Gender development in women with congenital adrenal hyperplasia as a function of disorder severity
ABSTRACT Prenatal-onset classical congenital adrenal hyperplasia (CAH) in 46,XX individuals is associated with variable masculinization/defeminization of the genitalia and of behavior, presumably both due to excess prenatal androgen production. The purpose of the current study was threefold: (1) to extend the gender-behavioral investigation to the mildest subtype of 46,XX CAH, the non-classical (NC) variant, (2) to replicate previous findings on moderate and severe variants of 46,XX CAH using a battery of diversely constructed assessment instruments, and (3) to evaluate the utility of the chosen assessment instruments for this area of work. We studied 63 women with classical CAH (42 with the salt wasting [SW] and 21 with the simple virilizing [SV] variant), 82 women with the NC variant, and 24 related non-CAH sisters and female cousins as controls (COS). NC women showed a few signs of gender shifts in the expected direction, SV women were intermediate, and SW women most severely affected. In terms of gender identity, two SW women were gender-dysphoric, and a third had changed to male in adulthood. All others identified as women. We conclude that behavioral masculinization/defeminization is pronounced in SW-CAH women, slight but still clearly demonstrable in SV women, and probable, but still in need of replication in NC women. There continues a need for improved instruments for gender assessment.
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ABSTRACT: Orchids is a welcome addition to the dozen or so films about intersex people (e.g., Celeste et al. 2005; Hsu and Thomas 2006; Puenzo 2008) and has the advantage of being directed by someone who identifies as such. Most of these films are U.S.-based; exceptions will be noted in the review. Defined as “congenital conditions in which genital, chromosomal, or anatomical sex development is atypical” (Lee et al. 2006), intersex bodies challenge the binary nature of biological sex. In 2005, the APA authorized a task force to review the state of knowledge about both transgender and intersex, but the task force decided it wasn’t feasible to consider both in the same report and focused their attention on transgender issues alone; the APA Task Force Report on Gender Identity and Gender Variance (APA 2009) was the result. As of yet, there has been no task force appointed to look at intersex. But an international body of medical experts convened in 2005 to produce a “Consensus statement on the mana ...Sex Roles 02/2014; 70(3-4):161-163. DOI:10.1007/s11199-013-0340-x · 1.47 Impact Factor
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ABSTRACT: Numerous studies have attempted to isolate biological factors in the development of transgender identities through research into genetics, prenatal hormone exposure, neuroanatomy, and cognitive processing. Genetic studies demonstrate that chromosomal variations are uncommon but may occur at higher rates than in the general population. Candidate genes have been investigated, with some positive results, though these have yet to be replicated. Investigations into the effects of hormone exposure on the developing fetus have focused on gender identity in intersex people, which is often unpredictable, and proxy markers for prenatal hormone exposure such as finger length ratio and birth order, which do not show clear trends in transgender groups. A few small neuroanatomical studies show distinctions in transgender people, but results are limited in their scope due to small sample sizes and confounding variables such as adult hormone exposure. Numerous studies demonstrate that male-to-female (MTF) transgender people have higher rates of left-handedness, but the theoretical basis for this difference is not well described. Accumulating evidence indicates that prenatal biology likely contributes to transgender identity, but that its role may be interactive, rather than deterministic.Journal of Gay & Lesbian Mental Health 04/2013; 17(2):150-174. DOI:10.1080/19359705.2013.753393
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ABSTRACT: The present study explored whether there were relationships between number of older brothers, handedness, recalled childhood gender nonconformity (CGN), and sexual orientation in men. We used data from previous British studies conducted in our laboratory (N = 1,011 heterosexual men and 921 gay men). These men had completed measures of demographic variables, number and sex of siblings, CGN, and the Edinburgh Handedness Inventory. The results did not replicate the fraternal birth order effect. However, gay men had fewer "other siblings" than heterosexual men (even after controlling for the stopping-rule and family size). In a sub-sample (425 gay men and 478 heterosexual men) with data available on both sibling sex composition and handedness scores, gay men were found to show a significantly greater likelihood of extreme right-handedness and non-right-handedness compared to heterosexual men. There were no significant effects of sibling sex composition in this sub-sample. In a further sub-sample (N = 487) with data available on sibling sex composition, handedness, and CGN, we found that men with feminine scores on CGN were more extremely right-handed and had fewer other-siblings compared to masculine scoring men. Mediation analysis revealed that handedness was associated with sexual orientation directly and also indirectly through the mediating factor of CGN. We were unable to replicate the fraternal birth order effect in our archived dataset but there was evidence for a relationship among handedness, sexual orientation, and CGN. These data help narrow down the number of possible neurodevelopmental pathways leading to variations in male sexual orientation.Archives of Sexual Behavior 02/2015; DOI:10.1007/s10508-014-0474-0 · 3.53 Impact Factor