Ch 5 - Gender and Gender Identity

Intro

• sex and gender have very different meanings and refer to separate aspects of the self.

• Sex is the term we use to categorize whether

  someone is biologically male or female. There are 3 different dimensions of sex: chromosomes, gonads, and hormones.

• gender is a psychosocial term

  that encapsulates all of the psychological, cultural, and social characteristics we think of as belonging

  to men and women. Thus, gender refers to our set of expectations about what makes someone

  masculine or feminine.

• Gender identity refers to an individual’s own psychological perception of being male or female.

  Although people’s gender identity is usually consistent with their biological sex, this is not always

  the case. Thus, someone with a biological sex of male could identify as female and vice versa. This is a form of transgenderism.

• Gender roles refer to a set of cultural norms or rules that dictate how people of a specific sex

  “should” behave. Gender roles create a set of expectations for the things that men and women are

  supposed to believe and how they are supposed to act.

• Closely related to gender roles are gender stereotypes, which refer to overgeneralized beliefs

  about the qualities and characteristics of men and women. Stereotypes about gender fall along

  several dimensions, including psychological traits, role behaviors, and occupations.

Biological Influences on Gender Identity and Sexuality

• Our biological sex is a function of three separate components: our chromosomes, gonads, and

  hormone levels. These factors work together to differentiate the bodies and brains of biological

  males and females.

• Chromosomal sex refers to the specific combination of sex chromosomes

  contained within our genes. Chromosomal sex is determined at the moment of conception

  (i.e., when a sperm cell fertilizes an egg). Typically, egg cells carry a single X-chromosome, while

  sperm cells carry either a single X- or Y-chromosome. If the resulting combination is XX, fetal

  development will proceed toward the female form; if the resulting combination is XY, development

  will proceed toward the male form.

• Gonadal sex refers to the specific gonads (i.e., ovaries vs. testes) present within the body. The

  gonads begin to develop in response to genetic signals approximately six weeks after conception. Once developed, the gonads begin releasing sex hormones.

• Hormonal sex refers to the major

  class of hormones released by the gonads: estrogens (primarily released by the ovaries) or androgens

  (primarily released by the testes). Men and women both produce a

  certain amount of each of these sex hormones, but the female body produces far more estrogens,

  while the male body produces far more androgens. As a fetus is developing, it is the presence or

  absence of these hormones that differentiates the internal and external sexual structures of the male and female body.

• In addition to influencing development of the internal and external genital structures, hormones

  have a profound effect on how our brains develop in utero. Specifically, hormones can

  masculinize or feminize the brain before birth in such a way that it creates lifelong effects on our

  gender identity and sexual behavior.

• Compelling evidence demonstrating some of these effects

  comes from studies of rats, which have shown that changing early hormone exposure affects

  adult rats’ sexual interests and behavior. Scientists have tested this by castrating male rat pups

  immediately after birth and exposing female rat pups to testosterone immediately after birth.

  This is equivalent to changing hormone exposure prenatally in humans, because rats are born at

  a much earlier stage of development than we are. Researchers have found that castrated male rats

  tend to show feminine sexual behavior through their lives.

  Specifically, when mounted by an intact (i.e., noncastrated) male rat, a castrated male rat will

  exhibit lordosis, a sexual posture that occurs naturally in female rats in which the back curves

  upward to assist in copulation. This effect persists even if the castrated rat is given testosterone

  injections later in life; however, if testosterone is administered within the first week after castration,

  lordosis behavior is unlikely to develop. The female rats who are given testosterone injections typically exhibit masculine

  behavior throughout their lives. That is, testosterone-injected

  females will attempt to mount other rats, and when they themselves are mounted, they do not

  exhibit lordosis; in fact, these rats seem rather indifferent to such sexual advances. Taken together,

  these findings indicate that, at least in animal studies, there appears to be a critical period of development

  during which hormones “wire” the brain for sexual behavior.

• One especially important area of the brain that appears to be affected by prenatal hormone

  exposure is the hypothalamus. The hypothalamus is a

  portion

  of the limbic system located deep within the brain that plays an important role in regulating

  sexual behavior, among many other things. One portion of the hypothalamus in which there

  are reliable sex differences is the preoptic area (POA), which tends to be larger in adult men than

  adult women. Rat studies have found that the POA controls copulatory

  behavior and that it undergoes a critical period, such that testosterone

  injections only affect its size until the fifth day after birth; injections beyond that have no effect on

  POA size. Another portion of the hypothalamus that differs

  between men and women is the bed nucleus of the stria terminalis (BNST). The BNST tends to be

  larger in men, perhaps also as a result of specific hormone exposure at

  certain stages of development. Research in humans suggests that size of the BNST is related to

  gender identity. Specifically, the number of neurons present in the BNST of male-to-female transsexuals

  more closely resembles the number found in biological females than biological males,

  while the size of the BNST of female-to-male transsexuals more closely resembles biological males

  than biological females. This suggests that early hormonal exposure may

  potentially organize the brain toward a specific gender.

