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At least 163 records · Page 9Linked to original sources
PubMed1987

Symptomatology, psychosexual development and gender identity in 42 anorexic males.

Forty-two male patients with an anorexic syndrome were assessed. Twenty-nine of them had a primary anorexia nervosa (most of them also had bulimic symptoms). They were compared with a series of 23 female anorexia nervosa patients. The males scored more highly than female patients on a number of symptoms, but generally more similarities than differences in symptomatology were apparent. Male patients with primary anorexia nervosa also showed several signs of a disturbed psychosexual and gender identity development. The data support the hypothesis that males with atypical gender role behaviour have an increased risk for developing anorexia nervosa or bulimia in adolescence.

Adolescent↗
PubMed2005

Psychiatric comorbidity in gender identity disorder.

OBJECTIVE: Despite being recognized as an important prognostic factor for the outcome in gender identity disorder (GID), psychiatric comorbidity has rarely been assessed by means of standardized diagnostic instruments. The aim of this study was to assess current and lifetime psychiatric comorbidity in patients with GID. METHODS: A cross-sectional sample of 31 patients who were treated for GID was assessed by the structured clinical interview for Axis I and II (SCID-I/II) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Twenty-nine percent of the patients had no current or lifetime Axis I disorder; 39% fulfilled the criteria for current and 71% for current and/or lifetime Axis I diagnosis. Forty-two percent of the patients were diagnosed with one or more personality disorders. CONCLUSIONS: Lifetime psychiatric comorbidity in GID patients is high, and this should be taken into account in the assessment and treatment planning of GID patients.

Adult↗
PubMed2002

Gender identity disorder and eating disorders.

We report three cases of transsexual patients who are suffering from an eating disorder: a biological male patient diagnosed with anorexia nervosa (AN), a biological male patient with bulimia nervosa (BN), and a biological female patient with AN as well as a severe alcohol dependence. The relationship between eating behavior, gender identity, sexual orientation, and body dissatisfaction is discussed.

Adult↗
PubMedDate not supplied

Gender identity disorder in a five-year-old boy.

Markedly effeminate behavior in a young boy is a source of concern and confusion for parents, teachers, and the child. It also represents a therapeutic dilemma for the child psychiatrist. The case of a five-year-old boy with gender identity disorder of childhood is presented and the literature on hypotheses of etiology, treatment, and long-term follow-up is reviewed. The ethical and philosophical questions posed by such a case are discussed.

Age Factors↗
PubMed2006

Nursing experience of redesigning a schedule to consider gender identity disorder in recruits' physical examination.

The military service in Taiwan currently uses a recruiting system. With the duty of helping examinees get through their physical examination, we examiners have to consider their individual statements and privacy so as to adjust where necessary while undertaking the examination. The purpose of this case study is to explore the nursing experience of handling the gender identity disorder patient in the field of physical examination. Through their participation, and by considering their personal circumstances, we can execute a thorough examination effectively and smoothly but not influence other examinees, and avoid unexpected disputes. In particular, private items including chest X-ray, electrocardiogram, and gender organ examinations must be executed with care. The nursing designed alternative schedule may provide a reference for the participants involved in the field of recruits' physical examination.

Female↗
PubMed2001

[Gender identity disorders as a symptom of psychosis, schizophrenia in particular].

In the Netherlands it has recently become possible for transsexual patients to receive hormonal treatment from the onset of puberty. Until the age of 16, pubertal development can be prevented with luteinizing hormone-releasing hormone (LHRH) agonists. From 16 years of age onwards, gender adjustment can be initiated by administration of hormones of the opposite sex. Surgical treatment can be offered once the patient reaches 18 years of age. Although such treatment will only be initiated with reticence and after a long phase of intense diagnostic screening, the question arises whether a clear differentiation can be made between pure gender identity disorders and secondary transsexual feelings that are part of an ongoing psychopathological development, such as schizophrenia. The potential diagnostic confusion is illustrated by a case history of a male schizophrenic patient. This patient had been treated hormonally for transsexualism for years before acute psychotic decompensation occurred. Neuroleptic treatment of the psychosis rapidly reduced the psychotic symptoms. In retrospect, the patient regards his transsexual period as a 'mistake'. Delusions about one's physical appearance and the urge to drastically change the way one looks appear to be relatively common in patients suffering from schizophrenia.

