Gender

1. Biosocial view including Gender Dysphoria 1
Gender Dysphoria
• Occasionally, boys and girls and men
and women feel that there is a
mismatch between their anatomy and
gender identity so much so they
identify more with the opposite sex.
• The feeling of mismatch of anatomy and
identity, wanting to be the opposite sex
and psychological discomfort is referred
to as gender dysphoria.
• It is still considered to be a disorder and
is categorised in the DSM as “gender
identity disorder.”

2. DEFINITION OF GENDER DYSPHORIA (“GENDER
IDENTITY DISORDER”)
o A strong and persistent cross-gender identification.
o Persistent discomfort with his or her sex or sense of
inappropriateness in the gender role of that sex.
o The disturbance is not concurrent with a physical intersex
condition.
o The disturbance causes clinically significant distress or
impairment in social, occupational or other important areas of
functioning.
In children, 4 or more of the following:
 Repeatedly stating a desire to be, or insistence that he or she
is, the other sex.
 In boys: preference for cross-dressing or simulating female
attire; in girls: insistence on wearing only stereotypical
masculine clothing.
 Strong and persistent preferences for cross-sex roles in
make believe play or persistent fantasies of being the other sex.
 Intense desire to participate in the stereotypical games and
pastimes of the other sex.

3. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 3
Zach Avery
• Zach Avery has insisted on wearing girls’ clothes
since the age of three. He is now five and was
assessed as having Gender Identity Disorder (GID)
after worried parents Theresa 32, and Darren, 41,
sought medical help.
• Mrs Avery explained her son was a ‘normal’ little boy
who liked Thomas the Tank Engine but became
obsessed with Dora the Explorer, a television
programme aimed at young girls.
• She said: ‘He just turned round to me one day when
he was three and said, “Mummy I’m a girl”. I
assumed he was just going through a phase and left
it at that. ‘But then it got serious and he would be
upset if anyone referred to him as a boy. He used to
cry and try to cut his willy off out of frustration.’
• Initially, Zach’s parents believed he was autistic but,
after several months, a child psychologist diagnosed
him with GID when he was four.
• Zach now attends his local primary school where the
toilets have been turned gender neutral to support
him.

4. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 4
ThePsychological Explanations
Conditioning
Exam Practice
Psychoanalytic
1
Freud
Psychoanalytic 2:
Separation
anxiety
•“Discuss explanations of gender dysphoria.” (5+10 marks)

5. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 5
Gender dysphoria can be explained from a
biological and psychological perspective
Psychological
• Psychoanalytic 1: state that
problems can result from
difficulties with establishing gender
identity.
• Psychoanalytic 2: GID could be a
result of an attachment disorder.
• Conditioning – Behaviourism and
SLT
Biological
• Visual differences in the brain
structures of men and women
thought to cause transsexualism.

6. Freud
“Psychoanalytic
1”
• Freudian concepts state
that gender dysphoria can
result from difficulties
establishing gender
identity in toddlerhood.
• Gender identity is
established through
resolution of the Oedipal
and Electra complexes in
the Phallic stage of
development from
identification with the
same-sex parent.
• Gender dysphoria may
result from identification
with an inappropriate role
model.
To distinguish Psychological and Biological Explanations
of Gender Dysphoria 6
Lothstein (1979), for example, claimed that some
female-to-male transsexuals had mothers who
lacked a cohesive self with which it was difficult
for girls to identify.

7. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 7
A02 Gender identification problems
• There is little evidence to suggest that some boys identify
with their mothers and girls identify with their fathers and
so go on to experience gender dysphonia.
• As psychoanalytic concepts rely on the unconscious mind and
repressed childhood traumas which affect adult personality it
is an impossible theory to test in any sort of scientific way.

8. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 8
Psychoanalytic 2: Attachment
problems/separation anxiety
• One approach that may be useful is to look at male
children with GD’s attachment to their mother.
• Boys may be ‘trying to restore a fantasy tie to a physically
or emotionally absent mother’ (by wearing her clothes!)
• A02 Support -Coates & Person (1985) and Lowry &
Zucker (1991) have found a high incidence of separation
anxiety in samples of boys with GD (60%). In other words,
there is a correlation.
• AO2 Support – Stoller found that individuals with GID had
overly close mother-son relationships.

9. Evaluation
• Cole et al studied 435 individuals experiencing gender
dysphoria and reported that the range of psychiatric
conditions experienced were no greater than that found in
the normal population. Therefore GID is generally
unrelated to trauma or pathological families.
• How is ‘separation anxiety’ measured?
• What samples are used?
• What inferences can we draw from a correlation?

