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PubMed1999

Building your own lifeboat: working-class male offenders talk about economic crime.

This study examines the ways in which a group of working-class men serving custodial sentences and probation orders for money-related crimes talk about criminal activity and the implications of this talk for their gender identity. Using a critical social-psychological approach, we carried out nine semi-structured group discussions in probation centres and one open prison and then analyzed the transcripts using a combination of grounded theory and discourse analytic methods. The men critiqued dominant constructions of crime and argued that their criminal activity was justified in two related ways. First, they drew on a discourse of male breadwinning to argue that they were expected to provide for their families. Second, they argued that those now suffering under the broken promises made by the State should not be expected to conform to its rules. For the majority of men, earning through crime was talked about as a last resort and the parameters of 'what they did to whom' were informed by a Robin Hood-type cultural narrative. Finally, the study contextualizes and critically explores these patterns of discourse and their rhetorical use from a historical and structural perspective.

Adult↗
PubMed1998

Factors predictive of regret in sex reassignment.

The objective of this study was to evaluate the features and calculate the frequency of sex-reassigned subjects who had applied for reversal to their biological sex, and to compare these with non-regretful subjects. An inception cohort was retrospectively identified consisting of all subjects with gender identity disorder who were approved for sex reassignment in Sweden during the period 1972-1992. The period of time that elapsed between the application and this evaluation ranged from 4 to 24 years. The total cohort consisted of 218 subjects. The results showed that 3.8% of the patients who were sex reassigned during 1972-1992 regretted the measures taken. The cohort was subdivided according to the presence or absence of regret of sex reassignment, and the two groups were compared. The results of logistic regression analysis indicated that two factors predicted regret of sex reassignment, namely lack of support from the patient's family, and the patient belonging to the non-core group of transsexuals. In conclusion, the results show that the outcome of sex reassignment has improved over the years. However, the identified risk factors indicate the need for substantial efforts to support the families and close friends of candidates for sex reassignment.

Adult↗
PubMed1994

Prenatal gender preference of mothers of feminine and masculine boys: relation to sibling sex composition and birth order.

A mother's (prenatal) wish for a girl has, at times, been implicated as an etiological factor for boyhood femininity or its DSM-III-R diagnostic equivalent, the Gender Identity Disorder of Childhood. In one sample of 52 feminine and 52 nonclinical control boys from Los Angeles, the proportion of mothers who recalled a wish for a girl during the pregnancy did not differ significantly between groups (26.9% vs. 19.2%, respectively); however, in both groups, the maternal wish for a girl was significantly more common in sibships in which all of the proband's older siblings were male. In a second sample of 103 feminine boys from Toronto, the maternal wish for a girl was significantly higher than that found in the Los Angeles sample (43.7% vs. 26.9%), but a control group was not available; as in the Los Angeles sample, the maternal wish for a girl was significantly more common in sibships in which all of the proband's older siblings were male. Implications of these findings for further study of maternal influences on boyhood femininity are discussed.

Birth Order↗
PubMed1997

Domain-specific gender comparisons in identity development among college youth: ideology and relationships.

Gender comparisons were conducted in six social domains of identity development on 210 college students: occupation, religion, politics, dating, sex roles, and friendship. The identity research literature often combines domains to create more global estimates of identity development. Such an approach may obscure differences among the domains, each of which may have different implications for different societal contexts, and for males and females. Analyses were made for each domain, and for the combined ideological, interpersonal, and overall domain scores. Several gender differences were apparent when domain-specific analyses were examined. Males were more likely to explore and commit in politics, whereas females were more likely to explore in sex roles and to commit in religion and dating. In politics, fewer males were in the diffused status; in contrast, for dating and sex roles, there were fewer females in the diffused status. However, when combined scores were examined, there were no gender differences in identity status. The results suggest that some gender differences still remain in specific domains. The utility of including domain-specific analyses is suggested when gender comparisons are examined. Regardless of gender, more youth were diffused in political identity than in any other domain, suggesting political apathy among today's college youth.

Adolescent↗
PubMed2006

Association between polycystic ovary syndrome and female-to-male transsexuality.

