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Gender Born, Gender Made: Raising Healthy Gender-Nonconforming Children

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A groundbreaking guide to caring for children who live outside binary gender boxes

We are only beginning to understand gender. Is it inborn or learned? Can it be chosen—or even changed? Does it have to be one or the other? These questions may seem abstract—but for parents whose children live outside of gender “norms,” they are very real.

No two children who bend the “rules” of gender do so in quite the same way. Felicia threw away her frilly dresses at age three. Sam hid his interest in dolls and “girl things” until high school—when he finally confided his desire to become Sammi. And seven-year-old Maggie, who sports a boys’ basketball uniform and a long blond braid, identifies as “a boy in the front, and a girl in the back.” But all gender-nonconforming children have one thing in common—they need support to thrive in a society that still subscribes to a binary system of gender.

Dr. Diane Ehrensaft has worked with children like Felicia, Sam, and Maggie for over 30 years. In Gender Born, Gender Made, she offers parents, clinicians, and educators guidance on both the philosophical dilemmas and the practical, daily concerns of working with children who don’t fit a “typical” gender mold. She debunks outmoded approaches to gender nonconformity that may actually do children harm. And she offers a new framework for helping each child become his or her own unique, most gender-authentic person.

304 pages, Paperback

First published May 10, 2011

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About the author

Diane Ehrensaft

11 books8 followers
Diane Ehrensaft, Ph.D. is a developmental and clinical psychologist in the San Francisco Bay Area and the Director of Mental Health and founding member of the Child and Adolescent Gender Center, a partnership between the University of California San Francisco and community agencies to provide comprehensive interdisciplinary services and advocacy to gender nonconforming/ transgender children and youth and their families.

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5 stars
109 (38%)
4 stars
124 (43%)
3 stars
39 (13%)
2 stars
6 (2%)
1 star
6 (2%)
Displaying 1 - 30 of 44 reviews
Profile Image for Laurel.
323 reviews15 followers
April 11, 2021
This book was really helpful as I try to understand gender and some of the non-binary and trans people in my life. I wanted to start with something that addresses children since this is when most people realize they are trans/non-binary/male-female. The author made some comparisons and metaphors that felt a bit problematic to me, but overall I think it's a useful and 5-star book. I was most interested in all of the individual experiences of the children and parents. It is completely clear that children who are being treated as the wrong gender know it, feel it deeply, and express it, and are happier, healthier, and more well-behaved when allowed to present as their internal gender. The book does cover other cases such as when children are simply going through phases or express desire to be another gender for an unrelated reason, and I'm sure it's difficult for parents to know exactly how to respond but there seem to be some best practices. Most important perhaps is all the data on sex and how non-binary it is for many babies, how many times a sex is literally chosen for a baby and an operation performed, etc. That alone makes it clear that forcing a strict binary in our society makes no sense.
85 reviews
March 10, 2018
Actual medical science in agreement with WPATH standards. Geared towards parents of adolescents and youth, and also researchers. Mentions the dangers of using outdated psychiatric methods now proven to be false/harmful. Awesome stuff.
164 reviews4 followers
September 7, 2012
Very important contribution to the advocacy for trans and gender non-conforming children. Less of a step-by-step practical guide than Brill and Pepper's "The Transgender Child," and more focused on the psychological aspects of trans/GNC children and their families. Still very accessible and critical for anyone who knows or loves such a young person.

As with many white writers, Ehrensaft needs to learn to describe the race of her white clients, not just that of her clients of color. She also could have used explaining her use of "sex" vs. "gender" as well as why and how she choose when to refer to children by their birth names and pronouns vs. their affirmed genders and pronouns of choice. Both of these would have been important additions to her first chapter.

Aside from that, though, i have no complaints. Thank you, Dr. Ehrensaft, for a wonderful and insightful book!
45 reviews11 followers
November 8, 2015
Reading the many case studies in this book took a weight off my shoulders. Hearing the children's own words, their ways of describing themselves, helped me figure out where on this spectrum my child sits (that is, not at the extreme end). It also helped reassure me that I'm making the right decisions when I let him figure out for himself who he is and how he wants to present himself to the world.

