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Hormones and Behavior

journal homepage: www.elsevi er. com/ locate/ yhbe h
Hormones and Behavior 64 (2013) 288–297

Review
Gender identity development in adolescence

Thomas D. Steensma ^a,b,⁎, Baudewijntje P.C. Kreukels ^a,b, Annelou L.C. de Vries ^a,c, Peggy T. Cohen-Kettenis ^a,b
a Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
^b Department of Medical Psychology and Medical Social Work, VU University Medical Center, Amsterdam, The Netherlands
^c Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands

A R T I C L E I N f O


Keywords:
Gender identity Gender variance
Gender non-conformity Identity development Disorders of sex development Adolescence
Puberty
Gender dysphoria
A B S T R A C T

This article is part of a Special Issue "Puberty and Adolescence".

This article aims to provide an outline of what is currently known on trajectories, and contributing factors to gender identity development in adolescence. We give a historical overview of the concept of gender identity, and describe general identity development in adolescence, gender identity development in the general pop- ulation and in gender variant youth. Possible psychosocial (such as child and parental characteristics) and biological factors (such as the effects of prenatal exposure to gonadal hormones and the role of genetics) contrib- uting to a gender variant identity are discussed.

Studies focusing on a number of psychosocial and biological factors separately, indicate that each of these factors influence gender identity formation, but little is known about the complex interplay between the factors, nor about the way individuals themselves contribute to the process. Research into normative and gender variant identity development of adolescents is clearly lagging behind. However, studies on persons with gender dyspho- ria and disorders of sex development, show that the period of adolescence, with its changing social environment and the onset of physical puberty, seems to be crucial for the development of a non-normative gender identity.
© 2013 Elsevier Inc. All rights reserved.

Contents
Introduction 288

The concept of gender identity 289
Adolescent identity development 289
Gender identity development 290
Gender variant identity development 290
Factors related to gender variant identity development 291
Psychosocial factors 291
Biological factors 291
Effects of gonadal hormones on sexual differentiation of the brain 291
DSD studies 291
GID studies 292
Adolescent gender identity development and the brain 294
Genetic studies 294
Conclusion 294
References 295
Introduction

* Corresponding author at: VU University Medical Center, Department of Medical Psychology, P.O. Box 7057, 1007MB Amsterdam, The Netherlands. Fax: [phone].