Tomboys Revisited : A Retrospective Comparison of Childhood Behavioral Patterns in Lesbians and Transmen

In 1979, a study conducted by Ehrhardt et al. retrospectively examined childhood behavioral patterns of 30 adults; 15 identified as lesbian women and 15 identified as transmen. All 30 adults had been assigned female at birth, and, as children, all were regarded as “tomboys.” The study found several key factors that distinguished the two cohorts. The goal of this study was to replicate and extend the 1979 study, utilizing a larger sample size and including a reference group of heterosexual women. Given the major social, technological, medical, and legal paradigm shifts that have occurred over the past four decades, we sought to determine if the previous findings still differentiate the cohorts. In light of the exponential rise in the number of gender diverse and dysphoric youth who request treatment, providing optimal, affirmative care and education is paramount, especially since many of these young people seek social and/or medical transition. Exploration of the early behavioral indices of the diverse trajectories may help to inform best practices for optimal care for these young people and their families.


Introduction
In 1979, Erhardt, Grisanti and McCauley retrospectively studied early childhood traits of 30 adults, all of whom were assigned female at birth, and most were considered "tomboys" during childhood and adolescence.Half of this group, 15 individuals, identified as lesbian women as adults.The other half transitioned, and identified as transmen.The investigators found several factors that differentiated the two groups.Most significantly, eighty percent of the transmen reported to have "cross-dressed" during childhood, which the investigators defined as having worn boys' shoes and boys' underwear.None of the lesbian women reported this behavior in childhood.Nearly all of the transmen (93%) and most of the lesbian women (67%) reported having been labeled as "tomboys" [1].Both groups displayed little interest in stereotypic maternal role play, i.e., playing with dolls or exhibiting an interest in babies [2,3] The last four decades have ushered in a dramatic paradigm shift, challenging traditional stereotypic roles.Therefore, it seems reasonable that given the contemporary social landscape with less restrictive gender constructs, differences between groups would be correspondingly less dramatic.Thus, our primary goal of this study was to determine whether the findings of the Erhardt et.al. study remain relevant given the sweeping societal shifts.We employed a similar retrospective design to compare tomboy behavior, maternal emulation and play, and clothing preferences between lesbians and transmen.However, we aimed to extend these findings with the inclusion of a reference group of adult heterosexual women.We hypothesized that the findings of Erhardt et.al. would partially replicate.Specifically, we hypothesized that male clothing preference and maternal role-play would differ significantly between the lesbian women and transmen, but "tomboy" behavior would not differ, as physical activity and participation in sports have become vogue for all girls.Finally, we hypothesized that measures of clothing preference and maternal role-play would be significantly different between the reference group and the lesbian women and transmen groups.

Participants
The participants in this study were 161 adults, all of whom had been assigned female at birth.Of these 161 individuals, 45 identified as lesbian women, 50 as transmen, and 66 as heterosexual women.None of the participants identified as non-binary.The demographics of the three groups are provided in Table 1

Questionnaire
To obtain information regarding demographic, behavioral, and gender-stereotypic preferences, a questionnaire was created and distributed, incorporating the parameters employed by the Erhardt et al study.The questionnaire consisted of 52 items, including questions regarding mental and physical health, and was designed to measure behaviors and preferences along a continuum.Content domains included childhood activities and behavior, childhood clothing preferences, and reaction to pubertal development.

Statistical Analyses
Comparisons of demographic variables between groups were evaluated using either an ANOVA for continuous variables and chi-square or Fisher's exact test for categorical variables.To assess differences in behaviors and clothing preferences between the three groups via continuous variables, either ANOVAs (three groups) or t-tests (two groups) were performed.For categorical variables, chi-square analyses were performed.

Demographics
There was a significant difference in age between the three groups (F 2,158 =30.5, p < 0.0001), with the transmen being younger than the lesbian women and the reference group.The lesbian women and the reference group had attained significantly higher levels of education 2 = 42.9, df = 4, p < 0.0001) and were more likely to have a partner Vol-1 Issue 1 Pg.no.-4 status of the household in which the participants were raised was quite similar across groups, with the exception that the lesbian women were slightly more likely to come from a lower socioeconomic status environment 2 = 9.7, df = 4, p < 0.05).

Transition Related Characteristics of the Transmen
The mean age in which the transmen first considered transition was 16.9 years; the mean age at

Tomboy Behavior
Participants were asked whether they had been regarded as tomboys during childhood and adolescence.
Thirty percent of the reference group endorsed having received a label of "tomboy," compared to 73% of lesbians and 90% of the transmen.All three comparisons were significant at (p<.001) Figure 1.
There were no significant differences in the physical activity levels between the transmen and the lesbians, however both groups engaged in more intense physical activity in childhood than did the reference group (F 2,158 =5.3, p=0.006).

Childhood Play and Interest in Child Care
There was a highly significant difference between the reference group compared to the lesbian women and the transmen in all areas related to interest in babies, maternal role-play, and doll play (Figure 2).
Between transmen and lesbian women there were significant differences in maternal role play (χ 2 =9.2, df=1, p=0.002), paternal role play (χ 2 =12.4,df=1, p=0.0004) and play with cars and trucks (χ 2 =4.9, df=1, p=0.03), with the lesbian women having spent significantly more time playing "mommy" and the transmen preferring cars and trucks to dolls.There were no differences between lesbian women and transmen in desire to become a parent, interest in babies, or in enjoyment of babysitting.

Clothing Preferences
Three questions pertained to childhood clothing preferences.There were significant differences between the reference group, the lesbian women and the transmen in regards to their clothing choices in childhood (Figure 3).Thirty-seven percent of the reference group preferred plain clothing to fashionable clothing.This is in contrast to both the lesbian women (82%) and the transmen (80%): both groups preferred plain rather than stylish or "fancy" clothing as youngsters.Interestingly, there were highly significant differences in the desire to wear boys' shoes and boys' underwear.None of the reference group, and only 9% of the lesbian women stated the desire to wear boys' underwear during childhood.This was in contrast to 78% of the transmen who preferred boys' underwear (χ 2 =45.7, df=1, p=1.4x10 -11 ).Six percent of the reference group, compared to 49% of lesbian women preferred to wear boys' shoes as a child.This is in contrast to 90% of the transmen who had a marked preference for boys' footwear (χ 2 =17.3, df=1, p=3.1x10 -5 ).

Hair Length
A continuous scale measuring the preference for short hair compared to long hair was highly significantly  Future longitudinal studies that examine these variables prospectively will help elucidate and potentially parse the complexities of identity formation, as well as the specificity of our findings.However, large population-based studies would be required to achieve an adequate sample size to test these factors within the general population.While much remains unknown, what is known is that the overarching goal is reducing stigma, fostering resilience and providing support and care for these children and their families.
which these individuals initiated transition was 23.4 years.The transition occurred at approximately the same time as the initiation of hormones (23.5 years).All of the individuals in this group had socially transitioned.All but four were receiving hormones.Twenty of the transmen underwent mastectomy; eight underwent hysterectomy; four underwent metoidioplasty; three participants had undergone vaginectomy, and one individual had undergone phalloplasty.

Figure 1 -
Figure 1 -Tomboy labels and levels of energy in lesbian women, transmen, and the reference group.

Figure 2 -
Figure 2 -Maternal care and role play characteristics