• chromosomes, gonads, and hormones are all linked to the development of our

  sexual and gender identities. In order to develop typical male and female bodies, brains, and

  behaviors, all of these factors must work together and build on each other in a very specific

  sequence. If anything falls out of that sequence, the end result can be very different.

• intersexuality results when things do not unfold according to the typical male or female schedule

Biological Sex Variations

• Although most people think of biological sex as having two categories (i.e., male and female), the

  reality is that sex is much more complex. There are several variations on sex because some people

  are born with bodies and genitals that do not appear completely male or female, but rather have

  features of both. A person who possesses both male and female biological traits is intersexed.

  Although you may hear some intersexed individuals referred to as hermaphrodites, that term is

  generally not used anymore because it is considered outdated, offensive, and inaccurate. You may

  also see other sexuality texts refer to intersexed individuals as having “ambiguous” genitalia

  because their genitals appear to be somewhere in between a penis and a vagina; however, keep in

  mind that any ambiguity is on the part of the perceiver. To intersexed persons, there is nothing

  “ambiguous” about what is between their legs.

• Being intersexed is more common than most people realize. The prevalence of specific sex

  variations

  differs, but overall, intersexed individuals represent approximately 2% of live births. So much of what we know about the impact of biology on gender and

  sexuality comes from research on these individuals because they can tell us what effect chromosomes,

  gonads, and hormones likely have in relation to gender identity and sexual expression.

• Klinefelter’s Syndrome

  • Klinefelter’s syndrome is one of the most common sex variations, occurring once in every 1,000

    male births. It results when a Y-carrying sperm fertilizes an egg that possesses

    two X-chromosomes. Although they possess both the typical male (XY) and female (XX)

    chromosome combinations, individuals with Klinefelter’s syndrome are anatomically male in

    terms of their genital appearance, but their testes are usually smaller than average and sperm production

    tends to be very low. In addition, their bodies often have feminized features, including

    increased breast tissue and a rounded body shape.

  • With respect to gender, individuals with Klinefelter’s syndrome tend to identify as male,

    although some adopt other identities. In terms of sexuality,

    same-gender attraction is no more common among Klinefelter’s males than it is among biological

    (i.e., XY) males; however, overall interest in sex tends to be low. Testosterone injections can enhance sexual desire and increase masculinization of the body among those who

    wish to pursue hormone treatment.

• Turner’s Syndrome

  • Turner’s syndrome is a less common sexual variation in which an individual is born with a single

    X chromosome. In such cases, the second sex chromosome is missing or damaged. Individuals

    with Turner’s syndrome have a feminine body appearance, although they tend to be shorter than

    average and typically have little breast development. External genitals appear feminine,

    but internally the ovaries are underdeveloped and may only appear as streaks of tissue, which

    means that menstruation does not occur at puberty and sexual reproduction is not possible.

  • Individuals with Turner’s syndrome usually identify as female and tend to have feminine interests. Turner’s syndrome is not linked to same-gender attraction. Many of these women go on to lead active sex lives; however,

    the age at which puberty is induced via hormone injections (a necessity because no ovaries are

    present) has an important effect on how their sexuality develops, and it is important that physicians do not delay its induction too long

• Androgen Insensitivity Syndrome (AIS)

  • Androgen Insensitivity Syndrome (AIS) occurs when a biologically male fetus is insensitive to

    the production of its own androgens. As a result, despite possessing the XY chromosome combination,

    testes, and high levels of masculinizing hormones, the end result is a body and genitals

    that have a feminine appearance. AIS can be either complete or partial. In cases of complete AIS, the child appears to be a typical female at birth and

    has a shallow vagina. A diagnosis of AIS is generally not made until adolescence when there is a

    failure to menstruate, although it may be detected earlier if an undescended testicle appears as a

    mass in the groin or abdomen. Individuals with complete AIS are usually raised as girls and

    almost always adopt a female gender identity. As adults, most become sexually

    active and the vast majority report sexual attraction to men.

