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PubMed2001

[Done is done--and gone is gone. Sex reassignment is presently the best cure for transsexuals].

Sweden was the first country to legislate on sex reassignment procedures in 1972. Patients with gender dysphoria are in Sweden referred to one of six university clinics specialised in the field; all surgery, however, is centralised to the Karolinska Hospital in Stockholm. The aetiological strivings regarding transsexualism have to date been inconclusive; however, several lines of evidence speak in favour of an early biological influence on gender identity. The vast majority of studies addressing outcome have provided convincing evidence for the benefit of sex reassignment surgery in carefully selected cases. The current article summarises the state of the art regarding work-up and treatment of transsexuals.

Adult↗
PubMed2005

46,XX patients with congenital adrenal hyperplasia: initial assignment as male, reassigned female.

Six 46,XX patients with congenital adrenal hyperplasia (CAH) presented with genital ambiguity, five so severe that initial gender assignment was male. Once diagnosis was realized, parents were involved in evaluation and chose sex re-assignment as female. To date, these girls and their parents all indicate satisfaction with their decision for a female sex of rearing. The girls have a female gender identity with behavior characteristics known for females with CAH. Thus, while outcome is satisfactory, it is realized that for most, expression of sexual orientation and adult life adjustments have not yet occurred.

Adolescent↗
PubMed1990

What do men want? Male rituals of initiation in group psychotherapy.

Men in mixed-gender psychotherapy groups form male subgroups that serve the cause of gender identity development. The resulting enhancement of masculine identifications allows men to more fully participate in the interactional work of the whole group. The author details four stages in the evolution of the male subgroup, and compares these stages to the structure and function of initiation ceremonies in traditional societies.

Anxiety, Separation↗
PubMed1979

A cross-cultural perspective on theory and research on male homosexuality.

In an effort to uncover useful directions for future research, this paper examines the cross-cultural data on male homosexuality in light of various theories that might account for its variation. Looking first at different psychological explanations, the study suggests that the sex of one's childhood companions may be an important factor in the origin of homosexuality. Two possible explanations for an association between male homosexuality and mixed-sex playgroups are offered: In one, gender identity serves as an intervening variable; in the other, the notion that "familiarity breeds contempt" is studied. A cultural materialist theory, which views homosexuality as adaptive under conditions of population pressure, is shown to be supported by the correlation between a society's natalist policy and its attitudes toward homosexuality.

Attitude↗
PubMed2003

Psychosexual development and eating disorders.

The relationship among eating disorders (EDs), psychosexual and identity development, and physical maturation (puberty) is reviewed. The developmental tasks of adolescence are summarized, and research from both community studies and clinical samples on the association between the development of an ED and putative risk factors that include pubertal development and psychosexual behaviors and attitudes for children and adolescents is reviewed. Specific issues explored include the role of child and adolescent abuse and EDs in males. Overall evidence suggests the following: there are inconsistent findings regarding early pubertal development as a risk factor; there is some support for differences between the ED subtypes in sexual attitudes, behaviors, and experiences; sexual abuse is not a specific risk factor; and gender identity issues may play more of a role for adolescent males than females. However, psychosexual issues are neither sufficient nor necessary for the development of an ED in a young person. It should be considered as only one factor in the multidimensional, multifactorial framework needed to clarify this complex and still poorly understood set of disorders.

Adolescent↗
PubMed2002

Who are tomboys and why should we study them?

Tomboys are girls who behave like boys and, as such, challenge some theories of sex-typing. We recruited tomboys (N = 60) ages 4-9 through the media and compared them with their sisters (N = 15) and brothers (N = 20) on measures of playmate preference, sex-typed activities and interests, and gender identity. On nearly all measures, tomboys were substantially and significantly more masculine than their sisters, but they were generally less masculine than their brothers. We outline some scientific benefits of studying tomboys and describe some goals and initial findings of the Tomboy Project.

Aggression↗
PubMed1998

Young females in the athletic arena.

There are factors that uniquely affect young females in sports. The sociologic aspects of female youth sports can be understood from a historical perspective. Athletics have an influence on the development of young girls, from gender identity and sexual orientation to the foundations of self-esteem and moral development. There is a relationship between certain psychopathologic conditions common in girls and athletics, including eating disorders, depression, and anxiety disorders. Although involvement in sports may engender some of these problems, others may be successfully treated through physical exercise.

