title: Self-perception in a clinical sample of gender variant children.
abstract: BACKGROUND
  Gender variance (GV) in childhood has a negative impact on the self-concept of children in the general population and can lead to mental health problems and even suicidal ideation in adulthood. This study explored the self-concept of clinically referred gender variant children and examined potential risk factors.
  
  
  METHODS
  The Self-Perception Profile for Children was administered to 147 children, who were referred to a gender identity clinic. Their parents completed the Child Behaviour Checklist and the Gender Identity Questionnaire to assess the degree of GV.
  
  
  RESULTS
  The referred children were at risk of developing a negative self-concept; more specifically gender variant girls had low scores on 'global self-worth', 'physical appearance' and 'behavioural conduct' compared to Dutch norms for girls. Gender variant boys had low scores on 'global self-worth', 'scholastic competence', 'athletic competence' and 'physical appearance' compared to Dutch norms for boys. Within the group of referred children, sex differences, but no age effects, were found. The referred girls felt more competent than the referred boys on 'athletic competence' and 'scholastic functioning'. For both boys and girls poor peer relations had a significant negative relationship with self-concept and more GV was related to a lower global self-worth.
  
  
  CONCLUSIONS
  Clinically referred gender variant children seemed vulnerable to developing a negative self-concept. Poor peer relations and extreme GV might be mediating variables. Interventions might focus on enhancing acceptance of the environment and improving social skills of gender variant children.
authors.affiliation: Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands. a.balleur@vumc.nl
authors.forename: Anouk Balleur-van
authors.initials: AB
authors.lastname: Rijn
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Steensma
authors.forename: Baudewijntje P C
authors.initials: BP
authors.lastname: Kreukels
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Cohen-Kettenis
mesh_terms: D002648:Child; D005260:Female; D005783:Gender Identity; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010290:Parents; D012649:Self Concept; D012919:Social Behavior; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*