Gender Dysphoria Gender Identity Disorder – GID

Introduction..

GID Dr Phil

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What is Gender Dysphoria... ?? …… it is a psychiatric disorder, occurring when an individual “feels” uncomfortable with their biological sex and wishes to change it. Prejudice and negative feelings of anxiety and distress can be experienced, leading to depression, self harm and even suicide.

Gender Dysphoria... It affects more males than females (On average, men are diagnosed with gender dysphoria five times more often than women) and it is estimated that 1in 11,000 people have the condition. The role of hormones is used to alter their physical features of the person i.e. give them a more masculine or feminine appearance with the ultimate remedy being gender re-assignment surgery.

Gender Dysphoria... This is a complex condition. People who have it believe that they were somehow born into the wrong body, and they often prefer to live as a member of the opposite sex. There is confusion between their sex, their gender identity and their gender role.

Remember these definitions.. Sex Whether someone is biologically male or female. Males have the sex chromosomes XY and females and the sex chromosomes XX. Gender identity Whether someone feels male or female. Gender role Whether someone behaves in a stereotypical or socially/ culturally male or female way.

Research Evidence for Gender Dysphoria Biological i.e. genes and hormones (nature) Environmental.. Social learning theory (SLT) could also play a part with an absence of or inappropriate role models to imitate. (nurture)

By the way..

The term ‘transsexual’ should not however be confused with transvestism or cross-dressing, which involves dressing as the opposite sex for emotional or sexual pleasure.

Transvestites are content with their gender identity but enjoy the fantasy of pretending to be a member of the opposite sex.

GID LAPTOP ACTIVITY 1.In pairs - using laptops - find answers to following questions 2.Put into word document 3. me answers 4.Then collated into handout

Questions 1.What is GID and how does it affect individuals behaviour? 2.What are the role of hormones in people with Gender Dysphoria? 3.What are the role of genes in people with Gender Dysphoria? 4.What is the environmental – SLT explanation for GID? 5.How does the nature versus nurture debate feature in the GID topic? 6.How does the ‘Batista family’ case study support the role of hormones in explaining GID? 7.Describe two supporting pieces of research for the role of genes in explaining GID. 8.What have researchers (e.g. Rekers, 1995; Bennett,2006) found about the role of SLT in explaining GID? 9.What have researchers (e.g. Wallien and Cohen- Kettenis,2008; Zucker et al, 2008) found about the short-term nature of GID ? 10.Describe what ethical and other issues you could include in a report on GID?

GID Essay Plan Beginning of A01 - Question 1 End of A02/3 - Question 10

Answers

Biological Explanations

The role of genetics Attention has centred on gene variants of the androgen receptor that influence the action of testosterone and is in the masculinisation of the brain. More research is needed, especially to identify what types of environmental factors are required to elicit an influence and the biological processes through which genetic effects may be medicated.

The role of hormones Many gender dysphorics take opposite sex hormones as part of their treatment but little is known effects of this process. What evidence there is does not indicate any substantial differences in hormone levels in individuals with gender dysphoria.

Gender Dysphoria... The role of hormones continued: There is evidence from case studies of children suggesting that hormones determine gender identity but there are problems in generalising from such samples to the general populations and there is also the possibility that it is the gender rearing that is crucial in determining gender identity and not genetic/chromosomal sex.

Research..

Support for genes. Hare et al (2009) examined the genes in a group of men and found that those with GID were likely to have a ‘faulty’ androgen receptor gene implying that the gene may be involved in a failure to masculinise the brain during development in the womb again strongly suggesting that GID is caused more by biological factors than psychological ones.

Support for hormones.. Kula and Slowikowska - Hilczer (2000) performed a meta-analysis and found that animal studies indicated sex hormones present during pregnancy influence sexual behaviour in adulthood suggesting that hormones affect masculinisation and feminisation of a child’s brain in the womb.

However.. Gladue 1985 reported that there were few, if, any hormonal differences between gender dsyphoric men, heterosexual men and homosexual men, evidence against the influence of hormones on gender dysphoria. Similar results are found with women.

However.. (SLT) Rekers (1995) reported that the lack of stereotypical male role models can cause GID in boys more so than biological factors. This study of 70 boys strongly supports the importance of SLT.

Also - SLT Alternatively, parents may have wished for a child of the opposite sex, therefore unintentionally reinforcing gender- inappropriate behaviours (Ceglie, 2000). In later life, peers and teachers would punish gender- inappropriate behaviour, contributing to the discomfort and unhappiness experienced by such individuals, perhaps producing a defensive boomerang effect, where the individual defends their acquired identity when under attack.