10. Conditioning
• Parents of gender dysphorics
often report that they gave
attention to and encouraged their
children when they cross dressed,
particularly boys.
• Social learning could also play a
part , with an absence of or
inappropriate role models to
imitate.
• This could lead to conditioning
that is incompatible to the
individual’s sex and difficulties
relating to the opposite sex such
as gender dysphoria may follow.
10

11. AO2 support -
Conditioning
A02 Support:
Rekers reported that
out of 70 gender
dysphoric boys none
had any evidence of
biological causes but
they had experienced
a common lack of a
stereotypical male
role model –
suggesting that social
learning theory
played a role in the
condition.
But ignores role of
BIOLOGY
11

12. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 12
Ruth’s Story
http://www.nhs.uk/Conditions/Gender-dysphoria/Pages/Introduction.aspx

13. Quick Questions
1. According to the Freudian assumption, gender
dysphoria children have not passed through which
stage?
2. Therefore, according to Freud children are unable to?
3. What is separation anxiety?
4. How can separation anxiety lead to gender dysphoria?
5. How can behaviourist psychology explain gender
dysphoria?
To distinguish Psychological and Biological Explanations
of Gender Dysphoria 13

14. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 14
The Biological Explanations
Exam Practice
Genetics
andHormone levels
Environmental
pollution
•“Discuss explanations of gender dysphoria.” (5+10 marks)

15. Biological explanation 1:
Genetics and hormone levels
• Genetic conditions may affect pre-natal hormone levels
which may lead to a mismatch between genetic sex and
hormones. It is possible that the hormones have caused
parts of the brain to develop in a way that is not consistent
with the genitalia and usually with the chromosomes. The
brain has not developed in the way that corresponds to
the sex/gender assigned to the child at birth.
• Conditions such as AIS and CAH

16. 16
• Brain sex theory is based on the difference in size of
certain brain structures in men and women.
• There has been particular interest in those that are
sexually dimorphic i.e. taking a different form in males
and females.
In 1995, Zhou, Hofman and Gooren
studied an area of the brain, which
is also located in the
hypothalamus, and is known as
the bed nucleus of the stria
terminalis central division.

17. Brain differences
17
• The stria terminalis is believed to be fully developed by
five years and influences sexual behaviour.
• In post-mortems of six male-to-female transsexuals who
had received feminising hormones, it was found to be
the same size as a heterosexual woman!!
HOWEVER:
Additional post-mortem comparisons, this
time with non-transsexual clients with
abnormal hormone levels, concluded
that the size of BSTc in male-female
transsexuals could not be wholly
accounted for by their sex hormone
exposure in adulthood.

18. Evaluation
• Several brain studies of transsexuals have supported this
view e.g. Zhou et al part of the brain usually larger in
males was found to be smaller in six male to female
transsexuals. (Zhou et al)
• However, some studies have shown no evidence of
atypical biological brain development on people with the
condition.

19. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 19
Evaluation
• A problem with this theory is that Chung (2002) found that
these brain differences only emerge in adulthood
(transsexual feelings usually begin in childhood)
suggesting brain differences might be the effect of
transsexualism rather than the cause.
• Transgender hormone therapy could have caused any
changes identified because brains are examined during
adulthood or after death.
• Recent research has suggested the hormones given to
help a person become their new gender do affect brain
structure – suggesting brains were not different before
they started therapy.

20. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 20
Environmental effects – bio exp 2
• One possibility is that environmental pollution may be
causing problems. For example the insecticide DDT
contains oestrogens which may affect males prenatally.

21. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 21
Evaluation of environmental effects –
bio exp 2
• A number of studies have produced supporting evidence
- for example showing boys exposed to high levels of
these chemicals displayed more feminine play.

22. Conclusion
What does seem clear is that:
• Individuals show gender-inappropriate behaviour for a
variety of reasons.
• Any complete explanation of an individual’s gender
behaviour is likely to involve complex interactions of
different factors, particularly biological (e.g. genetic and
hormonal); social (e.g. parenting, media role models,
cultural factors, labelling) and environmental (e.g.
learning/ conditioning).

23. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 23
IDA (Issues, Debates and Application)
The complex interaction of nature and nurture
•The human brain undergoes considerable development
pre-natally and continues to develop after birth.
•By the time it is fully developed, the child has also been
subjected to numerous environmental influences, including
gender socialisation.
•It then becomes impossible to detangle the effects of
nature and nurture on both the brain and gender
development.
•It appears that whilst researchers are prepared to accept a
biological dysphoria, can we be certain it can be explained
in this way alone?

24. To distinguish Psychological and Biological Explanations
of Gender Dysphoria 24
IDA (Issues, Debates and Application)
• It is generally difficult to tease out any behavioural
effects influence by nature and nurture by this
becomes even more so in the sensitive area of gender
dysphoria where strictly a biological reductionist
explanation could be inadequate.
• If the researchers resort to reductionist measures, the
fMRI scan is the most informative as it shows the brain
in action.
• However, the brain develops pre-natally and continues
to develop post-natally when exposed to the
environment.

25. IDA– cultural issues
• As a culture, we seem to be particularly obsessed with
gender roles.
• Perhaps “gender identity disorder” (gender dysphoria)
would simply disappear from the psychiatrist’s manuals if
we were more relaxed about it!
• Individuals born biologically “intersex” could then decide
whether to adopt a male or female role, or stay ‘in-between’.
• Agree or disagree?

26. Exam question
• Discuss biological and psychological (or biosocial)
explanations for gender dysphoria (24 marks)