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The intersexed patient.

There are at present two opposing points of view on problems of dealing with the intersexed patient (not the typical homosexual or transvestite) who has clearcut anatomical or biochemical qualities of the opposite sex. The first is that in the growing child or adult coming for treatment, the sex the patient should adopt is the summation of somatic sex. The other is that the sex role should be assigned according to the predominant psychological identification already present.A case history of a middle-aged pseudohermaphrodite, castrated in youth but raised from birth as a female and living thus in "homosexual" relations with women until examined and interviewed at UCLA Medical Center is presented to illustrate the psychological problems in sexual identity with which the patient had to cope. Psychiatric investigation revealed how confused the patient's sex identity was until treatment by a team consisting of psychiatrist, psychologist and endocrinologist permitted the patient, even at so late a date, finally to establish what his gender is. The patient was able, despite early rearing as a female and a castrating operation, to swing to a more masculine identification. This was possible because of some uncertainty of sexual role from an early age.

Adaptation, Psychological↗

The physical handicap and the body ego.

This paper has three parts. First, I reconsider the previously published analysis of Peter, the boy born with a severe congenital handicap. This time I focus on the boy's own major wish, not for the growth of normal arms, but to be accepted with pride by his mother as he actually was. I mention some thoughts concerning the deep-seated problems between mother and child occurring during the fusional phase and the consequent limitations this imposed upon the primary identificatory processes. In the second part of this paper a comparison is established between the fantasy life of this handicapped boy with the unconscious fantasy life of some obsessive-depressive patients experiencing minor, acquired, or temporary handicaps. The main point here is that the fantasy life of Peter is oriented towards ego-building while the fantasy life of the others is ego-inhibiting. A final comparison is attempted between, on the one hand, the psychological effects on this child of his own congenital handicap contrasted with, on the other hand, the effects on a physically normal child of the permanent physical handicap of one of the parents. The child in the second situation (handicap of a parent) seems more psychologically threatened in his body integrity and identity.

Achievement↗

Sex role identity related to the ratio of second to fourth digit length in women.

Prenatal gonadal hormones have been implicated as important factors in the development of sex-role identity. The aim of the study reported here was to examine the relationship between adult sex-role preference and the second to fourth digit ratio (2D:4D ratio) in healthy women. There is evidence that the ratio of the length of second and fourth digits associates negatively with prenatal testosterone and positively with prenatal oestrogen. In this study the 2D:4D ratio was measured on a sample of 46 female university students. The subjects completed the form of the Bem Sex Role Inventory (BSRI). It was found that the lower 2D:4D ratios associated significantly with higher, masculinized bias scores in BSRI indicating that 2D:4D ratio predicts the female or male self-reported sex-role identity in females.

Adult↗

A comment on cultural attributes and fluidity of bisexuality.

Selected aspects of the "essentialist" critiques and reviews in Bisexual and Homosexual Identities: Critical Theoretical Issues (De Cecco & Shively, eds., 1983/1984) of the idea of the bisexual identity are examined from the standpoint of their cross-cultural significance. Examples from recent studies in Melanesia are used to highlight possible areas of exploration for future research in homosexuality and bisexuality. The idea of fluidity of sexual identity is examined, including the associated notion of sexual desire.

Anthropology, Cultural↗

Gay liberation and coming out in Mexico.

This article presents information on three sociocultural variables and relates it to gay liberation and the behavior of gay youth in Guadalajara, Mexico's second largest city. A detailed history of the gay liberation movement in Guadalajara is given because it provides an excellent example of the interaction of sociocultural variables and shows how different the outcome of liberation may be for gay people in Mexico. Brief life histories of the "coming out" of two Guadalajaran gay men further illustrate some of the unique ways in which gay identities change the lives of gay youth in Mexico.

Adaptation, Psychological↗

Cultural, contextual, and intrapersonal predictors of risky sexual attitudes among urban African American girls in early adolescence.

The role of cultural factors in explaining sexual attitudes among African American urban girls, aged 10-13 years, was investigated in this study. The authors predicted that girls with higher school interest, family cohesion, religiosity, and behavioral self-esteem would endorse less risky sexual attitudes. Also, older girls were expected to have more risky sexual attitudes than younger girls, and girls from 1- rather than 2-parent households were expected to have more risky sexual attitudes. The authors hypothesized that ethnic identity and gender role orientations would contribute to explaining variability in sexual attitudes after controlling for contextual and intrapersonal variables. A questionnaire containing measures of the study constructs was administered to 214 girls who were participants in a substance abuse prevention program. Pretest data were used in analyses. A final regression model accounted for 23% of the variance in sexual attitudes. Age and behavioral self-esteem were significant predictors, with younger teens and teens with higher behavioral self-esteem having less risky sexual attitudes. Cultural variables contributed to explaining variation in sexual attitudes after other variables were controlled for. Higher levels of ethnic identity were associated with less risky sexual attitudes. A masculine gender role orientation was associated with more risky sexual attitudes.

Adolescent↗

Masculinity and undocumented labor migration: injured latino day laborers in San Francisco.

Drawing on data collected through clinical practice and ethnographic fieldwork, this study examines the experience of injury, illness and disability among undocumented Latino day laborers in San Francisco. We demonstrate how constructions of masculine identity organize the experience of embodied social suffering among workers who are rendered vulnerable by the structural conditions of undocumented immigrant status. Theoretical concepts from critical medical anthropology and gender studies extend the scholarly analysis of structural violence beyond the primarily economic to uncover how it is embodied at the intimate level as a gendered experience of personal and familial crisis, involving love, respect, betrayal and patriarchal failure. A clinical ethnographic focus on socially structured patriarchal suffering elucidates the causal relationship between macro-forces and individual action with a fuller appreciation of the impact of culture and everyday lived experience.

