Mammalian animal models of psychosexual differentiation: when is 'translation' to the human situation possible?

Clinical investigators have been forced primarily to use experiments of nature (e.g., cloacal exstrophy; androgen insensitivity, congenital adrenal hyperplasia) to assess the contribution of fetal sex hormone exposure to the development of male- and female-typical profiles of gender identity and role behavior as well as sexual orientation. In this review, I summarize the results of numerous correlative as well as mechanistic animal experiments that shed significant light on general neuroendocrine mechanisms controlling the differentiation of neural circuits controlling sexual partner preference (sexual orientation) in mammalian species including man. I also argue, however, that results of animal studies can, at best, provide only indirect insights into the neuroendocrine determinants of human gender identity and role behaviors.     

Gender Change from Female to Male in Classical Congenital Adrenal Hyperplasia

The psychoendocrinology of the development of normal gender identity and its variations is poorly understood. Studies of gender development in individuals born with endocrinologically well-characterized intersex conditions are heuristically valuable for the disaggregation of factors that are acting in concert during normal development. Four 46,XX individuals with classical congenital adrenal hyperplasia (CAH) and atypical gender identity entered a comprehensive research protocol including systematic interviews and self-report inventories on gender role behavior and identity, sexual history, and psychiatric history. Some of the data on gender variables were compared to data from 12 CAH women with the salt-wasting variant (CAH-SW) with female gender identity. The four patients (ages 28, 35, 38, and 30 years) represented three different subtypes of classical early-onset CAH: 21-OH deficiency, simple virilizing (CAH-SV); 21-OH deficiency, salt-wasting (CAH-SW); and 11-β-OH deficiency. Their medical histories were characterized by delay beyond infancy or lack of surgical feminization of the external genitalia and progressive virilization with inconsistent or absent glucocorticoid replacement therapy. Although three patients had undergone one or more genital surgeries, all had retained at least some orgasmic capacity. In regard to childhood gender-role behavior, the four gender-change patients tended to be more masculine or less feminine than (behaviorally masculinized) CAH-SW controls. All patients were sexually attracted to females only. The process of gender change was gradual and extended well into adulthood. The most plausible factors contributing to cross-gender identity development in these patients to be neither a particular genotype or endocrinotype nor a sex-typing bias on the part of the parents but a combination of a genderatypical behavioral self-image, a gender-atypical body image, and the development of erotic attraction to women. Implications for psychosocial management are also discussed.     

Gender role behavior in children with XY karyotype and disorders of sex development

Children exhibit gender-typical preferences in play, toys, activities and interests, and playmates. Several studies suggest that high concentrations of pre- and postnatal androgens contribute to male-typical behavior development, whereas female-typical behavior develops in the absence of high androgens levels. This study aims to explore the consequences of hypoandrogenization on gender-typical behavior in children who have an XY karyotype and disorder of sex development (DSD). Participants included 33 children (ages 2-12 years) with an XY karyotype and DSD; 21 reared as girls and 12 reared as boys. Children's preferred activities and interests and playmate preferences were assessed with parent report questionnaires, a structured free-play task, and choice of a toy to keep as a gift. Participant's responses were compared to those of children recruited in a pre-school and elementary school survey (N=166). In this study, the degree of hypoandrogenization as indicated by genital stage and diagnosis showed a significant relationship to nearly all of the gender-related behaviors assessed, supporting the hypothesis that masculinization of gender role behavior is a function of prenatal androgen exposure. Despite the fact that children with partial androgen effects reared as girls showed increased "boyish" behaviors, they did not show increased signs of gender identity confusion or instability on a group level. We conclude that androgen exposure plays a decisive role in the development of gender-typical behavior in children with XY karyotype and DSD conditions.     

What can the Samoan "Fa'afafine" teach us about the Western concept of gender identity disorder in childhood?

This article examines whether gender identity disorder in childhood (GIDC) constitutes a mental disorder as outlined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV-TR). Data were collected in Samoa, a culture that is characterized by a high degree of social tolerance towards feminine males who are known locally as fa'afafine. The study location was chosen because, unlike Western locales, it afforded the opportunity to examine whether gender-atypical behavior, gender-atypical identity, and sex-atypical identity, in and of themselves, cause distress in sex/gender variant individuals, while simultaneously controlling for the confounding effects of extreme societal intolerance towards such individuals. Because of our focus on the DSM-IV-TR's diagnosis of GIDC, we were specifically interested in ascertaining whether adult fa'afafine recalled a strong and persistent cross-gender identification in childhood, a sense of inappropriateness in the male-typical gender role, a discomfort with their sex, or distress associated with any of the above. In addition, we sought to determine whether parental encouragement or discouragement of cross-gender behaviors influence feelings of distress in relation to the behaviors in question. Based on the cross-cultural information presented here, we conclude that the diagnostic category of GIDC should not occur in its current form in future editions of the DSM, as there is no compelling evidence that cross-gender behaviors or identities, in and of themselves, cause distress in the individual.     

