title: Demographic characteristics, social competence, and behavior problems in children with gender identity disorder: a cross-national, cross-clinic comparative analysis.
abstract: This study examined demographic characteristics, social competence, and behavior problems in clinic-referred children with gender identity problems in Toronto, Canada (N = 358), and Utrecht, The Netherlands (N = 130). The Toronto sample was, on average, about a year younger than the Utrecht sample at referral, had a higher percentage of boys, had a higher mean IQ, and was less likely to be living with both parents. On the Child Behavior Checklist (CBCL), both groups showed, on average, clinical range scores in both social competence and behavior problems. A CBCL-derived measure of poor peer relations showed that boys in both clinics had worse ratings than did the girls. A multiple regression analysis showed that poor peer relations were the strongest predictor of behavior problems in both samples. This study-the first cross-national, cross-clinic comparative analysis of children with gender identity disorder-found far more similarities than differences in both social competence and behavior problems. The most salient demographic difference was age at referral. Cross-national differences in factors that might influence referral patterns are discussed.
authors.affiliation: Gender Clinic, Department of Child and Adolescent Psychiatry, University Medical Center, Utrecht, The Netherlands.
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Cohen-Kettenis
authors.forename: Allison
authors.initials: A
authors.lastname: Owen
authors.forename: Vanessa G
authors.initials: VG
authors.lastname: Kaijser
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Bradley
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Zucker
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002675:Child, Preschool; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D005260:Female; D005783:Gender Identity; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009426:Netherlands; D009864:Ontario; D010379:Peer Group; D010552:Personality Assessment / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012917:Social Adjustment; D012919:Social Behavior; D012959:Socioeconomic Factors