However (not SLT).. Bennett (2006) pointed out that while SLT can explain the development of non-gender typical behaviours it cannot explain the strength of such beliefs about one’s gender and resistance to any form of psychological therapy. This suggests that.. biology is a stronger factor.

However.... (short-term) Wallien and Cohen- Kettenis (2008) performed a longitudinal study on a group of children with GID. They found that when the children were aged around 19 only 40% of them were still gender dysphoric. These were the individuals that had exhibited (showed) the most extreme symptoms.

However ….(short-term) Wallien and Cohen- Kettenis (2008) continued: They also tended to have a homosexual or bisexual orientation, indicating that that the majority of children exhibiting gender dysphoria only do so in the short term and there is an association between being homosexual or bisexual and having childhood gender dysphoria.

Therefore ….. Wallien and Cohen- Kettenis (2008) continued: This study therefore suggests that.. homosexuality and GID are linked i.e. a child with homosexual feeling feels more comfortable identifying with the opposite sex rather than accepting the fact that they are gay/lesbian.

Short-term... Zucker et al (2008) performed a longitudinal study on gender dysphoric females referred to a clinic between 2 and 3 years of age. Only 12% were still gender dysphoric at age 18. A study on equivalent males found 20% still had the condition as adults, again suggesting that the majority of people exhibiting gender dysphoria do so only in the short term.

Support for biology (nature) Bennett (2006) Reported that 2% of more than 300 MZ (monozygotic) twins showed some evidence of gender dysphoria based on self report measures. Applying statistical modelling techniques to their data Coolidge et al (2002) concluded that 62% of the variance in GID symptoms was attributed to biological factors and 38% to environmental factors.

Support for biology (nature) Hines (2004) stated that: “the strong persistent desire to change sex and the willingness to undergo surgery and hormone treatment despite formidable obstacles including in some cases social stigmatisation and job loss suggests a biological imperative”.

Support – hormones... There is strong evidence to support the fact that hormones determine gender as in the Batista family however it is difficult to generalise the findings of the study.

Case Study - Batista family Dominican Republic there lived a family called the Batistas. Over the years several daughters were born to this family and they grew into lovely little girls. However at around 12 years of age something very odd started to happen. One of the girls went to see his mother – “Mummy – something a bit odd is happening to me down below” “What do you mean?” said the mother “Well it’s a bit embarrassing mum but I seem to have started growing a little willy!” “How odd” said the mother – “I have also noticed that your chin is getting a bit hairy and you are starting to develop a deeper voice!” “Oh my goodness I seem to be turning into a boy!” said the child

Case Study - Batista family And so it was … as the weeks went by the little girl gradually changed into a boy and had to swap all her girly toys and clothes for boyish ones. The family went to see a doctor and said “What is going on here, doc!” After some investigation and genetic tests the doctor told the family. “How funny! It appears that you have been a male all along. It’s just that a genetic defect passed down to you from one of your ancestors meant that you did not have the usual amount of testosterone released when you were a foetus so your testes and penis did not grow. But now you have reached puberty you have had a big release of testosterone and they have started to grow.” The whole family was very happy to have a new son, and held a party to celebrate! And it also happened to 3 other young girls in the family who also had the genetic abnormality. They have all taken on male roles, have men’s jobs, have married women, and are accepted as men in spite of the fact that they were reared as girls and supposedly thought of themselves as girls for 12 or so years (i.e. they had a female gender identity).

But.... The findings of this study are further complicated by the fact that some of the girls were intersex and may have been raised as boys due to their ambiguous genitalia

Homework Activity Find out who Gwen Araujo and Brandon Teena were and what happened to them?

Tuesday Dec.18th Exam Question... 1.Outline one explanation for GID (4 marks) 2.Critically consider explanations of gender dysphoria (4 +16 marks)

Plan A01- 4 marks Briefly describe main features of either; 1.Role of genes – gene variants of the androgen receptors …. Or … 2.Role of environment (SLT) – the lack of male role models and parents unintentionally reinforcing gender-inappropriate behaviours (Ceglie, 2000).

Plan A marks Compare SLT with hormones genes using research, e.g.. IDA - Nature versus nurture Support for hormones – Batista family case study + Kula (2000) Support for genes – Hare et al, Hines (2004) Support for environment (SLT) - Rekers (1995) Not SLT – Bennett (2006)

Overall GID Topic Summary AO1 Define GID – “individual feels uncomfortable with their biological sex and wishes to change it.” Nature versus Nurture explanations.. Role of hormones - many gender dysphorics take opposite sex hormones Role of genes – gene variants of the androgen receptors Role of environment (SLT) – the lack of male role models/parents A02/3 Support for hormones – Batista family case study + Kula (2000) Support for genes – Hare et al, Hines (2004) Support for environment (SLT) - Rekers (1995) Not SLT – Bennett (2006)