Laura R. Rosen’s research while affiliated with New York State Psychiatric Institute and other places

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Publications (13)


Sexual orientation after prenatal exposure to exogenous estrogens
  • Chapter

October 2007

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2 Reads

Anke A. Ehrhardt

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Laura R. Rosen

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Bruce S. McEwen

A collection of foundational texts on the nature and behavioral consequences of sex differences in the brain, allowing readers to follow the development of a rapidly growing but contentious field and giving them the tools to analyze emerging scientific findings from many perspectives. This collection of foundational papers on sex differences in the brain traces the development of a much-invoked, fast-growing young field at the intersection of brain and behavior. The reader is introduced to the meaning and nature of sexual dimorphisms, the mechanisms and consequences of steroid hormone action, and the impact of the field on interpretations of sexuality and gender. Building on each other in point-counterpoint fashion, the papers tell a fascinating story of an emerging science working out its core assumptions. Experimental and theoretical papers, woven together by editor's introductions, open a window onto knowledge in the making and a vigorous debate between reductionist and pluralist interpreters. Five major sections include papers on conceptual and methodological background, central nervous system dimorphisms, mechanisms for creating dimorphisms, dimorphisms and cognition, and dimorphisms and identity. Each section builds from basic concepts to early experiments, from experimental models to humans, and from molecules to mind. Papers by such leading scholars as Arthur Arnold, Frank Beach, Anne Fausto-Sterling, Patricia Goldman-Rakic, Doreen Kimura, Simon LeVay, Bruce McEwen, Michael Merzenich, Bertram O'Malley, Geoffrey Raisman, and Dick Swaab, illustrate a rich blend of perspectives, approaches, methods, and findings. Sex and the Brain will show students how a scientific paper can be analyzed from many perspectives, and supply them with critical tools for judging a rapidly emerging science in a contentious area.


Prenatal Estrogens and the Development of Homosexual Orientation

January 1995

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98 Reads

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85 Citations

Developmental Psychology

In psychobiological research on sexual orientation, the prenatal hormone theory has a central position. This article examines the hypothesis that prenatal estrogens contribute to the development of human sexual orientation. Several groups of women with a history of prenatal exposure to diethylstilbestrol (DES), a nonsteroidal synthetic estrogen, were compared with several samples of control women in the context of a comprehensive study of the psychiatric and psychologic effects of prenatal DES. Various aspects of sexual orientation were assessed by systematic interview. Consistently across samples, more DES-exposed women than controls were rated as bisexual or homosexual (scores 2-6 on Kinsey-format scales ranging from 0 to 6). The data are compatible with the hypothesis that prenatal estrogens may play a role in the development of human sexual orientation.


Prenatal Estrogens and the Development of Homosexual Orientation
  • Article
  • Publisher preview available

January 1995

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167 Reads

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131 Citations

Developmental Psychology

In psychobiological research on sexual orientation, the prenatal hormone theory has a central position. This article examines the hypothesis that prenatal estrogens contribute to the development of human sexual orientation. Several groups of women with a history of prenatal exposure to diethylstilbestrol (DES), a nonsteroidal synthetic estrogen, were compared with several samples of control women in the context of a comprehensive study of the psychiatric and psychologic effects of prenatal DES. Various aspects of sexual orientation were assessed by systematic interview. Consistently across samples, more DES-exposed women than controls were rated as bisexual or homosexual (scores 2–6 on Kinsey-format scales ranging from 0 to 6). The data are compatible with the hypothesis that prenatal estrogens may play a role in the development of human sexual orientation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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Psychopathology and social functioning in men prenatally exposed to diethylstilbestrol (DES)

November 1993

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74 Reads

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37 Citations

Psychosomatic Medicine

Previous research has suggested increased psychopathology in prenatally diethylstilbestrol (DES)-exposed persons. The current study compares the psychiatric histories and social functioning of 27 men with a history of high-dose prenatal DES exposure and their unexposed brothers. We expected DES subjects to show greater lifetime psychopathology and poorer social functioning than controls. Both groups showed high rates of lifetime depression, lifetime alcoholism, and current psychiatric symptoms in excess of community norms. The only diagnosis on which DES subjects exceeded their unexposed brothers was Major Depressive Disorder (MDD). DES-exposed men had almost twice the prevalence of at least one episode of MDD and had significantly more recurrent episodes. The relatively small number of subjects with concomitant lack of statistical power may have contributed to the difficulty obtaining significant effects.


