Chapter 10 Gender

Social Learning Theory

- According to the social learning perspective, gender differences in sexuality are the result of observational learning. - Few of us directly observe others' sexual behaviour, but our environment is awash in information about sexuality delivered via media such as the internet, television, film, and magazines, and this information may influence how we understand and display our sexuality. i.e., exposure to reality dating programs depicting a gender-stereotyped romantic and sexual behaviours such as 'Who wants to marry a multi-millionaire', is correlated with more permissive sexual attitudes and behaviours. - However, inferring causation requires an experimental design with control conditions; this correlation may reveal that individuals with more permissive attitudes are more likely to seek out media that portray sexuality in a fashion consistent with their attitudes. - A handful of researchers have conducted experimental studies that indirectly address the effects of observational learning. i.e., Ward (2002) examined women's and men's endorsement of sexual stereotypes after viewing sexualized or nonsexual scenes from TV shows such as Friends. - The sexualized scenes portrayed the following gendered sexual stereotypes: men are sex-driven, women are sexual objects, and dating is a game. - Women who viewed the sexualized clips reported stronger endorsements of sexual stereotypes than did women who viewed the nonsexual clips, and the more TV they watched, the greater their endorsement of the stereotypes. - Interestingly, viewing the clips did not seem to affect men in the same way; stereotype endorsement was equally high in groups exposed to the sexual clips and groups exposed to the nonsexual clips. - This exhibited gender difference may provide evidence for what some researchers have termed the female sexual fluidity hypothesis, which proposes that female sexuality is more malleable than male sexuality in response to cultural influences.

Androgen Insensitivity Syndrome (AIS)

- Androgen insensitivity syndrome (AIS) is an X-linked recessive disorder in which individuals born with XY chromosomes develop typically female physical characteristics, often including external female genitalia and female breasts. - During fetal development of an individual with AIS, testes develop under the influence of SRY, but the testes generally do not descend as they typically would. - As the individual develops, the testes secrete typical levels of androgens, but mutations in the individual's androgen-receptor genes prevent the body tissues from responding to these hormones. - The tissues do respond to androgens, however, which results in the development of a female-typical phenotype. - Cases of AIS are usually categorized as either partial or complete. - Individuals with partial AIS (PAIS) generally have intermediate male-and female-typical characteristics, with differing degrees of genital masculinization. - In cases of complete AIS (CAIS), the genitals usually appear typically female, although the vagina may be shallower than in genetic females. - Most individuals with CAIS appear female at birth, are raised as girls, and identify as heterosexual, and the majority are content with a female gender identity. - Women with CAIS highlight how female-typical psychological development is not dependent upon having two X-chromosomes but rather on hormonal sex--in the absence of effective exposure to androgens, a female-typical phenotype, sexuality (attraction to males), and gender identity may develop, although many women with CAIS, just as many hormonally typical women, will not identify as heterosexual and/or female.

5-Alpha-Reductase Deficiency

- Another DSD affecting chromosomal males is 5-alpha-reductase deficiency (5-ARD); it results from mutations of the genes that encodes the steroid 5-alpha-reductase 2, an enzyme that converts testosterone to dihydrotestosterone (DHT). - Cases are rare, although familial clusters appear in certain regions, such as in the Dominican Republican. - Individuals with 5-ARD have testes (usually undescended) that secrete typical levels of testosterone, so their internal reproductive organs are male. - Because of the enzyme deficiency, however, their external genitals develop as female-typical (these tissues require DHT to masculinize) - As adults, most individuals with 5-ARD have typical testes, a male ejaculatory system, and a shallow vagina, with mostly female external genitals. - Individuals with 5-ARD are typically raised as girls until puberty. - As testosterone levels increase at puberty, however, masculinization of the external genitals occurs, the testes descend, the scrotum becomes pigmented, the clitoris enlarges to resemble a small penis, and the rest of the individual's body masculinizes. - At this time, the majority of individuals with 5-ARD transition to a male gender identity and role, and the majority are sexually attracted to women. - However, for some, the path to becoming a man may not be so direct. - Individuals with 5-ARD may choose to undergo surgery to correct penile anomalies such as hypospadias (a developmental variation of the urethra); many may also choose hormone therapy.

Reporting Biases

- As mentioned before, women's and men's self-reports about their sexuality may be biased by desires to conform to gender norms. - In a research setting, biased reports can lead to inaccurate representations of women's and men's sexuality. - Consider, for example, the fact that men who have sex with women report significantly higher numbers of sexual partners than do women who have sex with men. - Such reports are somewhat puzzling, as we must wonder, with whom are these men having sex with? - One possible reason for this discrepancy is that men over-report their partner numbers and women under-report, consistent with the sexual double standard, whereby more liberal sexual attitudes and behaviours are tolerated in men but discouraged in women. - Alexander and Fisher (2003) - Used the 'Bogus Pipeline' methodology to help control for false accommodation of gender roles (i.e., self- reporting that falsely presents behaviours and/or attitudes as consistent with widespread gender norms) = Asked young women and men to report their sexual attitudes and behaviours under three conditions: one in which participants believed they had complete anonymity, one in which participants felt a threat of exposure (the experimenter might see their responses), and one involving a "bogus pipeline", in which participants felt pressure to tell the truth because they were attached to a polygraph machine (the decide was not active, but participants did not know this). - The results generally showed that gender differences in sexual attitudes, autonomous sexual behaviours (e.g., masturbation, use of erotic materials), and the numbers of sexual partners were smaller in the bogus pipeline group than in the exposure condition group, suggesting that women's and men's self-reports are influenced by reporting biases. - It is notable, however, that gender differences did remain, but the magnitude of these differences was smaller when the treat of discovery was increased. - Because gender norms are shared expectations of men's and women's behaviours, people are usually aware of them. - It is possible, however, to manipulate social and even personal norms, thereby altering self-reports. - Both men and women are more likely to report being unfaithful to a previous or current dating partner when they are under the impression that promiscuity is acceptable, compared to men and women who are under the impression that promiscuity is unacceptable. - Women's self-reports of sexual arousal also vary as a function of the feedback they are given about their own sexual arousal; women who are told their genital arousal is high subsequently report more arousal than do women who are told their genital arousal is low. - When evaluating gender differences research, therefore, we are well-served by carefully considering the conditions under which the data were collected.

Gender Development in Childhood

- At what point in a child's development does gender identity coalesce and become expressed as gender role? - Gender development involves three related processes: detecting gender, or being able to identify the similarities and differences between females and males; having gender, or recognizing oneself characteristics shared by either boys or girls both; and doing gender, or matching one's gendered behaviour with female or male gender stereotypes. A measure, published by the UN, of the economic equality of men and women - By age one, the majority of babies can detect gender, typically using gender-stereotyped physical characteristics, like hair length and clothing type, to differentiate between men and women. - Between two and three years of age, most children can identify what gender they have, whether they are a boy or a girl, and most have a sense of their gender identity. - Yet at this age, children tend to understand gender as a superficial characteristic believing that they can change their gender by changing their hairstyle or dress, and perhaps describing a woman with a deep voice as a man, or a man in a long wig as a woman. - Toward the end of this period, around the age of three or four, children come to understand gender as an inherent characteristic, in other words, they recognize gender constancy. - Doing gender, behaving in stereotypic female or male ways, emerges later in childhood, typically between ages five and seven. - This behaviour develops as children come to associate cultural symbols of femaleness and maleness (i.e., dolls and cars) with gender schemas, and as they are rewarded for showing preferences for gender-stereotypical activities and objects.

