In addition, in a girl there is either persistent marked aversion to normative feminine clothing and insistence on wearing stereotypic masculine clothing, or persistent repudiation of her female anatomic characteristics. In a boy, there is either preoccupation with female stereotypic activities, or persistent repudiation of his male anatomic characteristics. Boys with this disorder usually are preoccupied with female stereotypic activities. They may have a preference for dressing in girls' or women's clothes, or may improvise such items from available material when genuine articles are unavailable. They often have a compelling desire to participate in the games and pastimes of girls.
Female dolls are often their favorite toy, and girls are regularly their preferred playmates.
Gestures and actions are often judged against a cultural stereotype of femininity, and the boy is usually subjected to male peer group teasing and rejection, whereas the same rarely occurs among girls until adolescence. In rare cases a boy with this disorder claims that his penis or testes are disgusting or will disappear, or that it would be better not to have a penis or testes. Some children refuse to attend school because of teasing or pressure to dress in attire stereotypical of their assigned sex. Most children with this disorder deny being disturbed by it, except that it brings them into conflict with the expectations of their family or peers. Some of these children, particularly girls, show no other signs of psychopathology.