  • labels are difficult to apply in these cases. For example,

    a person with complete AIS is technically a biological male with a (usually) female gender identity.

  • Partial AIS usually results in an incomplete masculinization of the genitalia. Consequently, a

    child with partial AIS may possess genitals that are not clearly identifiable as male or female. In

    some cases, a penis does clearly develop, but the urethral opening may appear on the underside of

    the penis near the corona rather than at the tip of the glans (a physical variation known as hypospadias. Doctors and parents are often confused about how

    to raise children with partial AIS. A gender is usually “assigned” to the child and in some cases, the

    child’s genitals may be surgically altered to remove any perceived “ambiguity.” Gender identity and sexuality is more variable in cases of partial AIS. For example, while it is possible to

    identify as male and be attracted to women, other identities and

    patterns of attraction are possible.

• 5-Alpha-Reductase Deficiency (5αRD)

  • Related to AIS is 5-alpha-reductase deficiency (5αRD). This occurs when a biologically male

    fetus is unable to convert testosterone into dihydrotestosterone (DHT) due to insufficient levels of

    the 5-alpha reductase enzyme. DHT is necessary for the development of male external genital

    structures. Thus, without DHT (or with levels lower than usual), the end result is a feminized genital

    appearance. Depending upon the amount of feminization, external appearance may be completely

    female, a mix of male and female structures, or incomplete male. Regardless of external

    appearance, however, male gonads are present internally.

  • In most cases, babies with 5αRD are raised as girls and adopt a female gender identity during

    childhood. However, upon reaching puberty, testosterone production ramps up and their bodies

    start to become more masculine. Specifically, the testes usually descend, the genital structures

    begin to grow into a small penis, and male secondary sex characteristics develop (e.g., chest and facial hair, deepening of the voice, etc.). At this point, most individuals with 5αRD switch from a

    female to male gender identity. Those who switch to a male identity are

    usually sexually interested in women. Men

    with 5αRD may be capable of penetrative intercourse and produce viable sperm, but this varies across persons.

• Congenital Adrenal Hyperplasia (CAH)

  • Congenital adrenal hyperplasia (CAH) occurs when a person’s adrenal glands produce

    excessive amounts of androgens from before birth throughout the individual’s life. This can

    happen in both men and women. In affected men, physical and psychological development

    follows the typical male pattern. However, affected women become more masculine both

    physically and psychologically. At birth, a female child with CAH will have genitals that appear

    to be either partially or (in some cases) completely masculine, although internally, female gonads are present.

  • Most biological females with CAH end up adopting a female gender identity; however, they

    tend to have interests that are more typical for men. For example, they express more interest in working with things (e.g., in areas like

    technology) than in working with people. In terms of

    sexuality, most females with CAH report attraction to men, but some studies have found higher

    rates of same-gender attraction and bisexual orientations.

• What Do These Biological Sex Variations Tell Us About Gender Identity?

  • Together, all of these sexual variations tell us that biology and genetics play an undisputable role

    in the development of both gender identity and sexuality.

  • it should be clear that when biological

    events do not follow the typical male or female pattern, it is not always easy to predict the

    identity a person will adopt later in life.

  • out of all of the potential biological variables,

    prenatal sex hormone exposure may be the most important of all. For example, in both 5αRD and

    AIS, we have biological males with XY chromosomes and testes whose bodies do not get the full

    effect of androgen exposure. However, one of these cases usually results in a female identity (AIS)

    and the other in a male identity (5αRD). This is perhaps because in AIS, the entire body (including

    the brain) is not responsive to androgens, which means the brain never has an opportunity to

    become masculinized. In contrast, in 5αRD, the lack of DHT prevents external genital masculinization,

    but does not necessarily preclude masculinization of the brain. Thus, it may be the impact

    of hormones on the brain that explains why these sexual variations typically result in different

    gender identities. CAH also highlights the important role that prenatal hormones may play in

    organizing the brain toward a certain gender by showing that greater androgen exposure in

    women is linked to more masculine interests.

  • At the same time, however, these sexual variations also do not tell the entire story. For example,

    in the case of Turner’s syndrome, we see that a female gender identity can develop in the

    absence of a second sex chromosome, ovaries, and female sex hormones. Likewise, in the case of

    5αRD, it would appear that a female gender identity can be learned at least temporarily during

    childhood. Thus, there would certainly seem to be room for psychosocial factors to contribute to the development of gender.

Psychosocial Influences on Gender Identity and Sexuality

• In the absence of physical and environmental cues that “announce” a child’s sex (e.g., wearing the

  color pink versus the color blue), it is difficult to answer this question with any degree of certainty.

