1. Gender Issues
© Robert J. Atkins, Ph.D.

3. What is sex vs. gender? Sex = biological
Gender = psychosocial (cultural)

4. What are the sex chromosomes?
Eggs = XX
Sperm = XY

5. Prenatal sexual differentiation
In the absence of male hormones, female external genitals will develop

6. Prenatal structure

8. What are the prenatal structures?
Female = Mullerian ducts
Male = Wolffian ducts

9. What is the undifferentiated stage?

10. What is early genital development?

11. What is advanced genital development?

12. What is the peno-scrotal raphe?

13. What structures are homologous?
Ovaries = Testicles
Clitoris = glands of the penis
Scrotum = major lips

14. Do you remember? What is the female and male sex chromosome pattern?
What are the female prenatal structures?
What are the male prenatal structures?
What structures in the female are homologous to those in the male.

15. What is Transgender? Transgender: Umbrella term
16 or more intersex conditions
Transsexuals
Listed in the DSM-V as “Gender identity disorder”
Transvestites

16. What are intersex conditions?
Various chromosome, hormone, and developmental conditions that are not standard for male and female.
At least 16 conditions
Includes:
Turner Syndrome
Klinefelter syndrome
Androgen insensitivity syndrome
Ovo-testes (formerly called “true Hermaphroditism”)

17. What are chromosome errors?
Turner’s syndrome
Klinefelters syndrome

18. What is Turner’s syndrome?
(Sterile female with absent or underdeveloped ovaries) XO
Normal external female genitals
Lack of menstruation at puberty
Female gender identity

19. What is Klinefelters syndrome
What is Klinefelters syndrome? (sterile male with underdeveloped genitals)
XXY chromosome pattern
Gender identity confusion

20. What are the prenatal hormone errors?
Androgen insensitivity syndrome (AIS)
Fetally androgenized females (FAF)

21. What is Androgen Insensitivity Syndrome (AIS)?
External genitals of male fetus fail to differentiate
Newborn has normal-looking female external genitals
Diagnosed when menstruation does not occur

22. What are fetally androgenized females (FAF)?
Masculinized external organs

23. Do you remember? What are the characteristics of Turner’s syndrome?
What are the characteristics of Klinefelters syndrome?
What is Androgen Insensitivity syndrome?
What is a fetally androgenized female?

24. John Money study of Joan/John
Circumcision accident
The effect of prenatal hormones on brain differentiation may be much more influential in gender-identity than was originally assumed.

25. Transvestite VS transsexual
Transvestite cross dresses for sexual arousal
Transsexual cross dresses to feel comfortable and congruent

26. What is sex reassignment surgery?
Sex change surgery
Transsexuals feel trapped in a body of the “wrong” sex
Cross dresses to feel comfortable and congruent
More men (M-F) than women (F-M)
Ratio is narrowing
Most preoperative transsexual persons feel they are heterosexual.

27. M-F transsexual surgery

28. M-F transgender surgery results

29. F-M transgender surgery results
Before
After (Artificial testicles)

30. Do you remember? What did we learn from the John Money study?
What is the difference between a transvestite and a transsexual?
What sexual orientation do most preoperative transsexual persons feel they have?