Bryant states that feminine boys were not a new phenomenon at this time; however, the public emergence of adult transsexual women (male to female) in the 1950s was new and created a number of problems for psychologists, motivating some to undertake efforts at preventing their further emergence. Meyerowitz chronicles the deep disagreements which erupted between psychologists and physicians after Christine Jorgensens public gender transition, namely over whether transsexuals should be permitted to align their bodies with their inner identities or whether their inner identities must be brought in line with their bodies. At the time, transsexual women were beginning to publish first-person narratives which highlighted their awareness of their femininity at a young age and Bryant states that some clinicians and researchers thus turned their attention to feminine boys, constructing sissies as a new "medicalized patient and research population. "In 1960, Green and Money published a paper titled "Incongruous Gender Role: Nongenital Manifestations in Prepubertal Boys," detailing their observations of 5 children assigned male at birth(AMAB) who "showed incongruities in gender role", ranging from preferring to play with girls to praying God would change them into a girl. Citing that adult gay men and transgender women recollect gender incongruity in childhood, they later concluded 
early intervention is best in cases of gender incongruity and that "part of the successful rearing of a child is orienting him, from birth, to his biologically and culturally acceptable gender role.
Prevalence
According to a review published in 2020 relying on recent statistical surveys, 1.2% to 2.7% of children and adolescents identify as transgender. The data was drawn more from studies of adolescents than pre-pubertal youth and noted a difference in methodological quality between studies published before and after 2010. The review notes rising numbers of youth are self-identifying as trans and calls for more systematic studies and reviews in future. Management
The WPATH Standards of Care and other therapeutic interventions do not seek to change a childs gender identity. Instead, clinicians advise children and their parents to avoid goals based on gender identity and to instead cope with the childs distress by embracing psychoeducation and to be supportive of their gender variant identity and behavior as it develops. A clinician may suggest that the parent be attentive, listen, and encourage an environment for the child to explore and express their identified gender identity, which may be termed the true gender. This can remove the stigma associated with their dysphoria, as well as the pressure to conform to a gender identity or role they do not identify with, which may be termed the false gender self. WPATH Standards of Care also recommend assessing and treating any co-existing mental health issues.