• there are a vast number of social factors that teach us about our gender

  identity and gender role at a very young age. These same factors then encourage us to conform to

  a very specific set of gendered expectations throughout our lives.

Social Interactions and Norms

• Social interactions are among the first things to shape our perceptions of gender, and interactions

  with our parents in particular are among the most influential. A child’s gender is seemingly

  very important to parents, given how “it’s a boy” and “it’s a girl” is often announced and

  celebrated before a child ever even comes into the world. If you have taken a course in developmental

  psychology, you probably already know that from the moment a child is born, the

  way parents interact with that child is completely different depending upon whether it is a boy

  or a girl.

• As some particularly compelling evidence of this, dozens of studies have been conducted

  in which adult men and women were given the opportunity to interact with an infant

  that was presented as either male or female . In reality, all adults were interacting with the same infant. Researchers

  found that infants presented as male and female were often (but not always) treated differently and these differences usually fell along very sex-stereotypic lines. For example, adults verbalized

  more and engaged in more nurturing play when the child was perceived to be a girl compared

  to a boy. Likewise, adults tended to choose dolls and other feminine toys when playing with

  girls, but trucks and tools when playing with boys. Thus, the simple knowledge of a child’s sex

  appears to prompt a set of beliefs about gender-appropriate behaviors and traits that can creep

  into social interactions, sometimes completely outside of conscious awareness (Rubin,

  Provenzano, & Luria, 1974). This may lead children to engage in gender-stereotypic behavior

  through a self-fulfilling prophecy in which parents’ expectations elicit and reinforce gendered

  behavior, effectively making gender stereotypes come true. Of course, in an age where more

  mothers are in the workplace and more fathers are becoming stay-at-home dads, things are

  changing somewhat, and there are certainly many parents who make a concerted effort not to

  teach their kids strict gender roles. However, gendered expectations for children persist, and

  they are often conveyed subconsciously.

• Beyond parents, social interactions that occur in school with peers and teachers further reinforce

  these ideas about gender. For example, gender-segregated play begins very quickly in childhood

  and continues through adolescence. This means that boys typically play with other boys,

  and girls with other girls. Children who violate this norm are often looked down upon and have

  a hard time fitting in. Research shows that the more time children spend in sex-segregated play, the more gendertyped

  their behaviors become (e.g., girls playing “house” and boys playing superhero games.

• Teachers play a vital role in reinforcing societal and cultural gender expectations among students.

  For example, teachers tend to be more tolerant of bad behavior in boys than in girls, and

  they tend to give boys more attention). Teachers also harbor stereotypes

  about the academic abilities of the sexes, such as believing that math comes easier to boys. This can have important implications for students’ academic

  outcomes and ultimately their chosen career paths. Research has found that teachers’ beliefs about

  their students’ abilities subtly and unintentionally affects how well students do in school (e.g.,

  some students may be given more time and attention than others.

  This is essentially another self-fulfilling prophecy taking place. Also, to the extent that teachers

  subtly encourage mathematical and science abilities in their male students but not in female students,

  it may lead fewer women to pursue careers in these areas because they do not have the

  opportunity to develop their skills to the same level. Teacher expectations may contribute to stereotype

  threat as well, in which reminding women about the stereotype that females are not as good

  at math creates anxiety that distracts them and contributes to worse performance on mathematical tests.

• Socialization within religious contexts further reinforces gender role beliefs. The writings and

  teachings of many religious traditions propagate themes of male dominance and female submissiveness.

  Likewise, many religions do not permit women to serve as clergy or in leadership roles,

  which can send a very visible and powerful statement that men are the ones in charge. Consistent

  with this idea, research finds that religiosity is typically a strong predictor of holding traditional gender-role attitudes.

Physical Environments

• The physical environment in which we grow up can have a profound influence on our gender role

  beliefs. For instance, what is your earliest memory of what your bedroom looked like as a child? If

  you do not remember, try to track down a picture of your room and see what sort of gendered

  cues it contained. Probably, many of you will find that your room was blue (if you are male) or pink (if you are female). You will probably also see that the clothes you wore and the selection of

  toys at your disposal was fairly typical for your gender. Speaking of toys, check out the toy section

  the next time you are in a big store. You will likely notice that the store has made it glaringly obvious

  which aisles are meant for boys and which are meant for girls. As a child walking down the toy

  aisle designated for your gender, you are told in a not-so-subtle way what your likes and interests

  “should” be. At the same time, these toy aisles put pressure on parents to select gender-appropriate gifts for their children.

