More modern therapeutic interventions do not seek to change a childs gender identity, but are instead focused on creating a supportive and safe environment for the child to explore their gender identity and gender expression. Classification
Children with persistent gender dysphoria are characterized by more extreme gender dysphoria in childhood than children with desisting gender dysphoria. Some (but not all) gender variant youth will want or need to transition, which may involve social transition (changing dress, name, pronoun), and, for older youth and adolescents, medical transition (hormone therapy or surgery). DSM-5 (2013)
In May 2013, the American Psychiatric Association published the DSM-5 update to the Diagnostic and Statistical Manual of Mental Disorders, in which the GIDC diagnosis was removed and replaced with gender dysphoria, for the first time in its own distinct chapter. Subtyping by sexual orientation was deleted. The diagnosis for children was separated from that for adults.
Under "conditions related to sexual health", the ICD-11 lists "gender incongruence", which is coded into three conditions:
Gender incongruence of adolescence or adulthood (HA60): replaces F64.0
Gender incongruence of childhood (HA61): replaces F64.2
Gender incongruence, unspecified (HA6Z): replaces F64.9

Persistence
According to the American Academy of Pediatrics, "by age four most children have a stable sense of their gender identity" and "research substantiates that children who are prepubertal and assert [a transgender or gender diverse identity] know their gender as clearly and as consistently as their developmentally equivalent peers who identify as cisgender and benefit from the same level of social acceptance".If gender dysphoria persists during puberty, it is very likely permanent. For children with gender dysphoria, the period between 10 and 13 years is crucial with regard to long-term gender identity. Factors that are associated with gender dysphoria persisting through puberty include intensity of gender dysphoria, amount of cross-gendered behavior, and verbal identification with the desired/experienced gender (i.e. stating that they are a different gender rather than wish to be a different gender).Prospective studies have reported that gender dysphoria in children is more heavily linked to adult homosexuality than to an adult transgender identity, especially with regard to boys.