You may be surprised to hear how early kids start to question their gender. In my clinical work, I’ve had children as young as 3 years old say things like, “My body is a boy, but I am a girl” or, “My parts don’t match who I am.” These kids may prefer to wear certain clothes, style their hair or play with toys that match the gender they feel. As these kids approach ages 9 and older, some stay gender fluid and others begin to reject these ideas. You really never know what will happen with a child who is questioning their gender at a young age.

This can be a very challenging time for parents. How does a parent know if it’s a phase or not? Should a parent let their five-year-old son wear his favorite pink dress in public? How far should parents let their children explore this, and what boundaries should parents put on young children? These are all very tricky questions to answer. Let me shed some light on each of these questions.

Is this a phase?

The general guideline that people use to determine whether something is a phase or not is whether the conversation is persistent, insistent and consistent. If a child’s conversation around his or her gender expression is persistent, that means it comes up in conversation frequently, not just when a child is reminded about it or in certain situations. If it is insistent, that means that the child is passionate about his or her gender expression, and it isn’t just something he or she is saying with slight curiosity or interest. And consistent refers to the 19 year old whose been saying that she feels like a boy since she was 3, not someone who occasionally talks about gender every couple of years, or who talked about it for a few months and never came back to it. If a child’s gender expression meets those three criteria then it’s more likely to be true for the long term. But it is not a rule. Some kids meet these criteria and some kids do not. It’s not as simple as this but it’s a good starting place.

With gender fluidity, you never know the outcome while you’re in the middle of it. Some kids will go on to become transgender, some will not, and some will decide that they will always stay in a non-binary gender place. Because of this, there is no reason to take extreme measures for young children, such as legal name changes. However, parents can accommodate a child through simple things like using a child’s preferred pronoun or name, or allowing a child to dress the way he or she prefers.

Should a parent let a child dress however he/she wants? Are there different standards for what parents should allow at home versus in public?

Allowing children to choose is very important. I always advise parents to let their children choose what they wear, how long or short they wear their hair, and even the language that they prefer to use when referring to themselves. I also always tell parents that these choices may change. A child may go back and forth or end up never talking about gender again after a certain age. The best bet is to allow the child to lead the way.

One technique that some families use is to dedicate a whole weekend to allowing the child to choose how he/she wants to express him/herself. During this weekend, parents allow the child to take the lead – dress in the clothes he/she wants, choose the toys or activities he/she likes, etc. Some families even go away for the weekend and make it a getaway weekend. This experience can help tell parents how serious a child is about their gender expression, as well as help parents understand what impact these changes might have on the family’s everyday life. It’s one way to get this process of acceptance and understanding started.

I see this understanding and acceptance as a progressive process. My advice to families is generally to start with acceptance at home. Parents need to assess whether they can handle this conversation on their own or consult with a professional who specializes in this area. Some parents feel comfortable having these conversations with their children and others feel that they need additional support to say and do the right thing.

When a child feels safe expressing their gender identity at home, he or she may want to start expressing it in public as well. We often see girls who want to cut their hair short or wear certain masculine clothing, or boys who love pink or want to wear dresses. A child needs to have strong self-esteem and self-confidence in order to go out into the world. He or she needs to be prepared that people will stare and make comments. Parents need to be very realistic about how strong their child is in this area and whether he or she will be able to handle any unpleasant experiences. If a child attempts going out in public and has a bad experience, parents must continue to provide unlimited positive support at home to offset any damage done to a child’s self-esteem.

When a child leaves the safety of the home and goes to school or out in public expressing their gender identity, parents and schools need to be watching. Kids can handle a few comments and looks – and that can be better than hiding who they really are – but if it becomes a bully-fest, adults need to step in. Adults working with this population need to be vigilant and stand just on the sidelines ready to step in if needed.

What limits or boundaries should adults set on children who are exploring gender expression?

Data shows that about 50% of children who question their gender at a young age go on to become transgender, and about 50% don’t. With that in mind, there’s no reason to do anything drastic at a young age. When children go through adolescence, their gender expression is likely to change in some capacity. About half of the kids will drop it and others will continue to explore and evolve their understanding of gender.

Rather than focusing so much energy on gender, the focus should be on acceptance. Parents can let their kids know that they accept them no matter what. This will help children know that their parents accept them if they do go on to become transgender, or if they never talk about it again. Their parents’ acceptance does not hinge on their gender identity.

Some parents worry that the more they allow their child to explore this, the more it will push them over the top, so to speak. If they let their kids dress a certain way or attend a support group, they may become more inclined to question their gender. There is no evidence to these claims. Just as a person with brown hair hanging out with blonde people doesn’t turn their hair blonde, neither does hanging out with transgender or gender-questioning people.

Some parents fall into the overly-accepting category and build an identity around their child’s gender expression. Later, in the 50% of cases where the child drops it and moves on, the child can feel guilty or even shame that he or she is not filling the role the parents have created for him/her in their minds. Gender expression can change on a daily basis. One day a child could like football and the next day play with “girl” toys. If parents try to analyze it too much, it can be very confusing. Parents who get caught trying to forecast the future or assign labels can end up feeling disappointed when things change. Again, the best bet is to be fully accepting and allow the child to take the lead.

What should parents avoid?

The biggest harm comes when a child feels shame around his or her gender expression. Even subtle shaming, such as putting certain gender-stereotypical toys in front of a child, or telling a child not to “walk like a girl” or “dress like a boy” is damaging to a child’s sense of self. When children feel shame around their gender expression, they may start to hide their feelings. This can lead to a very harmful path toward self-loathing and depression.

So what should parents do?

Acceptance and encouragement are the most important ingredients when working with any child – particularly this vulnerable population. Children must have a sense of safety and security, and home might be the only place where they feel that. Parents can still worry about their child’s future, wonder what life will be like, and provide unconditional support.

Many parents will feel a sense of grief during this process. That is normal and okay. Many parents will worry about the path that lays ahead for their child. Most parents will need additional support from professionals to work through their feelings and concerns on this issue. Support groups of other parents in a similar situation can be very valuable as well. When a parent decides to be a child’s biggest advocate and fan, no matter what path the child chooses, the child, and the whole family, will be strong and powerful enough to overcome future challenges.