its acquisition is a multifactorial process maybe influenced also by minipuberty. GI develops in early childhood and is consolidated around 3-4 years. Several tests assess GI as the Gender Identity Questionnaire for Children (GIQC). GIQC is intended for parents and aims to assess GI in both clinical and non-clinical populations. Aim of the research is to describe the main characteristics of GI in 3 years old children using the Italian version of the GIQC and to evaluate its relation to minipuberty.

Methods: Single-centre, prospective birth-cohort study enrolling born at term from a singleton pregnancy, appropriate for gestational age. The GIQC was administered to the parents at age 3. Questionnaire scoring was performed trough the original coding scheme and by new coding scheme for non-clinical group based on 3 scales: Female Typical Behaviour (FTB), Male typical Behaviour (MTB), and Cross Gender (CG). Urinary sampling was performed at birth, three and six months and hormonal assessment (LH, FSH, testosterone, oestradiol) analyzed by immunoassay.

Results: 86 children (51 males, 59.3%) were enrolled with mean age 3.08 ±0.09 years. Using the original coding scheme the rating as a function of birth-assigned sex showed a similar trend in boy or girls for most items. The major differences were detected for items 9 (roles in fantasy play) and 12 (dress-up play). As expected for non-clinical samples, high ratings for same-gender behaviour and low for gender-variant behaviour were observed. FTB, MTB, and CG scores differed significantly according to sex: boys (3.28±0.6) scored higher than girls (2.47±0.45) on MTB, while girls (3.39±0.75) scored higher than boys (1.89±0.6) on FTB. Interestingly, girls (4.14±0.63) scored higher than boys (3.67±0.88) on CG scale (P <0.001). Within the whole sample the FTB scale significantly correlated with CG (r: 0.395, P <0.001) and negatively with MTB (r: -0.468, P <0.01). Moreover, MTB was negatively related to uFSH at T3 (r: -0.526, P <0.05) while FTB was found to be related to uFSH at T6 (r: 0.515, P <0.05).

Conclusion: Our findings confirm that by age 3, most children are able to easily identify themselves as male or female according to the sex they were assigned at birth. The correlations shown with uFSH with MTB and FTB scales underscore a correspondence between sex assigned at birth and GI as assessed by the GIQC in a non-clinical population.