An Intro to Gender and Sexuality, by Spencer Small

As part of the Children’s Mental Health Week Speaker Series, I presented on Supporting Families with Gender Variant Children and Teens. For those who weren’t able to attend, I’d like to share some of the information here on our blog.

I am a therapist in our OK2BME program for LGBTQ youth aged 5-18 in the Waterloo region. Our services include: free counselling for youth who identify as LGBTQ or who are questioning their sexuality, a bi-weekly social group for youth, support for GSAs (Gay-Straight Alliances) in our local schools, public education, an annual Pride Prom for teens aged 14-18 and an annual GSA Conference.

It’s usually helpful to begin with a discussion and explanation of various terms and their definitions.

“Sex” refers to biological and physiological characteristics, while “gender” refers to behaviours, roles, expectations, and activities in society. When most people are born, their sex (male or female based on their genitalia) and their gender (male or female based on their brain) are usually in total alignment.

“Transgender” is an umbrella term for people whose gender identity differs from what is typically associated with the sex they were assigned at birth while “Cisgender” refers to individuals who have a match between the gender they were assigned at birth, their bodies, and their personal identity. It includes the majority of people and is used in counterpoint to “transgender” or “trans.”

“Sexual Orientation” is a person’s sexual identity in relation to the gender to which they are attracted. It refers to the fact of being heterosexual, homosexual, bisexual, etc.

Someone who identifies as trans is not necessarily gay. Trans people can be of any sexual orientation. Sometimes it’s helpful to think in these terms: Who you go to bed with is sexual orientation and who you go to bed as is gender identity. Gender and sexuality are much more complex than is generally thought.

At age 2-3, gender identity emerges. It is at this age that toddlers learn the gender of toys and clothes. It’s also at this age that children can identify men and women or boys and girls based on external appearances. Children at this age will often seek same-sex role models. Some children at this age will begin to announce to parents that they sense a difference between what they are told they are and what they know about their own gender identity (Brill & Pepper, 2008).


By age 12-18 gender identity is usually fully developed. After toddlerhood and prepubescence, this is the third most common time for a child to realize they are transgender. This can be an especially difficult time for trans youth who may feel they are going through the wrong puberty. It is common for trans youth of this age to go through social withdrawal and depression (Brill and Pepper, 2008).

The Genderbread Person is a great tool that we use to help explain some of these concepts. Take a look below and visit for more detailed information.

My next post will focus on transgender folks and how we can be more inclusive.

Brill, S. and Pepper, R. (2008). The Transgender Child: A Handbook for Families and Professionals.  Cleis Press Inc. San Francisco, California.