BACKGROUND: The aim of this study is to understand the relationship between polycystic ovary syndrome (PCOS), altered hormonal characteristics and insulin resistance in female-to-male (FTM) transsexual patients. METHODS: We studied 69 Japanese FTM cases, aged 17-47 years, who were seen in the Gender Identity Disorder Clinic of Sapporo Medical University Hospital between December 2003 and May 2006. The subjects had never received hormonal treatment or sex re-assignment surgery. Prior to treatment, they received physical examinations entailing measurement of anthropometric, metabolic and endocrine parameters, after which we compared the values obtained according to the presence or absence of PCOS and/or obesity. Insulin resistance was determined using the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS: Of the 69 participating FTM cases, 40 (58.0%) were found to have PCOS. Of the 49 for whom HOMA-IR was calculated, 15 (30.6%) also showed insulin resistance, whereas of the 59 for whom adiponectin was measured, 18 (30.5%) showed hypoadiponectinaemia. Of 69 for whom androgens were measured, 29 (39.1%) showed hyperandrogenaemia. Insulin resistance was associated with obesity but not with PCOS. In contrast, hyperandrogenaemia was associated with both PCOS and obesity. CONCLUSION: FTM transsexual patients have a high prevalence of PCOS and hyperandrogenaemia.

Adiponectin↗
PubMed2000

The psychoanalyst and the transsexual patient.

The author remarks on the dearth of psychoanalytic literature concerning analyses of transsexuals and of clinical experience with such patients in general. Drawing on her personal work with transsexual patients at a specialised centre, as well as with children suffering from gender identity disorders and their parents, she is able to specify the factors which, in her view, make the psychoanalysis and psychotherapy of these subjects so difficult. In particular, they are totally focused on the body and on their intention of securing sex reassignment by hormonal and surgical treatments, so that they rule out the involvement of any psychic element. The psychic functioning of these patients is illustrated by some clinical vignettes, and the transference and countertransference problems are discussed. The author shows how the patients concerned have great difficulty in accepting a psychological approach to their problems; they do not speak the language of wishes and conflict, and claim to remember nothing of their childhood or past life. She concludes that transsexualism is a narcissistic disorder in which the constitution of the self has been profoundly impaired and that it is only since analysis have embarked on the treatment of non-neurotic patients that the condition has become accessible to psychoanalytic psychotherapy or indeed to psychoanalysis. The difficulties notwithstanding, the author considers that such work is worthwhile and that patients can benefit from it.

Adult↗
PubMed1992

Sibship size, sibling sex ratio, birth order, and parental age in homosexual and nonhomosexual gender dysphorics.

This study investigated whether demographic variables previously reported to differentiate ordinary homosexuals from heterosexuals also differentiate gender-dysphoric homosexuals from gender-dysphoric persons with other sexual orientations. Subjects were outpatients aged 16 and older who were referred by physicians to a specialty clinic for the assessment of gender identity disorders. The subjects were divided into three groups: 204 homosexual women, 193 homosexual men, and 273 nonhomosexual men; the last category included men sexually attracted to females, to both sexes, and to neither sex. Demographic data on patients' families of origin were extracted from their clinical charts and from structured interview protocols. A multiple-range test at the .05 level showed that the homosexual men had significantly more siblings than the homosexual women, who, in turn, had significantly more siblings than the nonhomosexual men. The sibling sex ratio of the homosexual men, 131 brothers per 100 sisters, was significantly higher than the sex ratio of live births for the population as a whole (106 men per 100 women; p = .01); the sibling sex ratios of the other groups did not differ from the expected value. The homosexual men had a significantly later birth order than the nonhomosexual men (p = .004); the homosexual women, who fell in between, did not differ significantly from either male group. There were no between-groups differences in paternal or maternal age at the time of the subject's birth. The results concerning sibling sex ratio and birth order are consistent with previous findings for homosexual men.

Birth Order↗
PubMed2002

Masculinity, femininity, and transsexualism.

