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PubMed2005

What's culture got to do with it? Prevention programs for African American adolescent girls.

This paper examines prevention programming for African American girls by placing the prevention process within the larger African and African American cultural context. We provide an overview of the theories and issues we consider most relevant to African American culture, including Africentric theory, ethnic identity, gender identity and relational theory, developmental issues, the community context, and historical considerations. Drawing from our own drug prevention work, we provide examples of how to incorporate culture into prevention programs to make them most relevant for the target population. We also summarize our own efforts to create culturally appropriate prevention interventions and their impact on the girls in our programs. We conclude with suggested directions for future research into culture-specific prevention programs.

Adolescent↗
PubMed1988

Sex reassignment surgery: a study of 141 Dutch transsexuals.

This is an evaluation of the therapeutic effect of sex reassignment surgery on 36 female-to-male transsexuals and 105 male-to-female transsexuals in the Netherlands. Data were collected by means of structured interviews. The evaluation was made on the basis of subjective data only, that is on what the persons themselves reported on their gender identity, gender role, and physical condition. Allowing for the restrictive methodology of the (ex post facto) study, it is concluded that there is no reason to doubt the therapeutic effect of sex reassignment surgery. No specific differences were found between those who were still in medical treatment and those who had completed treatment. The findings obtained in the female-to-male transsexuals compare favorably with those obtained in male-to-female transsexuals. Finally, the conclusion is drawn that more attention ought to be paid to psychosocial guidance in addition to medical guidance.

Adult↗
PubMed2007

[Intersexuality. Disorders of sex development].

Different forms of intersexuality (Disorders of Sex Development, DSD) are described (congenital adrenal hyperplasia, androgen insensitivity, disorders of androgen biosynthesis, gonadal dysgenesis). Treatment interventions for individuals with ambiguous genitalia and untypical sex development are discussed with respect to medical and psychosocial aspects considering the consensus paper on the management of subjects with intersexuality. The role of gender identity, gender role and sexual orientation are presented as well as problems of disclosure and gender change. Further research is needed to evaluate the optimal treatment procedures.

Disorders of Sex Development↗
PubMed1993

Neurobiology and sexual orientation: current relationships.

Despite great progress in the neurosciences, our understanding of the determinants of sexual orientation is incomplete. The authors review for the clinician/neuropsychiatrist studies pertaining to the formation of sexual orientation in the following areas: hormone effects on sexual behavior (animal and human); the complicated relationship between gender identity, gender role, and sexual orientation in humans; cross-cultural studies of homosexuality; behavioral observations in pseudohermaphrodites and offspring of mothers treated with hormones during pregnancy; brain studies of homosexual and heterosexual individuals; and genetic studies. The authors conclude that human sexual orientation is complex and diversely experienced and that a biopsychosocial model best fits the current state of knowledge in the field.

Animals↗
PubMed2001

Gender roles and/or styles in crisis: an integrative analysis of the experiences of fathers of children with cancer.

Despite a proliferation of research with families of children with cancer and gender differences in parental coping, few studies have explicitly explored the experiences of fathers of children with cancer. Using several different data collection efforts, including semistructured in-depth interviews and open workshops, this integrative analysis views fathers' experiences through the lens of gender. Findings suggest that fathers' experiences can be understood as influenced by gender identities, gender roles, and the gendered organization of support systems, employment, and health care institutions. The results suggest the need for interventions that provide fathers and entire families with the opportunity to develop new skills and coping strategies for dealing with the stresses and challenges of childhood cancer.

Adaptation, Psychological↗
PubMed1993

Sex reassignment surgery. A study of 141 Dutch transsexuals.

"This is an evaluation of the therapeutic effect of sex reassignment surgery on 36 female-to-male transsexuals and 105 male-to-female transsexuals in the Netherlands. Data were collected by means of structured interviews. The evaluation was made on the basis of subjective data only, that is on what the persons themselves reported on their gender identity, gender role, and physical condition. Allowing for the restrictive methodology of the (ex post facto) study, it is concluded that there is no reason to doubt the therapeutic effect of sex reassignment surgery. No specific differences were found between those who were still in medical treatment and those who had completed treatment. The findings obtained in the female-to-male transsexuals compare favourably with those obtained in male-to-female transsexuals. Finally, the conclusion is drawn that more attention ought to be paid to psychosocial guidance in addition to medical guidance."