I'd give this four and a half stars, because even after reading the whole thing, I don't have a good sense of what it means to be transgender. The author does barely more than just asserting that "male" and "female" reside somewhere in the brain rather than the body, before moving on to other subjects. This is a concept I've been struggling to wrap my mind around for years, and I was hoping for more help than that.
Profile Image for Dar.
486 reviews18 followers
November 23, 2014
The author, a psychologist and trans advocate, warmly reaches out to children across the gender spectrum, and understands non-binary kids. Unfortunately, I thought the book was a mess, speaking to multiple audiences and getting bogged down in clinical language. Parents like me are desperate for this information, will read it anyway, and will feel reassured they're doing right by their children. But a truly readable parent guide has yet to be written. I've marked this review up one star for good intentions.
Profile Image for Linda Bramwell.
12 reviews
May 30, 2012
Fantastic reference for anyone grappling with issues around gender dysphoria. I realise how sheltered and ignorant I have been before reading this book. Dr. E shares many stories and many points of view in an effort to help us understand that these children simply need our help to be who they already are.
Profile Image for Mary Carter.
1 review
May 10, 2015
This book provides an accessible entry point into a larger and more complex discussion about gender identity in young children. At times I found Ehrensaft's analysis diluted, but mostly insightful. A must read for parents and teachers and human beings in general.
Profile Image for Sondra.
Author 2 books4 followers
January 24, 2016
A little slow in parts, but a useful read for anyone exploring the topic of gender and children.
Profile Image for Nivienne.
6 reviews1 follower
May 7, 2016

Really great and informing. I feel much more prepared to raise a transgender child now that I have read this book.
Profile Image for Emily VA.
696 reviews5 followers
January 18, 2022
While this book occasionally feels a bit dated (initially published 10 years ago, which feels like a million years ago to me in terms of gender awareness and rights), it’s not the author’s fault that I read this first instead of her newer book, The Gender Creative child.

And given the caveats about the time in which it was written, this is a helpful, generous, open-hearted, deeply experienced look at gender creative children, and their parents and siblings, and the support those families need to produce the best outcomes for the children.

Well narrated on audio.
Profile Image for Sonia.
100 reviews11 followers
December 14, 2018
this book is a wonderful companion for parents, therapist, any caregiver and citizen!

in raising a child, the more 'you follow your child' the healthy -in every phase emotionally, physically and psychologically- will be.

if one understands and applies the montessori philosophy and methodology, i can't imagine how one will impose a child not to explore their gender creativity.

this book handles pretty awesome every aspect conforming a gender fluid child -from their body struggles being trans to the ones between parents, community, therapist et all in dealing with their own definitions of male and female.

