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PubMed1990

Relationship between masculinity and feminity in drinking in alcohol-related behavior in a general population sample.

The relationship between gender-related personality traits, on one hand and drinking, permissiveness towards drinking, and social as well as personal problems associated to drinking on the other, was studied in a general population sample from the City of Morelia, Mexico. Four gender-related traits scales were used for measuring assertive and aggressive masculinity and affective and submissive feminity, in addition to a standardized questionnaire for assessing drinking and other associated behavior. Some of the main results showed that people with high scores in affective feminity were less willing to allow drinking. Men who adopted a submissive feminine role and women with high masculine aggressive scores were more permissive as regards drinking. Among men, assertive masculine and affective feminine traits were more characteristic among those who drank than among abtainers. Drinking among women was related to liberal attitudes towards drinking and to aggressive masculinity. As regards the number of drinks consumed per month, assertive masculinity and liberal attitudes among men and affective feminity and liberal attitudes among women predicted the number of drinks. Affective feminity was negatively related to drinking. Regarding drinking-associated problems, frequency of drunkenness and submissive feminity among males predicted greater personal and social problems. Among women, drunkenness frequency and number of drinks were the most significant predictors. Contrary to what has been found in other countries, gender was a better drinking predictor than gender-related personality traits.

Adolescent↗
PubMed2004

Feminizing genital reconstruction: experience with 52 cases of ambiguous genitalia.

AIM: The last decade witnessed the introduction of different modifications and even new techniques for feminizing genitoplasty. The claim was that the classical Hendren's procedure was associated with unsatisfactory results. At the King Khalid University Hospital, the Hendren's operation was the procedure of choice for feminizing genitoplasty. In this report, we describe our experience with a total of fifty-two cases of ambiguous genitalia. We understand that this comes in the midst of growing criticism of the Hendren's procedure. MATERIALS AND METHODS: The medical records of 52 consecutive patients with ambiguous genitalia who underwent feminizing genital reconstruction were reviewed. Forty-five patients (86.5%) had congenital adrenal hyperplasia (CAH), 3 patients had testicular feminization syndrome, 2 patients had mixed gonadal dysgenesis, one patient had vaginal atresia with Kaufman's syndrome and one patient had isolated congenital clitoromegaly. Age at first presentation ranged between 1 day to 15 years. Feminizing genital reconstruction using Hendren's technique was carried out as a single stage procedure in 29 (55.81%) patients and as staged surgery in 23 (44.2%) patients. A total of 50 clitoral operations and 43 vaginoplasties were performed. Follow-up ranged from 6 months to 12 years (mean 3 and 1/2 years). The surgical results were analyzed and complications documented. RESULTS: Reconstruction was completed in 47 (90.2%) patients. Thirty-six (78.2%) patients had a satisfactory genital appearance with normal looking clitoris. Seven patients required revision clitoroplasty. Thirty-six (83.7%) patients had a good size vagina appropriate for age. Seven patients (16.2%) had vaginal stenosis and two had revision vaginoplasty with good results. Postoperative complications included urethral fistula (one patient), meatal stenosis (one patient), and transient neurogenic bladder (one patient). The final cosmetic results were considered excellent in 40 (85.1%), fair in 4 patients, and poor in 3 patients. CONCLUSION: The Hendren's techniques of flap vaginoplasty for low confluence and vaginal pull-through for high confluence offer satisfactory cosmetic and functional results. Long-term follow-up is necessary to ensure social and psychosexual adjustment.

Adolescent↗
PubMed1970

Studies on testosterone metabolism in subjects with testicular feminization syndrome.