This study examined the relationship between sex role and gender identity in a Polish transsexual population where, unlike in Western countries, male-to-female (MF) transsexualism is much less common than female-to-male (FM) transsexualism. One hundred and three FM (82 primary, 21 secondary) and 29 MF (16 primary, 13 secondary) transsexuals plus 135 control males (CM) and 303 control females (CF) completed a Sex Role Inventory, which measures sex-role identification, that is, the degree to which one self-identifies with masculine and feminine characteristics. Data obtained from primary transsexuals revealed that, on a femininity scale, MF transsexuals scores exceeded not only CM but also CF. On a masculinity scale, MF transsexuals rated themselves significantly lower than CM, but at a level comparable to CF. The comparison of FM transsexuals and controls showed that, on a masculinity scale, transsexuals scored higher than CF but were not different from CM. On the femininity scale, FM transsexuals rated themselves in between the two control groups: lower than CF but slightly higher than CM. The relations of secondary transsexuals' scores to CF and CM scores, on both masculine and feminine scales, were in the same direction as the primary transsexuals' scores. Secondary transsexuals rated themselves very similarly to their primary counterparts (the exception was a much higher score of MF-primary transsexuals than MF-secondary transsexuals on the femininity scale). Our study revealed that transsexualism does not imply a simple inversion of sex-role patterns: transsexuals differ not only from nontranssexual individuals of the same anatomical sex but also from those of the opposite sex. Moreover, MF transsexualism is not a mirror image of FM transsexualism: it constitutes a more extreme condition in the identification with feminine versus masculine personality traits. These differences seem to be universal for different countries and regions. The diagnostic value of our findings is discussed.

Adult↗
PubMed1985

Pediatric sexology and hermaphroditism.

Lacking an empirically based theory of erotosexual development and health in childhood, pediatrics too easily falls back on reductionistic hypotheses of the nature versus nurture type. A new, three-term paradigm, namely, nature/critical-period/nurture, is needed to explain, for example, the phenomenology of hermaphroditism, and the differentiation of gender-identity/role (G-I/R) in individual cases. In 30 young women with a history of the early-treated, 46,XX congenital virilizing adrenal hyperplasia (CVAH) syndrome, 37% (N = 11) had a history of bisexual imagery or practice, as compared with 7% in the control patients (chi 2 = 17.7; p less than .001); and 5 of these 11 rated themselves as exclusively or predominantly lesbian. In Kinsey's sample, 15% of females reported homoerotic imagery by age 20, and 2 out of 3 of them also had homoerotic partner contact. The CVAH finding may be a function of prenatal and/or neonatal brain androgenization, but other variables, such as the history of juvenile erotosexual rehearsal play, cannot be ruled out. Among adolescents with a history of hermaphroditism, sex-reassignment applications are honored predominantly if they are made by 46,XY hermaphrodites assigned neonatally as girls and with nonfeminizing hormonal puberty, as medical and folk traditions both favor approval of such applicants more than others. Parthenogenic whiptail lizards that alternately simulate the male and female mating behavior of related diecious species provide an animal model that demonstrates the existence of both male and female sexual schemas in the same brain. In human beings, the irreducible sex differences are that males impregnate, and females menstruate, gestate, and lactate. Otherwise, sexual dimorphism that is programmed into the brain under the influence of prenatal hormones appears to be not sex-irreducible, but sex-shared and threshold-dimorphic. A complete theory of the differentiation of all the constituents of masculinity or femininity of G-I/R needs to be both multivariate and sequential in type. It must be applicable to all of the syndromes of hermaphroditism, and to the genesis of all the G-I/R phenomena, including transvestism and transsexualism, as well as to the genesis of a heterosexual G-I/R.

Adrenal Hyperplasia, Congenital↗
PubMed1981

Cognitive development and female psychology.

