One of the cornerstone phrases for recognizing a transgender child is whether or not they have been “persistent and consistent” in their cross-gender identification. This means the child has shown a consistent (“of a person, behavior, or process unchanging in achievement or effect over a period of time”) identification with the brain gender of that of the “opposite” gender than which they were assigned at birth, and that this has persisted “continued to exist or endure over a prolonged period”. This is in regards to not just gender expression and interests, but in how they relate to themselves or identify in terms of gender. More recently, I have heard “insistent” added on to further qualify how a transgender child will likely present. I have to say, I don’t agree with this one being one of the characteristics a parent or professional might look for in terms of clarification. I think if one is looking for all three of these characteristics, they might miss something. I think the level of insistence displayed by the child is largely dependent upon the child’s temperament. Not all transgender children will be insistent about their “true” gender identities. Really, if taking all different temperaments into consideration, we may want to also reconsider our thinking about the use of the word “persistent” when it comes to transgender children as well. Another definition for persistent is “continuing firmly or obstinately in a course of action in spite of difficulty or opposition”. Will all transgender children be persistent in this way or insistent in the face of opposition or re-direction from parents or other significant figures in their lives? Likely not. Just like everything, one’s personality and desire to please guardians are on a spectrum. MANY children are not insistent about anything, so they sure as heck aren’t going to be about their gender identity or desire to be recognized as a different gender than their assigned gender at birth. Some children eat their vegetables simply because they are told to. Others refuse to take even a bite despite any tactics used by those in charge of feeding them. Such is the same with gender identity: if a child is consciously aware of identifying with a gender other than that assigned to them at birth (i.e. a natal female feels like a boy or some other gender, or a natal male feels like a girl or some other gender), how much they express this will depend upon the level of distress it brings to them as well as their temperament. Some children will scream, “I am a _______!” and insist upon wearing what they want, being referred to as they want, etc. until everyone around them is quite clear of who they really are. Others, if told the way they feel or how they perform gender is wrong or unexpected, will quickly make modifications to please those around them. When considering persistency and consistency, this is typically in regards to cross-gender identification and gender expression. This may include way of dress, interests, how the child seems to categorize themselves (in play, roles, or how they relate to others), gender of friends, bathroom behavior, etc. If these things seem to be an expression of “cross-gender” identification, that may be a sign of having a gender identity that does not match one’s birth sex. However, the individual (a child, teen, or adult) may not be consciously aware of being transgender until much later. Transgender people become consciously aware of being so at various ages and stages; some seem to know since birth, others as children, others as soon as puberty hits, still others only in late teens or adulthood. I think this largely depends on how much the individual has been exposed to knowledge of variations of gender, family environment, how freely one is allowed to express self in regards to gender, defenses, suppression, the list goes on and on. Only once the individual is consciously aware of being transgender does transition become a factor. From the child who insists on their true gender since the time they could speak to the adult who does not become consciously aware until much later, both are equally transgender; the age of conscious awareness was simply different. If the child is yet to be consciously aware that they have the brain gender identity of something other than their assigned birth sex, there is nothing to be insistent about. The point of my post? Don’t wait for your child to insist that they are transgender or needs to transition in order to open up the lines of communication. Ask a lot of questions about how your child is feeling. If you sense gender is a source of internal conflict or stress, make it known it is a topic that is welcomed in your home. Ask creative questions to find out how your child experiences their gender. Be honest about options that are available in regards to transitioning. (Doing so will not make your child transgender or “plant” ideas in their head. Transition is not an appealing option for non-transgender child.) If you still sense distress but they are not being open about their feelings, seek a consultation with a gender therapist trained in interviewing children. The benefits of early intervention (and transition if right for the child), are many. If you are transgender, looking back to yourself as a child: How consistently did you express a cross-gender identification? How long did this persist before you transitioned? Were you insistent about it?
CONSISTENT! PERSISTENT. INSISTENT?
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Gender Blog by Darlene Tando, LCSW 
i grow more and more impressed by your insight and unconditional love. Your wisdom in this post is astounding. Form personal experience some children know who they are but fear of so many things keeps their feelings internal without coming to the surface but an astute observer would have seen obvious signs. As you say children are each unique an react differently. THANK GOD that now there are parents like you. The heart break parents like you save children from touches my heart deeply.
Thank you so much for your positive feedback. To clarify, I am not the parent of a transgender child, but I work with many who are. 🙂
This fact makes me more impressed. i find myself wondering for so many what a difference life would have been if there had been wonderful support from people like you and special parents who love their children unconditionally who are transsexual like there is today.
Hi Darlene,
Another interesting post.
I, too, have concerns about the persistent, consistent, insistent description. I worry that people treat it diagnostically. I think the description was meant to describe how a transgender identity tends not to be a passing phase, especially after age 11.
I am a woman of transgender history and a school psychologist.
I remember clearly thinking I was more like the girls in my neighborhood when I was age 4. That was 1959, a repressive time. I didn’t really have a language to express it; “I want to be a girl” just sounded so impossible. I already knew that femininity in a boy was ridiculed and I was terrified of that. When I was 11 (1966) I heard a news story about Christine Jorgensen, and I did start to have a language for what I was. But, my Dad often threatened to take me to a psychiatrist about my crying (which he said I did “at the drop of a hat”), and I already knew people could be disappeared into hospitals, as my brother’s friend across the street was. The only time it felt safe to come out was in 2004. I have had to tell my history numerous times. Had it been safe to be out, I would have been insistently, consistently, and persistently female identified, but had I come out as a child I have no doubts I would be dead today.I also have no doubt that most trans children today are just as afraid of annihilation if they came out. It’s still not safe for most children and youth to be out.