Media

• the media plays a part in conveying gender role information to children.

  By the time most students graduate from high school, they will have spent more hours

  watching TV than they spent at school. When you factor in time spent on the Internet, at the movies, playing video games,

  and listening to music, there is simply no comparison for the amount of influence the media

  has. When it comes to sex and gender, the media tends to present men and women in highly

  gender-stereotyped ways.

• These stereotypical portrayals do not go unnoticed

  by children and adolescents either. For example, studies have found that holding more

  traditional gender-role beliefs is associated with more frequent watching of music videos and toy commercials in children and adolescents.

• gender-role information and expectations are conveyed to us from the moment

  we come into being through a number of different sources. Repeated exposure to these ideas leads us to internalize these gendered beliefs, which then become self-perpetuating. However, despite

  the amount of pressure exerted by these sources to conform to a specific gender identity and role,

  not everyone follows their socially prescribed role. This often happens for intersexed individuals,

  but it also happens for persons who are transgendered.

Variations in Gender Expression

• The general term for someone whose behaviors or physical appearance is not consistent

  with societal gender roles is transgender. In other words, a transgendered person does not

  conform to ideas of what men and women are “supposed” to be. Transgender is a broad

  umbrella term that encompasses different forms of gender role nonconformity.

• two of the most common transgender variants: transsexualism and

  cross-dressing (i.e., transvestism).

Transsexualism

• A transsexual is someone whose gender identity does not match their biological sex. The

  clinical term for this is gender dysphoria, which refers to unhappiness and discomfort that

  stems from an incongruence between one’s physical sex and one’s psychological gender identity.

  Thus, a male-to-female (MTF) transsexual is someone who is born male but perceives

  herself as female, whereas a female-to-male (FTM) transsexual is born female but perceives himself as male.

• Up through the DSM-IV-TR, an entry called gender

  identity disorder (GID) was listed. In the DSM-5, published in 2013, although the diagnostic criteria

  remained similar, the GID name was replaced with “gender dysphoria,” which is now diagnosed according to the following criteria:

  • Incongruity between one’s expressed gender and one’s physical characteristics.

  • A desire to get rid of one’s primary and secondary sex characteristics, and to have the primary and secondary sex characteristics of the other sex.

  • A desire to be the other sex and be treated as such.

  • A belief that one’s feelings and behaviors are typical of the other sex.

  • Clinically significant distress or impairment in addition to feelings of incongruence. Gender dysphoria is not considered a clinical problem unless the patient is distressed.

• Although transsexualism is no longer called a “disorder,” the fact that a diagnostic label still exists

  is highly controversial among professionals in the field and transsexuals themselves. For one thing, many people believe that including transsexualism in the DSM

  serves to stigmatize this community. Additionally, the primary treatments for GID are sex reassignment

  surgery (in adults) and puberty-blocking drugs (in adolescents). However, these are not psychiatric

  treatments, and this, some have argued, calls into question whether this should even be

  thought of as a psychological disorder Moreover, many transsexual persons are

  not distressed because of their identity, and being transsexual does not necessarily prevent one

  from leading a normal life. On the other hand, some argue that a diagnostic category is valuable in

  that it offers the opportunity for health insurance coverage for treatment, guides research in the

  area, and prevents transsexuals from being misdiagnosed with other labels.

• We do not have a good sense of how common transsexualism is, because relatively little research

  has explored this topic and many transsexuals attempt to keep their identity hidden as a result of

  widespread prejudice and discrimination. What little research does exist suggests that transsexualism

  is less common than intersexuality and that MTF transsexuals far outnumber FTM transsexuals.

• The origin of transsexualism is not well understood, but current research suggests that it has a

  neurological basis and may be tied to prenatal hormone exposure.

  Transsexualism is not linked to any kind of chromosomal or physical anomalies, nor is it linked to

  general psychopathology. We also know that most transsexuals begin identifying with the other

  sex at a very young age, usually well before any feelings of sexual attraction develop.

• Studies have typically found that a majority of FTM transsexuals report attraction to women, while a majority of MTF transsexuals report attraction to me. Thus, most transsexuals appear to be attracted to people

  who match their biological sex, not people who match their gender identity. However, keep in

  mind that the transsexual community is incredibly diverse, and patterns of sexual attraction and

  sexuality labels vary widely. This means that FTM and MTF transsexuals can be attracted to men

  or to women, they can be bisexual, they can have sexual interests outside of the traditional gender

  binary, or they can be asexual (i.e., lacking in sexual interest). Most transsexuals define their sexual

  orientation in relation to their gender identity and not their biological sex. This means that a MTF

  who is attracted to men would likely think of herself as heterosexual, while a FTM who is attracted

  to men would likely consider himself gay.