Gender-Related Behavior Development in Females Exposed to Diethylstilbestrol (DES) in Utero: An Attempted Replication

February 1991

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39 Reads

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58 Citations

Journal of the American Academy of Child & Adolescent Psychiatry

This report concerns the role of prenatal hormones in normal and abnormal psychosexual differentiation. Several studies indicate that perinatal treatment of infrahuman female mammals with diethylstilbestrol (DES) masculinizes certain features of their brain and behavior. Accordingly, the authors have hypothesized that prenatal exposure to DES may also masculinize the gender-role behavior of girls and women. A previous study suggested that prenatally DES-exposed women show decreased interest in parenting. The authors failed to replicate these findings in a different sample despite the use of similar methodology. Post-hoc analysis shows that the assessment devices would have detected masculinization if it were present. The implications of these findings for an understanding of psychosexual development are discussed.


The development of gender-related behavior in females following prenatal exposure to diethylstilbestrol (DES)

January 1990

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10 Reads

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26 Citations

Hormones and Behavior

Animal research has shown that diethylstilbestrol (DES) present during the sensitive developmental periods of the hypothalamus and adjacent areas of the brain affects the development of sex-dimorphic brain structures and subsequent behavior. To test for corresponding behavioral effects in humans, 30 women with a history of prenatal DES exposure were contrasted with 30 unexposed women who had been referred to the same clinic for a colposcopic examination because of an abnormal Pap smear. Gender-role behavior of childhood, adolescence, and adulthood was assessed by means of a semistructured interview, the Gender Role Assessment Schedule-Adult, and the Bem Sex Role Inventory. The mothers of these women were interviewed about their daughters with the "mother form" of the same interview schedule. The results suggest that DES women show less orientation toward parenting than the controls. There were no consistent group differences in other domains of gender-role behavior.


The development of gender-related behavior in females following prenatal exposure to diethylstilbestrol (DES)

December 1989

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14 Reads

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57 Citations

Hormones and Behavior

Animal research has shown that diethylstilbestrol (DES) present during the sensitive developmental periods of the hypothalamus and adjacent areas of the brain affects the development of sex-dimorphic brain structures and subsequent behavior. To test for corresponding behavioral effects in humans, 30 women with a history of prenatal DES exposure were contrasted with 30 unexposed women who had been referred to the same clinic for a colposcopic examination because of an abnormal Pap smear. Gender-role behavior of childhood, adolescence, and adulthood was assessed by means of a semistructured interview, the Gender Role Assessment Schedule-Adult, and the Bem Sex Role Inventory. The mothers of these women were interviewed about their daughters with the “mother form” of the same interview schedule. The results suggest that DES women show less orientation toward parenting than the controls. There were no consistent group differences in other domains of gender-role behavior.


Psychopathology in prenatally DES-exposed females: Current and lifetime adjustment

March 1987

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10 Reads

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24 Citations

Psychosomatic Medicine

This report concerns the long-term effects of prenatal exposure to diethylstilbestrol (DES) on overall psychologic functioning in females. Thirty DES-exposed women aged 17-30 years and 30 control women with a history of abnormal Pap smear findings were interviewed with the SADS-L and completed the SCL-90-R and the PRI-Q. Both DES and PAP women showed elevated symptoms on the SCL-90-R in comparison to published norms and were similar to women with cancer, but their rates of psychiatric disorders (SADS-L/RDC) at the time of the evaluation did not differ from community norms. However, both groups met criteria for Major Depressive Disorder (lifetime) significantly above expectancy, and the DES women reported slightly more episodes than the control group. The DES women also had significantly more problems than the PAP control group in social relations with spouses and other significant persons.