Adult↗
PubMed1977

Gender identity change in a female adolescent transsexual.

Two years of individual and milieu therapy are described of a 14 1/2-year-old girl who had presented with the persistent request to have a sex-change operation since age 12. Her past history was obtained from her parent and the records of the child guidance clinic which evaluated her at 3 years of age. She gives a history of remarkable tomboyism during her latency years and increasing withdrawal from peers and family during early adolescence. The patient's personal and family dynamics are explored, and these major therapeutic themes are discussed. The individual and milieu therapy are described and discussed with some speculation about the reasons for her positive response to psychotherapy. It would appear that this is a rare case of postpubertal female transsexual reported to have made a gender identity change.

Adolescent↗
PubMed1989

Infantile sexuality, gender identity, and obstacles to oedipal progression.

Contrary to when it was first proposed, infantile sexuality nowadays is accepted as an important part of child development. However, Freud's views on masculine primacy and feminine inferiority are seen to be incomplete and inaccurate not only because they over-emphasize sexuality and sexual anatomy, but also because they neglect aggression, object relations, ego and superego functioning, and the sense of self. Infantile sexuality is therefore reconsidered within the broader perspective of gender identity. Within this broader perspective, normal and aberrant sexual development is discussed, and new ideas are offered about familiar concepts such as castration anxiety and penis envy.

Child↗
PubMed1982

Narcissism and female gender identity: a reformulation.

The theory of narcissism and the study of the psychological development of the female child have both been subjects of considerable controversy within psychoanalysis. Some issues central to these controversies have been discussed and evaluated with attention to the contributions made by advances in each area upon the other. From a historical perspective, Freud's illuminating introduction of the concept of narcissism opened the door toward explaining a variety of puzzling clinical phenomena. Deutsch then elaborated upon Freud's contribution as well as upon his specific bias in her description of the psychology of women. Later, Jacobson addressed herself to a reformulation of then existing views of female psychological development. Kohut's innovative clinical observations and Stolorow's functional definition of narcissism provided a unique vantage point from which to offer a critical restatement of narcissistic factors in the development of the female child. Specifically, narcissism was freed from its singular relationship to female development (the emphasis on castration shock and penis envy as rock bottom factors in female character formation) and related to structuralization of the representational world--self- and object-representations. Sexual differences can then be understood as most relevant for the content of these structures. In this context, the work of Stoller was cited. Finally, three topics that grew out of these considerations and elaborations were considered: the role of the little girl's attachment to and separation from her mother, the role of the psychosexual phases and an evaluation of penis envy, and the role of the father as an ideal. The reciprocal relationship between psychosexual development and the differentiation, integration and consolidation of self and object images has specific relevance for the manner in which femininity as the content of the self-representation of the developing girl enhances and is enhanced by the structuralization of the representations. The unfolding of the psychosexual phases with their associated imagery can be viewed as the gradual unfolding of more complex, differentiated and articulated self and object representations. Conversely, the gradual separation, integration and consolidation of self- and object-representations makes possible the development of increasingly more advanced forms of psychosexual experiences. Thus, the original question of the relationship between narcissism and female development has led to much broader issues. Narcissism concerns the structuralization and maintenance of the self. However, while narcissistic activities may promote structuralization, they may also serve to shore up a precarious sense of gender identity.

Adolescent↗
PubMed1997

Urban low-income African American men, HIV/AIDS, and gender identity.