Freud was an astute observer, but his understanding of female psychology was distorted by centration on biological forces, the adult neurosis, libido theory, the Oedipus complex, and male psychology. His views on the role of penis envy, narcissism, and masochism in women, and on the female superego, currently are being updated on the basis of new data emerging out of psychoanalytic investigation and direct observational studies. It has become clear, for example, that core feminine gender identity develops very early and that it is mediated in large part by cognitive development and learning rather than by the impact of the observation of genital differences between the sexes. The little girl's level of cognitive organization does not permit her at first to construct logical, consistent categories of female and male, predicated or coordination of criteria of inclusion and exclusion. She puts girls and women into one group out of intuitive recognition that they "go together" and builds up a view of herself as female on the basis of what she feels as her mother's daughter and what she perceives of the way her parents and other significant object see her. Her mother's feelings about her, about herself, and about females in general influence her greatly, and her father's responses to and expectations of her have an important impact on her self-image and self-esteem. Her representation of herself as female at first does not necessarily take genital differences between the sexes into account. The discovery, some time in the second or third year, that the genitals of boys and girls are different from one another presents the girl with a number of problems, however. Her cognitive organization makes it extremely difficult for her to apprehend her complex, incompletely demarcated, and to a large extent internal, unobservable, and impalpable sexual organs. Her initial conclusion is that she lacks desirable body parts which are possessed by other beings. Because of the narcissistic-exhibitionistic libidinal organization of that period of life, this represents a painful narcissistic injury. The intensity of the girl's castration reaction and the degree to which she will be able to overcome it in the course of further development are determined by multiple internal and external developmental factors. Masochism, narcissistic vulnerability, and penis envy are neither limited to the female sex nor normal outcomes of female development. Where they are prominent features in the psychopathology of female patients, it is insufficient to interpret them as emanating from penis envy as a bedrock, primal cause. Detailed clinical examples are presented to illustrate the thesis that through exploration and explication of the multiple sources of such symptomatology in a female analysand is the most effective way of relieving the symptomatology and releasing the potential for emotional growth.

Adolescent↗
PubMed1997

A higher rate of hyperandrogenic disorders in female-to-male transsexuals.

In an effort to elucidate the aetiology of female-to-male transsexualism (FM-TS) 12 out of an annual sample of 16 untreated female-to-male transsexuals (FMT), aged 19 years 7 months (19;7) to 44 years 8 months (44;8) [median age (M) 27;5] were assessed by means of sexual-medical questionnaires, physical and endocrinological examination. The control group consisted of 15 healthy women (CF), aged 19 years 2 months (19;2) to 36 years 1 month (36;1) (M 22;7) without gender identity disorder, who were not under hormonal medication (including contraceptives). Baseline levels of testosterone (T; ng/dl), androstenedione (A4; ng/dl), dehydroepiandrosterone sulfate (DHEAS; ng/ml), luteinizing hormone (LH; IU/l), follicle stimulating hormone (FSH; IU/l), and sex-hormone binding globuline (SHBG; microgram/dl) were measured. A standard single-dose ACTH stimulation test (250 micrograms ACTH IV; Synacthen) was performed with all subjects. Aldosterone (ALDO), corticosterone (B), deoxycorticosterone (DOC), progesterone (PROG), 17-hydroxyprogesterone (17OHP), 11-deoxycortisol (S), cortisol (F), cortisone (E), pregnenolone (PREG) and 17-hydroxypregnenolone (OHPREG) were assessed before and 60 min after ACTH stimulation. Transvaginal ultrasound was performed in nine out of 12 FMT (20;11 to 44;8, M 27;5; m 29.1 +/- 7.5) but not in CF. Results showed that 10 FMT (83.3%) and five CF (33.3%) were above normal values for at least one of the measured androgens. Baseline levels of T and A4 were significantly higher in FMT than in CF (T: 54.0 +/- 13.8 vs. 41.1 +/- 12.8; A4: 244.8 +/- 73.0 vs. 190.5 +/- 49.3; p < .05), whereas DHEAS, SHBG, LH and FSH did not differ between the groups. Unbound T (T/SHBG ratio) was higher in FMT (72.0 +/- 67.6) than in CF (26.4 +/- 15.1). Baseline levels of 17OHP, OHPREG and DOC were higher in FMT than in CF (p < .05). After ACTH stimulation 17OHP and OHPREG remained higher in FMT than in CF (p < .05). Single case analysis of ACTH stimulation test together with physical examination revealed symptoms for non-classical congenital adrenal hyperplasia (NC-CAH) in six FMT (50%) and two CF (13.3%). Eight out of nine FMT who were assessed by means of transvaginal ultrasound (i.e. 88.9%; 50.0% of 16) had polycystic ovaries (PCO). Oligomenorrhoea or menstrual dysregularities (81.7% of 16 FMT vs. 0% of CF), hirsutism (56.2% of 16 FMT vs. 13.3% of 15 CF) and adiposity (25.0% vs. 0%) were frequent in FMT, but not in CF. Hyperandrogenism with polycystic ovarian syndrome (PCOS) and adrenocortical hyperresponsiveness to ACTH seems to be a common finding in FMT. This offers support for a hormonal factor in the genesis of FM-TS. Because the prevalence of PCOS and NC-CAH in the female population is higher than FM-TS, the true nature of this factor and its interaction with environmental influences remains unknown.

