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At least 307 records · Page 17Linked to original sources
PubMed1995

A childhood gender identity disorder. Analysis, preoedipal determinants, and therapy in adolescence.

This paper is about a four-year-old boy's wish to be a girl. This wish was a compromise formation, the consequence of intrapsychic conflict. Using reconstructive inferences and research findings, I suggest a line of development in the boy's femininity, beginning with constitutional and maturational factors, with being shaped in a feminine direction by his environment, and with shaping himself internally in the form of a compromise formation in that direction by the time he was two to three years of age. The disorder began to acquire a persistence and stability during the preoedipal phase and, with minor changes in its components, remained operative during the oedipal phase, latency, and adolescence.

Child, Preschool↗
PubMed2005

Deciding on gender in children with intersex conditions: considerations and controversies.

Biologic factors such as genetic and hormonal influences contribute to gender identity, gender role behavior, and sexual orientation in humans, but this relationship is considerably modified by psychologic, social, and cultural factors. The recognition of biologically determined conditions leading to incongruity of genetically determined sex, somatic phenotype, and gender identity has led to growing interest in gender role development and gender identity in individuals with intersex conditions. Sex assignment of children with ambiguous genitalia remains a difficult decision for the families involved and subject to controversial discussion among professionals and self-help groups. Although systematic empirical data on outcomes of functioning and health-related quality of life are sparse, anecdotal evidence from case series and individual patients about their experiences in healthcare suggests traumatic experiences in some. This article reviews the earlier 'optimal gender policy' as well as the more recent 'full consent policy' and reviews published data on both surgical and psychosocial outcomes. The professional debate on deciding on sex assignment in children with intersex conditions is embedded in a much wider public discourse on gender as a social construction. Given that the empirical basis of our knowledge of the causes, treatment options, long-term outcomes, and patient preferences is insufficient, we suggest preliminary recommendations based on clinical experience, study of the literature, and interviews with affected individuals.

Culture↗
PubMed2005

Measurement of psychosexual differentiation.

Since the early 1990s, there has been a surge in interest in the study of infants, children, adolescents, and adults with physical intersex conditions or other congenital conditions that affect, among other things, the configuration of the external genitalia. Regarding psychologic evaluation, an important aspect of both short-term and long-term outcome concerns gender differentiation. This article provides an overview of various measures pertaining to gender identity, gender role, and sexual orientation that have been used in assessment studies of samples of either children and adults with gender identity disorder and/or children and adults with various physical intersex conditions. All of the measures have good psychometric quality although some have been studied more systematically than others. It is hoped that this overview will provide a template for the new generation of studies that are looking at both gender development and sexual orientation in people born with physical intersex conditions.

Adolescent↗
PubMed2002

The ultimate challenge of cloacal exstrophy.

PURPOSE: Our review addresses the various system abnormalities associated with cloacal exstrophy and revisits the question of gender assignment. Gender assignment decisions and psychological aspects of gender issues have become the "ultimate challenge." Exploration of gender identity, gender role behavior and sexual orientation has just begun. MATERIALS AND METHODS: A comprehensive literature review was performed with all world literature regarding the current management of cloacal exstrophy. Research focused on management principles, outcomes and documentation of concurrent anomalies. We also describe original research evaluating gender identity in our own series of patients raised as girls to illustrate the challenge of treatment and augment the available literature, which is scant. RESULTS: Abnormalities of the vertebral column ranged from hemivertebra to myelomeningocele. With magnetic resonance imaging, the incidence of spinal dysraphism approached 100% and cord tethering was also more frequently recognized. For children with the short bowel syndrome, advances in antibiotic usage, and parenteral and enteral nutrition have increased the survival rate and reduced morbidity. A neurological component has been recognized for bladder function, bladder neck continence, lower extremity function and erectile capacity. Mitrofanoff-type reconstruction with bladder neck closure and continent catheterizable stoma dramatically increased continence. Diminutive or absent penis has been documented in 30% of males, and no documentation of paternity exists. The majority of females have bicornuate uterus. However, ovaries and tubes were generally normal. No reports of proven fertility exist. CONCLUSIONS: The strategy and timing of surgery relating to gender assignment remain controversial. A desperate need exists for research focusing on gender development and quality of life. Until that time, a cautious watchful approach may be most appropriate as our patients with cloacal exstrophy mature into adulthood.

Abnormalities, Multiple↗
PubMed2001

[Sexuality in adolescence: development, experience, and proposals for intervention]

OBJECTIVE: To present a literature review of some aspects concerning the development of sexuality in the period between childhood and adolescence, and to work on some proposals for prevention and intervention. METHODS: Review of literature on relevant issues related to the process of psychosocial and sexual development during childhood and adolescence, and to the importance of prevention education. RESULTS: Differently from genitality, which is only concerned with biological aspects, sexuality encompasses emotional aspects, life history and cultural values. These factors contribute to the formation of general identity and to the components of sexual identity: gender identity, gender role, and sexual orientation. Psychosocial and sexual development, emotional balance, and social relations are based on sexual experience during childhood and adolescence. During adolescence, the relationship with family and social group go through marked changes: conflicts arise, and experimentation and risk behavior are enhanced. The family, school, and health systems represent important links of identification, support, and protection for children and adolescents before they reach maturity. CONCLUSIONS: Sexuality education, either individually or in group, allows adolescents to experience sexuality and their emotional relations in a satisfactory, creative, and risk-free manner, combined with mutual respect and absence of gender discrimination.

Journal Article↗