• Options for Transsexual Adults

  • the primary treatments offered to transsexuals are not

    psychiatric in nature. In fact, providing psychotherapy alone as a way of relieving the distress that

    many transsexuals experience is generally ineffective. As a result of significant medical advances,

    biological alterations are increasingly being pursued by transsexuals to bring their body in line with their gender identity.

  • For transsexual adults, the primary way of accomplishing this is through sex reassignment surgery. Contrary to popular belief, it is not possible to simply walk into a doctor’s office and ask

    for sex reassignment. There is usually a lengthy prequalification process that consists of (1) psychological

    evaluations and interviews to determine the individual’s motivations and identify potential

    conflicts; (2) a transition period of up to one year where the patient lives as a member of the other

    sex for all intents and purposes; and (3) hormone therapy to begin adjusting the patient’s body to

    more closely match the desired sex (e.g., MTF transsexuals would be given estrogen to reduce

    body hair and stimulate breast growth, while FTM transsexuals would be given testosterone to increase growth of body and facial hair and halt menstruation). Genital surgery is only performed after all of the preceding criteria have been met.

  • For MTF transsexuals, the main surgical process involves removing the penis and scrotum and

    reusing the skin to create a functional vagina with labia (vaginoplasty). In this surgery, the urethra

    is rerouted to permit urination as a biological female would experience it. Surgical procedures

    such as breast implants, Adam’s apple reduction, and voice box operations (to raise voice pitch)

    may also be performed, depending upon the patient’s wishes.

  • For FTM transsexuals, the surgical process usually includes a complete hysterectomy (i.e., removal

    of the ovaries, fallopian tubes, and uterus) and mastectomy (i.e., removal of the breasts). Genital

    reassignment can be accomplished in one of two ways. One possibility is a metoidioplasty, in which the clitoris is turned into an erectile phallus. Specifically, the

    clitoris is straightened and lengthened, moved slightly to approximate the location of a typical

    male penis, and the urethra is routed through it. Because the clitoris is homologous to the penis

    and contains actual erectile tissue, the result is a phallus capable of erection through sexual stimulation.

    However, the size of the phallus may not be sufficient for penetrative intercourse because

    it is only a few centimeters long. If a larger phallus is desired, a phalloplasty may be performed

    instead in which skin taken from other parts of the body is transplanted to the genital area to create

    a functional penis with the urethra running through it. Although the end result is much

    larger with a phalloplasty, these phalluses are not capable of erection on their own because they

    contain no erectile tissue. As a result, a penile implant must be inserted. In both metoidioplasty and phalloplasty, the labia are usually sutured

    together to create a scrotum, and testicular implants may be inserted.

  • In both FTM and MTF surgeries, the original sensory pathways in the genital region are retained

    and reused as much as possible to maximize the ability to be sexually responsive afterward. Indeed,

    orgasm is often possible after such surgeries. However,

    the ability to orgasm usually declines among MTF transsexuals, but increases among FTM

    transsexuals. One caveat to this is that FTM transsexuals given metoidioplasty tend to have more

    orgasmic capacity afterward than those given phalloplasty, because metoidioplasty retains more of the original nerve pathways.

  • The outcomes of sex reassignment surgery are generally favorable. Genital surgeries can produce

    results that are not only functional, but appear very physically accurate, which helps to

    explain why levels of satisfaction are generally very high post-surgery.

    Even in cases where orgasmic capacity is lost or declines, sexual satisfaction is usually still higher after surgery than it was before.

• Options for Transsexual Children

  • Transsexuality is increasingly being recognized in children by parents and doctors alike. For transsexual

    children who have not yet gone through puberty, there has been a growing trend to administer

    puberty-blocking drugs, medications that halt the development of secondary sex characteristics. In FTM boys, these drugs inhibit breast development, increase height and muscularity,

    and prevent menstruation. In MTF girls, these drugs inhibit growth of facial and body hair,

    restrict growth of the Adam’s apple, and maintain a higher pitch voice. In effect, these drugs

    prevent bodily changes that can be difficult to adjust surgically once puberty has taken place.

