The dressing-up box is a prized resource at any early years setting, as practitioners are aware of the boundless learning possibilities of pretend play and how a mundane item such as a scarf can transform a child into pirate or princess.
However, sometimes early years professionals can become uneasy about a child's enthusiasm for dressing up and wonder whether it might indicate something more significant.
For example, take the case of a boy aged three-and-a-half who, on arrival, always goes directly to the box and dresses himself in girls' clothes. Or consider the little girl who prefers toy cars to dolls. Is anything more going on than a young child's interest in explorative play, and how should the adults respond?
'I wouldn't get excited about it,' says Robin Balbernie, a consultant child psychotherapist. 'It is interesting that if a boy dresses up in girls'
clothes everybody gets very worked up, but if a girl dresses in boys'
clothes nobody notices.'
'Generally, I don't think it's a big deal,' says early years consultant Margaret Edgington. 'I think all children love dressing up. At nursery there are lots of clothes and accessories they can use and it is a chance to try being someone else.
'Boys as well as girls enjoy all kinds of dressing-up clothes, but some boys particularly love the opportunity to try on more feminine clothes, which they never normally get the chance to do. Boys as well as girls want to imitate or act out being their mum, with whom they have usually spent a lot of time. For some parents this is a worry. But I don't think early years workers worry, because this is so normal.
Ms Edgington adds, 'I have observed some children, both boys and girls, becoming very attached to a particular item of dressing-up clothing, such as a hat, skirt or handbag. It often provides them with a bit of security in their first months in a new setting.
'Some children remain attached for longer, but usually they discard the item quite suddenly one day. I see nothing odd or sinister in this and would accept it as part of what the child needs at that time in his or her life. Parents often become anxious, but practitioners need to reassure them that many three- and four-year-olds do this.'
No fuss
Mr Balbernie says, 'Has anybody asked him? That is a first step. The child should not be asked in a confrontational way, but in a game. One of the nursery nurses can ask during a game, "which do you want to be: the boy or the girl?" to find out where he is coming from.'
'You could say it's about boys getting in touch with their feminine sides,'
adds Ms Edgington. 'There are these expectations in society that boys will always want to be superheroes and will not be interested in that kind of feminine side, but I don't think that is true when you watch children playing. I think some dads get worried, but you just have to reassure them that this is what children do at this age.'
'If you start making a fuss you can invest too much in something,' says Mr Balbernie. 'If the child genuinely has gender identity issues, which are rare, making a fuss will make no difference, apart from driving that child into a corner.
'The message is not to make a fuss about it, but at the back of your mind there would be questions such as, are dreadful things going on at home? Is dad so frightening that the child is identifying with his mother?'
'There is nothing sinister at all in most cross-gendered behaviour,' says a spokesman for the Gender Identity Research and Education Society. 'At three-and-a-half you don't know what the outcome will be. It could be that the cross-gendered behaviour will go away, possibly to return later in life, maybe in adulthood. It could be that the child's feelings are really feelings of sexual orientation rather than gender identity, in which case he or she would eventually come out as gay or lesbian. Or in rare cases it could be that the outcome will be transsexualism, in which case he or she would seek permanent re-assignment as a woman or man.
'The Government reckons that about 6 per cent of the population is homosexual, the transgender population is about 1 per cent, and those who are actually transsexual, who desire a permanent change, number only one in 4,000.
'There would need to be some very careful counselling from the local child mental health team. The difficulty is that this is quite rare and the team may not have a great deal of experience. Behaviour that is a prelude to homosexuality will be more common.'
Being valued
A spokeswoman for Mermaids, a support group for gender-variant children and teenagers, says, 'For parents, the problem is trying to find the right balance between letting them be themselves and protecting them from harm.
It is important that the children are valued for who they are and not told "you must not do this." This is not a child being naughty or trying to seek attention. This is a child just being himself.
'At three-and-a-half they are just regarded as cute, but things will get worse when they go to primary school. Word will soon get around if someone is a bit different. Most people are quite relaxed, but there will be some adults who will take the mickey and make comments, and other children can be unpleasant. If you don't fit in, life can be very difficult.
'The most important thing is that he knows that his parents love him, support him and protect him.'
Models of care
No single cause has yet been found with certainty for the development of gender identity issues, according to Dr Domenico Di Ceglie, a consultant child and adolescent psychiatrist and director of the Gender Identity Development Unit at the Tavistock Clinic, London. But he says advances in clinical practice and research over the past 20 years have made it possible to create models of care to benefit children and adolescents.
'The recognition and non-judgemental acceptance of the gender identity issue, which is not the result of the child's conscious choice, is important. Without this the child would experience feelings of rejection. A psychological splitting process would increase to cope with this and no further therapeutic work could be undertaken.'
Dr Di Ceglie has run courses of group work for parents of children with gender identity issues, which the families found very helpful. He says, 'It helps parents to realise that their problem is not unique.'
Case history
A mother tells of the atypical gender identity development that her eldest child, now aged 12, has experienced.
'Although the baby was announced to be a boy at birth, I now always refer to her as a female. Until our child was nearly two years old there were no indications she was anything other than a normal little boy.
'Our child started raiding my wardrobe and wearing my skirts and dresses. I didn't see anything wrong with this and considered her to be exploring. She started nursery when she was two-and-a-half, and within the first few weeks the staff told me that she was not interested in the boys' toys, but was heading straight for the little black dress and the pinafore. I suggested that they simply let her get on with it, and they agreed not to say anything that would make her self-conscious.
'Over the next couple of years her preference for girl friends, girl toys and girl clothes became more obvious. My husband found this very difficult to cope with and when our child was nearly four years old, and stated to me that he should have been a girl, my husband decided that we had to try to stop this growing obsession.
'I called a halt to the ban on girl things when I realised that far from making our child want to be a boy, it was making her feel depressed and anxious. Our first child has never wavered from her conviction that she should be a girl. She accepts that she has a male body, but she hates it.'
Further information
* A Stranger in My Own Body: Atypical gender identity development and mental health by Dr Domenico Di Ceglie, published by Karnac books (www.karnacbooks.com)
* Mermaids supports gender-variant children and teenagers and their families and carers. It runs a helpline on 07020 935066 (12 noon to 9pm, when staffed) or visit www.mermaids.freeuk.com
* Gender Identity Research and Education Society is a registered UK charity that sponsors research and education on gender identity. See www.gires.org.uk
* The Gender Variance unit at the Children's Hospital in Washington DC, publishes a guide for parents which is available at www.dcchildrens.com/gendervariance