Female↗
PubMed1975

Development of gender constancy and selective attention to same-sex models.

4 developmental levels of gender constancy were identified in 55 preschool-age children on the basis of a reproducible Guttman scale of answers to sets of questions pertaining to gender identity, gender stability over time, and gender consistency across situations. Children's developmental level of gender constancy was predictive of the amount and the proportion of time they attended to an adult male and an adult female film model. As boys developed gender constancy, their relative preference for watching the male model increased significantly; as girls developed gender constancy, their relative preference for watching the female model increased, though not significantly. At the more advanced levels of gender constancy, boys watched the male model more than did girls. It was suggested that same-sex social learning may develop as a function of children's cognitive understanding of gender as an identifiable, stable and consistent human attribute.

Age Factors↗
PubMedDate not supplied

[University of Quebec at Montreal. Psychosexuality of childhood and adolescence: trends in research].

This paper reviews the literature on child and adolescent psychosexuality. It intends to identify the major trends in contemporary research in the field of psychosexual development. Reviewing first, the theories of the child and adolescent development, in exploring the psychosexuality dimension, it shows afterward that in the actual state of research two thematics are privileged in empirical literature: "gender" and "sexual and contraceptive attitudes-values-behaviours". These thema are mainly studied in the descriptive correlation researches which focus on gender identity, gender roles, gender differences in one part and on initiation to first sexual relationships, its predictors and consequences on the other part. In a whole, these data are factual rather than developmental in nature. These one identifies the facts inherent to development but they rarely shows the interaction between these facts nor their evolution in the courses of time. This literature review does not cover all the interests touched by the searchers in the field nor it pretend to fully examine the research content exposed in this paper. It limits itself to identify the major trends in the contemporary research and to offer some indication for the future.

Adolescent↗
PubMed2005

Gender dysphoria and gender change in chromosomal females with congenital adrenal hyperplasia.

This article reviews the literature on studies and case reports on gender identity and gender identity problems, gender dysphoria, and gender change in chromosomal females with congenital adrenal hyperplasia, raised male or female. The large majority (94.8%) of the patients raised female (N= 250) later developed a gender identity as girls and women and did not feel gender dysphoric. But 13 (5.2%) patients had serious problems with their gender identity. This percentage is higher than the prevalence of female-to-male transsexuals in the general population of chromosomal females. Among patients raised male, serious gender identity problems were reported in 4 (12.1%) out of 33 patients. From these observations, we conclude that the assignment to the female gender as a general policy for 46,XX patients with CAH appears justified, even in severely masculinized 46,XX newborns with CAH (Prader stage IV or V).

Adrenal Hyperplasia, Congenital↗
PubMed1993

Childhood cross-gender behavior and adult homosexuality: the resurgence of biological models of sexuality.

Research on the causes of homosexuality frequently treat it as a matter of disturbed gender identity and/or gender role. Recently, attempts have been made to link cross-gender behavior among boys with adult homosexuality. Often this research presumes a common biological determinant to both the childhood behavior patterns and homosexuality in adulthood. Authors have described such childhood cross-gender behavior in boys as part of a "prehomosexual" configuration. This paper argues that the research to date suffers from (1) a failure to differentiate such concepts as gender identity, gender role and sexual orientation, (2) a reliance upon potentially inappropriate dichotomies in describing such concepts, (3) problematic interpretations of research that makes few distinctions between human sexual behavior and sexual behavior among rodents, and (4) the contradictions implicit in seeking simple biological determinants of constructs (such as cross-gender behavior) that are culturally determined. The author argues that any potential biological factors contributing to sexual orientation must be mediated by a complex sequence of experiences and psychosocial factors. Therefore, the essentialists' search for a simple congruence between physiological or biological traits and homosexuality may be expected to fail.

Female↗
PubMed1980

Exclusive adult lesbianism associated with Turner's syndrome mosaicism.