    Puberty blockers are taken until about age 16, when the individual begins taking hormones of

    the desired sex. If desired, genital surgery can follow once the individual reaches adulthood. This

    treatment approach is new, with puberty blockers having been administered only since 2004. It is

    also highly controversial, with some questioning whether children can truly comprehend the

    effects of these drugs, which produce physical changes that cannot easily be undone.

• Attitudes Toward Transsexualism

  • In most parts of the world, sex is viewed as a binary construct. That is, people tend to think that you

    can be either male or female, with nothing in between. Generally speaking, if you have a penis you

    are expected to be a man, whereas if you have a vulva you are expected to be a woman. Persons who violate these social norms are typically marginalized. Prejudice against transsexuals (known as transphobia) is very common. Transphobia

    is strongly correlated with homophobia (i.e., prejudice against nonheterosexuals), but people feel

    more negatively about transsexuals than they do about gay men, lesbians, and bisexuals. In addition, men tend to be more transphobic and homophobic than women. Due to

    the widespread prevalence of transphobia, many transsexuals attempt to keep their identity secret.

  • That said, some cultures adopt a much broader view of gender and are more accepting of persons

    who do not fit neatly into the gender binary. One example of this would be the two-spirit phenomenon

    documented in dozens of Native American tribes. The idea

    behind two-spirit is that both male and female spirits are presumed to occupy a single person’s body.

    Historically, two-spirits were respected in their tribes and in many cases were revered and held important

    social positions; however, this has changed somewhat as Christian values have crept into many

    tribes and displaced traditional beliefs. Aside from the two-spirit concept in North America, third genders exist in many other parts of the world, including India, Pakistan, and Indonesia.

Cross-Dressing

• Another subtype of transgenderism is cross-dressing. Cross-dressing is a broad term that refers to

  the act of wearing clothing typically associated with the other sex. One variant of cross-dressing is

  transvestism, which refers to the act of obtaining sexual gratification from wearing clothing of

  the other sex. However,

  not everyone who cross-dresses does so because it is a turn-on. Thus, keep in mind that while the terms “cross-dresser” and “transvestite” are overlapping, they are not synonymous. Also, please

  note that the term “transvestite” is considered offensive in some parts of the transgender community.

  The use of this term in this book is not meant to be offensive in any way and is only used to

  distinguish the subtype of cross-dressers who experience arousal as a function of their behavior.

• Aside from sexual arousal, some cross-dressers engage in this behavior for performance art.

  Examples of this would be drag kings (women who dress as men) and drag queens (men who dress

  as women), people who cross-dress primarily for entertainment or as a career. On a side note,

  although cross-dressing of this nature often seems to coincide with being gay or bisexual, this is not always the case. Heterosexuals can and do participate in drag.

Other Identities

• Transgendered persons may adopt a number of other identities beyond those already mentioned,

  although somewhat less is known about these identities from a scientific standpoint. For example,

  androgynous persons possess both masculine and feminine psychological characteristics

  simultaneously (please note that this does not necessarily imply being intersexed). Bigendered persons

  change their gender role behavior depending upon the context, moving fluidly between a

  more masculine and feminine role. Genderqueer individuals think of themselves outside of binary

  gender classifications, such as individuals who think of themselves as having a third gender or as

  being genderless. Being genderless is sometimes referred to as asexuality, although this term is

  used more commonly to represent a lack of interest in partnered sex. As you can

  see, transgender is a broad term that encompasses a multitude

  of perspectives on gender.

Just How Different Are Men and Women?

• sex differences.

• the stereotype (and very popular book of

  the same name) “Men are from Mars, Women are from Venus.” Stories about sex differences

  appear frequently in the popular media, from front page headlines, to relationship advice columns,

  to self-help books. The media is pushing the idea that men and women want fundamentally

  different things when it comes to sex and relationships, and also that men and women use

  completely different language to communicate. These ideas are selling to the tune of millions

  of books and billions of dollars.

• Although people have staked out very different

  positions on this topic, a review of research in this area makes it clear that the Mars/Venus

  analogy is a hyperbole. The reality is that while there are indisputably some differences between

  men and women, these differences are often smaller than we have been led to believe, and

  sociocultural factors offer a very plausible explanation for many of them. In other words, men

  and women are not from different planets, but they are certainly socialized very differently.