Congenital Adrenal Hyperplasia (CAH).

- Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disorder affecting cortisol synthesis in the adrenal gland. - There are at least five variations in this genetic disorder, but the most common, 21-hydroxylase deficiency and 11-beta-hydroxylase deficiency, result in increased androgen production and account for the majority of clinically diagnosed cases. - It is estimated that the incidence of the 21-hydroxylase variation is between 1 in 5000 and 1 in 15,000, with some variability by ethnicity. - Individuals with CAH are typically exposed to elevated levels of androgens produced by their adrenal gland before they are born. - Such prenatal exposure during the sixth week of gestation affects the development of female fetuses' genitals, causing varying degrees of virilization; larger clitorises, partially fused labia majora, shorter vaginal length, and an incomplete differentiation of the urethra and vagina are common, with observable variations ranging from slightly enlarged clitorises to typically male-appearing external genitals (e.g., a penis with a urethral opening). - Virilization: The biological development of sex differences, specifically changes that make a male body different from a female body. - The development of the internal reproductive organs, the uterus and ovaries, is typically unaffected in girls. - Genetic males' genital appearance is mostly unaffected by the condition. - In cases in which genital anomailes are noticeable, CAH is most often diagnosed at puberty, when it may present as early onset of puberty (prior to eight years for girls, nine years for boys), accompanied by penile or clitoral enlargement. - Other signs of androgen excess, such as excessive body hair, acne, hair loss (alopecia), and lack of ovulation and menstrual irregularities (in females), are typical in adolescence. - In addition, about half of women with CAH may present symptoms of polycystic ovarian syndrome, which can lead to infertility. - Children with CAH may exhibit behaviours and interests that differ from those of their non-CAH same-sex peers. - Girls with CAH may show less nurturance and 'tender-mindedness' (empathy), greater aggression, and less interest in infants, while boys with CAH may show less aggression and more 'tender mindedness'. - Women with CAH are also more likely to report malw-typical occupations, interest in rough sports, and interest in motor vehicles than are non-CAH women. - Many women with CAH have compromised sexual functioning, and they may avoid sexual intercourse because of pain associated with a shallow vagina or consequences of genital surgeries. - Compared with non-CAH women, women with CAH report lower sexual arousability in response to both physical and mental sexual stimuli, both with and without a partner. - Kenneth Zucker and his colleagues at the Centre for Addiction and Mental Health in Toronto also demonstrated that among women with CAH, sexual arousability is most strongly related to degree of heterosexual experience, suggesting that low heterosexual sexual interest may be related to lower sexual arousal among women with CAH. - The sexual orientation of women with CAH is often of particular interest to sex researchers because of the strong evidence that prenatal exposure to androgens is associated with same-sex attractions and behaviours. - It is not the case that all women with CAH are same-sex attracted; in fact, the majority are heterosexual. - Women with CAH do, however, show increased rates of same-sex and bisexual attractions, with positive correlations between the degree of prenatal exposure to the degree of same-sex attraction. - In these studies, women reporting 'some degree of same-sex attraction' include women who report predominant attraction to men, but some occasional attraction to women. - Compared to recent population-based surveys, this rate is 21% slightly elevated. - Treatment of CAH primarily centres on addressing symptoms. - Hormone therapy is commonly used to adjust the timing of puberty, managing the 'salt-wasting' form of CAH ( a dangerous metabolic condition_, and increase fertility. - Surgery may also be performed to create more female-typical appearing genitals. - In some girls, genitoplasty is performed to open the vagina, with the goals of enabling vaginal penetration and creating an opening for menstrual flow. - Genital surgery can also be performed to reduce the size of a woman's clitoris, although such procedures are unnecessary and may be harmful to a woman's sexual functioning. - Women who want to become pregnant and are carriers of the genes associated with CAH may be prescribed the steroid dexamethasone to interrupt the production of prenatal androgens, to reduce the chance that their child will develop CAH, although the safety and efficacy of this practice are largely unknown, and the ethics of this practice are questionable. - There is increasing evidence that use of this drug causes harm to fetuses, including developmental defects and cognitive deficits. - In addition, dexamethasone is often administered to all pregnant women carrying the genes for CAH when only one in eight fetuses that are treated with the drug may benefit from it (one quarter of a CAH woman's pregnancies will result in a CAH infant, and half of these will be female). - The remaining seven out of eight fetuses therefore receive an unnecessary treatment. - Thus, pregnant women who carry the genes associated with CAH must ask themselves, is having a more stereotypical vulva worth the risk of cognitive deficits, unknown maternal effects, unknown other harms to the fetus, and the risk of impaired sexual functioning, when we know that women without DSDs show broad variation in the size and shape of all parts of their vulva.

Disorders of Sexual Development

- Disorders of Sexual Development (DSDs) are congenital conditions in which the development of anatomical, gonadal, and/or chromosomal sex is atypical. - Disorders of Sexual Development (DSDs): A group of conditions in which the reproductive organs and/or genitals develop differently than expected. - In the past, individuals whose physical sexual characteristics, or phenotype, did not correspond to a typical female or male pattern, or who differed from their genetic or hormonal sex, were erroneously referred to as hermaphrodites, which properly refers only to individuals with both female and male reproductive organs. - True hermaphroditism, however, is exceptionally rare among humans, although it is far more common among certain invertebrate animals, like snails. - The somewhat more accurate term pseudohermaphrodite has also been used to describe individuals with DSDs, to suggest the presence of both female and male characteristics. - In the past decade however, activists have rejected this term as inaccurate and pejorative. - Currently, in medical contexts, the more descriptive term disorders of sexual development (DSDs) is favoured to describe the congenital conditions that lead to intermediate expression of female and male phenotypes. - To avoid the pejorative and stigmatizing identification if individuals as their medical conditions, individuals with DSDs often identify as intersex. - Intersex Individuals: Individuals whose reproductive and/or sexual anatomy develops differently from what is considered to be typical in either a female or a male. - Although many individuals who identify as intersex have DSDs that involve chromosomal and/or hormonal irregularities, not all do. - For some individuals, their intersexuality relates to problems with physiological development, such as cloacal exstrophy or penile agenesis, pr physical traumas such as penile ablation. - Cloacal Esxtrophy: A rare developmental variation in which the abdominal organs are exposed and the genitals develop abnormally. - Penile Agenesis: A rare developmental variation in which a male child is born without a penis.

