Behavioral Treatment of Deviant Sex-Role Behaviors in a Male Child

• Study Overview

  • Investigated behavioral treatment of severe feminine behaviors in a male child diagnosed with "childhood cross-gender identity".

  • The child's history included:

  • Cross-gender clothing preferences

  • Feminine mannerisms and voice inflection

  • Desire to be a girl

• Treatment Method

  • Conducted in clinic and home settings by the child's mother, who was trained as his therapist.

  • Used reinforcement to encourage masculine behavior and extinguish feminine behavior via:

  • Social reinforcement (praise) in the clinic

  • Token reinforcement at home (reward system)

• Key Findings

  • Feminine behaviors significantly decreased while masculine behaviors increased.

  • Treatment effects were mostly context-specific; thus, reinforcement of multiple behaviors was necessary.

  • Follow-up three years later showed that the boy's sex-typed behaviors had normalized, suggesting long-term effectiveness of the treatment.

• Clinical Implications

  • Early intervention may prevent severe adult transsexualism or other sexual identity issues.

  • The need to treat supra-contexts, suggests that systemic family involvement and environmental changes are crucial for effective therapy.

The study investigated the behavioral treatment of severe feminine behaviors in a male child diagnosed with "childhood cross-gender identity." The child's history included cross-gender clothing preferences, feminine mannerisms and voice inflection, and a desire to be a girl. The treatment was conducted in both clinic and home settings by the child’s mother, who was trained as his therapist. She used reinforcement to encourage masculine behavior and extinguish feminine behavior via social reinforcement (praise) in the clinic and token reinforcement at home (reward system).

Key findings revealed that feminine behaviors significantly decreased while masculine behaviors increased. However, the treatment effects were mostly context-specific, indicating that reinforcement of multiple behaviors was necessary. A follow-up three years later showed that the boy’s sex-typed behaviors had normalized, suggesting the long-term effectiveness of the treatment.

The clinical implications of this study highlight that early intervention may prevent severe adult transsexualism or other sexual identity issues. Furthermore, the need to treat supra-contexts suggests that systemic family involvement and environmental changes are crucial for effective therapy.