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PubMed1983

Increasingly Ruth: toward understanding sex reassignment.

Both the clinician and the patient present accounts of a 44-year-old male's search for a comfortable gender identity. The juxtaposition of these two perspectives illustrates many of the dilemmas inherent in the therapy of gender dysphoria. Ruth underwent sex reassignment surgery in 1976--one year after the assumption of a full-time female gender role. Six months after surgery, she made a serious suicide attempt. At age 50, she has now consolidated her feminine gender identity and has become a thoughtful, unusually honest, articulate person. The physician's "objective" and the patient's retrospective perspectives provide evidence of the psychodynamic nature of transsexualism and the limitations of evaluation criteria for sex reassignment surgery.

Adult↗
PubMed1975

Heterosexual interest in homosexual males.

Androphilic, ephebophilic, and homosexual pedophilic males were compared on heterosexual interest and arousal potential. The former was measured by the subjects' retrospective reports and the latter by penile responses to pictures of females. The penile responses of the ephebophilic and homosexual pedophilic groups to pictures of physically mature females were not different from those of androphilic males. In the present study as well as in an earlier one, the ephebophilic males responded significantly more to physically mature males than to physically mature females. Homosexual pedophilic males showed little difference in responses to physically mature males and females. In retrospective reports of heterosexual interest and experience and of development of homosexual interest and activities, there were only two differences among the groups: as opposed to androphilic males, a relatively greater number of ephebophilic and homosexual pedophilic males indicated that up to age 15 or later they had felt attracted exclusively to females and that they had been seduced in childhood or early adolescence by a male. These results will have to be replicated before being accepted as reliable. As in some earlier studies, there was a weak but significant correlation of degree of "feminine gender identity" with age at onset of homosexual interest and with heterosexual interest or experience. A higher degree of feminine gender identity went together with less heterosexual interest and experience and with an earlier onset of homosexual interest and experience.

Adolescent↗
PubMed1992

Parental role strains, salience of parental identity and gender differences in psychological distress.

Although past research indicates that women's higher levels of psychological distress can be accounted for by their greater exposure and vulnerability to role-related stress, the social psychological factors contributing to female vulnerability have not been fully identified. This paper applies identity theory to the phenomenon of gender differences in distress among parents. From an identity perspective, I propose that salience of the parental identity in women's self-conceptions contributes to their vulnerability to parental role strains. Using 1988 survey data from a stratified random sample of married and divorced Indianapolis residents (N = 448), I find that gender differences in distress are explained by differences in exposure to parental role strains. Further analyses reveal, however, that salience of the parental identity contributes to both men's and women's vulnerability to parental role strains. These findings underscore the utility of identity theory for explaining psychological distress among women and men.

Adult↗
PubMed2000

Barbie and the tree of life: the multiple functions of gender in development.

Gender identity is the lens through which people experience being boy or girl, man or woman. It is a complex compromise formation that is not separate from the wishes, fears, and intrapsychic conflicts of other domains. Over the course of development, gender identity becomes layered and reconfigured. This paper looks at one child's experience of gender over several phases in her development in order to learn how gender is integrated into identity. At different times, as different conflicts came to the fore, she used gender to shape and lend definition to these conflicts. Conversely, her experiences in other spheres influenced her experience of gender.

Child↗
PubMed1985

Cross-sectional investigation of adolescent perceptions of gender roles.

Data from a sample of youngsters, 12 through 18 years old, are analysed to examine the difference in gender role perceptions across age groups. A series of multivariate correlational analyses are employed to examine the relationship between respondent gender, age and self-reported perceptions of gender identity. The results of the study indicate indirect support for Erikson's speculations about resolution of Identity "Crisis". The youngest respondents showed the greatest disparity between male and female role perceptions. The older subjects, those in adolescence, displayed greater ambiguity toward gender roles. Finally, the oldest respondents, approaching adulthood, indicated a stronger perceived gender identity.

Adolescent↗
PubMed2004

Psychosexual development in individuals who have female pseudohermaphroditism.

This article describes psychosexual outcomes and issues in syndromes of female pseudohermaphroditism, broadly defined. Congenital adrenal hyperplasia, the most common cause of intersex genitalia at birth, is covered as are Turner Syndrome and syndromes in which XY infants who are born with undervirilized genitalia are assigned and reared as girls (androgen insensitivity syndrome; cloacal exstrophy). The same hormonal abnormalities that cause most physical intersex conditions also influence brain development and behavior; individuals who have intersex conditions can show behavior that is in between that of the typical boy/man and the typical girl/woman. Changes in sex-typical play behavior in childhood are larger than in sexual orientation or core gender identity in adulthood. Most female pseudohermaphrodites, whether XX or XY, who are assigned and reared as girls evolve a feminine core gender identity and primarily are heterosexual. Implications for current debate about the treatment of infants who have ambiguous genitalia are discussed, as is the need for additional research and for consideration of psychologic counseling as part of the treatment program.