Sex Differences in Psychology

• Researchers have examined how men and women differ in many ways, including their personality,

  level of aggression, and communication style. With respect to personality, many studies have compared

  men and women in the context of The Big Five personality factors of openness to experience,

  conscientiousness, extraversion, agreeableness, and neuroticism. Generally speaking, research has yielded sex differences that are

  either inconsistent or very small for extraversion, openness to experience, and conscientiousness;

  in contrast, larger and more reliable sex differences have emerged with respect to agreeableness

  and neuroticism. Thus, the main areas men

  and women seem to differ in terms of personality concern the fact that women tend to be (1) more

  trusting and compliant, and (2) experience more anxiety and negative affect than men. Although

  we cannot say for sure why these personality differences exist, the fact that sex differences in the

  Big Five vary considerably across cultures suggests that

  such differences are a product of culture and society, not genetics.

• With respect to aggression, there has been a longstanding assumption that men are more

  aggressive than women in almost all ways, and most early research in social psychology seemed to

  support this idea. However, recent work has found that there are sex differences in certain types of

  aggression. Specifically, men are more inclined than women to aggress in very direct and physical

  ways, while women are more inclined than men to aggress in more indirect and verbal ways (e.g.,

  by spreading rumors or gossip). In addition, when you take into account

  provocation (i.e., when someone incites another person to become aggressive, such as through

  taunting), sex differences in aggression become much smaller. At

  least part of the reason that men are more aggressive overall is that they are provoked more

  often. Together, these findings suggest that men may not be genetically predisposed to be more aggressive than women; rather, it may be that society expects men and women to act out their aggression in very different ways and allows men more opportunities to be aggressive.

• Lastly, in terms of communication style, studies have found differences in terms of how men

  and women communicate verbally and nonverbally. For instance, men tend to interrupt their conversation

  partners more than women; however, the degree to which this difference is observed

  varies across different social situations, which suggests that this is a situational effect rather than a

  stable individual difference between men and women. As another

  example, women tend to be better at men in decoding the emotion behind facial expressions. Although there are numerous other studies suggesting that women have a

  greater ability to decode nonverbal cues such as this, it is not clear whether women are “hardwired”

  to pick up on others’ emotions or if this is simply a reflection of the fact that we expect women to be more sensitive to other people’s feelings than men.

Sex Differences in Sexuality and Attitudes Toward Sex

• Research has also examined how men and women differ with respect to their attitudes toward

  sex, their sexual behaviors, and their sexuality. For instance, men have more favorable attitudes

  toward “hooking-up” and are more willing to have sex with someone they have just met. In terms of sexual behaviors, a few of the biggest areas men and

  women differ include frequency of masturbation and use of pornography. Perhaps not surprisingly,

  men masturbate more, and utilize far more porn, than women. In addition, men report having a higher sex drive and more daily thoughts about sex. However, there is no truth to the common stereotype that men think

  about sex every seven seconds. Just think about it: if the average guy is awake for 16 hours and

  thinks about sex every 7 seconds, he would have 8,228 sexy thoughts per day! The reality is that

  when asked to tally their daily thoughts about sex, men average 34 sexual thoughts per day, or

  about twice per hour. In contrast, women average about 19 sexual thoughts

  per day, or just over once per hour.

• there are many possible explanations for them and they

  are not necessarily a function of men having a stronger libido than women, as many people

  assume. For instance, the evolutionary perspective argues that men and women have evolved distinct

  mating strategies due to differences in the parental investment required to create a child (i.e., it is more work for women than it is for men). One implication of this is that men should have

  more permissive attitudes toward casual sex than women because it is more reproductively advantageous

  for men to have multiple partners. In contrast, the sociocultural perspective argues that

  most sex differences are a reflection of patriarchal gender roles and a sexual double standard that

  inhibits female sexuality. As some evidence of this, survey research has found that women report

  having had more sexual partners when they think their answers will be anonymous compared to

  when they think their answers might become known to others. Not

  only does this finding highlight the important role of psychosocial factors on women’s reported

  sexual attitudes and behaviors, but it tells us that some sex differences may be overstated due to

  social pressure on women to underreport their true sexual experiences.

• One other important area men and women seem to differ is in their sexuality. Specifically,

  research suggests that women have more erotic plasticity than men. That is, female sexuality is

  more flexible and responsive to social and cultural factors than male sexuality. Evidence for this

  comes from a variety of studies indicating that (1) women become physiologically aroused to

  a wider range of sexual targets, (2) women are more

  likely to report a bisexual orientation, (3) women’s sexual

  identity is more likely to change over time, and (4) women are far less likely

  to develop fetishes or become fixated on one specific sexual object. As

  with all of the other sex differences discussed above, it is not entirely clear. However, the evidence

  seems to point to differences in how sexuality is organized in the brains of men and women.