One of the most important developmental functions of puberty is the acquisition of identity. Identity is shaped by the biological traits, spiritual needs, interests and beliefs, as well as the sociocultural environment of the individual. One of the important constituents of the feeling of identity, is the development of sexual identity. Sexual identity is the feeling and acceptance of an individual’s belonging to either gender, and exhibited behavior accordingly. Core sexual identity defines the state of awareness of an individual in being either male or female. The feeling of belonging to either gender forms at ages 1.5-2, and develops completely after ages 4-5 not to be changed again. It is imperative for the healthy development of sexual identity that the male child identifies with the father or a father figure, and the female child identifies with the mother or a mother figure.

Factors negatively affecting sexual identity:

• Lack of suitable identity models
• Lack of love or the presence of violence inside the family
• Attacking the child with sexual-content or sexual abuse
• Extreme accusations related to sexuality, the extreme feeling of “shame”
• Excessive control, the lack of privacy provided before and after puberty that is needed
• Misinformation regarding sexuality, attitudes pushing towards perversion, provocative behavior
• The introduction by the mother to her daughter, of “womanhood” as unworthy and despised
• The father’s lack of love towards his daughter, or excessive scaring or negligence of the son

The clothes of the child, the gender of the chosen playmates, preferred games and toys, behavior and attitude are important in the development of gender roles, and are affected by the attitude of the parents in raising the child.

Research shows that 2/3 of the male children with sexual identity disorders exhibit gender role behavior not accepted as belonging to the male gender, before the ages of 4-6. These children show excessive fixation on clothes that belong to the opposite sex and avoid playing games that male children of the same age play, finding these games aggressive. They prefer to play with soft, feathery plush (peluche) or dolls, and play the mother, female artists or actors while role-playing.