it is not an exhausting book but will give precise information for helping promote a freer society that welcomes and protects a beautiful gender spectrum.
Profile Image for Jason.
20 reviews5 followers
September 3, 2012
This book covers a lot that you probably won't find in many other books; it considers the many levels of complexity and the importance of learning to be with ambiguity and uncertainty when raising a gender-nonconforming child. It stresses that the child is her/his own authority and we are all best served by letting the child lead; that this is a creative process, NOT a disorder. It also discusses the common but dangerous approach of pushing a child to become more comfortable with their assigned gender (taking away toys, shaming gender-nonconforming activities, etc.). Research shows overwhelmingly that, even in spite of the social difficulties of being nonconforming, children who are allowed to pursue their authentic and creative gender self are happier with a much lower risk of depression or suicide. Parents did not do anything "wrong" for a child to appear in the world this way; it's a mystery, and it can be hard to take in, but so often we came into the world KNOWING who we are, and it's not a burden but a gift. I found the concept of true gender self, false gender self, and gender creativity exciting and useful, not only for parents raising children, but for anyone with gender non-conforming aspects of ourselves. As a gender nonconforming adult, I didn't find a whole lot in this book that was particularly new or eye-opening to me, though I think it would be an absolutely brilliant read for someone encountering these issues for the first time. It was a reminder that gender nonconformity can be something to be celebrated. One perspective that was not offered in this book, which is important to me, is that too often we tend to treat our children as boy or girl rather than responding to what emerges in the moment; so, we don't know how to deal with our child when their gender happens to be other than we thought it was. I feel that much of that confusion could be resolved if we could only be present for who is showing up in the moment, what the child's needs are, and allow the child to lead, to teach us how they want to be seen and treated moment to moment. Though I do not yet have children, this book has opened me to what a great gift it can be to a child to have a parent who embraces and nurtures their gender creativity.
Profile Image for Connor.
94 reviews2 followers
February 9, 2015
This book is life-changingly wonderful and developmental psychology at its best. In an age where many parents still abandon their trans or gender-nonconforming children, where these kids are at a far higher risk of suicide than the general population, what can be done?
Dr Ehrensaft, having worked with gender-nonconforming kids for decades, has a plethora of experience to bring to this book. She breaks down the basics: being GNC=/=gay, nor does it equally transgender, nor are gender and sexuality related. Some of her stories from her practice are a bit dated, sure, but she is clearly at the forefront of this area of child psychology.
Of particular interest was a section on parents taking their children to gender-corrective therapy and how harmful it is. We see this in practice all the time: fathers not letting their sons wear pink or enjoy cooking, or keeping their daughters from playing certain sports or cutting their hair. This is often reinforced by a therapist. However, I hadn't ever thought about it as a type of conversion therapy -- like 'pray the gay away' -- but of course it makes sense. And is just as harmful, as has been seen with recent prominent suicides in the transgender community.

I want to buy a copy of this book for every friend who has a kid.
Profile Image for Gwen.
270 reviews
May 19, 2012
This book is a must-read for anyone with gender-variant children as well as children who do not exhibit stereotypical heterosexual traits. Dr. Ehrensaft is a therapist who works in Oakland, California, helping parents understand, support, and accept their "gender-creative" children. Her examples are heartfelt and real, and show the range of parental reactions to gender-creative children. She describes the societal-induced suffering of children who are not supported by their parents, and shows how proper parental support can result in a child who is much more at peace with the world and their own gender identity or sexual orientation. The world needs more therapists like Dr. Ehrensaft!
Profile Image for Rosie.
300 reviews3 followers
November 20, 2017
Ok, so I'm a preschool teacher with strong feelings about the binary nature of gender in our culture that really wants to try and instill in the kids I teach the idea that gender is NOT binary and more (as this book describes it) like a web. I really liked this book. It's generally speaking more a resource for parents who may have children presenting outside the gender norms but it also closely examines gender within our culture in general and really I learned a LOT about transgender children in particular. If you're a person who feels strongly about gender and wants to banish all the gender norms and labels within our culture, pick this up.
186 reviews1 follower
January 18, 2012
Incredibly eye-opening. This is a book I've been waiting years to read, and found myself so relieved that someone finally wrote it!
It's more about Transgender kids than it is about Cisgender gender-nonconforming kids, but much of the overarching themes and ideas of supporting children when their gender presentation may be something that some people will dislike, fear, and/or judge them poorly for apply to both.
Everyone who works with kids, families, parents or knows any kids, families or parents should read this book.
Profile Image for Jordan E.
Author 1 book7 followers
February 20, 2014
What an interesting look at gender non-conforming children. As a future parent, it was great to look at some of the analysis about gender non-conforming children and children who may become trans in the future. The doctor discusses ways in which communication and letting your child express themselves, when possible, in order to help them be "all of me", regardless of what gender that may be.
Profile Image for Shane.
351 reviews2 followers
June 12, 2015
A very good book that covers many aspects of understanding and parenting a gender creative child. I occasionally felt overwhelmed by the number of examples but was very thankful for the information and insight provided. I appreciated the chapter on siblings as well.
Profile Image for marmix.
226 reviews1 follower
July 21, 2017
My copy is all dog-eared and post-it marked and I've ordered copies for Grandma and Nana.
Profile Image for Alisha.
7 reviews1 follower
August 17, 2012
This is a wonderful book! Really helped me understand gender differences on a different level.
Profile Image for Michelle.
1,074 reviews
June 15, 2013
This is a must read for any therapist or any parent with a gender fluid child.
2,140 reviews
May 18, 2015
ordered today from the ILL
From the library
Notes /ref's
This entire review has been hidden because of spoilers.
Profile Image for Tara.
529 reviews8 followers
December 8, 2016
Halfway through, but it was due back to the library. Really great information for parents or people working with gender-nonconforming children, sometimes got repetitive, but overall a great resource
155 reviews10 followers
March 18, 2023
I definitely learned a lot from this book. It is heartfelt and empathic, written by a psychologist dedicated to the well-being of children and to defending gender creative, non-conforming, questioning, genderfluid and trans children and youth.