Sexual activity level and sexual functioning in women prenatally exposed to diethylstilbestrol

November 1985

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27 Reads

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34 Citations

Psychosomatic Medicine

Thirty women with a history of prenatal exposure to diethylstilbestrol (DES) underwent a detailed sexual history and were compared to a demographically similar sample of 30 women with a history of an abnormal Pap smear. The DES women were found to have less well-established sex-partner relationships and less experience with child-bearing, to be lower in sexual desire and enjoyment, sexual excitability, and orgasmic coital functioning, but to be comparable (and low) with regard to such sexual dysfunctions as vaginismus and dyspareunia. Both potential psychosocial and neuroendocrine explanations are discussed.


Sexual orientation after prenatal exposure to exogenous estrogen

March 1985

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217 Reads

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215 Citations

Thirty women aged 17 to 30 years with documented prenatal exposure to the nonsteroidal synthetic estrogen diethylstilbestrol (DES) were compared to thirty women of similar demographic characteristics from the same medical clinic who had a history of abnormal Pap smear findings. A subsample of the DES women were also compared to their DES-unexposed sisters. Sexual orientation in its multiple components was assessed by systematic semistructured interviews. In comparison to both control groups, the DES women showed increased bisexuality and homosexuality. However, about 75% of the DES women were exclusively or nearly exclusively heterosexual. Nonhormonal and hormonal interpretations of these findings are discussed.


Citations (12)


... A handful of studies have examined aspects of sexual behavior in women exposed prenatally to diethylstilbestrol (DES), a synthetic estrogen administered to pregnant women during the mid-twentieth century to reduce the risk of abnormal pregnancy and miscarriage, with several unintended health consequences to their children (Schrager & Potter, 2004;Titus-Ernstoff et al., 2003). Although previous, smaller studies found the opposite or null results (Ehrhardt et al., 1985;Meyer-Bahlburg et al., 1995;Newbold, 1993), in by far the largest study of over 5,500 women, those exposed prenatally to DES were less likely than controls to report same-sex sexual behavior (Titus-Ernstoff et al., 2003), suggesting that prenatal estrogens reduce gynephilia, increase androphilia, or both. ...

Reference:

Organizational Effects of Gonadal Hormones on Human Sexual Orientation
Prenatal Estrogens and the Development of Homosexual Orientation
  • Citing Article
  • January 1995

Developmental Psychology

... It has been estimated that 5-10 million people were exposed to DES in the U. S. during 1938-1971(Giusti, Iwamoto, & Hatch, 1995. Unfortunately DES did not prevent miscarriages, but turned out to be a synthetic estrogen that increased cancer risk (Ehrhardt et al., 1985;Meyer-Bahlburg et al., 1995). ...

Prenatal Estrogens and the Development of Homosexual Orientation

Developmental Psychology

... A handful of studies have examined aspects of sexual behavior in women exposed prenatally to diethylstilbestrol (DES), a synthetic estrogen administered to pregnant women during the mid-twentieth century to reduce the risk of abnormal pregnancy and miscarriage, with several unintended health consequences to their children (Schrager & Potter, 2004;Titus-Ernstoff et al., 2003). Although previous, smaller studies found the opposite or null results (Ehrhardt et al., 1985;Meyer-Bahlburg et al., 1995;Newbold, 1993), in by far the largest study of over 5,500 women, those exposed prenatally to DES were less likely than controls to report same-sex sexual behavior (Titus-Ernstoff et al., 2003), suggesting that prenatal estrogens reduce gynephilia, increase androphilia, or both. ...

Sexual orientation after prenatal exposure to exogenous estrogen

Archives of Sexual Behavior

... Earlier vaginal opening, an estrogen-mediated marker of pubertal onset analogous to thelarche in humans [23,24], has been observed in rodents exposed to DES during gestation [25]. A study of 30 DES-exposed daughters and 30 controls found no difference in mean age at thelarche associated with DES [26]. While strengths of that study were the use of medical record-confirmed history of prenatal DES exposure and shorter recall time for age at thelarche (recalled at ages [17][18][19][20][21][22][23][24][25][26][27][28][29][30], the small sample size, women with abnormal Pap smears as controls, and lack of control for confounding could explain the lack of association with age at thelarche. ...

