Thus, gender role is often an outward expression of gender identity, but not necessarily so. In most individuals, gender identity and gender role are congruous. Assessing the acquisition of this congruity, or recognizing incongruity (resulting in gender-variant behavior), is important in the developing child. It is important also to note that cultural differences abound in the expression of one's gender role, and, in certain societies, such nuances in accepted gender norms can also play some part in the definition of gender identity.
In order to understand gender identity development and related issues, definitions must be emphasized for clarity. The topic of gender identity is often discussed merely in terms of dysfunction, and the diagnosis of gender identity disorder is a known phenomenon in both children and adults. However, physicians should remember that all individuals possess a gender identity and that the process of becoming aware of it is an important part of the psychosocial development of a child. In the realm of pediatrics, recognition of gender identity is a process rather than a particular milestone, and variance from societal norms can cause distress to both the child and the child's family. It is necessary to understand the varied pathways that lead to a mature and congruent gender role in order to fully assess a person's behavioral health.