Gender & Psychopathology WK 5

Question 1

According to Zucker, what were the 5 most important proposed changes to the GID dx criteria for DSM-5? What was the rationale?

Answer 1

1. Change the name from GID to GD
2. Merge point A & B criteria into one category
3. Change the intro descriptor to the point A criterion
4. for children the A1 criterion is a necessary indicator for dx
5. change point B criterion to capture distress, impairment & increased risk of suffering/disability

Question 2

Why combine criteria A and B for GD?

Answer 2

strong and persistent cross-gender ID and persistent discomfort w/natal sex are best represented by one underlying dimension, according to factor analysis

Question 3

Why change the name from GID to GD?

Answer 3

The terms “identity” and “disorder” are stigmatizing and adding “dysphoria” implies distress.

Question 4

What is the A1 criterion necessary for GD diagnosis in children? How does it improve dx?

Answer 4

A1 criterion: repeatedly stated desire to be, or insistence that he/she is, the other sex. correlates highly with other cross-gender behaviors and will make the dx more restrictive, thus reducing false positives.

Question 5

what change was proposed for the A criterion intro description for GD? why?

Answer 5

removal of the “desire for perceived cultural advantages of being the other sex” because that’s ridiculous.

Question 6

why change point B criterion for GID to reflect dysphoria (distress)?

Answer 6

adolescents undergoing a clear path towards gender change are not distressed, but become extremely distressed if parents or society try to block their path.

Question 7

What are 3 types of antecedent validators?

Answer 7

Familial aggregation, sociodemographic and cultural factors, and environmental risk factors.

Question 8

Give an example of a familial aggregation antecedent validator in GD

Answer 8

higher concordance in MZ than DZ same sex twins

Question 9

Give an example of sociodemographic and cultural antecedent validators in GD

Answer 9

prevalence of childhood GD is higher in boys than girls, possibly bc male cross gender behavior is less tolerated in society. in adolescence, referral ratio narrows but boys are still referred more than girls.

GD is not culture bound, occurring in us Canada Europe India and Japan.

Question 10

Give an example of an environmental risk factor antecedent validator in GD

Answer 10

boys w/GD have a lot of brothers and are later born, possibly indicating a maternal immune response that affects the sex differentiation of the brain while the fetus in utero

Question 11

According to Zucker, what are the concurrent validators of GD? give examples

Answer 11

Cognitive, emotional, temperamental, and personality correlates (e.g. boys poor performance on visuospatial tasks from iq test and parent reported diffs in activity level compared w/controls) also, Patterns of comorbidity. boys and girls with GD in clinical samples have rates of behavior problems comparable to other clinic-referred children (of their desired gender, i.e. boys w/gd have internalizing disorders comparable with cisgender girls and girls w/gd have externalizing disorders comparable w/cisgender boys). and boys have higher rates of separation anxiety traits.

Question 12

What is Coates’ theory on childhood GID?

Answer 12

Gender is recruited to solve unresolved issues of trauma in the parental generation where unconscious anxieties over power and/or abuse have haunted parents and where these issues have become represented in the parental mind in gender preoccupations. In effect, the child’s mind is recruited to solve these problems for the parents.

Question 13

According to Coates, at what age does a child’s sense of gender begin? What is a finding that supports this?

Answer 13

6 months. between 6-12 months babies look more at same-sex pics than other sex pics.

Question 14

According to Coates, At what age do nearly all children understand that sex categorization is based on anatomy?

Answer 14

6-7 years

Question 15

According to Coates, At what age can children ID which doll they look like anatomically? How do children this age understand gender?

Answer 15

2 years. they don’t understand it anatomically, but rather by external characteristics such as clothes and hair length

Question 16

According to Coates, at what age do peer groups become powerful reinforcers of sex categorization?

Answer 16

3-4 years

Question 17

According to Coates, at what age do cross-sex interests become increasingly less tolerated?

Answer 17

5-6 years

Question 18

What is the age of onset in childhood GID (CGID)? is there a gender diff in onset?

Answer 18

2-3 years, but in girls it’s not usually referred for eval until 4-5 years

Question 19

According to Coates, how do parents react to their child’s cross gender behavior?

Answer 19

They enjoy it and think it’s cute and amusing.

Question 20

According to Coates, How does maternal psychopathology relate to CGID in boys?

Answer 20

maternal depression, anxiety, and unresolved trauma make the mother emotionally unavailable. this triggers separation anxiety in boys, who may exhibit cross gender behavior to restore relationship with mom or simply replace the missing maternal role in their life with a fantasy mom that they embody. He may dis-ID w/the dad to prove to the mom or both parents that he is non-threatening.

Question 21

According to Coates, How does maternal psychopathology relate to CGID in girls?

Answer 21

when maternal depression, anxiety, and unresolved trauma cause a mother to withdraw, the girl with a sensitive inhibited temperament will either develop separation anxiety disorder or an exaggerated hyper-femininity. a girl with a bold temperament will disID with the mother who she perceives as ineffective and fragile (and possibly devalues herself as a woman), and IDs with the dad, who is typically hyper aggressive and devalues women.

Question 22

According to Karasik (Istar Levy) what are 4 criticisms of gender identity diagnoses?

Answer 22

1) diagnoses use classification systems that seek to type and subtype gender variant people to determine who is “legit” trans and only those who fit these narrow criteria are eligible for tx.
2) the dx criteria for GID conflates people w/GD and people who desire sex reassignment, thus disallowing the possibility of people who are healthy and functional but desire med/surgical tx for self-actualization, rather than to cure their mental illness.
3) GID is used to dx children w/cross-gendered behavior, who are then “treated” to prevent homo-and trans-sexuality in adulthood which raises moral and ethical questions about the use of DSM as a tool of social control of children and adolescents
4) dx criteria of GID is based on stereotypical and heterosexist assumptions. e.g. normative male and female experience, which reifies traditional gender-based hegemony.

Question 23

According to Karasik, what is winters main objection to GD as a dx in the DSM-5?

Answer 23

if gender variant behavior wasn’t stigmatized by labeling these expressions as psych diagnoses, trans people might experience signif less emotional legal and social distress.