Membranous glomerulonephritis: rapidly fatal course.

Adolescence is a time of life marked by emotional turbulence and turmoil, which creates problems for the adolescent, his family and society in general. The psychological development that occurs during this period can be organized into developmental tasks, which emphasize the purposefulness of adolescence. An awareness of the nine essential tasks of development can serve as a basis for assessing the appropriateness and the developmental level of adolescent behavior. The establishment of a realistic self-concept (identity) is the most basic task of adolescence. Behavioral experimentation, the process through which much of the emotional growth of adolescence occurs, also accounts for the majority of the paradoxical and perplexing actions that typify the adolescent.To be in a better position to understand today''s teenagers, the physician should not judge normality or abnormality by adult standards, but should view adolescence in reference to its own processes and purposes.     

Configuring gender: Male and female in Mexican heterosexual and homosexual relations

Mexican mestizo gender imagery is deceptively simple, represented through categorical and essentialist classifications of male and female. However, the essen‐tialist notions which ground gender as unambiguous simultaneously work so as to disrupt the seemingly unequivocal categories of male and female. This article explores the way gendered distinctions are generated by examining the interconnections between heterosexual and male homosexual gender discourses in two Mexican mestizo contexts. Particular emphasis is placed on the significance of sexuality for eliciting meanings of gender, focusing on those cultural phenomena ‐ such as motherhood, virginity, machismo, penetration ‐ which serve to constitute same‐sex relations and cross‐sex relations differently.     

2D:4D finger-length ratios in children and adults with gender identity disorder

Previous research suggests that prenatal testosterone affects the 2D:4D finger ratio in humans, and it has been speculated that prenatal testosterone also affects gender identity differentiation. If both things are true, then one would expect to find an association between the 2D:4D ratio and gender identity. We measured 2D:4D in two samples of patients with gender identity disorder (GID). In Study 1, we compared the 2D:4D ratios of 96 adult male and 51 female patients with GID to that of 90 heterosexual male and 112 heterosexual female controls. In Study 2, we compared the 2D:4D ratios of 67 boys and 34 girls with GID to that of 74 control boys and 72 control girls. In the sample of adults with GID, we classified their sexual orientation as either homosexual or non-homosexual (in relation to their birth sex) to examine whether or not there were any within-group differences as a function of sexual orientation. In the sample of adult men with GID (both homosexual and non-homosexual) and children with GID, we found no evidence of an altered 2D:4D ratio relative to same-sex controls. However, women with GID had a significantly more masculinized ratio compared to the control women. This last finding was consistent with the prediction that a variance in prenatal hormone exposure contributes to a departure from a sex-typical gender identity in women.     

Clinical implications of the organizational and activational effects of hormones

Debate on the relative contributions of nature and nurture to an individual's gender patterns, sexual orientation and gender identity are reviewed as they appeared to this observer starting from the middle of the last century. Particular attention is given to the organization-activation theory in comparison to what might be called a theory of psychosexual neutrality at birth or rearing consistency theory. The organization-activation theory posits that the nervous system of a developing fetus responds to prenatal androgens so that, at a postnatal time, it will determine how sexual behavior is manifest. How organization-activation was or was not considered among different groups and under which circumstances it is considered is basically understood from the research and comments of different investigators and clinicians. The preponderance of evidence seems to indicate that the theory of organization-activation for the development of sexual behavior is certain for non-human mammals and almost certain for humans. This article also follows up on previous clinical critiques and recommendations and makes some new suggestions.     

A gendered uprising: political representation and minority ethnic communities

This article explores the interface between gender and ethnicity in a microlevel study of a conflict which involved members of a minority ethnic community. Focusing on gender reactions to the unfolding conflict, it explores arguments raised by women in its aftermath. These arguments concern who has the right to define and represent them in public spaces in the future. The specific conflict examined took place in Bradford, UK, in 1995, and involved male Pakistani Muslim youths and the police. In the aftermath, public debate on the issue has centred on community representation in general and the role of male youth in particular. It is argued that the conflict also accelerated a process whereby Pakistani Muslim women are (re)defining intra- and inter-community relationships in the public sphere. This article affirms that the gender analysis being employed by these women to understand the events of 1995 has wider implications for the future management of plural societies, and poses a challenge to the dominance of men in creating, maintaining and managing public spaces.     

