Ritual circumcision and castration anxiety.
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OBJECTIVE: To review the clinically relevant literature on gender identity disorder (GID) in children and adolescents over the past 10 years. METHOD: All literature referring to gender identity and children or adolescents from 1985 on was reviewed. RESULTS: Changes in the DSM-IV nomenclature include (1) adoption of the single diagnosis of GID to apply to children, adolescents, and adults; (2) changes in the format of the criteria; and (3) placement in the section "Sexual and Gender Identity Disorders." Rates of associated psychopathology in children with GID are comparable with those in children with other psychiatric disorders, particularly disorders that are internalizing in form. Biological and psychosocial factors thought to be relevant in the development of GID are reviewed. CONCLUSIONS: Research is required to elucidate the complicated interaction between biological and psychosocial factors in the development of GID and to evaluate treatment efficacy.
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The primary developmental task for homosexually oriented adolescents is adjustment to a socially stigmatized role. Although the individual homosexual adolescent reacts with diversity and great resilience to societal pressures, most pass through a turbulent period that carries the risk of maladaptive behaviors that may affect adult performance. Despite individual variation, certain issues have been found to concern most homosexual adolescents. Empirical data from the Institute for the Protection of Lesbian and Gay Youth, Inc. in New York City suggests that isolation, family violence, educational issues, emotional stresses, shelter, and sexual abuse are the main concerns of youth entering the program. If not resolved, the social, cognitive, and social isolation may extend into adulthood, and anxiety, depressive symptoms, alienation, self-hatred, and demoralization may result. In a non-threatening supportive environment that provides accurate information and appropriate peer and adult role models, many of the concerns are alleviated and internalized negative attitudes are either modified or prevented from developing. The authors discuss the effects of prejudice and the impact of negative societal attitudes on the developing social and personal identities of homosexual youths.
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Current views of masturbation in latency girls are drawn from direct observation, clinical experience with children, and from recollections of adult women. Reports in the literature and from the author invite re-examination of Freud's original theory that latency girls turn away from clitoral masturbation and develop persistent penis envy as a necessary step in development toward mature femininity.
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Emphasis is placed in the difficulty in conceptualizing sexuality as a complex and controversial subject. This is a presentation of a concept based on freudian psychoanalysis. With this in mind, many of Freud's references are collected from the Brazilian Standard Edition of the Complete Psychological Works of Sigmund Freud. The following concept is arrived at: sexuality is an instinctive vital energy directed to pleasure, with the possibility of quantitative and qualitative variations, closely bound to homeostasis, to affection, to social relations, to phases of development of childhood-libido, to eroticism, to genitality, to sexual relations, to procreation and to sublimation.
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