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PubMed1979

Gender identity.

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Child, Preschool↗
PubMed1988

Mutually gratifying heterosexual relationship with micropenis of husband.

Three adult patients with micropenis are described: two genetic females, reared as boys, with congenital adrenocortical hyperplasia (CAH), and one male with anorchia. The patients had a male gender identity/role. All three had established a satisfying heterosexual relationship. For only one of the patients intravaginal intercourse was possible. In one patient (with CAH), penile reconstructive surgery was attempted but failed. Nevertheless, he developed a satisfactory sexual relationship with a woman friend. This report illustrates that for patients with micropenis, penile reconstructive surgery is not obligatory for the establishment of a satisfying sexual relationship.

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↗
PubMed1969

[Child sexuality].

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Anxiety, Castration↗