Adrenocorticotropic Hormone↗
PubMed2003

Interdependencies, values and the reshaping of difference: gender and generation at the birth of twentieth-century modernity.

The paper explores the mutuality of values, claims and social relations in the process of social change. Values are not separable from social relations but are embedded in the shaping and reshaping of social difference and interdependence. The paper focuses on developments around the turn of the twentieth century, and analyses changes in the relative social positioning of children and adults, and women and men, shifting patterns of interdependence, and linked values and ideas about difference. The reconfiguring of generational and gender relations was integral to the first fertility decline, to transformation in family life and societal divisions of labour, and to the embedding of particular values and claims regarding gendered difference, identities and gender appropriate roles. Analysis of these developments reveals the mutuality of 'cultural' and 'material' processes and holds lessons for interpreting social change today.

Adult↗
PubMed1987

Sexual orientation and boyhood gender conformity: development of the Boyhood Gender Conformity Scale (BGCS)

Two hundred twenty-five [corrected] respondents (109 [corrected] heterosexuals and 116 [corrected] homosexuals) completed a survey containing a 20-item Boyhood Gender Conformity Scale (BGCS). This scale was largely composed of edited and abridged gender items from Part A of Freund et al.'s Feminine Gender Identity Scale (FGIS-A) and Whitam's "childhood indicators." The combined scale was developed in an attempt to obtain a reliable, valid, and potent discriminating instrument for accurately classifying adult male respondents for sexual orientation on the basis of their reported boyhood gender conformity or nonconforming behavior and identity. In addition, 33% of these respondents were administered the original FGIS-A and Whitam inventory during a 2-week test-retest analysis conducted to determine the validity and reliability of the new instrument. All the original items significantly discriminated between heterosexual and homosexual respondents. From these a 13-item function and a 5-item function proved to be the most powerful discriminators between the two groups. Significant correlations between each of the three scales and a very high test-retest correlation coefficient supported the reliability and validity assumption for the BGCS. The conclusion was made that the five-item function (playing with boys, preferring [corrected] boys' games, imagining self as sports figure, reading adventure and sports stories, considered a "sissy") was the most potent and parsimonious discriminator among adult males for sexual orientation. It was similarly noted that the absence of masculine behaviors and traits appeared to be a more powerful predictor of later homosexual orientation than the traditionally feminine or cross-sexed traits and behaviors.

Adolescent↗
PubMed1993

Gender roles in a geriatric therapeutic community.

During the years 1983-1989 an action research/intervention study in a 40-bed Finnish home for the elderly had as its goal the development of a modified therapeutic community. This paper focuses on the gender roles. Logistic regression analysis indicated that males (N = 17) were best differentiated from females (N = 38) by extramural functional activity, extramural social passivity, religious neutrality, passivity in contacts with a personal nurse, and better education. These five explanatory variables correctly predicted gender in 84% of the cases. These mild gender differences reflect the traditional sex roles of an agrarian Finnish village and were seen mainly as a positive phenomenon. The findings, and some other gender identity themes in the elderly, also were illustrated by qualitative case material. These data suggested that the therapeutic community of aged people should permit active preservation of even conservative and stereotyped gender roles, thereby aiding in the defense and continuity of their often frail identity. The search for new role elements should be supported as well, however, because some elderly continue to develop their gender roles during their final years.

Activities of Daily Living↗
PubMed2003

Margo and me. Gender as a cause and solution to unmet needs.