The metabolism of radioactive testosterone simultaneously administered intravenously and either orally or percutaneously has been studied in seven patients with the syndrome of testicular feminization and compared with that of normal males and females. This investigation was carried out in order to determine the relative contribution to urinary 17-oxo and 17beta-hydroxy androstane steroids of labeled testosterone, according to its mode of administration. In normal males the yields of urinary 5alpha-androstane-3alpha,17beta-diol (androstanediol) originating from either an intravenous or a percutaneous dose of testosterone were respectively 3 and 6 times higher than those arising from an oral dose which perfuses the liver directly. These data indicate that in normal males, testosterone might be 5alpha-hydrogenated outside the liver. By contrast in patient with feminizing testes, because the contribution to androstanediol of radioactive testosterone is identical whatever its mode of administration, the extrahepatic 5alpha-reduction of this substrate seems very unlikely. The metabolic abnormalities observed in patients with testicular feminization syndrome may be reproduced in normal males by estrogen treatment. Nevertheless, the sensitivity of the patients to estrogen seems to be 10 times greater than that of normal males. This sensitivity was appreciated from the reduction of radioactive testosterone intravenously injected to urinary 17beta-hydroxy-5alpha-androstan-3-one and androstanediol and also from the level of plasma binding for testosterone. This level was significantly higher (P < 0.05) in patients with feminizing testes than in normal males. The level increased dramatically after administration of a low dose of estrogen whereas this effect was not observed in normal males under the same experimental conditions. In light of these results the defect of extrahepatic 5alpha-reduction of testosterone observed in patients with feminizing testes does not necessarily reflect an enzymatic impairment but might be related to an abnormal synthesis of plasma binding protein(s) under the effect of circulating estrogens so that an abnormally small amount of unbound testosterone may be available in target cells for 5alpha-reduction.

Adult↗
PubMed1981

Continuous infusion of growth hormone feminizes hepatic steroid metabolism in the rat.

The metabolism of 4-[4-14C]androstene-3,17-dione was studied in the microsomal fraction of rat livers after continuous administration of human GH (hGH) in Alzet osmotic minipumps under varying conditions. hGH caused a complete feminization of hepatic steroid metabolism (i.e. increased the 5 alpha-reductase and decreased the 6 beta- and 16 alpha-hydroxylase activities) in normal male rats when infused at a rate of 5 microgram/h for 7 days. Hypophysectomy and castration or adrenalectomy and thyroidectomy of male rats did not reduce the feminizing capacity of hGH, indicating that the adrenals and the thyroid gland are not involved in the mediation of the feminizing effect of hGH. The same dose (5 microgram/h for 7 days) of hGH was also able to refeminize the liver steroid metabolism in hypophysectomized-ovariectomized female rats. The effect of the homologous hormones, rat PRL and rat GH on hepatic steroid metabolism was also investigated. Either hormone was infused at a rate of 10 microgram/h for 7 days, a dose which was sufficient to increase the serum level of the hormone in hypophysectomized animals. No feminizing effect was seen after the administration of rat PRL, whereas rat GH caused a partial feminization of hepatic steroid metabolism in hypophysectomized male animals. It is concluded that GH or a hormone related to GH is involved in sexual differentiation of liver steroid metabolism.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1979

Origin of estrogen in normal men and in women with testicular feminization.

The purpose of this study was to quantify the various sources of estrone (E1) and 17 beta-estradiol (E2) production in normal men and in women with testicular feminization. The mean production rate of E1 in four young adult men was 58 micrograms/24 h, while that of E2 was 44 micrograms/24 h. In these men, E1 production could be accounted for totally by extraglandular formation through 1) aromatization of plasma androstenedione, 2) conversion of E2 which was formed from the aromatization of plasma testosterone, and 3) conversion of secreted E2. In these men, only 12 micrograms or less of E2 production could not be accounted for by extraglandular formation from plasma C19 precursors, and is presumed to have arisen by testicular secretion. In six women with testicular feminization, the mean production rate of E1 was 99 micrograms/24 h, while that of E2 was 77 micrograms/24 h. THe amount of E2 production that arose by glandular secretion could be computed in four of these women and was considerably greater than that found in the young adult men. In these women with testicular feminization, an average of 44 micrograms/24 h E2 could not be accounted for by extraglandular formation and is presumed to have arisen by testicular secretion. The mean plasma production rate of testosterone in the normal men was 5.7 mg/24 h, while that in the women with testicular feminization was 8.3 mg/24 h. However, the range of plasma production rates of testosterone in the women with testicular feminization was large (1.3--17.0 mg/24 h).

