Most parents of young children are willing to discuss their child’s gender identity with their pediatrician, according to a new University of Michigan and University of Pennsylvania study.

Published in the journal Transgender Health, the study investigated the acceptability of screening young children’s gender identity among parents. Researchers found that nearly 88% of parents are willing to talk about their child’s gender identity.

“These findings illustrate how, across several demographic categories, parents were broadly willing to discuss their child’s gender identity, and that gender identity is often more complex than a binary,” said Matthew Diemer, U-M professor of education and psychology.

“We were surprised how a broad swath of parents were open to discussing their child’s gender identity, which we assumed would be a sensitive topic, viewed as too personal, or something parents would not otherwise be comfortable discussing.”

Findings came from a national sample of 2,680 parents with children aged 3-12 who completed an online survey that included questions about their child’s gender, play behavior and parents’ comfort in discussing these topics.

“At present, parents and children are not asked about gender during pediatric well-visits,” said Amy Hillier, associate professor of social work at Penn. “It doesn’t happen even though we know that gender identity is an important part of health and that gender exploration among young children is common and developmentally appropriate.”

While most parents found the gender identity screening questions acceptable, about 7% expressed strong resistance to answering the questions, referencing religious and moral objections. They believe young children cannot understand and should not be encouraged to think about gender identity, and that such questions sexualize children.

Previous research asked similar questions about the acceptability of parents answering questions about their adolescent’s gender. Those studies also found that most parents are willing to answer questions and to have their children answer questions about gender.

“Gender exploration is common and developmentally appropriate for young children,” Hillier said. “Parents of children who are exploring gender and even challenging traditional gender norms do not need to feel shame; they are not alone. Talking with pediatric care providers and other trusted professionals with their child about their child’s gender identity is an important step in affirming their child.”

Researchers say that if parents are ready to be asked about their child’s gender identity, pediatricians need to be prepared to initiate these conversations. They need to know the best questions to ask and how to integrate a short gender screening into pediatric well visits.

“Our team is actively working to create a short and rigorously validated screener designed for use in medical and educational settings,” Diemer said. “A screener that assesses how aligned children feel their perceived gender identity is with their sex assigned at birth, as well as whether they feel any distress because of misalignment between their gender identity and sex assigned at birth.

“These screeners are important because they open up conversations between parents and medical providers (and school personnel) about gender identity and developmentally normative exploration of those gender identities.”