Mental health articles

Understandings of gender dysphoria and GID A number of factors contribute to our understanding of gender dysphoria and GID. Biological development, infant–parent relationship issues and the experiences of people born intersex are all areas of study that have contributed to knowledge in this area. Biological development Biological theories have looked at possible genetic influences, the effects of prenatal sex hormones and studies of children for evidence of possible sexrelated differences in cognitive abilities and noted that as a group, GID boys are considered physically attractive when assessed by independent raters (Zucker & Bradley, 1995). On the whole there is no clear evidence for a simple biological course of GID. Current models of brain-sex differentiation hypothesise that inutero development, possibly in response to hormones, may result in a ‘crossgendered’ development of certain brain structures. While there is some limited evidence for structural brain differences in adult transsexuals, little work has yet been done on infant brain-sex development. A complicating issue is that adults interact very differently with male and female infants, which may in itself affect the way the brain develops. Infant–parent relationship issues Stoller (1968), from a psychoanalytic point of view, comments on an overly close relationship with the mother—an excessively symbiotic physical relationship— and the absence of a psychological father in boys with GID. Mothers, Stoller thought, had their own conflicts over femininity, penis-envy, and were excessively masculine in their own childhoods and bisexual. For Stoller, the little boy with GID cannot separate from his mother or identify with his father so he ‘becomes’ his mother. In assessment of families with concerns about a child’s gender development it is important to examine the parents’ acceptance of their child’s sex, and a history of any gender confusion in the parents’ own childhood. Assessment should also focus on the parent’s practices of gender socialisation, such as choice of toys and games activities. Effect of being born intersex Intersex infants are known to their parents as being ambiguously sexed from birth. Ambiguity about gender is not very well tolerated in our culture, by parents or surgeons, and the demand is to operate to fix the body. Parents therefore have to go through the decision-making process about which sex their child will be and this clearly influences their relationship with their child. The focus on genitals and the often protracted multiple operations needed to correct them must mean that parents are sensitised to possible gender deviance. That is,
parents expect there might not be congruence between the assigned sex and the gender behaviour that emerges, and are therefore more likely to notice behaviour that is not consistent with gender norms.

Tags: dysphoria