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Gender identity refers to one’s own experience of one’s gender. Concomitantly there are few traits that are identified with each gender and as the child grows, he adapts to these expectations. If there is a good fit about the patients gender and the attributes, the patient is not distressed about it. However there could be a mismatch. As the person grow, they could take up the role of the other gender than his own and may cause others to criticize and they may be confuse. This is called as gender identity disorder in which there is a mismatch, where it is a perceived mismatch or a psychological mismatch. So how does this happen? It happens in a There is a nature – nurture controversy which is raging. We imbibe certain stereotypes like a blue, pink, which is there right from birth. Blue toys for the boys and pink for the girls. Secondly it is being investigated whether it is a physiological or a genetic phenomenon, at the level of the chromosomes. Third is a socio psycho bio phenomenon, that is it is a combination of all the 4. It is found that gender identity is recognized by an individual as early as 3 years of age. After that is a process of imbibing the values culturally, appropriate dress or ways of being of that particular gender. If a person in his late 20’sdicovers a mismatch in his gender, it causes a confusion. So one needs to check whether it is true case of a gender identity disorder or an anxiety, depression or any kind of fleeting of chronic mental disorders that can come in young adults leading to a sense of gender identity disorder.