A case of exclusive adult lesbianism and manic-depressive illness associated with Turner's syndrome mosaicism is reported. Turner's syndrome women are described as hyperfeminine without problems in gender identity, gender role, or arousal pattern. Adult lesbianism has never previously been reported in these women. The significance of lesbianism in association with Turner's syndrome mosaicism is discussed.

Adult↗
PubMed2000

[Sexual differentiation of the human brain].

Normal human development requires the compatibility between genetic sex (sex chromosomes), sex of gonades (tests or ovaries), genitalia (external and internal sex organs), somatic features (body characteristics) and psychic sex. The psychic sex, called frequently gender, consist of gender identity (self-estimation), gender role (objective estimation) and sexual orientation (hetero- or homosexual). It was believed that the psychic gender depends only on socio-environmental influences such as rearing, learning and individual choice. Although, the process of sexual differentiation of human brain is not completely elucidated, it has became recently evident that endogenous hormones more then socio-environmental factors influence gender differences. Experimental studies on animals revealed that transient action of sex steroids during perinatal period of life is crucial for the dymorphism of sexual behavior (male or female) in adulthood. It seems, that also in the human male neonates testosterone produced by testes perinatally takes the main role in the irreversible masculinization of the brain i.e. creation of the differences vs. female brain. The evaluation of patients with disturbances of sexual differentiation of external genitalia (the lack of the testosterone transformation into 5-alpha dihydrotestosterone in peripheral tissues of men or the inborn excess of androgens in women with the congenital adrenal hyperplasia) has served as a useful clinical model for understanding factors, affecting the formation of gender. In these individuals the formal sex established according to genetic sex and somatic sex may be incompatible with gender identity and role. However, it has been found that the female gender identity is most frequently associated with the presence of ovaries or the lack of gonads (gonadal dysgenesis), while the male gender identity appear most frequently in the presence of testicular tissue irrespective of female or hermaphrodite (intersex) phenotype. In genetic men with the absence of male genitalia formation, caused by the aberrant function of androgen receptor, the gender identity depends on the severity of the disorder: female gender identity in the complete androgen insensitivity syndrome and female or male gender identity in the complete androgen insensitivity syndrome and female or male in the partial androgen insensitivity. These clinical observations confirm the experimental data indicating androgen role in the male gender identity creation. This knowledge is necessary for the decision of the direction of surgical correction of sex organs in children with ambiguous genitalia, which should not depend on the expected efficiency to perform sexual intercourse, but mostly on the expected or already present individual gender identity.

Animals↗
PubMed2006

Transgender youth: invisible and vulnerable.

This study used three focus groups to explore factors that affect the experiences of youth (ages 15 to 21) who identify as transgender. The focus groups were designed to probe transgender youths' experiences of vulnerability in the areas of health and mental health. This involved their exposure to risks, discrimination, marginalization, and their access to supportive resources. Three themes emerged from an analysis of the groups' conversations. The themes centered on gender identity and gender presentation, sexuality and sexual orientation, and vulnerability and health issues. Most youth reported feeling they were transgender at puberty, and they experienced negative reactions to their gender atypical behaviors, as well as confusion between their gender identity and sexual orientation. Youth noted four problems related to their vulnerability in health-related areas: the lack of safe environments, poor access to physical health services, inadequate resources to address their mental health concerns, and a lack of continuity of caregiving by their families and communities.

Adolescent↗
PubMed1998

Threat to gender representation: identity and identification.

To investigate the effect of a threat to gender identity on the use of defense mechanisms, college students were given false feedback regarding their sex-role identity. Male and female students who were given gender-contrary feedback showed a marked increase in the use of the defense of identification, as compared to students who were given gender-consistent feedback. Further, both affect change and the use of identification was a function of the degree of discrepancy between feedback condition and conscious gender identity.

Adolescent↗
PubMed2002

Sexual orientation of adolescent girls.

It is important for healthcare providers to have a clear understanding of sexual orientation and other components of sexual identity (genetic gender, anatomic gender, gender identity, gender role, and sexual behavior). Knowledge of how a lesbian identity is formed will aide providers in guiding these girls through adolescence. Societal stigma often forces isolation that leads to many risky behaviors that affect health (alcohol and drug use; risky sexual behaviors; truancy and dropping out; running away and homelessness; and depression and suicide). Health providers need to ensure a safe and understanding environment for these girls, to enhance their physical, emotional, and social development to healthy adulthood.