In a 1993 Human Organization article, Jerome Wright called for more research on African American male sexual behavior and the risk for HIV infection. The present article is a response to that call. Wright pointed out a well-known fact of HIV/AIDS prevention programs: such programs have not been very successful in reaching low-income African American males. The present article suggests that perhaps the key to better understanding sex-related health-risk behavior is to conduct more systematic research on gender identity, and the historical and sociocultural origins of such identities. I argue that if we are truly interested in developing effective HIV/AIDS programs targeting low-income African American males, then the sociocultural "meanings" that this population attaches to AIDS-related phenomena must be understood in the broader contexts of American constructs of masculinity, and in the real and perceived experiences of black men in America. Data from several ethnographic and qualitative research projects carried out among low-income African American male and female residents of Baltimore, other parts of Maryland, and Washington, D.C. are used in support of my primary arguments.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Male gender identity and sexual behaviour.

One consequence of a heightened interest in intersubjectivity in the current psychoanalytic literature has been a relative neglect of the examination of unconscious fantasies. Presenting material from the analysis of three males, each of whom, in childhood and/or adolescence, hid his penis between his legs and looked at himself in a mirror naked, the author demonstrates the importance of attending to both unconscious fantasies and their manifestations within the interactive field of analysis. The first patient is a young child with a gender identity disorder, whose wish to be like his mother was a response to the emotional loss of her during early childhood. The second patient is an adolescent, whose behaviour in front of a mirror was a manifestation of his desire to possess his mother and be her, to humiliate and sadistically control her, and at the same time, to experience the masochistic sexual gratification of being a seemingly helpless victim. The third patient, a 48-year-old male, came to analysis filled with suicidal impulses and self-hatred related to homosexual impulses. His repeated examination of himself in a mirror, with penis hidden, reflected severe castration anxiety, related to an ambivalent relationship with an angry mother and a longing for attention from an unavailable father. The article closes with a description of the similarities and differences in the dynamics of these three males as well as a discussion of the meaning of similar behaviour in other males seen in consultation.

Adolescent↗
PubMed1984

Gender identity and its implications for the concepts of masculinity and femininity.

In this chapter, I have suggested that although the terms masculine and feminine and masculinity and femininity have rarely been defined, they appear to have two types of meaning both for psychologists and for the community at large. First, masculine and feminine have an empirical meaning, being used as labels to identify specific objects, events, or qualities that in a given culture are perceived as more closely associated with males or with females. Second, these adjectives and, even more exclusively the nouns masculinity and femininity, are used as theoretical constructs that refer to a fundamental property or aspect of the individual's self-concept that is not directly observable. Masculinity and femininity in this second sense are conceived as bipolar opposites, almost all men having a firm sense of their psychological masculinity and almost all women having a similar sense of their femininity. The implicit assumptions on which conventional theories of masculinity-femininity are predicated imply that all gender-related phenomena contribute to a bipolar femininity-masculinity factor so that assessment of an individual's masculine and feminine qualities (in the empirical sense of these terms) can be used to infer his or her position on the hypothetical masculinity-femininity continuum. Constructs such as sex-role identification and sex-role orientation are based on the same assumptions. More recently it as been proposed that masculine and feminine qualities and their accompanying self-images of masculinity and femininity constitute instead two separate, statistically independent dimensions. However, most investigators nominally advancing this two-factor model and tying the measurement of masculinity and femininity to instruments containing separate scales of masculine and feminine attributes have in fact employed unidimensional bipolar models, based on such concepts as sex-role identification, sex typing, or gender schema. The empirical data, however, support neither the one-factor nor the two-factor model of gender-differentiating phenomena, suggesting instead that they are multidimensional. To the extent that the concepts of masculinity-femininity (and other similar unidimensional constructs) or of masculinity and femininity are intended to represent the structure of gender-relevant characteristics, these constructs lack validity. I proposed, however, that masculinity and femininity, as they refer to an individual's self-concept, be retained and reconceptualized as gender identity: a basic phenomenological sense of one's maleness or femaleness that parallels awareness and acceptance of one's biological sex and is established early in life.(ABSTRACT TRUNCATED AT 400 WORDS)

Assertiveness↗
PubMed2005

Impact of environment upon gender identity and sexual orientation: a lesson for parents of children with intersex or gender confusion.