Cognition↗
PubMed1999

Gender traits and identities in a "masculine" organization: the Israeli police force.

Gender and occupational identities were examined within the Israeli police force, a stereotypically masculine organization. The principal hypothesis was that women in this organizational setting did not reject their gender identity. Rather, they self-attributed more traditionally masculine traits in addition to their feminine traits. This was especially so among women going through particularly intense occupational and organizational socialization needed for field jobs. The findings only partially confirmed the hypothesis. Most women in the sample considered themselves to be highly feminine, even though they self-attributed masculine traits. Although the women, like their male colleagues, ranked occupational identity higher than gender identity, their feminine identity (usually in contrast with the masculine organizational context) was not repressed and their gender identity was as strong as that of the men.

Adult↗
PubMed1981

Expressive psychotherapy with gender dysphoric patients.

The dictum that transsexualism is resistant to psychotherapy has led many investigators to view sex reassignment surgery (SRS) as the treatment of choice and dismiss psychotherapy as unfeasible. The Gender Identity Clinic at Case Western Reserve University, Cleveland, was organized to treat transsexuals with individual and group psychotherapy and SRS. Of 50 gender dysphoric (GD) patients, 70% have adjusted to nonsurgical solutions, 20% are receiving treatment, and 10% have received SRS and psychotherapy. The crux of psychotherapy is establishing a therapeutic alliance; this is aided by the context of the Gender Identity Clinic. Clinical evidence suggests that new therapeutic techniques may enable psychotherapy to become the treatment of choice with most GD patients and that psychotherapy and SRS are not mutually exclusive. Most patients request and benefit from psychotherapy after SRS.

Adolescent↗
PubMed1975

Ablatio penis: normal male infant sex-reassigned as a girl.

Forty-five cases of genetic males were assigned and habilitated as females, 43 because of a congenitally defective penis (micropenis with or without hypospadias), and two because of infantile ablatio penis. One of the latter has an identical twin brother as a control. Now 9 years old, she has differentiated a female gender identity in marked contrast to the male gender identity of her brother. Some of the other patients are now adolescent or adult in age. They demonstrate that the twin can expect to be feminine in erotic expression and sexual life. Maintained on estrogen therapy, she will have normal feminine physique and a sexually attractive appearance. She will be able to establish motherhood by adoption.

Child↗
PubMed1987

Assessment of sexual orientation.

This paper reviews the multitude of methods which have been utilized to assess sexual orientation. The basic assumption of most of the previous methods of assessment is that sexual orientation is determined by one's gender or genitalia and the gender or genitalia of the individual one is attracted to. This assumption is challenged and the complexity of sexual orientation is illustrated. Consequently, a model for assessment of sexual orientation is proposed which includes nine dimensions: current relationship status, self-identification identity, ideal self-identification identity, global acceptance of their current sexual orientation identity, physical identity, gender identity, sex-role identity, and sexual orientation identity as measured by behavior, fantasies and emotional attachments, and finally the individual's past and present perception of their sexual identity compared to their idealized future.

Female↗
PubMed1983

The stress of coming out.

To conclude, (1) although homosexuality has been recognized for hundreds of years, we still do not understand it completely. (2) This paper places emphasis on the process of individuation and gender-identity that takes place very early in childhood as the cause of homosexuality. (3) If the process is not completed properly, the individual's gender-identity will deviate from that of the vast majority of people. Homosexuality is, therefore, considered by me as a deviation from, rather than a variation of, human sexuality. (4) The degree of neurosis or psychosis associated with homosexuality or heterosexuality is not causal in nature, although the two are intimately intertwined. (5) The stress of coming out varies a great deal in intensity and depends on the degree of integration of the individual and the support given to him by his friends, associates, and family. (6) Although the last decade has brought about a greater acceptance of homosexuality than ever before, sufficient prejudice, ignorance, and fear remain to keep many homosexuals "in the closet." (7) Even today the disclosure of one's homosexuality threatens the individual with the loss of so many important aspects of his life, such as his job, his friends, and even his family, that there is little wonder that coming out of the closet poses such problems for so many homosexuals.

Anxiety↗
PubMed2000

Sexual orientation of female-to-male transsexuals: a comparison of homosexual and nonhomosexual types.

Homosexual and nonhomosexual (relative to genetic sex) female-to-male transsexuals (FTMs) were compared on a number of theoretically or empirically derived variables. Compared to nonhomosexual FTMs, homosexual FTMs reported greater childhood gender nonconformity, preferred more feminine partners, experienced greater sexual rather than emotional jealousy, were more sexually assertive, had more sexual partners, had a greater desire for phalloplasty, and had more interest in visual sexual stimuli. Homosexual and nonhomosexual FTMs did not differ in their overall desire for masculinizing body modifications, adult gender identity, or importance of partner social status, attractiveness, or youth. These findings indicate that FTMs are not a homogeneous group and vary in ways that may be useful in understanding the relation between sexual orientation and gender identity.