Adolescent↗
PubMed2000

Family cooccurrence of "gender dysphoria": ten sibling or parent-child pairs.

Ten (10) sets of siblings or parent-child pairs concordant for gender identity disorder (transsexualism) or gender identity disorder and transvestitism are reported. For concordant gender identity disorder, there is one set of male monozygotic twins; three sets of non-twin brothers; one brother-and-sister pair; one set of sisters; and one father and son. With gender identity disorder and transvestism, there is one transsexual father with a gender dysphoric; transvestic son; one transvestic father with a gender dysphoric, transvestic son; and one transvestic father with a transsexual daughter. The emerging technology of genetic markers makes collation of such families a potentially valuable resource for unraveling the origins of atypical gender identity.

Adult↗
PubMed2005

Hormonal therapies for individuals with intersex conditions: protocol for use.

Hormonal therapy forms part of the treatment of every intersex condition. For some conditions, such as salt-wasting congenital adrenal hyperplasia, hormonal replacement therapy is life saving because hormones necessary for survival (cortisol and aldosterone) are replaced. In contrast, other hormones such as androgens or mineralocorticoids are secreted in excessive amounts in congenital adrenal hyperplasia due to an enzyme imbalance, and the role of hormonal therapy is to suppress the unwanted hormone excess by exerting negative feedback. For patients with one of the many causes of hypogonadism, sex hormone replacement therapy may be prescribed to stimulate sexual development: growth of a hypoplastic penis in a young boy, pubertal changes (male or female), psychosexual development, and adult sexual behavior. It has equally important and highly beneficial effects on bone mineral density. Hormonal therapy is also used to treat the unborn child. For the last 20 years, prenatal dexamethasone treatment administered to the pregnant woman has been used to prevent the development of ambiguous genitalia in females with 21-hydroxylase deficiency. Outcome studies show this treatment to be well tolerated and, in general, efficacious. Intersex conditions are, however, difficult to treat because they may intrinsically perturb complex aspects of the person's gender identity, gender-role behavior, sexual orientation, sexual functioning, and psychologic adjustment. Furthermore, decisions made about the sex of an infant by doctors and parents do not always turn out to be correct; the person may grow up feeling uncertain about his or her gender identity, or worse still, harbor a sense of outrage about their life and treatment experiences. Such a person will have definite views about hormonal therapy when the time comes and skillful counseling will be needed. A vigorous debate about ethical aspects of current medical practices relating to intersex conditions has been waged for the last 7 years between certain patient advocacy organizations and the medical profession, and is expected to continue for some time. The quality of the debate will be improved by evidence. The results of a number of long-term follow-up studies have been published, and more are expected. The published studies show mixed, but mainly encouraging, results.

Adrenal Hyperplasia, Congenital↗
PubMed1997

Transvestism: a survey of 1032 cross-dressers.

One thousand and thirty-two male periodic cross-dressers (transvestites) responded to an anonymous survey patterned after Prince and Bentler's (1972) report. With few exceptions, the findings are closely related to the 1972 survey results. Eighty-seven percent described themselves as heterosexual. All except 17% had married and 60% were married at the time of this survey. Topics surveyed included demographic, childhood, and family variables, sexual orientation and sexual behavior, cross-gender identity, cross-gender role behavior, future plans to live entirely as a woman, and utilization of counseling or mental health services. Of the present sample, 45% reported seeking counseling compared to 24% of the 1972 survey, and those reporting strong transsexual inclinations were up by 5%. Today's transvestites strongly prefer both their masculine and feminine selves equally. A second research objective was to identify variables discriminating between so-called Nuclear (stable, periodic cross-dressers) and Marginal transvestites (more transgendered or transsexually inclined); 10 strongly discriminating parameters were found. The most important are (i) cross-gender identity, (ii) commitment to live entirely as a woman, (iii) taking steps toward body feminization, (iv) low sexual arousal to cross-dressing. Neither age nor experience as a cross-dresser were found to be correlates of cross-gender identity. Although the present generation of transvestites describe themselves much as did similar subjects 20 years ago, the percentage migrating toward full-time living as a woman is greater.

Adult↗