This paper presents a six-year analytic treatment that began when Margo was five and a half years old. Unable to get the love and attention that her older brothers received, Margo sought repair by deciding to be both a boy and a girl. Before a solid gender identity could emerge, I needed to facilitate her development and help her obtain a cohesive sense of self that would include ego integration of feelings and object relationships. Margo's bi-gender solution crystallized a fundamental struggle and conflict with identity, and served to repair feelings of narcissistic injury, cope with extreme feelings of love and hate and good and bad objects, quell annihilation anxiety, and repair a sense of ego disintegration.

Child, Preschool↗
PubMed2004

Gender differences in identity processes and self-esteem in middle and later adulthood.

Gender differences were examined in the identity processes of identity assimilation (maintaining identity despite age changes), identity accommodation (changing identity) and balance (using both processes) and in the relationship of these processes to self-esteem. We tested a community sample of 222 adults (131 females and 91 males) ranging from 40 to 84 years of age (M = 57.5, SD = 12.1). Analysis of variance yielded evidence showing greater use of identity accommodation for women. Identity accommodation was negatively associated with self-esteem for both genders, while identity assimilation was positively associated with self-esteem for women only. For both men and women, identity balance was positively related to self-esteem. Women's use of the identity processes in relation to self-esteem is discussed. Societal views on aging are suggested to impact women, such that they engage in identity accommodation while benefiting from identity assimilation. From these findings, it appears that examining the processes contributing to the maintenance of self-esteem may be a more useful approach to characterizing the aging process and gender differences than focusing on mean differences alone.

Adaptation, Psychological↗
PubMed1980

Familial male pseudohermaphroditism due to deficiency of 5 alpha-reductase.

Two brothers of Greek Cypriot origin, karyotype 46 XY, aged 17 and 19 years were brought up as females because of predominantly female external genitalia with clitoromegaly and urogenital sinus. At puberty there was genital masculinization with testicular enlargment and descent and development of male musculature and body habitus without gynaecomastia. Both subjects acquired male gender identity and changed from a female to a male gender role. The internal genitalia were normally formed with an ejaculate containing mature spermatozoa. In both subjects plasma testosterone levels were slightly elevated, dihydrotestosterone was in the low normal range and the plasma testosterone to dihydrotestosterone ratio was markedly elevated. Plasma oestrogens were normal whereas SHBG binding capacity was elevated. The urinary 5 beta-aetiocholanolone to 5 alpha-androsterone ratios were elevated compared with normal subjects. Basal plasma LH was normal but, the LH response to LHRH was exaggerated and basal and peak plasma levels of FSH were elevated. 5 alpha-reductase activity in genital skin homogenates was higher when androstenedione was used as a substrate, compared with testosterone, suggesting a decreased affinity of the enzyme for testosterone. The clinical and hormonal features in the two siblings are consistent with an impaired peripheral conversion of testosterone to dihydrotestosterone due to deficiency of the enzyme 5 alpha-reductase.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed2004

(Dis)embodying gender and sexuality in testicular cancer.

Testicular cancer is the most common cancer in men aged 15-34. Although post-treatment prognosis is generally very good, the impact on sexuality, gender identity and fertility is amplified in this age group. A Canadian study of men with testicular cancer explores how men (re)consider questions of sexuality and gender post diagnosis and treatment. Semi-structured interviews with 40 men were analyzed using thematic decomposition, an analytic technique that combines discursive approaches with thematic analysis. The theoretical framework that guides this work relies on material discursive approaches. From an analytic stance, this perspective is concerned with a focus on the ways in which both subjectivity and the body are experienced and constituted in language. In particular, we are concerned with how these men interpret the (altered) male body as a locus of gender signification and gender disruption. Men in this study construct testicular cancer as alternately inhibiting and enhancing masculinity and sexuality. Disruption interpolates with potentiality. A discourse of precarious masculinity predominates these accounts, wherein the link between anatomy and masculinity is simultaneously asserted and disavowed. Constructions of anatomical essentialism (i.e., testicular integrity is equated with masculinity) are juxtaposed against construals of anatomical superfluousness (i.e., other sites of sexuality and male identity are emphasized as being more central).

Academic Medical Centers↗