Adolescent↗
PubMed1975

[Rudimentary uterus in testicular feminization (author's transl)].

The absence of uterus has been regarded by a number of authors as a condition for the diagnosis of testicular feminization, although cases with a rudimentary uterus have been reported. However, their number within the framework of this syndrome cannot be exactly determined. In the present report on a 22 year-old patient with testicular feminization and uterus bicornis solidus a double uterus malformation identical with that described in the Mayer-Rokitansky-küster syndrome was found. Forms of testicular feminization with rudimentary uterus in genetically-male individuals may be explained by the absence of androgens, or the absence of reactivity on the part of the target organ, and a simultaneous disturbance (lessening) of the function of the so-called X-factor (oviduct repressor) during early embryonal development. Our own observations, as well as reports in the literature, suggest a theory according to which testicular feminization may be regarded as a series of morphological variants, from male-oriented forms with vaginal aplasie, hypertrophy of the clitoris and male distribution of pubic hair, to female-orientated ones with a vagina of normal length and a rudimentary uterus. The absence of a uterus as a condition for the definition of the syndrome can be maintained only so far as no cases have, as yet been observed with a normally-developed uterus in a typical position. The karyogram showed a small Y-chromosome. Functional anomalies may only be surmised, since Y-anomalies are frequent (3% in a random collection). The morphology of the testes mirrored the functional embryonal insufficiency (pre-pubertal, undifferentiated testicular tissue with a varying amount of stroma and Leydig cells); the basal excretion of testosterone, 17-ketosteroid fractions and pregnane in the 24-hour urine was within the normal range for males. Oestrogen production over and above the "adrenal values" was also present. The values for plasma testosterone, which are in accordance with those of males of a similar age, are considered as indicating the importance of "androgen resistance in the periphery" as a factor in the aetiology of testicular feminization.

17-Ketosteroids↗
PubMed1992

Hormone pattern in pharmacologically feminized male transsexuals in the California State prison system.

The hormonal profile of 40 transsexual inmates from a pool of 86 inmates in the California State prison system was studied before and after therapy with feminizing hormones. Clinical and social data were obtained on all 86 inmates; the incidence of human immunodeficiency virus (HIV) seropositivity was examined in 76 of the 86 individuals. Despite similar degrees of feminization in all 40 individuals in whom hormonal studies were performed, variable suppression of serum testosterone concentrations was present. Based on their testosterone concentrations while on feminizing hormone therapy, the transsexual inmates could be divided into three groups. In Group I (the "suppressed" group), the serum testosterone concentrations were markedly depressed (less than 10 ng/dL); in Group II (the "non-suppressed" group), the values of testosterone were normal (446 to 1072 ng/dL); and in Group III (the "intermediate" group), the testosterone values were between those of the suppressed group and the nonsuppressed group. We speculate that feminizing hormone therapy may induce the development of a state of target hormone resistance to testosterone that results in similar degrees of feminization independent of the circulating concentrations of testosterone. The incidence of HIV seropositivity (3/76) was considerably less than anticipated based on previous studies in populations at high risk for developing the acquired immunodeficiency syndrome.

Adult↗
PubMed1988

Sex-specific proteins in normal chick embryo gonads and testis feminized by oestrogen treatment: a two-dimensional gel electrophoresis investigation.

Gonads dissected from 17-day-old normal chick embryos, as well as testes feminized by oestrogen treatment, were labelled in vitro with [35S]methionine and [14C]leucine. The patterns of cytosolic protein synthesis by the gonads were analysed using two-dimensional (2-D) polyacrylamide gel electrophoresis. In the feminized testis, two female-specific proteins appeared, the rate of synthesis of four testis-specific proteins was decreased, and quantitative variations of other synthesized proteins in relation to sex were detected. This altered protein synthesis indicates that the protein synthesis of the testis feminized by oestrogen treatment has in part become similar to that of a normal ovary. The synthesis of female-specific proteins in the feminized testis raises the question of their role in normal ovarian differentiation.