Adult↗
PubMed1985

Mexican male bisexuality.

Even one adult homosexual act may threaten the masculine gender identity of American males, and raise the question of their homosexuality. However, fieldwork in Northwestern Mexico revealed a different belief system. A Mestizo Mexican male's masculine gender identity is not threatened by homosexual acts as long as he plays the insertor sex role; only the male insertee, playing a female sex role, is considered homosexual. An analysis of the Mexican data suggests that bisexual behavior is thus more easily accepted by Mestizo Mexican males and is more widely practiced in that region of Mexico than in the United States.

Attitude↗
PubMed1996

Birth order and sibling sex ratio in two samples of Dutch gender-dysphoric homosexual males.

Two studies were undertaken to confirm the previous findings that homosexual men in general tend to have a later than expected birth order and that extremely feminine homosexual men also tend to have a higher than expected proportion of brothers (i.e., a higher sibling sex ratio). Subjects in Study 1 were Dutch, adult and adolescent, biological male patients with gender dysphoria (persistent and recurrent desires to belong to the opposite sex), who were undergoing treatment with feminizing hormones. These comprised 83 patients who reported sexual attraction to other males (the homosexual group) and 58 who reported sexual attraction to females or equal attraction to males and females (the non-homosexual group). Subjects in Study 2 were Dutch adolescent male patients at another hospital. The homosexual group consisted of 21 gender-dysphoric homosexual teenagers referred to a gender identity clinic for children and adolescents. The control group were 21 adolescent males referred to the child psychiatry department of the same hospital for reasons other than gender identity disorder, homosexuality, or transvestism. These were individually matched to the homosexual subjects on age and sibship size. In both studies, the homosexual group had a significantly later average birth order than the comparison group. In Study 1, the homosexual group had a significantly elevated sibling sex ratio; this was not tested in Study 2 because of its small sample size. These studies add to the mounting evidence that late birth orders are common to all homosexual samples and that elevated sibling sex ratios are an additional characteristic of extremely feminine ones.

Adolescent↗
PubMed1978

[Transsexualism].

According to the literature, the transsexual phenomenon can be assessed as a distinct psychiatric illness. Transsexualism, a rare but spectacular disorder, realizes a gender identity reversal raising questions regarding systems of psychiatric diagnosis, nosology and treatment. A better clinical knowledge of this "experiment" and its follow-up allow studying processes contributory to marked deviation of gender identity and furthering concepts of development of masculinity and feminity. Current research deals with hypotheses that can be stated as testable propositions about underlying dynamics in various fields: learning factors, psychoanalytic components and psycho-biological data. Focusing on the early infantile development and the environmental influences reflects a variety of non specific psychogenetic precursors. The treatment of "gender dysphoria syndrom", i.e. hormonal treatment, sex-reassignment surgery and psychotherapic processes, aims towards réduction of psychic pain and social adjustment in the cross-gender role. Transsexual phenomenon largely overlaps the psychopathological area; beyond surgical and medical aspects, social implications and legal positions refer to an ethical problem.

Adult↗
PubMed1978

A family study of gender identification.

Self-reports about 70 masculine and feminine behaviors were collected from 177 undergraduates and their families. These self-report scores were correlated within family pairs to assess family resemblances in masculine or feminine preferences. The obtained family correlations were compared with those predicted by a simple additive-genetic theory, an X- linkage model, and a same-sex identification theory of gender-identity acquisition. The obtained pattern of correlations (mother x daughter=.26, sister x sister=.28, father x son=.33, and brother x brother=.23, all other family correlations near 0) strongly rejects the X-linkage and simple additive-genetic models of gender-identity acquisition. On the other hand, the obtained family correlations are quite consistent with a same-sex theory of gender identification, although, of course, within-family correlations only suggest causal relations, they do not prove them. Other factors such as social class could affect sex role identification as well.

Family↗
PubMed1978

Two transsexuals with 47-XYY karyotype.

Previous reports of sexual orientation and gender identity in subjects with XYY karyotype are reviewed. Two patients seeking a change of sex operation and found to have an XYY karyotype are described. It is argued that an XYY karyotype may predispose to a disturbed gender identity and possibly to the development of the transsexual syndrome.

Adult↗
PubMed2006

Mammalian animal models of psychosexual differentiation: when is 'translation' to the human situation possible?

Clinical investigators have been forced primarily to use experiments of nature (e.g., cloacal exstrophy; androgen insensitivity, congenital adrenal hyperplasia) to assess the contribution of fetal sex hormone exposure to the development of male- and female-typical profiles of gender identity and role behavior as well as sexual orientation. In this review, I summarize the results of numerous correlative as well as mechanistic animal experiments that shed significant light on general neuroendocrine mechanisms controlling the differentiation of neural circuits controlling sexual partner preference (sexual orientation) in mammalian species including man. I also argue, however, that results of animal studies can, at best, provide only indirect insights into the neuroendocrine determinants of human gender identity and role behaviors.

Animals↗