Evolutionary Psychology

- Evolutionary psychologists understand gender differences in sexuality as arising from evolutionary processes aimed at maximizing reproductive fitness. - According to parental investment theory, women and men are faced with different reproductive problems, owing to the biological parameters of their potential reproductive output. - Reproductive fitness: The ability to successfully pass on genes to the next generation. - Parental Investment Theory: A theory proposed by Robert Trivers (1972) that predicts that the sex making the larger investment in offspring will be more discriminating in mating. - Thus, evolutionary psychologists propose, differences in biologically and physiologically determined reproductive roles give rise to differences in gendered psychological processes and behaviour aimed at maximizing the likelihood that children will survive and reproduce. - B/C a woman can produce only a limited number of children, the psychological mechanisms that regulate a woman's sexual behaviour are thought to be, on average, more conservative than those of men, thus, evolutionary forces are thought to result in women having a lower sex drive, preferring fewer sexual partners, desiring sex within the context of committed relationships with clear paternal investment in child-rearing, and preferring males with traits associated with ability to provide resources. - On the other hand, because men have a greater physiological capacity to produce more offspring, the psychological mechanisms that regulate men's sexuality are thought to be less conservative, with heterosexual men expressing greater interest in casual sex, showing evidence of a higher sex drive, and preferring female partners who exhibit characteristics associated with fertility (e.g., youthfulness) - Evolutionary psychology also posits that psychological and behavioural traits associated with higher rates of reproduction (e.g., those described above) are retained through natural selection. - This is because individuals who possess traits that are advantageous to successful reproduction tend to mate and transmit these traits to the next generation at a higher rate than others who do not possess these traits. - Transmission of psychological traits is thought to occur mainly through genetic pathways, although cultural transmission, through memes (representations of ideas that can be learned and transmitted through a cultural group, such as how to hunt or prepare food), is another route by which information can be passed onto subsequent generations. - Another key feature of evolutionary approaches to understanding gender is its emphasis on the exceptionally important role that the environment plays in shaping human behaviour over successive generations. - A trait's adaptiveness, or its potential to maximize reproductive fitness, can be judged only in relation to the environment within which it manifests. i.e., researchers in Sub-Saharan Africa studying the adaptiveness of infant temperament found that difficult, cranky babies do worse in times of plenty; these children create a lot of stress for their parents and are more likely to be neglected or abused than babies with calm, more even temperaments. - In times of droughts, however, babies with cranky temperaments are the ones most likely to survive because they demand more attention from their caregivers. - This example shows that we can judge the adaptiveness of a baby's temperament only in relation to the environment within which that temperament is expressed. - Similarly, we can judge the adaptiveness of gendered psychologies, such as sex drive, only in the environments in which they manifest in.

Nature and Nurture: Theoretical Perspectives on Gender and Sexuality

- Few contemporary sexuality researchers would endorse a model of gendered sexuality that suggests gender to be either purely biologically determined (i.e., determined by "nature") or purely socially constructed (i.e., determined by "nurture"); however, gender-difference research is often portrayed in media as strictly following one of these two paths. - In reality, the major theoretical models of gender development typically ascribe different weights to the role of biological, psychological, and socio-cultural factors in determining gender. - Most common theoretical frameworks used to understand gender and sexuality: evolutionary psychology, social learning theory, and social structural theory.

Transitioning to the Felt Gender and Sex

- For most transwomen and transmen, 'treatment' means processes and procedures aimed at aligning their social role and physical self with their felt gender. - Health care providers committed to evidence-based and ethical practices typically follow the criteria for hormone-replacement therapy (HRT) and TRSs outlined in the World Professional Association for Transgender Health's (WPATH"s) Standards of Care for the Health of Trassexual, Transgender, and Gender-nonconforming people.

What Factors Shape a Child's Sense of Gender Identity and Gender Roles?

- From the moment babies are born, gender roles are imposed on them, and babies' behaviour is interpreted through a gendered lens. - Any parent can tell you how, in Western culture, baby clothes are undesirably gendered, designed to disambiguate the gender of the tiny infant wearing them. - The pink-for-girls and blue-for-boys gender stereotype is. however, a fairly recent phenomenon. i.e., The Earnshaw Knitting Company offered the following advice to new parents: Pink for the boy and blue for the girl. - the reason is that pink being a more decided and stronger colour, is more suitable for the boy, while blue, which is more delicate and dainty, is prettier for the girl. - These days, parents are hard-pressed to find clothes for girls that aren't pink. - John and Sandry Condry (1974) had women and men rate the presence and intensity of fear, anger, and pleasure responses of a nine-month-old baby to a teddy bear, a jack-in-the-box, a doll and a buzzer. - Half of the raters were told the infant was a boy, and half were told the infant was a girl. - Those who believed the baby was a boy labelled the emotional responses as showing greater pleasure; those who believed the baby was a girl labelled the responses as showing greater intensity over all situations. - Ratings of responses to the jack-in-the-box, which caused the baby to become agitated and eventually cry and scream, were most illustrative of gender stereotypes in emotional responses. - Those who believed the baby was a boy rated the infant's response as 'anger' whereas those who believed the baby was a girl rated the infant's response as 'fear', reflecting gender stereotypes about acceptable emotional expressions. - Most parents marvel at how temperamentally different female and male children are; boys are notoriously more active, engaging in rough-and-tumble play and preferring active toys, whereas girls are typically less active, preferring to play with dolls and emulate nurturing. - Some believe that toy preferences, one expression of gender role and identity, are solely the result of gender socialization a process thought to be mediated by two forms of learning. - The first is observational learning, where children watch and emulate the behaviours and choices of other children and adults; the Second is operational learning or shaping, whereby gender conforming behaviours are reinforced and gender nonconforming behaviours are punished. - The result of such learning is that children adhere to playing with toys that are prescribed for the male or female gender role in childhood. - Evidence from research on women with CAH, however, suggests that the influence of androgen during prenatal development is associated with preferring boys' toys and behaving in a gender nonconforming manner. - Evidence for the biological contributions to gendered behaviour has also been found in research on non-human primates. i.e., one study has shown that female and male vervet monkeys make toy choices similar to those of their human counterparts. - In this study, the male vervet monkeys spent more time in contact with a toy car than did the females, and the female vervet monkeys spent more time in contact with a doll playing with the doll as if it were an infant, than did the males. - Further, non-gendered toys (a stuffed dog and a picture book) attracted similar levels of attention from both males and females. - This research suggests that the features of gendered toys, such as their colour, shape, and movement, interact with the characteristics of boys and girls and contribute to toy preferences. - Boys may prefer cars over dolls because cars are more amenable to active play, and girls may prefer dolls because these objects facilitate this expression of nurturance. - The monkey's, however, had observed other monkeys behaving in gender-specific ways (i.e., female monkeys nurturing infants), so their behaviour may also reflect observational learning.

Gender Differences or Similarities in Sexuality

- In 2005, Janet Hyde, an American psychologist at the University of Wisconsin-Madison contended that the predominant model of difference between women and men was fundamentally flawed. - She argued that the popular media representations, such as that in John Gray's bestselling Men are from Mars, Women are from Venus bias our interpretations of women's and men's behaviours, attitudes, and aptitudes in the direction of finding differences. - In her detailed analysis, she demonstrated that the magnitude of the differences, measured using Cohen's d effect size, was actually quite small; this led her to develop the gender similarities hypothesis, which proposes that women and men are more similar than different for most, but not all, psychological variables. - Cohen's d effect size: A measure of the strength of the relationship between two variables in a population. - The notable exceptions include psychological factors related to physical capacities like throwing velocity and distance, spatial ability, aggressive behaviours, and certain aspects of sexuality; men show greater masturbation incidence, greater erotic materials use, more frequent casual sex behaviour, and more permissive attitudes toward casual sex.