Animals↗
PubMed1976

Feminization of hepatic steroid metabolism in male rats following electrothermic lesion of the hypothalamus.

The metabolism of [4-14C]androst-4-ene-3,17-dione, [4-14C]5alpha-androstane-3alpha,17beta-diol and [1,2-3H]5alpha-androstane-3alpha,17beta-diol, 3,17-disulfate in the 105,000 X g supernatant and microsomal fractions of liver was studied in male and female rats after electrothermic lesion of the hypothalamus including the median eminence. Following electrothermic lesion, hepatic steroid metabolism in male rats was generally "feminized" (increased 5alpha-reduction and decreased 6beta- and 16alpha-hydroxylation of 4-androstene-3,17-dione, decreased 2alpha-, 2beta-, 18- and 7beta-hydroxylation of 5alpha-androstane-3alpha, 17beta-diol and induced 15beta-hydroxylation of 5alpha-androstane-3alpha,17beta-diol,3,17-disulfate), whereas hepatic metabolism in female rats remained essentially unchanged. Previous investigations have pointed to the occurrence of a sex-specific secretion of "feminizing factor" from the female pituitary that is responsible for the "feminization" of the basically "masculine" type of metabolism characterizing the rat liver. Taken together with these findings, the present results indicate that the release of the pituitary "feminizing factor" is controlled by means of a release-inhibiting factor from the hypothalamus. This factor is not secreted in female rats; it is suggested that its secretion in male rats is turned on as a result of neonatal imprinting by testicular androgens.

Androstane-3,17-diol↗
PubMed2003

Feminism and women's health professions in Ontario.

Historically, prevailing gender ideologies were an important element in both the exclusionary strategies employed by male occupational groups and the countervailing responses by female groups. The way in which evolving gender ideologies, and feminism in particular, influence the continuing struggle for greater status and recognition by female professions, however, remains to be fully explored. In this paper, we examine the impact and the role of feminism and feminist ideologies within three female professional projects: nursing, dental hygiene and midwifery in Ontario. We argue that feminism provides an ideology of opposition that enables leaders in these professions to battle against professional inequalities by laying bare the gender inequalities that underlie them. Framing their struggles in feminist terms, female professions also seek recognition for the uniquely female contribution they make to the health care division of labour. At the same time, there exists a tension between ideals of feminism and ideals of professionalism, that has the potential to undermine female professional projects.

Female↗
PubMed1995

[Feminization: a paradoxical effect of stimulation with hCG/hMG in the infertile male].

Male feminization is an uncommon and complex phenomenon which occurs as a consequence of an imbalance in the effective oestrogen/androgen relationship. One of the many approaches used in the treatment of idiopathic male infertility is hCG/hMG stimulation. This paper reports one case of an infertile male treated with hCG/hMG after surgical correction of a varicocele, which resulted in a feminization effect evidenced by gynaecomastia and severe spermatogenesis blockade. When therapy was discontinued the feminization disappeared, a rebound phenomenon with normalization of most of the seminal parameters being seen. No other fully documented cases were found in the literature. Finally, the pathoetiological mechanisms involved in the feminization are analyzed and a revision is made of the causes that may cause it.

Adult↗
PubMed1977

Induction of estrogen-independent persistent vaginal cornification in cyproterone acetate (CA)-induced feminized male mice.