Psychosexual milestones in women prenatally exposed to diethylstilbestrol
  • Citing Article
  • January 1984

Hormones and Behavior

... In addition to the focus on increased risk of clear cell adenocarcinoma of the cervix and vagina in females, emphasis here has been largely on reproductive track abnormalities in males. Some hints of psychosexual and gender identity issues have emerged from various patient interest groups, and there are reports of small but significant increases in bisexuality and homosexuality in DES exposed women [Ehrhardt et al., 1985;Ehrhardt et al., 1989] but for the most part the effects are small and inconsistent and therefore not sufficient to warrant substantial investigations [Kebir and Krebs, 2012]. That there are no profound effects of DES exposure on psychosexual development is consistent with the view that androgens, not estrogens, are the dominant masculinizing hormone in primates. ...

The development of gender-related behavior in females following prenatal exposure to diethylstilbestrol (DES)
  • Citing Article
  • December 1989

Hormones and Behavior

... Their primary evidence consists of two studies (Ehrhardt et al., 1985;Meyer-Bahlburg et al., 1995) suggesting that women who were exposed prenatally to the synthetic estrogen diethylstilbestrol (DES) were masculinized behaviorally, in that they were more likely than controls to exhibit non-heterosexual orientation. However, these results were not replicated in subsequent larger studies (Newbold, 1993), including one by the same authors (Lish et al., 1991). The largest investigation of psychosexuality in women exposed prenatally to DES included 3946 women exposed prenatally to DES and 1740 women not exposed (Titus-Ernstoff et al., 2003, cf. ...

Gender-Related Behavior Development in Females Exposed to Diethylstilbestrol (DES) in Utero: An Attempted Replication
  • Citing Article
  • February 1991

Journal of the American Academy of Child & Adolescent Psychiatry

... From 1940 to 1970, the endocrine disruptor diethylstilbestrol (DES) was prescribed for women in the first trimester of pregnancy to prevent miscarriage. It increased the chances of lesbian orientation in the female offspring [62]. Even exogenous estrogens can cause mounting behavior in female rats, likely due to aromatization of the excess estrogens in the brain into testosterone [63]. ...

The development of gender-related behavior in females following prenatal exposure to diethylstilbestrol (DES)
  • Citing Article
  • January 1990

Hormones and Behavior

... Kebir and Krebs (10) emphasized the limitations of such epidemiological studies and noted in particular that, apart from depression and anxiety, other psychiatric disorders have not been studied. Post-adolescent behavioral disturbances reported for these two estrogens in exposed children were depression [15,16], anxiety [1,11,17], schizophrenia-like [18,19], anorexia, and bulimia nervosa [20]. All these observations were synthesized by Pillard et al. [16] and Giusti [21]. ...

Psychopathology in prenatally DES-exposed females: Current and lifetime adjustment
  • Citing Article
  • March 1987

Psychosomatic Medicine

... (It did not, in fact, but doctors like to prescribe medicines, and patients are always keen to be treated.) DES turned out to increase the likelihood of bisexuality and homosexuality in the daughters of women given this drug (Ehrhardt et al., 1985). In addition, a high prevalence of gender identity problems has been reported in DES sons (Kerlin, 2005). ...

Sexual orientation after prenatal exposure to exogenous estrogen

... Although the genital and obstetrical iatrogenic effects of prenatal exposure to DES are now well established (Barnes et al. 1980), conflicting findings have been reported by studies exploring the psychological outcome of persons exposed prenatally. Several studies have reported that the prevalence of psychiatric disorders, particularly depression or eating disorders, was increased in women or men prenatally exposed to DES (Gustavson et al. 1991;Meyer-Bahlburg et al. 1985;O'Reilly et al. 2010;Pillard et al. 1993;Vessey et al. 1983). The study by Vessey et al. (1983) is of particular interest as persons prenatally exposed to DES and unexposed controls were the children of 1000 women included in a randomized controlled trial performed in the 1950s that aimed at comparing DES to placebo. ...

Sexual activity level and sexual functioning in women prenatally exposed to diethylstilbestrol
  • Citing Article
  • November 1985

Psychosomatic Medicine