Yes! Thank you for this. I think you are absolutely right. We still have a long way to go!
Darlene,
IMHO one of your best posts. Points very well taken. This should be published in a professional journal to gain wider distribution.
Paul Hetrick
Sent from my iPhone
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Thank you so much, Paul!
Thanks so much for this post. I could not possibly have been more consistent in my self-sense as mostly male, but my gender expression–while everyone saw me as a tomboy, from my own perspective at the time even my gender expression was very limited by the fact that others refused to believe or see it and I was not at liberty to pick out the appropriate clothes or put myself in the boys’ groups at school or in any way be acknowledged as a boy.
In terms of insistence, I tried and tried for a few years, but it was terrifying; I really thought the message I was receiving was that I was not allowed under any circumstances to be a boy and that if anyone found out that I was a boy, the universe would collapse around me. I was not insistent. Instead, I disappeared.
I’m really glad you consider kids’ temperaments and environment in ways that will help people to be more sensitive to the array of factors kids have to negotiate.
Thanks for your piece.
Thank you so much for sharing your experience, Finn! I’m glad you didn’t disappear for long… 😉
“Insistent” absolutely should not be expected. I’ve kept my agender thoughts to myself for decades. I didn’t start my favourite sport until it was too late to really succeed because I didn’t insist. My self-esteem is broken because I don’t insist. I work with children every day whose lives are negatively impacted because their personality and upbringing insist on the wrong things.
I second the opinion that your perspective needs to be published. We are about eight months in to being part of my son’s transition. I was puzzled at first because it seemed out of the blue at age 13. Now that we have had time to talk more, it does seem like temperament and fear of rejection from me because of religious beliefs absolutely kept him from feeling like he could say anything. As we try to get medical interventions, it feels like he has to “prove” he is transgender by demonstrating the “consistent, persistent, insistent” litany.
Darlene,
Thank you for this post and your obvious clear advocacy and thoughtfulness on this subject. You are dead on that many, indeed probably the majority of children who have discordant gender identity WRT their assigned gender will *not* be insistent or persistent in assertion of their identity in terms of “I’m REALLY a ____” in the face of harsh or subtle gender policing from family, authority, cultural models or peers. I’ve frequently voiced my dissatisfaction with this essentializing formula that has been emerging, as it will leave so many gender non-conforming children without support. It is a throwback to many of the polarizing, stereotyping formulas and scales for categorizing and ranking the “reality” of the identity of trans people from the mid 20th century. As such, only gender non-conforming children with oppositional behaviors and personality bents and highly gender stereotypical interests and styles will be likely to be recognized and validated and consensus will crystalize around this most obvious case.
This is a big subject but like minded advocates must develop and promote a more expansive model and standard for nurturing and supporting gender non-conforming children of all personality types and gender styles.
Even most of the support organizations for trans and GNC youth, many of whom I know well and truly appreciate, are helmed by parents of or individuals who were stereotypically strong willed Insistent and Persistent trans youth and so promote this paradigm. I suspect this is also presented as a defense against claims from critics that we are promoting a dangerous agenda to recruit confused or experimental youth with a novel meme.
Very Best,
Breanna Anderson
Thank you so much! So nice to hear from a like-minded practitioner. 🙂
This was very informative, as I just happened to be searching for the actual differences between these words. As a fellow SW and one who identifies with the LGBTQ community, it was also refreshing to see these definitions come to light in a personal way. Very well put!
Thank you for your kind feedback! 🙂
Very interesting. My daughter was adopted at age 8 and I immediately started wondering if she was trans. They only thing she wasn’t was insistent. She may have thought she’d be rejected. But I had seen the video “My Secret Self” and decided to show it to her and discuss it with her. She spent a few weeks humming, “a boy as a girl, a boy as a girl.” I told her she didn’t have to know or decide or she could feel neither or both, it didn’t matter. Soon, though she said “My heart tells me I’m a girl.”
Love this! Thank you for sharing!
Thanks for the article, Darlene. This is an important issue.
As a transgender child, I had my first clues about my female gender identity at 4yo, conscious awareness of it at 7yo, distress starting at 10yo, and depression, anxiety, panic attacks, depersonalisation episodes and suicidal thoughts from 11 or 12yo.
I was silent about all of it. I learned ways to cope.
If there was one thing I was persistent, consistent and insistent about, it was staying in my closet, feeling safety in my silence.
I was a teenager in the 1980’s, and my Mum was very understanding and accepting, and she even tried to draw me into conversation about gender diversity on two occasions. She saw signs that I might be transgender, for all that I worked so hard to hide it.
I deeply regret that I didn’t tell my Mum. I wish I’d had counselling, because I might have opened up and talked, maybe. My silence was my way of keeping a lid on it.
Given the violence and discrimination against transgender people back in the 1980s, maybe keeping a lid on it was the best possible thing for me to do.
Thank you,
Naomi
https://www.quora.com/profile/Naomi-Lauren