Two histories of physically normal men with persistent gender issues highlight the major impact played by parental input on the sexual and gender development of children. Both men had been subjected to firm, harsh behavior modification by their parents, particularly their mothers, during childhood in response to effeminate behavior. While both men continue to manifest major gender/sexual issues as adults, their outcomes have been dramatically different. The first man takes female hormones and denies any satisfaction from his sexuality. This individual remains convinced that he has female internal sexual organs and monthly internal menstrual bleeding. Although he has a career, he has become alienated from his family and is a social cripple. The second man has a successful career, lives a heterosexual life with his children and wife of 20 years and is involved in his community. He is visually attracted to men and remains obsessed with male pornography. This individual credits his mother with directing him toward a successful heterosexual life, which he feels has prevented the emotional burden of an active homosexual life. These two cases illustrate the tremendous influence played by environment and parental input on the sexual perspectives of developing children.

Adaptation, Psychological↗
PubMed2002

Etiology, clinical profile, gender identity and long-term follow up of patients with ambiguous genitalia in India.

There is little information on the profile of children with ambiguous genitalia in India. Presented here is an analysis of patients with ambiguous genitalia registered in a general endocrine clinic during the last 2 decades. Seventy-four patients (age 4 months to 36 years) were registered during this period. Fifty-two were more than 5 years old at the time of registration. Thirty-five were reared as females, 29 as males; nine children (4 months to 1 year old) were brought for sex assignment, and one (with epispadias) was brought for correction of urinary incontinence. Investigations revealed 28 patients with congenital adrenal hyperplasia, 14 dysgenetic male pseudohermaphroditism, ten true hermaphroditism, six partial androgen insensitivity, four castration and one epispadias. There were eight patients with perineal hypospadias with normal Leydig cell reserve (normal LH, FSH and testosterone response to LHRH). Sex of rearing and gender identity were concordant in all except the patients with perineal hypospadias with normal Leydig cell response. These observations support the theory that prenatal androgen exposure masculinizes the brain.

Adolescent↗
PubMedDate not supplied

Gender identity disorder and HIV disease.

Four cases of male-to-female transsexuals with HIV infection are described, showing that individuals with gender identity disorder are vulnerable to HIV infection through unsafe sexual behaviour and intravenous drug use. The various practical problems associated with carrying out major surgery on this group of individuals are discussed, as well as some of the ethical issues raised by their treatment needs.

Adult↗
PubMed2004

Concordance of phenotypic expression and gender identity in a large kindred with a mutation in the androgen receptor.

A 14-year-old female presented to the Pediatric Endocrine Clinic, Universidade Federal o Parana Curitiba, Brazil, for obesity. A few years later, despite normal breast development, the patient had failed to menstruate and lacked pubic and axillary hair. Laboratory analyses revealed high levels of testosterone. Karyotype analysis was XY. Direct sequencing of her genomic DNA showed a G to T transition at nucleotide 2089 at exon 2 in the androgen receptor gene, resulting in a substitution of Phe for Cys at position 576. This mutation disrupts the first Zn finger critical to DNA binding and transcriptional activity and results in complete androgen-insensitivity syndrome (CAIS). This individual was part of 700-member multigenerational kindred of German origin living in small villages in Southern Brazil. Family members who gave informed consent were screened using a polymerase chain reaction-based method. Nineteen CAIS-affected individuals and carriers were identified. All presented with infertility and lack of or sparse pubic hair. The prevalence of common AIS within the kindred greatly exceeds that of the general population and is due in part to their isolated familial and community structures. All individuals are genuinely feminine in their appearance, sex behavior, gender identity, and integration within their communities. We conclude that CAIS leads to complete feminization of XY individuals and results in individuals who are psychologically and socially established and integrated as women within the familial and cultural contexts of their communities.

Adolescent↗