Diversity and family: an inquiry into the effects of ethnic,linguistic, and religious fractionalization on family values

This article focuses on the connection between three forms of diversity – religious, ethnic, and linguistic – and family values. The article builds on the idea that diversity challenges social identity and people react by returning to traditional family values in order to protect their social identity and the in-group culture. The paper aims at contributing to the sociological debate about the effect of diversity on social life and investigates how different types of diversity connect with traditional family values because individuals want to protect their in-group culture that is mainly transmitted within family. The paper tests the research hypotheses employing multilevel regression models and using data from the ISSP IV from 2012. Religious diversity associates with traditional attitudes regarding marriage and gender roles, ethnic diversity goes together with lower support for marriage, but has no connection with attitudes towards gender role, while linguistic diversity is not associated with attitudes family values.     

Ethical problems with the mental health evaluation standards of care for adult gender variant prospective patients

The World Professional Association for Transgender Health's "Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons" (SOC) set forth standards clinicians must meet to ensure ethical care of adequate quality. The SOC also set requirements gender variant prospective patients must meet to receive medical interventions to change their sexual characteristics to those more typical for the sex to which they were not assigned at birth. One such requirement is that mental health professionals must ascertain that prospective patients have met the SOC's eligibility and readiness criteria. This article raises two objections to this requirement: ethically obligatory considerations of the overall balance of potential harms and benefits tell against it, and it violates the principle of respect for autonomy. This requirement treats gender variant prospective patients who request medical intervention as different in kind, not merely degree, from other patient populations, as it constructs the very request as a phenomenon of incapacity. This is ethically indefensible in and of itself, but it is especially pernicious in a sociocultural and political context that already denies gender variant people full moral status.     

Zinc deficiency and growth

Zinc deficiency remains a serious health problem worldwide affecting developed as well as developing countries. Despite the evidence proving that zinc deprivation during the periods of rapid growth negatively affects the cognitive brain as well as sexual development, there are few complete studies carried out in children. The present article proposes a revision of the evidence gathered until now on the relationship existing between zinc deficiency and intellectual and sexual development during the stages of childhood, preadolescence, and adolescence. An erratum to this article is available at .     

Like one of the family: race,ethnicity, and the paradox of US national identity

The tensions between individual rights promised to US citizens and group discrimination targeted against African Americans and similar racial/ethnic groups constitute one enduring paradox of US society. This essay examines this paradox by exploring how a gendered family rhetoric contributes to understandings of race and US national identity. Using African American women's experiences as a touchstone for analysis, the article suggests that African American women's treatment as second-class citizens reflects a belief that they are 'like one of the family', that is, legally part of the US nation-state, but simultaneously subordinated within it. To investigate these relationships, the article examines 1) how intersecting social hierarchies of race and ethnicity foster racialized understandings of US national identity; 2) how the gendered rhetoric of the American family ideal naturalizes and normalizes social hierarchies; and 3) how gendered family rhetoric fosters racialized constructions of US national identity as a large national family.     

The basis of gender assignment in disorders of somatosexual differentiation

Sex assignment of patients with disorders of somatosexual differentiation is a controversial topic. The aim is to enable the patient to develop a stable gender identity during childhood, adolescence and adulthood. Enormous advances have recently been made in our knowledge of the molecular mechanisms of sexual differentiation and it is understood that long-term outcome may depend on the underlying diagnosis. There is increasing evidence that genital development is dependent on the action of androgenic steroids; moreover, both androgens and oestrogens may have an impact on other developing organs including neuronal structures such as the brain. Long-term outcome studies on the various intersexuality disorders are desperately needed in order to establish a basis for evidence-based medicine regarding sex assignment and treatment options. Premature decisions leading to irreversible interventions before an accurate diagnosis has been established must be avoided.     

The Gentle Art of Criticism

Although much has been written about professional development in general education and music education literature, little has addressed the benefits of music-making as meaningful professional development for music teachers. For music teachers, music-making and meanings of music-making have been connected with teachers' identity, well-being, beliefs, and effectiveness, as well as being a powerful pedagogical tool and a way to develop presence in teaching. Presence in teaching is linked with self-awareness, attentiveness, and pedagogical knowledge. The purpose of this article is to explore the benefits of music-making for music teachers in order to convince policymakers of the value of music-making as a professional development activity for music teachers. This article explores theories from psychology and education that link engagement, well-being, and identity to lay the foundation for a justification of broadening professional development policies. Then, literature is presented that connects teachers' art-making experiences (past and present), identity, teaching, and student learning. The third section draws on my previous work to illustrate the intersections between teachers' music-making and teaching. Then, suggestions for implementing professional development programs with music-making components are made. Although there are many ways music-making could be included as professional development, I offer four suggestions: including music-making in departmental or district-wide meetings, granting professional development credit to music teachers who make music outside of the classroom, setting up in-classroom reflection opportunities/action research based on integrating music-making and music teaching, and initiating a collaborative teacher study group that includes chamber music collaboration.     