Sex Hormone Variations

- In some DSDs, the developmental variation relates to genetic abnormalities in some aspect of hormone synthesis or hormone receptors. - Three of the most common DSDs of this sort are: congenital adrenal hyperplasia (CAH), androgen insensitivity syndrome (AIS) and 5-alpha-reductase deficiency.

Klinefelter's Syndrome (XXY)

- Klinefelter's syndrome is the most common sex chromosome trisomy disorder, affecting 1 in 500 to 1000 males of all ethic backgrounds. - Males with Klinefelter's syndrome have an abnormal chromosomal complement, with the presence of one Y chromosome and two or more X chromosomes (typically XXY). - The developmental differences associated with Klinefelter's syndrome are thought to result from genetic abnormalities relating to having two copies of the androgen-receptor gene present on the X chromosome. - Through a complex genetic and hormonal feedback loop, the result is lower testosterone production because of cell abnormalities and impaired feedback signalling to the hypothalamic pituitary axis, resulting in high levels of follicular stimulating hormones. - In the majority of cases, Klinefelter's syndrome is not diagnosed until puberty, at which time physical feminization becomes apparent. - Boys with Klinefelter's syndrome often present with gynecomastia (breast development), small testes, shorter-than-average penises, low testosterone levels, tall stature, verbal cognition problems, and compromised fertility. - Many individuals with Klinefelter's syndrome report low sexual desire, later onset of masturbation in childhood, and reduced interest in partnered sexual activity. - In addition, most are sexually attracted to women. - Typical treatment for Klinefelter's syndrome includes testosterone supplementation. - Gender identity varies among ppl with Klinefelter's syndrome, and most tend to score lower than other males in masculinity on gender role inventories (e.g., the Bem-Sex Role inventory). - Many ppl with Klinefelter's syndrome do not identify as male and some seek gender transition, reflecting androgynous or female identification that can develop from an early age.

Ethical debate--Raising a Child Genderless

- Many parents attempt to minimize gender stereotyping and strong gender schemas in their households but, to their dismay, their children end up doing gender just as other children do. - 2011--Kathy Witterwick and David Stocker publicly announced, in a Toronto Star Article, that they intended on raising their four-month-old baby, Storm 'genderless'. - The parents, who have two older sons, Jazz and Kio elected to not share information about heir child's biological sex with the world, including the child's grandparents. - The parents stated that they were giving Storm the freedom to choose whom the child wants to be rather than having a gender role consistent with the child's biological sex imposed upon the child, noting that gender role socialization begins form an early age. - Given that the family practices 'unschooling', a form of home schooling where a child's curiosity drives learning in an unstructured fashion, their children are unlikely to experience bullying in a traditional elementary school. - At some point in their lives, however, these children will have interactions with others in mainstream society. - This bold social experiment raises several interesting questions about the nature of the development of gender identify in children: 1. Is it possible to be genderless in Western society? 2. Is it ethical for Storm's parents to choose no gender identity for the child? 3. Will Storm be marginalized for not conforming? 4. How will Storm's gender identity be affected by storm's parent's decision? 5. Does this experiment have the potential to cause harm? If so, what kinds of harm?

Gender Variation in Childhood and Adolescence

- Not all children adopt the gender identity or role strongly associated with their biological sex. - Among gay men and lesbian women, a significant percentage of individuals recall a gender nonconforming childhood. - In children who insist that they are the other sex, not simply that they wish to be the other sex, their transgender identity is more likely to persist into adolescence and adulthood. - Considerable controversy surrounds the diagnosis of gender nonconforming children with gender dysphoria, and whether treatment, and what kind, should be started at a young age. - Because sex hormones begin to significantly transform girls' and boys' bodies at puberty, some treatment centres are providing drugs that block the hormones associated with puberty. - The aim of this treatment is to stop the feminizing or masculinizing effects of estrogens and androgens until the child is old enough to male the decision to pursue or not pursue gender transition. - Kenneth Zucker works with gender dysphoric children to encourage them to accept their birth sex,, and with heir families to address negative attitudes toward gender variance that may negatively affect their child. - This approach has received considerable criticism, as it has often been misinterpreted as discrimination or silencing of gender minorities. - Research data suggest, however, that the vast majority of fender nonconforming children lose their gender dysphoria, and many grow up to be happy and well-adjusted adults. - Gender Dysphoria: Distress resulting from the discrepancy between one's felt gender identity and one's biological sex and/or the gender one was assigned at birth. - Therefore, Zucker's approach may be preferable to invasive often irreversible medical interventions such as transition related surgeries (TRSs), which can be risky and may carry long-term health consequences, including infertility for the majority, circumventing this process is thought, by some, to be a more positive approach. - Transition Related Surgeries (TRSs): Surgical procedures to alter physical characteristics to reassemble those typically associated with one's felt gender.

Culture and Diversity: A Third (or more) Gender(s)?

- Not all cultures have a choice of only two gender boxes to tick when you are completing forms. - Australia--offers a third option for gender on passport applications - In 2011: an 'other' category was added to the male and female options to accommodate intersex individuals. - Unfortunately, Canada lags behind in this respect: those seeking a change in gender identification on their passport, are required to submit medical documentation showing that they have undergone SRS - Applicants who have not yet undergone SRS can get a passport that states their preferred gender, but these passports are valid for two years only and are issued only to applicants who can provide documentation that they will undergo SRS in the next year. - These requirements have been dropped in the US and in Britain, where individuals can choose the 'other' category without having had the surgery or without plans to have the surgery. - Other countries have long recognized diversity in gender expression. i.e., Fa'afafine of Samoa - The Hijras are a religious community of biological males (and a small group of intersex individuals_ who dress and act like women. - Most Hijras undergo an operation (called nirvaan) in which their genitals are removed. - Although the penis, testicles, and scrotum are removed, unlike transwomen undergoing SRS, no vagina is constructed. - The hijras are therefore defined as eunuchs, and they are seen as a third sex. - Hijras are accorded a special status in India through their connection with the Mother Goddess and the female creative power embodied by her. - Although many view hijras view themselves as neither male nor female, some see themselves as females, feminine males, or androgynes. - A minority of them--those who have been influenced by international discourses around LGBTTIQQ identities--may identify as transgender or as transwomen. - However, unlike Western transwomen, hijras do not attempt to 'pass' as women. - Typically, hijras will have masculine men as sexual partners and will be (anally) penetrated by them. - Although some hijras have 'married' men n the past, the marriage is not usually recognized by law or religion. - Most hijras live marginalized lives and have a low socio-economic status. -There are few employment opportunities for them outside of performing at ceremonies, and there is typically little money to be made from this livelihood. - Many can be seen begging on the streets for money, and some turn to prostitution.

Gender or Sex?