Pregnant ICR/JCL mice were treated with 6 mg of cyproterone acetate (CA) from days 14 to 20 of pregnancy to feminize male offspring. Feminized males delivered on day 20 of pregnancy by cesarean section were castrated the same day, injected with estradiol-17beta(E2) or sesame oil from the day of delivery (=day 1) to day 10 and sacrificed on day 60. In oil-injected feminized males, the vaginal epithelium was atrophic and did not show cornification. In feminized males given 20 microgram E2 neonatally, the vaginal epithelium exhibited well-differentiated stratified squamous organization, but was not cornified in seven out of the nine mice of this group. In the mice treated with 50 microgram E2, persistent cornification was recognized most frequently in the posterior two-thirds of the vaginal epithelium which is considered to originate from the urogenital sinus. However, the incidence of cornification in the anterior one-third which may contain the epithelial cells of müllerian duct was low. These results provide supporting evidence for the possible participation of epithelial cells which come from the urogenital sinus in the development of estrogen-independent persistent vaginal cornification in neonatally estrogenized mice.

Animals↗
PubMed2006

All ZZ male Xenopus laevis provides a clear sex-reversal test for feminizing endocrine disruptors.

We investigated the possibility of using all ZZ male Xenopus laevis tadpoles produced by mating normal ZZ males with feminized ZZ males to detect estrogenic chemical activity. We examined the effects of 17beta-estradiol (E2) on sex differentiation by treating NF stage 49/50 to stage 57 tadpoles with 0.1, 1, 10, and 20 nM E2 for 4 weeks. Following this, the tadpoles were allowed to develop in clean water until the animals reached stage 66. Increased developmental abnormalities and mortality were not observed in all E2-exposed groups during metamorphosis. Feminization of gonads was detected at all E2 concentrations, whereas nonexposed controls developed testes. Morphological and histological analyses showed that feminized gonads were ovaries. Five and one hermaphroditic frogs were found in the 0.1 and 1 nM E2 groups, respectively, showing testicular as well as ovarian regions within one gonad. These results indicate that phenotypically normal females can be produced from genetic males and demonstrate the utility of a sex-reversal test based on all ZZ males for examining in vivo effects of chemicals with estrogenic activity. The testing of all ZZ male tadpoles might be a useful tool for assessment of feminizing compounds not only estrogenic substance.

Animals↗
PubMed2001

1-Stage feminizing genitoplasty: 8 years of experience with 49 cases.

PURPOSE: We retrospectively evaluated the results of a modified technique for 1-stage feminizing genitoplasty in children with congenital adrenal hyperplasia (CAH) and other rare intersex conditions. MATERIALS AND METHODS: Between 1991 and 1998, 47 infants and 2 adolescents underwent 1-stage feminizing genitoplasty at our hospital. Of the patients 44 had CAH, 2 had the partial androgen insensitivity syndrome and 3 were true hermaphrodites. In 3 patients we used the Passerini-Glazel technique, while in 46 our technique of feminizing genitoplasty was used, which consists of maximal mobilization of the urogenital sinus en bloc including the vagina and urethra via the perineal approach. Two lateral plates built from dorsal split phallic and preputial skin together with the dorsal split urogenital sinus are used to construct the vaginal introitus and labia minora, and the scrotal folds are used to construct the labia majora. Reduction clitoroplasty is done according to the technique of Kogan et al. Mean age plus or minus standard deviation was 0.9 +/- 0.3 years of the patients with CAH and 13 +/- 2.3 of the remainder. Preoperative information, including status of the internal genitalia, anatomical length of the vagina site of communication between the vagina and urogenital sinus, in relation to the pelvic floor, was obtained by transabdominal pelvic ultrasound. RESULTS: Operating time ranged between 120 and 180 minutes, average hospitalization period was 4 to 5 days and mean followup was 4.7 +/- 2.6 years. Preoperative ultrasound provided the correct data regarding the vaginal and internal genitalia anatomy in all cases, and the exact communication site between the vagina and urogenital sinus was demonstrated in 93%. Complications consisted of intraoperative rectal injury in 1 case and mild wound infection of the buttocks area in 3. In 1 case total clitoris loss was observed. All patients who underwent modified genitoplasty have had successful cosmetic and early functional results. Two patients presented with repeat clitoromegalia due to inadequate adrenal suppression. CONCLUSIONS: Our adapted technique of 1-stage feminizing genitoplasty provides good cosmetic and functional results. The functional results of this operation should be reevaluated after puberty and in adulthood.