Chto Delat'? Ethnography in the Post-Soviet Cultural Context

The article takes up issues of doing ethnography in the post-Soviet context. Exploring some of the pressing questions revolving around post-Soviet ethnography such as nationalism and identity, it also touches on problems of gender and sexuality. This article is offered as an overview of challenges to post-Soviet ethnography and intends to furnish new ideas for anthropological studies in the post-Soviet context.     

A Critique of the Gender Recognition Act 2004

This article critiques recent UK transgender law reform. The Gender Recognition Act 2004 is to be welcomed in many respects. Formerly one of the European states most resistant to social change in this area, the UK now occupies pole position among progressive states willing to legally recognise the sex claims of transgender people. This is because the UK is, at least ostensibly, the first state to recognise sex claims irrespective of whether applicants have undertaken any surgical procedures or had hormonal treatments. The article highlights the significance of this development through providing an overview of the trajectory of common law reform around the world. The legislation clearly benefits transgender people unable to undertake surgery due to financial reasons and/or medical contra-indications. It also benefits transgender people whose search for harmony does not require surgical intervention. However, the Act also perpetuates a mental illness model for understanding transgender desires; contributes to the break-up of legally recognised marriages; insists on the permanence of gender crossings and assumes that surgery will occur. The Act also contains exceptions to the generality of legal recognition provided by the state. In this respect the article considers concessions to religious and sporting lobbies. Finally, the article highlights how non-disclosure of gender history prior to a marriage assumes a kind of legal significance under the Act which non-disclosure of other facts generally lacks in relation to marriage. In this regard, the article will contend that a biological understanding of sex operates as a subtext within the Act.     

Pour en revenir à la masculinisation de statues-menhirs féminines du Rouergue

The literature regards the statues-menhirs from the Rouergue and the Haut-Languedoc as being predominantly male. When they have been the object of a gender change, the operation is always perceived as being a transformation from male effigies into female effigies. This interpretation postulates an initial male pre-eminence. However, in a previous article, this point of view seemed hardly constitute a general rule (Peeters, 2005). In the light of the statues-menhirs that have been discovered since, we have resumed the reading of the modified statues, as well as the quantitative approach of the groups and of the attributes, from the data updated and collated by M. Maillé (2010).     

Evidence Supporting the Biologic Nature of Gender Identity1

ObjectiveTo review current literature that supports a biologic basis of gender identity.MethodsA traditional literature review.ResultsEvidence that there is a biologic basis for gender identity primarily involves (1) data on gender identity in patients with disorders of sex development (DSDs, also known as differences of sex development) along with (2) neuroanatomical differences associated with gender identity.ConclusionsAlthough the mechanisms remain to be determined, there is strong support in the literature for a biologic basis of gender identity. (Endocr Pract. 2015;21: 199-204)     

Monoamine oxidase A polymorphism moderates stability of attention problems and susceptibility to life stress during adolescence

Attention problems affect a substantial number of children and adolescents and are predictive of academic underachievement and lower global adaptive functioning. Considerable variability has been observed with regard to the individual development of attention problems over time. In particular, the period of adolescence is characterized by substantial maturation of executive functioning including attentional processing, with the influence of genetic and environmental factors on individual trajectories not yet well understood. In the present investigation, we evaluated whether the monoamine oxidase A functional promoter polymorphism, MAOA‐LPR, plays a role in determining continuity of parent‐rated attention problems during adolescence. At the same time, a potential effect of severe life events (SLEs) was taken into account. A multi‐group path analysis was used in a sample of 234 adolescents (149 males, 85 females) who took part in an epidemiological cohort study at the ages of 11 and 15 years. Attention problems during early adolescence were found to be a strong predictor of attention problems in middle adolescence. However, in carriers of the MAOA‐LPR low‐activity variant (MAOA‐L), stability was found to be significantly higher than in carriers of the high‐activity variant (MAOA‐H). Additionally, only in MAOA‐L carriers did SLEs during adolescence significantly impact on attention problems at the age of 15 years, implying a possible gene × environment interaction. To conclude, we found evidence that attention problems during adolescence in carriers of the MAOA‐L allele are particularly stable and malleable to life stressors. The present results underline the usefulness of applying a more dynamic GxE perspective.