- On the surface, distinguishing between biological sex and gender seems simple; sex refers to biological femaleness or maleness--as indicated by genes, hormones, and physiology--whereas gender refers to the psychological experience of femaleness or maleness--an emergent property of the biological and socio-cultural factors that influence gender identity and gender roles. - Biological sex: The biological condition of being male and/or female, as determined by genes, chromosomes, hormones and physical traits. - Gender identity: The way in which one identifies with a gender category (e.g., man, woman, neither). - Gender Role: The set of social and behavioural norms that are considered to be socially appropriate for individuals of a specific sex in the context of a specific culture. - Gender development begins much the same way as sex development begins--before birth, based on an individual's genetic makeup. - After all, an individual's phenotype is strongly influenced by that person's genotype. - Phenotype: The outward appearance or expression of a set of physical and behavioural traits, determined by genotype and environment. - Genotype: The genetic constitution of an organism, determined by genetic components inherited from the organism's parents. - Chromosomal sex plays a definite role, as the X and Y chromosome contribute to determining whether a fetus develops as genetically female (XX) or genetically male (XY). - Genes present on the X and Y chromosomes are also key players in influencing sex and gender, particularly those that instruct the indifferent gonads to develop into ovaries (FOXL2, WNR4, RSP01, DAX1) or testes (SOX9). - The gene that determines which gonad-differentiating genes are expressed is the SRY gene, found on the Y chromosome. - In a typically developing XY male, the presence of SRY overrides the ovary-promoting genes present on the X chromosome, resulting in male gonads (testes) that secrete androgens at puberty, resulting in a male-looking body. _ If there are ovary-determining genes present and no SRY gene, as in the case of a typically developing XX female, ovaries develop and will secrete estrogens at puberty and result in a female-looking body. - If SRY is expressed on an X chromosome in an XX female (Called SRY translocation), testes will develop, and the individual will develop to be phenotypically male. - Similarly, if SRY is silent on a Y chromosome in an XY male, ovaries will develop, and the individual will very likely be phenotypically female. - As this discussion suggests, an individual's gonadal sex is an important component of that person's resulting sex and gender, largely because the gonads play a role in regulating hormones and, thus, influencing the individual's hormonal sex. - Gonadal sex: Sex determined by the presence of female gonads (ovaries) and.or male gonads (testicles) - Hormonal sex: Sex determined by levels of estrogens and androgens. - Hormones secreted by the gonads not only influence the appearance of external sex characteristics and reproductive organs, but also affect many other sites in the body, including the brain. - Throughout prenatal and postnatal development, the hormonal milieu has both organizational and activational effects on the brain, influencing subsequent behaviour and experience, sexual and otherwise. - Gender could therefore be described as brain sex, the distal result of genetics, proximally shaped by interactions with hormonal secretions during development. - Biological development does, of course, unfold within a socio-cultural and political context. - The individual's experience of gender therefore becomes formulated in theses context and is labelled as gender identity, corresponding to the individual's sense of femaleness and/or maleness. - These core beliefs about the self are then expressed within a gender role, or 'shared expectations that apply to individuals on the basis of their socially identified sex', as behaviours the individual engages in, characteristics the individual possesses, and positions the individual holds in society. - Gender role is, in turn, informed by gender schemas and stereotypes, or attitudes about what are acceptable behaviours, attributes, and positions in society for women and men. - Gender schemas: Mental frameworks based on understandings of how men and women typically behave. - Gender stereotypes: Widely held beliefs about the typical characteristics and behaviours of men and women. - Gender role and gender identity are therefore products of the intersections among psychological, biological, and socio-cultural facets of gender.

Masturbation, Numbers of Sexual Partners, Attitudes toward Casual Sex, and Erotica Use

- One interpretation of the consistent gender differences in masturbation frequency, reported number of sexual partners, attitudes toward casual sex, and erotica use is that they reflect a stronger and more persistent male sex drive. - Attitudes about casual sex and actual sexual behaviour in non-committed contexts have consistently shown gender differences, with men reporting greater sociosexuality. - Sociosexuality: Individual difference in the willingness to engage in casual sexual activity. - According to parental investment theory, gender differences in sociosexuality reflect men's greater reproductive effort and lower cost of reproduction. - Women do engage in casual sex - There is some evidence to suggest that women do so strategically at times of high fertility, by selecting male casual partners who have characteristics associated with high genetic fitness, such as facial symmetry and low vocal pitch. - Further, research has shown that women's interest in sex may fluctuate as a function of their menstrual cycles, with women reporting greater sexual interest and sexual receptivity when they are ovulating. - Thus, differences in men's and women's sexual behaviours may be less prominent when women are ovulating. - Bailey and Colleagues (1994) - found that among LGBTTIQQ individuals, differences in sexuality are both gender typical-that is, congruent with what is espected for women and men based on gender norms--and gender atypical. - The researchers found that gay men have similar interest in visual sexual stimuli, exhibit similar attitudes toward uncommitted sex, place similar importance on the physical attractiveness of their sexual partner, and reveal a similar lack of concern about their partner's social status as heterosexual men do, but they report significantly greater sociosexual behaviour, likely because they are having sex with men who also have less conservative attitudes about casual sex. - Heterosexual men, however, show significantly greater preference for youthful partners and significantly greater sexual jealousy, or emotional upset at the idea of their partner having other sexual partners, than gay men do. - According to evolutionary accounts of gender differences, these aspects of heterosexual men's mating psychology are attributable to a bias toward women of reproductive age, and to a gear of their female partner giving birth to a child that is not theirs, a very costly enterprise from the perspective of reproductive fitness. - In the same study, lesbian women did not differ from heterosexual women in their preference for youthful partners, interest in uncommitted sex, sense of the importance of their partner's physical attractiveness, or sociosexuality. - Lesbian women did, however, report significantly greater interest in visual sexual stimuli for lesbian women. - Heterosexual women reported significantly greater importance of a partner's social status than lesbian women did, consistent with parental investment theory; heterosexual women are prioritizing mate characteristics associated with the ability to provide resources. - Social role theorists interpret reported gender differences in sexuality, such as those discussed above, reflecting men's and women's desire to conform to gender norms, rather than differences in actual behaviour. - The consequences of deviating from any social norm are high, but the costs of deviating from gender norm expectations with respect to sexuality are particularly high: men's sexual orientation or prowess may be questioned, and women's sexual integrity may be questioned. - Indeed, the largest gender differences in sexual behaviours appear to be associated with agentic activities: men masturbate and use erotic materials more frequently than women do. - Self-reports of partnered sexual activities are also influenced by gender-stereotyped expectations: men are allowed (and expected) to be more sexually permissive than women. - Thus, men and women may report--both in formal research settings and in informal personal encounters--that their sexual attitudes and behaviours are consistent with gender norms in order to avoid negative social consequences.

Sex Chromosome Variations

- Recall that the typical sex chromosomal complement is either two XX chromosomes (in females) or one X and one Y chromosome (in males). - In some cases, however, individuals are born with extra or fewer X or Y chromosomes. - Such chromosomal anomalies can have profound effects on physical and psychological aspects of sex, sexuality, and gender. - Two of the most frequent chromosomal abnormalities are Klinefelter's Syndrome and Turner's Syndrome.