It covers a lot of ground in its eight chapters, but the main takeaway is that the children know best, that we (adults) must listen, hear, trust, believe, and support them as they create their own selves and identities that fit them best, regardless of what society/parents/experts think.

Written from a psychoanalytical lens, Ehrensaft examines what gender is, how gender emerges and manifests in young children, how the family can best support gender non-conforming children, how parents can best support the transition of their child, the different options available for gender-affirming treatment, how to deal with other family members and society at large, and finally, how therapists can best provide care and support to gender creative children. Parts of the text, such as how to handle siblings or how to be a good therapist, weren't so relevant to me, but surely would meet the needs of some readers.

Throughout, Ehrensaft really brings her points home by providing numerous compelling case studies of both the right and wrong ways to do things, of how to handle different life situations as they arise, and in general of how to be the best possible parent to a gender creative child, regardless of how that child's gender manifests on the gender "web" or "spectrum." She also importantly pushes back strongly against therapists and treatments that only believe in the gender binary and seek to label non-conforming children as having a "disorder" who must be "corrected."

Overall, an important, insightful, professional, compassionate text all too necessary in our current moment. Highly recommended.
Profile Image for Heather.
776 reviews15 followers
August 11, 2022
Listened via hoopla.

I'm the target audience, and yet not, as I'm not really grappling with this stuff. Just follow the kid's lead and you're good.

The book only barely mentions intersex kids/youth, and that's a problem.

Since the publication of this, the diagnosis of "gender identity disorder" is no longer use and is diagnosed as "gender dysphoria." Sounds better and not labeled as a disorder, and having a diagnosis can be nice for insurance reasons, but the assumption that gender-nonconforming people will require a therapist to go through this process is a little much- I have a gender fluid kid who is very mentally healthy and content and hasn't needed therapy (so far). Hoping for the future that gender diverse people get so much support that they don't deal with anxiety/depression, etc.

But yes, emphasize this is a process and things do change/have phases sometimes. Early on in my kid's gender fluidity, I kind of hoped they'd just "pick a side" so we knew exactly what kind of puberty to prepare for and the path ahead would be laid out. But it's not clear and that's fine. Expectations are the source of suffering.
Profile Image for Marsha.
Author 2 books33 followers
June 21, 2021
This in-depth book explores the world of transgender identity. The notion that a child knows at a very young age what his/her gender is and that it contradicts what’s written on the birth certificate can bring up a lot of mixed reactions, especially from the parents. Dr. Ehrensaft digs into the issue, brings up real-life scenarios and outlines helpful courses of action and discussion.

Dr. Ehrensaft emphasizes that she doesn’t tell parents what to do or say, only offers outlines. She understands that the tricky notion of gender designation can be decided only on a situation-by-situation basis. It makes her writing highly sympathetic and accessible.

She ends the book on a slightly sentimental note, reminiscent of a John Lennon song Imagine. but this is just another, if unusual, look on how to rear happy children…and if you’re happy and you know it, clap your hands.
Displaying 1 - 30 of 44 reviews

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