Adolescent↗
PubMed1999

Feminized management and backlash toward agentic women: the hidden costs to women of a kinder, gentler image of middle managers.

Women who display masculine, agentic traits are viewed as violating prescriptions of feminine niceness (L. A. Rudman, 1998). By legitimizing niceness as an employment criterion, "feminization" of management (requiring both agentic and communal traits for managers) may unintentionally promote discrimination against competent women. Participants made hiring recommendations for a feminized or masculine managerial job. Agentic female job applicants were viewed as less socially skilled than agentic males, but this perception only resulted in hiring discrimination for the feminized, not the masculine, job. Communal applicants (regardless of sex) invariably received low hiring ratings. Thus, women must present themselves as agentic to be hireable, but may therefore be seen as interpersonally deficient. Ironically, the feminization of management may legitimize discrimination against competent, agentic women.

Administrative Personnel↗
PubMed2004

Huge seminoma developed in a patient with testicular feminization.

We report a 36-year-old patient who presented with primary amenorrhea and was found to have a giant abdominal tumor. There was a family history of primary amenorrhea in her two aunts. Physical and hormonal examinations as well as chromosomal analysis led to a diagnosis of testicular feminization. The patient underwent tumorectomy along with pelvic and para-aortic lymphadectomy. The pathological diagnosis was bilateral seminoma of the testis with metastasis to para-aortic lymph nodes. Nowadays, cases of undiagnosed seminoma developing into a huge abdominal mass in patients with testicular feminization are rarely encountered, since surgical castration is generally recommended as early as possible after puberty. In testicular feminization, the risk of malignant transformation of the dysgenetic male gonads increases substantially after puberty. Early and correct diagnosis together with careful follow-up are critically important in managing testicular feminization, a rare congenital disorder.

Adult↗
PubMed1990

Testicular feminization syndrome in the neonate.

If we see a young, phenotypically female patient with an XY karyotype, it is of great importance to differentiate between the testicular feminization syndrome and gonadal dysgenesis. Patients with testicular feminization will always have normal testes, which are situated either in the ovarian fossa or in the inguinal canal. Patients with gonadal dysgenesis always have streak gonads. The risk of developing a malignancy in an abnormally located testis is very low, certainly before puberty, whereas the risk for dysgenetic gonads to develop a malignancy is high. Testes in patients with testicular feminization have an important endocrine function in puberty, whereas in gonadal dysgenesis patients they do not. For these reasons, in patients with testicular feminization, one should not remove the testes until the completion of puberty, whereas in patients with gonadal dysgenesis removal should be performed immediately upon recognition of the disorder.

Androgen-Insensitivity Syndrome↗
PubMed1995

A frame-shift mutation of the androgen receptor gene in a patient with receptor-negative complete testicular feminization: comparison with a single base substitution in a receptor-reduced incomplete form.

Mutations of the androgen receptor that impair the action of androgens result in abnormal male sexual development. We studied the structure of the androgen receptor gene in a patient with the receptor-negative form of complete testicular feminization and another patient with a receptor-reduced form of incomplete testicular feminization. In the subject with complete testicular feminization, the deletion of a single nucleotide occurred at nucleotide number 1893 at exon 2. The subsequent frame-shift mutation changes the sense of codon 622 from cysteine to a translational stop signal. Codon 622 is exon 3, so the mutation predicts the synthesis of a truncated receptor that lacks the entire androgen-binding domain. Analysis of a subject with incomplete testicular feminization revealed a single substitution (CGT --> CAT) at nucleotide 2675 of exon 7, resulting in the conversion of an arginine at amino acid 840 to a histidine. This mutation in the androgen-binding domain may impair, but not remove, the androgen binding to its receptor. These results suggest that the phenotypes in our subjects are due to the mutations, and that single amino acid substitution and premature termination codon can cause variably severe functional abnormalities.

Adult↗