Patterns of Sexual Response

- Research suggests that women and men differ in two aspects of their sexual response to sexual stimuli: Specificity of sexual arousal and sexual concordance. - Specificity of sexual arousal: Agreement between self-reported sexual attractions and sexual arousal patterns. - Sexual Concordance: Agreement between self-reported sexual arousal and genital arousal. - Whereas men's patterns of sexual arousal and genital response closely correspond to their stated sexual attractions to women and/or men, heterosexual women's do not. - Although women who are exclusively heterosexual report greater sexual arousal to both stimuli (visual and auditory) depicting men than that depicting women, they show genital responses to sexual stimuli depicting women as well as to as that depicting men. - Women who report same-sex attractions, however, show greater arousal to female stimuli than do women who report no same-sex attractions, and this response varies with the reported degree of their same-sex attractions. - Reasons for gender differences in specificity and concordance may relate to how women and men incorporate feedback from sexual response into their emotional experience of sexual arousal and subsequent sexual desire. - For women, awareness of genital arousal may not be a significant factor in determining their desire for a partner. - Given that most women experience automatic genital response to sexual stimuli, the lower concordance in women may often be produced by low reports of feeling sexually aroused. - Reporting biases and sexual double standards may explain why studies repeatedly find that women's minds and bodies are not as in sync as men's are.

Sexual Orientation

- Sexual orientation is one aspect of sexuality that shows a large gender difference. - The majority of men report sexual attraction to women, and the majority of women report sexual attraction to men. - The effects of this gender difference is estimated to be between d=3.8 (Lippa, 2005) and d=6.0 (Hines, 2004) (which is massive, considering that 0.8 is considered to be a 'large' effect size). - Women are, however, less likely than men to report exclusive opposite-sex attraction: 23% of women, compared with 94% of men (based on data from a nationally representative US survey). - Are women more likely to be bisexual than men are? Chandra et. al's (2010) study data suggests that yes, women are more likely to identify as bisexual, to report sexual behaviour with both women and men, and to report feeling sexually attracted to both women and men. - Women are also more likely than men to have had same-sex sexual contact (13% of women compared to 5.2% of men). - Among women who had opposite-sex partners, same-sex behaviour appears to be related to their total number of opposite-sex partners; women reporting four or more opposite-sex partners in their lifetime were more likely to report same-sex behaviour (20%) than were those reporting fewer numbers of opposite-sex partners (3.5 to 8.5%). - Among men who have had opposite-sex partners, no association between total number of opposite-sex partners and sexual behaviour with same-sex partners was shown. - These data coincide with results from research by Richard Lippa (2006), which has demonstrated that as women's sex drive increases (as would be indicated by a higher number of sexual partners) so does their sexual attraction to both women and men, whereas for men so such association exists. - Another notable gender difference in sexual orientation relates to the exclusivity of same-sex attractions: cisgender women (women whose gender matches their biological sex) are far more likely than cisgender men (men whose gender matches their biological sex) to report some degree to both same-and-other-sex attractions. - Some interpret this gender difference to reflect a broader pattern of greater flexibility in women's sexuality, compared to that of men, when it comes to gender preferences. - Bisexual and Lesbian identified women are also more likely to change sexual identities over a 10-year-period than are gay or heterosexual men; bisexual men, however, also show flexibility in their identity over time. - The reason for the seemingly greater fluidity of women's sexuality is not known, although research suggests that women's capacity to experience sexual arousal in response to a broad range of sexual stimuli may be related to higher levels of same-sex attractions among women. - Socio-cultural factors, such as cultural prohibitions against same-sex sexuality, likely play a significant role in women's reporting of same-sex attractions. - Chandra et. al (2010) found that non-Hispanic White women were less likely than Hispanic women or Black women to say they are attracted "only to the opposite sex (81%, 89%, and 86%, respectively). - Further, women who completed the survey in Spanish were more likely than other women to say they are attracted "only to the opposite sex" (95% compared to 82%)

Social Structural Theory

- Social structural theory proposes that gender differences in sexuality, particularly in relation to mate preferences, arise because of a gendered division of power that emerges from a gender-stratified workforce where men control resources; men tend to work outside of the home and be the primary breadwinners, while women are more often primary caregivers to children and secondary breadwinners. - These different expectations, or gender norms, dictate the appropriate conduct for men and women, resulting in further gender-differentiated behaviours. - Men are expected to take on agentic roles, behaving in an assertive, independent, and dominant manner, whereas women are expected to take on communal roles, by being relationship-oriented, submissive, and dependent. - Gendered power inequality often manifests as the privileging of male sexuality, sexual objectification and dehumanization of women, and women prioritizing the acquisition of long-term mates with resources, as they have limited means to provide resources for themselves. - Supporting this theory, women and men from more gender-egalitarian societies, as indexed by a gender-empowerment measure developed by the United Nations Development Programme, report more similar incidence and frequency of sexual behaviours such as masturbation, vaginal intercourse, anal intercourse, and casual sex; yet even in these societies certain gender differences remain, in particular, masturbation and erotica use. - Although power differentials do seem to influence expression of certain sexual behaviours, sexual attitudes do not seem to vary with gender empowerment.

Physical Traumas and Congenital Variations

- Some individuals are raised in a gender role discordant with their chromosomal sex for reasons other than a genetic disorder (i.e., David who lost his penis during infancy). - In other cases, physical developmental anomalies unrelated to sex chromosomes or sex hormones, such as penile agenesis or cloacal exstrophy, result in a genetic male not developing a penis. - In the past, these males were reassigned to the female role in infancy because they lacked a penis. - One review has suggested that such males who are assigned a female gender role at birth are significantly more likely to transition to the male role than those assigned to the male role at birth. - Other studies following the gender identify development of genetic males with cloacal exstrophy raised as girls suggest that their gender role, and for some, their gender identify, is more strongly associated with genetic and hormonal sex than the assigned gender. - In one study examining genetic males with colacal exstrophy, for example, 8 of 14 individuals raised as girls had transitioned to the male gender role between the ages of 5 and 12 years, and all had markedly male-typical interests. - These cases suggest that both NATURE and NURTURE play crucial roles in shaping gender identity.

Trans Identities

- Some individuals feel, often from a young age, that their gender doesn't match the gender typically associated with their biological sex. - These individuals may feel as though they are trapped in the wrong body and forced to live in a gender role that doesn't match their inner self. - People whose gender is opposite to their biological sex may refer to themselves as trans or transgender, following a similar nomenclature, borrowed from biochemistry, ppl whose gender matches their biological sex are referred to as cis or cisgender. - The terms transgender and transsexual are often used interchangeably. - The term transgender will reefer to an individual whose gender identity and gender role are opposite to that person's biological sex but who has not (or has not yet) elected to have transition related surgeries (TRSs), and transsexual will refer to an individual who is transgender and has elected to undergo TRSs. - Biological males who identify as women are referred to as transwomen, and biological females who identify as men are referred to as transmen. - The terms male-to-female (MTF) transgender (or MTF transsexual) and female-to-male (FTM) transgender (or FTM transsexual) are also used to describe transgender (or transsexual) individuals, with the initial gender term denoting biological sex at birth, and the second gender term denoting the felt gender identity (and, in the case of transsexual people, the gender associated with their acquired physical characteristics). - Transwoman: A biological male who identifies and presents as a woman. - Transman: A biological female who identifies and presents as a man. - Some individuals eschew gender categories altogether, preferring the concept of a continuum of fluid gender, or choosing to identify as genderqueer, similar to LGBTTIQQ individuals who choose to identify as queer or unlabelled instead of more standard labels of sexual identity. - Genderqueer: A person whose gender identification and self-presentation does not conform to gender categories.