Adult↗

Migrancy, masculine identities and AIDS: the psychosocial context of HIV transmission on the South African gold mines.

Levels of HIV infection are particularly high amongst migrant workers in sub-Saharan Africa. This paper presents a case study of one such vulnerable group of migrants-underground workers on the South African gold mines-and highlights the psychosocial context of HIV transmission in the mining setting. On the assumption that social identities serve as an important influence on peoples' sexual behaviour, the study examines the way in which miners construct their social identities within the parameters of their particular living and working conditions. It also identifies some of the key narratives used by miners to make sense of their experience in the realms of health, ill-health, HIV and sexuality. Masculinity emerged as a leading narrative in informants' accounts of their working life, health and sexuality, and the paper examines the way in which the construction of masculine identities renders miners particularly vulnerable to HIV. The implications of these findings for HIV educational interventions are discussed.

Gender Identity↗

When multiple identities interfere: the role of identity centrality.

The current study extends research in the area of identity conflict or interference by focusing on a new identity combination, the woman and scientist identities. In addition, it examines the influence of identity centrality, or importance, as a predictor of interference and moderator of the relation between interference and well-being and science performance. Supporting hypotheses, greater identity interference was related to lower levels of performance and well-being. Furthermore, woman centrality was unrelated to interference for those with a central scientist identity, but for those without a central scientist identity, they were positively related. Although central identities were related to positive outcomes in the absence of interference, the outcomes of all women suffered when interference was high, contrary to the hypothesis. The implications of identity centrality for understanding the negotiation of potentially conflicting identities, and for the retention of women in the sciences, are discussed.

Adolescent↗

Proposed model of lesbian identity development: an empirical examination.

A 42-question written survey was administered to 197 women, approximately 96% of whom were self-identified lesbians, for the purpose of gathering information about their experiences from first awareness of lesbian identity to their current status. Descriptive data are presented which seem to suggest that lesbian identity is present prior to the individual's recognition of incongruency between her feelings and those of non-lesbians, and that the process of self-labeling occurs through interaction with the non-lesbian world. The term lesbian identity is discussed and defined. The findings of this study are, in part, described in the framework of a proposed Model of Lesbian Identity Awareness and Self-Labeling which is currently undergoing further investigation.

Adult↗

Drug identity change processes, race, and gender. II. Microlevel motivational concepts.

Events and experiences that are damaging and which sever young people from normative ideals and positively sanctioned statuses (marginalization) create feelings of alienation or social isolation within them and earn them undesired statuses and treatment from important others. An underlying premise of the drug-use identity change model is that individuals are motivated toward drug-related identity change because of such socially defined problems with existing ego identities (ego identity discomfort and lost control in defining an identity) in childhood and early adolescence and that certain macrolevel phenomena (e.g., social appraisal sources and social climate conducive to drug use) provide an opportunity structure for that change. Part 2 of this paper describes each of the three motivational concepts and how they vary by race and gender in the process of becoming a drug misuser. Part 3 discusses the two macrolevel opportunity concepts and how they vary by race and gender.

Adolescent↗

Psychological problems resulting from parent-to-adolescent renal transplantation.

This paper deals with the ways in which the psychological responses of renal transplant donors and recipients interfere with the developmental tasks of adolescence. The characteristic responses of donors and recipients in general are briefly reviewed. The special problems of the adolescent who has received a transplant from a parent are considered. Interference with the separation-individuation process is discussed. Also considered is the difficulty posed to the development of sexual identity. Excerpts from brief therapy are presented that illustrate the characteristic psychological conflicts described.

Adolescent↗

Homosexuality, ethics and identity synthesis.

Implicit metaphysical assumptions concerning the nature of sexual orientation are reflected in the language used to frame ethical debates concerning "reorientation" therapies. An alternative metaphysical construal is presented concerning sexual orientation and sexual identity development and synthesis. This alternative construal allows for humility concerning what we know and do not know about sexual orientation, underscores the client's self-determination and autonomy, and demonstrates regard for personal and religious valuative frameworks. Rather than focusing on therapies aimed specifically at sexual reorientation, clinicians would do well to provide clients with informed consent and to facilitate identity development and synthesis in keeping with their clients' requests for professional services.

Behavior Therapy↗

Defining, assigning and designing sex.

This article challenges the distinction the law draws between male and female. It focuses on the legal and medical treatment of intersexual people. Analysing the nature and rate of intersexuality it argues that there is a significant number of people who cannot be described as either male or female and instead exhibit a range of sexual characteristics. Until recently the law and medicine have insisted that intersexual people should be categorized as either male or female. Surgery was performed to ensure that they had the appearance assumed to be the 'norm' for a man or woman and the law followed this medical assignment of sex. Over the last couple of years the established medical practice and the legal treatment have been challenged. This article discusses the nature of these challenges and argues that there is a strong case for rejecting the traditional legal and medical approach to intersexual people. Cosmetic surgery on intersexual babies should be delayed until the individual is old enough to be able to choose their own sexual identity, which may be neither male nor female. The insistence that every person must either be male or female is no longer supportable in medical or social terms and a much wider range of sexual identities must be recognized by the law.

Birth Certificates↗