Atypical gender development

• Gender dysphoria


  Used to describe when a person experiences discomfort or distress because there is a mismatch between their sex assigned at birth and their gender identity.
• Brain sex theory of atypical gender development

  • Suggests that gender dysphoria has a basis in the brain structure- the bed nucleus of the stria terminalis.
  • People with gender dysphoria have a BST which is the size of the gender they identify with.
• What is the BST (bed nucleus stria terminalis) responsible for?

  • Emotional responses and male sexual behaviour in rats.
• What sex is the BST bigger?

  • The area is larger in men compared to women and has been found to be female-sized in transgender females.
• Research support for size of BST

  • People having the same size BST as the gender they identify with.
  • Zhou et al, people who are transgender feel from early childhood that they were born in the wrong sex.
  • Kruijver et al, 6 transgender individuals showed an average BST neuron number in the female range.
• Genetic explanations of atypical gender development

  • Coolidge et al, assessed 157 twin pairs. Found 62% of the variance could be accounted for by genetic factors. Suggests that there is a strong heritable component to gender dysphoria.
  • Heylens et al, compared 23 MZ twins with 21 DZ twins where one of each pair was diagnosed with gender dysphoria. 39% concordance in MZ twins compared to none in DZ twins.
• Other brain differences associated with atypical gender development

  • Rametti et al studied another dimorphic area of the brain, the white matter. There are regional differences in the proportion of white matter in male and female brains.
  • They analysed the brains of both male and female transgender individuals before they began hormone treatment as part of gender reassignment. White matter corresponded to the gender the person identified themselves as being rather their biological sex.
  • Early differences in the brains of transgender individuals .
• Contradictory evidence

  • Hulshoff Pol et al, studied changes in transgender individuals brains using MRI scans during hormone treatment. Transgender hormone therapy affects the size of the BST.
  • In the studies by Kruijver et al and Zhou’s et al, BST was examined post-mortem and after transgender individuals received hormone treatment during gender reassignment treatment.
  • Observed differences in the BST are a consequence of hormone therapy not because of gender dysphoria.
• Biological- socially sensitive research

  • Suggesting a biological basis to gender dysphoria offers a relief for some individuals.
  • Classifying GD as a medical category requiring treatment removes responsibility from the person, so less likely to assume it is there fault.
  • However others object to the labelling of a mental disorder. Such label risks stigmatising those who are subject to it, characterising them as ill or sick. They may be subject to prejudice or discrimination.
  • Research into GD shapes the way society sees the label. So clinicians should avoid reinforcing damaging stereotypes
• Social explanations of atypical gender development

  • For individuals who experience gender dysphoria, the gender confusion arises because society forces people to be either a man or women.
  • Social constructionism argue that gender dysphoria occurs when people are required to choose one of two particular paths.
• Research support for social explanations of atypical gender development- McClintock

  • References to cases of individuals with a genetic condition in the Sambia of New Guinea.
  • This causes some biological males to be categorised as girls at birth because they have labia and clitoris.
  • At puberty, genitals change due to an increase in testosterone
  • This genetic variation is common in Sambia, as it was accepted some people are men some are women and some are females then males.
  • Since this culture has had contact with other cultures kwolu-aatmwol are now judged as having gender dysphoria.
• Social explanations of gender dysphoria

  • Social constructionism
  • Psychoanalytic theory
• Psychoanalytic theory

  • Ovesey and Person emphasis social relationships within the family as a cause of gender dysphoria.
  • GD in biological males is caused by a boy experiencing separation anxiety before gender identity has been established.
  • Boy fantasises a symbiotic fusion with his mother to relive anxiety and the danger of separation is removed.
  • Consequence is that the boy become the mother and adopts the woman’s gender identity.
• Research support for psychoanalytic theory

  • Stroller
  • Reported that in interviews GD biological males displayed overly close relationships with their mothers suggesting a stronger female identification and conflicted gender identity in the long-term.
• Social constructionism- useful because not all cultures have 2 genders

  • For example, the fa’afafine of Samoa and Hijras in India/
  • Challenges traditional binary classification as male and female.
  • Additionally, due to increasing numbers of people now describing themselves as non-binary, it suggests that cultural understanding is now beginning to catch up with the lived experience of many.
  • This suggests that gender identity and dysphoria is best seen as a social construction rather than a biological fact.
• Fa’afafine of Samoa

  • A third gender for those who fall outside of the classification of male or female
  • Biological males who adopt the traditional gender role of women are known for their hard work in domestic settings and caring for family
  • They may have sexual relations with non-fa’afafine men but are not considered to be gay.
• Issues associated with psychoanalytic theory

  • Overseys and person’s explanation does not provide an adequate account of gender dysphoria in biological females as the theory only applied to transgender females.
  • Rekers said that GD in biological males is more likely to be associated with the absence of the father than the fear of separation from the mother.
  • The psychoanalytic theory doesn’t therefore provide a comprehensive account of GD as it does not acknowledge the role of both parents in the development of GD.
• GD may not be a long-term condition

  • Some people with GD decide to have gender reassignment surgery.
  • Such treatment is available on the NHS or through private healthcare. With support those individuals are able to reconcile their external appearance with the gender they identify with.
  • However, Drummond et al followed a sample of 25 girls diagnosed with GD. Only 12% were still classified as having GD at 24 years old.
  • So gender reassignment surgery before the age of consent must be carefully managed.