Autogynephilia

- Some individuals in the transgender community reject the idea that autogynephilia is is developmentally associated with a trans identity in some trans-women. - These individuals argue that applying the concept of autogynephilia to transwomen equates a trans identity with psycho-sexual pathology or paraphilia, and that this equation is harmful to the trans community because it contradicts the subjective experience of transwomen as women trapped in men's bodies. - No clearer example of the bitter dispute between some in the trans community and some in the scientific community exists than the backlash J. Michael Bailey received for his book, The Man Who Would be Queen (2003). - In this book, Bailey discusses feminity in biological males, with a chapter devoted to transgender/transsexual typologies in which he provides a detailed discussion of Blanchard's research on autogynephilia. - The publication of this book sparked an onslaught of attacks on the scientific community, the majority aimed at Bailey. - The conflict regarding discussions of autogynephilia in relation to transwomen in general--and in reaction to Blanchard's and Bailey's work in particular--is surprising for many reasons. - First, prior to Blanchard's work, there was little consensus on how to understand the variability in sexual and gender histories among trans-women, or how this variability related to the desire to transition to the felt gender role. - Many typologies existed, but that of 'primary' and 'secondary' transwomen persisted, describing 'homosexual' transwomen (those attracted to men) and 'nonhomosexual'/'transvestitic' transwomen (those attracted to women) respectively. - Along with this typology persisted the belief that 'secondary' transwomen were inappropriate candidates for SRS. - B/C of a lack of understanding and knowledge, transwomen with a history of erotic cross-dressing were at risk of being misdiagnosed as 'transvestites' and the legitimacy of their transgender identity as women being called in to question. - As a result, transwomen frequently concealed their erotic cross-dressing and autogynephilia for fear they would be labelled 'secondary' and denied treatment. - Blanchard's research showed that transwomen reporting a history of autogynephilia also experienced significant transgender feelings and gender dysphoria, and that they should therefore receive support for gender transition. - More recently, Anne Lawerence's reasearch has demonstrated that factors associated with the autogynephilic transwoman typology are not associated with post-SRS regrets. - Second, rejection of the legitimacy of autogynephilic pathways to a trans identity means that transwomen with this history are silenced and marginalized within the trans community. - Moreover, some within the trans community have described autogynephilia using the pejorative and judgmental term 'perversion', thus stigmatizing individuals with both atypical sexual interests and gender variation. - With research clearly demonstrating the benefits of social supports to sexual and gender minorities, this feature in the trans community may serve to further alienate autogynephilic transwomen trying to understand their gender and sexual variations, and it may increase the risk of psychological harm. - Third, autogynephilia and its association with a trans identity has been described in the clinical and research literature's for decades, there is still only an incomplete understanding og how this sexual interest develops or how it relates to the emergence of a transgender identity. - B/C first cross-gender wishes typically emerge simultaneously with the onset of erotic cross-dressing in autogynephilic transwomen and well-developed transgender identities emerge only years later, both advocates and opponents of autogynephilia theory have assumed it is the autoerotic impulse that motivates gender transition in autogynephilic transwomen. - In reality, however, it is not clear that there is a casual relationship between autogynephilia and gender identitiy in transwomen. - Fortunately, the rejection of discussions of autogynephilia in relation to trans identities was not universal. - Many transwomen are relieved that autogynephilic interests, previously a taboo topic, are now being openly discussed in the trans community.

The Choice Not to Transition

- Some transgender people opt not to transition to the opposite sex, rejecting the medical model of transsexuality, which suggests that transgender individuals have a medical disorder that requires a medical intervention to correct. - These individuals may have practical reasons for not fully transitioning, such as medical conditions that preclude physical procedures, or they may reject the notion that they must choose one gender, or must possess all physical and psychological traits of one gender. - In many cases, these individuals identify as genderqueer, and they may view modern Western culture's binary division of their physical and psychological selves. - This view is more consistent with that held by various societies around the world in which gender minorities are more commonly accepted.

Psychological and Physical Evaluation

- The first stage is a psychological and physical evaluation by professionals with experience assisting gender transitions. - Some individuals opt to start individual or group psychotherapy at this stage to recruit social and psychological support throughout gender transition, to connect with others undergoing gender transition, and to identify and negotiate potential barriers to a smooth gender transition. - Because transition typically involves extensive and irreversible surgeries, the individual seeking treatment should be seen by a mental health professional to ensure that the decision is not motivated by factors other than a strong desire to match physical attributes to the felt gender role. - The purpose of the physical evaluation is to determine whether the individual is intersex, and to identify any other factors that may play a role during hormonal and surgical transition, such as general health.

Transition Related Surgeries (TRSs)

- The fourth stage is transition related surgeries (TRSs), which WPATH recommends to start at least one year after hormone therapy begins. - This stage generally involves multiple surgeries to create genitals (bottom surgery) and a chest contour (top surgery) associated with the felt gender. - For transwomen, key surgeries include bilateral orchidectomy (removal of the testicles) and reconstruction of the penile and scrotal tissues to form a vulva (labiaplasty, clitoral construction) and a vaginal canal (vaginoplasty). - Depending on the extent of breast development from estrogen therapy, a trans-woman might also elect to have breast augmentation surgery. - Other surgeries may be performed to raise vocal pitch, reduce the size of the laryngeal prominence (adam's apple), and create a more feminine facial and/or body appearance. - For transmen, top surgery involves having a bilateral mastectomy (removal of both breasts) and cosmetic surgery to create a male-typical chest appearance. - Bottom surgery includes a complete hysterectomy (removal of the uterus), an oophorectomy (removal of the ovaries) and often scrotoplasty and phalloplastu (construction of a scrotum and a penis respectively). - Many transmen forego phalloplasty because creating a penis with a functioning urethra and capacity for erections (using a mechanical erection device) involves many expensive surgeries. - The constructed penis, depending on the procedure, can be erotically sensitive when constructed from skin grafts from areas such as the forearm or thigh. - Nerves from the graft can be connected with those on the clitoris, facilitating erotic sensation in the new penis. - Many transmen opt to obtain a metoidioplasty, a surgical procedure in which the enlarged clitoris is freed from the clitoral hood and a penile shaft is created; some opt for no bottom surgery at all beyond a full hysterectomy. - The result is a small, erotically sensitive penis capable of an erection and orgasm, although penetration may not be possible depending on how firm the erection is.

Introduction

- The idea of gender as a psychological construct was f2wwwwwwwwwwirst coined in the 1960s by John Money, he used the term gender to describe the psychological experience of femaleness and maleness. - Money's treatment of gender-variant individuals led him to co-opt the term gender from linguistics, creating language that describes the experiences of those whose biological sex and psychological sense of femaleness or maleness do not coincide, and giving rise to the concept of gender as a psychological phenomenon. - Gender: The psychological experience of femaleness and/or maleness.

