Juvenile, pedophile, heterophile: hermeneutics of science, medicine and law in two outcome studies.
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Biomedical subjects
Publications and source records attributed to J Money.
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Psychological data were collected on 12 young women, aged 16 to 27 years, with a history of prenatal progestin exposure. In 11 cases, this exposure had induced virilization of the external genitalia. The 12th woman was an anatomically unaffected sister of one of the other women. The sample was composed of 10 women reported on as children by Ehrhardt and Money (1967), Money and Ehrhardt, (1972) as well as two others who were added to this group because they conformed to the original selection criteria for the Money and Ehrhardt studies. Of the 12 women, 10 had completed high school; of these, 7 were in college, 2 were in graduate school, and was raising a family full-time. None of the 12 had a history of difficulty in establishing friendships or dating relationships. Despite childhood characterizations as "tomboys" and avid interest in high school sports, none of the women pursued sports as a career or major pastime. Because of difficulties in personally contacting all 12 women, data on erotic behavior are available for only 6. Only one of these 6, the youngest, reported no erotic experience, and the remaining 5 reported exclusively heterosexual erotic experience and imagery.
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The parents of three children with a history and diagnosis of abuse dwarfism responded to an interview on erotosexual history in such a way as to indicate a nondescript erotosexual existence, or else a censored one. One additional couple, known on a personal basis by a youth worker, colluded in child abuse that was, in fact, a paraphilia of masochism by proxy. Two boys were beaten by their father as masochistic surrogates for their mother who instigated their beatings. Sexual intercourse between the parents was contingent on the beatings.
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The absence of an interdisciplinary science of sexology has resulted in sexuality being narrowly defined by the particular ideology of the various scientific disciplines. This review presents a theoretical model to integrate the interdisciplinary data related to the development of the three phases of eroticism. A biosocial integration of the multiple aspects of eroticism will hopefully generate research and psychotherapeutic innovations not plagued by mind-body dichotomization. The emphasis of this paper is on the solicitation, attraction and pair-bonding phase of eroticism, since this has been more neglected by sexologists than the copulatory and conceptive phases.
A paraphiliac with syndrome of exhibitionism has received treatment with the anti-androgenic hormone, Depo-Provera, for three years and is maintained on 350 mg, intramuscularly each week. He and his wife had been in a pathological oppressor/martyr relationship, he as a paraphiliac-oppressor and she as an abuse-martyr. They both receive reciprocal counseling therapy in individual and couple sessions. Antiandrogen diminishes paraphilic fantasy and enhances self-governance of its behavioral concomitants, but does not totally suppress erotosexual expression. Reciprocal counseling therapy enhances erotosexuality and pair-bondedness between the two partners as they both change, not singly, but mutually, toward a more healthy life style.
Sexuality includes eroticism. Though its determinants are multivariate and developmentally sequential, most current biological theories arbitrarily exclude social determinants, and vice versa. Developmentally, masculinization is not necessarily synonymous with defeminization, nor feminization with demasculinization. In the development of brain and behavior, behavior that appears to be either male or female may actually be sex-shared but sex-different in the threshold for its expression. Parent-child bonding is a precursor of subsequent erotosexual pair-bonding. Suppression of erotosexual rehearsal play in childhood is a precursor of postpubertal and adult erotosexual pathology. The criterion defining the heterosexual, bisexual, and homosexual conditions is the sex of the partner with whom a limerent (falling-in-love) pairbond is possible; and there is no evidence that pubertal sex steroids, per se, are responsible for which of the three it will be. The phases of an erotosexual encounter are proception, acception, and conception. The disorders of proception, manifested in both imagery and practice, are the paraphilic syndromes (formerly known as perversions). The disorders of acception may be either hypophilic deficiencies, or hyperphilic increases. The disorders of conception are those of infertility. There is a nonsystematic relationship of erotosexualism to the hormonal cycle of the menses and to gerontological hormonal changes.
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A micropenis is an abnormally small penis with a normal configuration. This finding constitues a sign not a diagnosis. The etiologies may be classified as hypogonadotropic hypogonadism, primary hypogonadism, androgen insensitivity, or idiopathic; among 45 patients, the respective percentages in these categories were 31, 24, 2 and 7% with 36% as yet undiagnosed. Various clinical syndromes may include a micropenis and can be classified in one of the etiologic categories. This paper provides the criteria for determining the presence of a micropenis. A phallic length which is 2.5 or more standard deviations below the mean should be considered as abnormal; for an infant of 0 to 5 months of age, the lower limit is 1.9 cm. The technique of penile measurement, determination of etiology, guidelines for sex of rearing and psychologic, surgical and medical management are discussed.
Eleven behaviourally abnormal XYY males who had been treated in a structured combined programme of antiandrogen medication and counseling were followed up 1 year after cessation of the programme. Behavioural ratings were made in each of 5 categories: assault against people, destructiveness against things, threatening behaviour, stealing, and self-harming. On examining the follow-up findings, therapeutic success appeared questionable.
Surgery is the most effective means of controlling or curing cancer of the penis, but management of a patient with penile cancer encompasses more than excising the lesion. Anticipatory guidance and counseling are required components of total patient care. An integral part of counseling is psychotherapy, including marital and sex therapy. This comprehensive management program is best provided by a team of health care professionals including the family physician.
The IQ of eight male patients with Noonan's syndrome, aged 13 to 26 years, ranged from 64 to 127, with a median of 102. The full IQ masked the possible presence of specific verbal or praxic (visual-constructional) disability. There was no verbal/praxic disparity in three cases; there was substantial verbal disability in one case; and there was major praxic disability in four cases, three unrelated to vision and one accounted for by severe visual impairment. Ostensible general mental retardation in Noonan's syndrome should always be further evaluated for specific disability. Academic placement should then be arranged accordingly.
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