Adolescent↗
PubMed1993

[Sigrid Undset's "views" on the father-son relationship. References in her writings].

Our Nobel prize winner, Sigrid Undset, is famous for her insight into female relationships and her descriptions of climate and flora. This article focuses on men's gender identity and the relationship between father and son in the Middle Ages, compared with our own times. In the light of today's psychological knowledge, it is remarkable how clearly she elaborates the characters of "her" men. We should therefore read the great authors, in addition to our professional papers.

Famous Persons↗
PubMed2000

The phenomenon of claimed memories of previous lives: possible interpretations and importance.

Several disorders or abnormalities observed in medicine and psychology are not explicable (or not fully explicable) by genetics and environmental influences, either alone or together. These include phobias and philias observed in early infancy, unusual play in childhood, homosexuality, gender identity disorder, a child's idea of having parents other than its own, differences in temperament manifested soon after birth, unusual birthmarks and their correspondence with wounds on a deceased person, unusual birth defects, and differences (physical and behavioral) between monozygotic twins. The hypothesis of previous lives can contribute to the further understanding of these phenomena.

Child↗
PubMed2005

Gender and psychotherapy with traditional men.

Therapists who are accustomed to operating in a world where gender roles are becoming increasingly androgynous may underestimate how foreign the experience of psychotherapy can be to "traditional" men. This paper describes the occurrence of transference and resistance encountered by female therapists when seeing male patients at a Veterans Administration (V.A.) Medical Center who identify with traditional American male gender roles. The discussion is informed by recent advances in the theory of male gender identity development and yields new insights into the typical defenses men may bring to the early phases of psychotherapy. Case examples from the authors' practices illustrate strategies for intervening with resistance and enhancing the therapeutic alliance. Common countertransference issues encountered by therapists working with "traditional" men are also discussed.

Combat Disorders↗
PubMed2004

Symbolic violence and the neighbourhood: the educational aspirations of 7-8 year old working-class girls.

This article focuses on the experiences of 7-8 year old working-class girls in Belfast, Northern Ireland and their attitudes towards education. It shows how their emerging identities tend to emphasize relationships, marriage and motherhood at the expense of a concern with education and future careers. The article suggests that one important factor that can help explain this is the influence of the local neighbourhood. In drawing upon Bourdieu's concepts of symbolic violence and habitus and Elias' notion of figuration, the article shows how the local neighbourhood represents the parameters of the girls' social worlds. It provides the context within which the girls tend to focus on social relations within their community and particularly on family relationships, marriage and children. It also provides the context within which the girls tend to develop strong interdependent relationships with their mothers that also tend to encourage and reinforce the girls' particular gendered identities. The article concludes by arguing that there is a need for more research on working-class girls and education to look beyond the school to incorporate, more fully, an understanding of the influence of the family and local neighbourhood on their attitudes towards education and their future career aspirations.

Anthropology, Cultural↗
PubMed1984

The role of surgery in the treatment of transsexualism.

The increasing use of surgery for sex reassignment in the treatment of transsexualism is described. The author's early experience over a twenty-year period with the Gender Identity teams at The Johns Hopkins University and The University of Virginia is summarized. Many of the reasons for slow acceptance of this type of surgery by many members of the medical profession are analyzed. The satisfactory subjective results described by patients who have received sex reassignment continue to exceed the results obtained by other methods. The author concludes that further study of surgical treatment is justified, but that it should be limited to established multidisciplinary teams working in academic settings. Physicians are urged to withhold judgment on the role of surgery in gender disorders until they have had significant personal experience with these desperate and complex patients.

Europe↗
PubMed2006

Two monozygotic twin pairs discordant for female-to-male transsexualism.

Two monozygotic female twin pairs discordant for transsexualism are described. These reports double the number of such case studies in the current scientific literature. Interviews with the twins and their families indicated that unusual medical and life history factors did not play causal roles. However, inspection of medical records for one transsexual twin suggested that some early life experiences may have exacerbated tendencies toward male gender identification. In both pairs, the twins' gender identity differences emerged early, consistent with, but not proof of, co-twin differences in prenatal hormonal influences. The identification of additional discordant MZ female twin pairs can advance biological and psychological understanding of transsexualism. Suggestions for future research, based upon findings from these two twin pairs and from studies of female-to-male transsexuals, are provided.