Life Experiences and Sexual Orientations of Transmen and Transwomen

- The majority of transmen recall a gender nonconforming childhood--being tomboys, preferring stereo-typically male toys and physically active games, having more male than female playmates, rejecting female clothing and hairstyles, and insisting that they were boys and would eventually grow a penis. - Many transmen also recall feeling distress as their bodies became more feminine during puberty. - In adolescence and into adulthood, many seek to hide physical characteristics of their biological sex, binding their breasts and dressing androgynously. - Research suggests that the majority of transmen report sexual attraction to women and so are, relative to their biological sex, same-sex oriented; after transitioning to the male role, these men identify as heterosexual. - A minority of transmen do, however, report predominant sexual attractions to men, and after transitioning, identify as gay men. = On average, transmen who are primarily attracted to women recall a somewhat more gender atypical childhood and report greater interest in sexual stimuli than do transmen who are primarily attracted to men, but both groups report similar levels of male gender identification in adulthood, and both report a desire for a masculine body. - The childhood experiences of transwomen are more divergent and, according to clinical research by Ray Blanchard, professor emeritus of psychology at the U of T, generally fall in two groups corresponding with the individual's sexual orientation. - The first group is that of biological males who were very gender atypical as children--they dressed as girls, believed they were girls, preferred girls' toys and activities, had predominantly female playmates, and experienced gender dysphoria. - Physically, these individuals may appear very feminine in their mannerisms, gait, voice, and physical presence, prior to any hormonal or surgical interventions or cross-living in the female role, and they may be indistinguishable from cisgender women when presenting in the female role. - These transwomen typically are sexually attracted to men (are same-sex oriented relative to their biological sex) and, after transitioning to the female role, typically early adulthood, identify as heterosexual women. - The second group is that of transwomen who report a childhood that tended not to be gender atypical, and who report feeling predominantly sexually attracted to women. - These individuals often recall feeling different from other male children, but they were not overtly gender nonconforming and generally did not experience gender dysphoria in their childhoods. - Many recall dressing in women's clothing for the first time around puberty, becoming sexually aroused, and masturbating to orgasm; such behaviour is similar to that associated with transvestic fetishism (or transvestic disorder), which occurs when a non-gender dysphoric cisgender man experiences sexual pleasure from dressing in women's clothing. - For many who seek transition to the female role, their eroticized cross-dressing progresses to sexual arousal at the idea of possessing female physical characteristics such as a breasts and a vulva. - Blanchard refers to this phenomenon as 'autogynephilia'. Authogynephilia: A sexual variation in which a man is sexually attracted to the thought of himself as a woman. - Transwomen who are predominantly attracted to women tend to be less physically feminine in their gait, physical presence, and mannerisms, despite their strong identification as being female. - Many of these transwomen seek gender transition later in life, after living as a male in a heterosexual relationship, often after an extensive history of cross-living in private. - Many transwomen with a history of autogynephilia report that sexual arousal at wearing women's clothing or presenting as a woman lessens or disappears altogether after gender transition.

Post-Surgery Outcomes

- The majority of transsexual ppl report satisfaction with their surgery and improvement to their quality of life after transitioning. - In a study of 232 post-operative trans-women treated by the same surgeon, the vast majority reported being satisfied with the outcome and experiencing improvement in the quality of their lives. - Transmen who obtain hormone treatment report better quality of life than those not taking hormone therapy. - Ray Blanchard and his colleagues conducted a follow-up study of transsexual women and men; they reported that all 61 transmen and 46 out of 50 transwomen had satisfactory outcomes. - All of the transwomen who reported regrets were sexually attracted to both women and men, and on average, they were older when they transitioned. - Age at the time of TRSs, physical health, mental health, strong social support, a body build compatible with the chosen sex, and success of the surgery are all components that contribute to satisfaction with the transition process.

The Real-Life Experience

- The second stage is called the real-life experience, in which trans individuals fully transition to the social role matching their felt gender. - It is recommended that the real-life experience continues for at least one year, to give individuals time to cope with adjustments in their personal and work life , and to ensure they are able to function in their felt gender role. - Depending on where individuals undergo this transition, they may face significant discrimination; gender support groups can therefore provide a place to share stories, information, and support. - In Canada, human rights laws generally prohibit discrimination against pre-operative, transitioning, and post-operative transgender and transsexual persons, although section 15 of the Canadian Charter of Rights and Freedoms does not explicitly refer to gender minorities.

Hormone-Replacement Therapy (HRT)

- The third stage, HRT is usually initiated after at least one year of real-life experience, ideally under the care of an endocrinologist. - Transmen begin taking injections of testosterone at this stage. - The male hormone causes male-pattern hair growth on the face, chest, and body, thickening of the cartilage in the larynx, causing deepening of the voice, and changes in body fat distribution consistent with a male-typical pattern. - As testosterone accumulates in the individual's system, menstrual periods cease, and the clitoris becomes larger. - Many transmen undergoing hormone therapy also report increased sexual desire, more frequent sexual thoughts, stronger feelings of aggression, and greater salience of sexual stimuli; some also report a change in their preferences for visual sexual materials. - Transwomen begin taking androgen-blocking drugs and estrogens at this stage. - The estrogens change body fat distribution to a more female-typical pattern and cause the skin to feel smoother. - Transwomen undergoing hormone therapy will also experience breast growth, and for some this growth will be satisfactory and obviate breast augmentation. - The treatment does not, however, stop male-pattern balding or beard growth; most transwomen must undergo extensive electrolysis or laser treatments to remove their male-typical facial hair permanently. - The androgen-blocking treatment typically reduces sex drive, along with the frequency of erections and ejaculations. - Many transwomen report relief at the subsiding of their sex drive, although some experience complete lack of sexual interest as a side effect and may take small quantities of testosterone to restore their sex drive after they have undergone SRS.

Turner's Syndrome (XO)

- Turner's syndrome affects approximately 1 in 2500 females. - It involves abnormalities of the X chromosome that result in a missing second X chromosome, a chromosomal 'monosomy'. - Women with Turner's Syndrome tend to have a short stature, a broad chest, and widely spaced nipples, under-developed female physical characteristics (i.e., breasts), and problems with ovarian development and sex hormone levels, leading to infertility. - Women with Turner's syndrome are often treated with growth hormones during childhood, hormones to reduce pubertal development, and hormone-replacement-therapy throughout childhood. - Sexual milestones, such as first masturbation and first partnered sex, are typically reached at later ages than in unaffected women. - Most women with Turner's syndrome identify as female and intersex.

Other Areas of Transition

- Undergoing physical and physiological changes is only one component of a gender transition; post-operative transsexual women and men must also negotiate changes in their personal relationships. - Coming out as trans can be as or more challenging than coming out as not heterosexual, particularly since many individual may have little experience with trans people and may have negative attitudes and actively discriminate against gender minorities. - Hate crime and abuse rates are higher for gender minorities than for LGBTTIQQ individuals. - Some trans ppl face discrimination from LGBTIIQQ individuals as well, particularly if they have transitioned to become a lesbian transwoman or a gay transman. - Transsexual individuals must decide when and how to discuss their transsexuality with new romantic and sexual partners. - Because transwomen are able to obtain genital surgery that creates a very natural-looking vulva and functional vagina, some transwomen are able to have sexual relationships with women and men without revealing their identity as trans; for transmen, this discussion typically happens much earlier in a sexual relationship. -Fortunately, many ppl have positive attitudes toward gender minorities, accepting trans people as their new sex.

Gender Socialization

The learning of behaviour and attitudes considered appropriate for a given gender role.