Atypical Gender Development

Question 1

Gender Dysphoria

Answer 1

• Some men and women experience a mismatch between their sex and the gender they feel they are.
• Individuals with gender dysphoria do not identify as the sex given at birth.
• For many people who experience this, it is a source of stress and discomfort and is thus recognized as a psychological disorder in DSM-5.

Question 2

The Diagnostic Criteria

Answer 2

• The fifth edition of the DSM-5 says that diagnosis occurs when a person feels persistent psychological distress due to the mismatch between the gender they identify with and that which was given to them at birth.
• It must occur for 6 months and cause significant impairment in social, occupational and other important areas of functioning.

Question 3

Biological explanations

Answer 3

• In its categorisation of gender dysphoria, DSM-5 specifically excludes intersex conditions that have a recognised biological basis.
• Nevertheless, it is plausible that gender dysphoria may be subject to some biological influence.

Question 4

Brain sex theory

Answer 4

• One biological explanation suggests that gender dysphoria has a basis in brain structure - the bed nucleus of the stria terminalis (BST).
• This structure is involved in emotional responses and in male sexual behaviour in rats. This area is larger in men than women and has been found to be female sized in transgender females (Kruijver et al. 2000).
• This leads to the suggestion that people with gender dysphoria have a BST which is the size of the gender they identify with, not the size of their biological sex.
• This dimorphism in the BST fits with the report made by people who are transgender that they feel, from early childhood, that they were born the wrong sex (Zhou et al. 1995).
• In a follow-up study six transgender individuals showed an average BST neuron number in the female range (Kruijver et al. 2000).

Question 5

Genetic factors

Answer 5

• Frederick Coolidge et al. (2002) assessed 157 twin pairs (96 MZ and 61 DZ) for evidence of gender dysphoria.
• The researchers found that 62% of the variance could be accounted for by genetic factors. This suggests there is a strong heritable component to gender dysphoria.
• Similarly, Gunter Heylens et al. (2012) compared 23 MZ twins with 21 DZ twins where one of each pair was diagnosed with gender dysphoria.
• They found that nine (39%) of the MZ twins were concordant for gender dysphoria compared to none of the DZ which would indicate a role for genetic factors in the development of gender dysphoria.

Question 6

Phantom Limb and Cross-wiring

Answer 6

• It is proposed that the image of the sex organs is innately hardwired in the brain in a manner opposite to the person’s biological sex (Ramachandran and McGeoch (2007)).
• Such cross wiring = males feel they shouldn’t have a penis and some females feel they should.