Adult↗
PubMed1998

Psychological aspects of Turner syndrome.

Turner syndrome (TS) is a sex-chromosome disorder, occurring in 1 in 2500 female births. The principal features of TS are short stature and dysfunctional gonads, resulting in a lack of sex hormones, incomplete pubertal development and impaired fertility. The aim of this paper is to review the literature on the psychological effects of TS. The main areas covered relate to well-being and psychopathology, self-esteem, social functioning, gender identity, partner relations and sexual functioning, coping, family aspects and clinical aspects of cognitive impairment. Research on the psychological effects of medical intervention is described, and the methods used for psychological and educational support are presented. Finally, methodological issues are discussed and areas for future research are proposed.

Adaptation, Psychological↗
PubMed2000

Primary femininity: clinical advances and theoretical ambiguities.

This paper examines the use of the term "primary femininity" in current psychoanalytic thinking. The concept of primary femininity arose in reaction to early theories about female sexuality and development; based on a model of male development, these presented problems when applied to females. The author attempts to demonstrate the clinical advances that have resulted from the idea of primary femininity. At the same time she argues that the idea has been used to carry widely differing meanings, and has reflected many writers' differing frames of reference, which range from gender identity through biological traits, object relations, genital anxieties, and bisexuality. Like the terms it originally was intended to replace or augment, it has come to be used reductionistically or loosely. The author warns against its misuse and argues that primary femininity is not a unitary concept, but rather encompasses a related group of ideas about the female body and mind.

Anxiety↗
PubMed1977

The explanatory value of the idea of reincarnation.

The idea of reincarnation is presented as having considerable explanatory value for several features of human personality and biology that currently accepted theories do not adequately clarify. Reincarnation is not offered as a substitute for present knowledge derived from genetics and understanding of environmental influences; it may, however, usefully supplement such knowledge. The present paper does not present evidence from cases suggestive of reincarnation. It does, however, cite cases of subjects who have claimed to remember previous lives, most of whose statements have been verified in the course of detailed investigations. For each case, a reference is provided to a detailed published case report furnishing the evidence in that case. The idea of reincarnation may contribute to an improved understanding of such diverse matters as: phobias and philias of childhood; skills not learned in early life; abnormalities of child-parent relationships; vendettas and bellicose nationalism; childhood sexuality and gender identity confusion; birthmarks, congenital deformities, and internal diseases; differences between members of monozygotic twin pairs; and abnormal appetites during pregnancy. Empirical studies of cases of the reincarnation type have so far not provided any evidence that justifies using reincarnation as an explanation for the occurrence of child prodigies of the large inequities in socioeconomic conditions of humans at birth.

Aptitude↗
PubMed2006

[Influence of socio-cultural context on risk perception and negotiation of protection among poor homosexual males on the Peruvian coast].

This paper focuses on risk, conceived not as an individual action, but considering its social dimension, analyzing the various forms in the socio-cultural context related to internalized homophobia and hegemonic gender norms that allow barriers to be constructed in risk perception. Such barriers hinder negotiation and protection among homosexual men that have adopted a female gender identity, living in low-income barrios of Lima and Trujillo, Peru. Risk perception is analyzed on the socio-cultural plane, allowing one to explain the limited negotiating capacity of this population, even though they have extensive knowledge of HIV/AIDS and its consequences.

Adolescent↗
PubMed2006

Penile reconstruction with bilateral superficial circumflex iliac artery perforator (SCIP) flaps.

The free radial forearm flap is a very common material for penile reconstruction. Its major problems are donor-site morbidity with large depressive scar after skin grafting, urethral fistula due to insufficiency of suture line for the urethra, and need for microvascular anastomosis. A new method using combined bilateral island SCIP flaps for the urethra and penis is developed for gender identity disorder (GID) patients. The advantages of this method are minimal donor-site morbidity with a concealed donor scar, and possible one-stage reconstruction for a longer urethra of 22 cm in length without insufficiency, even for GID female-to-male patients. A disadvantage is poor sensory recovery.

Adult↗