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 a natal male feels like a girl), 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 his or her 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 he or she is 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 his or her 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?