L14: Human Development: Gender Identity & Sexual Orientation

Question 1

Define biological sex.

Answer 1

• Based on physical / visible characteristics, reproductive functions and genetics. Usually viewed as 2 discrete categories: male & female. - Exception to this is intersex individuals, previously known as hermaphrodites.

Question 2

What are issues surrounding sex assignment surgery?

Answer 2

• Debate in medical/larger community on whether or not surgery should occur in infancy or later, or whether should occur at all. - Advocates state it reduces potential stigma - Opponents state lack of choice and informed consent by child, results in loss of sexual sensation for some

Question 3

Define gender, gender identity, gender role and gender expression.

Answer 3

• Gender is a social construct of culturally-based expectations typically based on one’s biological sex - Gender identity is one’s core self-concept of his/her gender - Gender role includes appearance, clothing, speech, manner, interests, play and occupations - Gender expression is how one chooses to outwardly manifest one’s gender identity

Question 4

What are models for classification of gender?

Answer 4

• Dichotomous categories: masculine and feminine - One-dimensional continuum: increasing masculinity toward one end, increasing femininity toward other end - Two-dimensional continuum: low to high femininity on one axis, low to high masculinity on other - Bam Sex Role Inventory

Question 5

Explain the 4 classifications of the Bem Sex Role Inventory for gender classification.

Answer 5

• Sex-typed: males with high masculinity, low femininity; females with high femininity, low masculinity - Cross sex-typed: males with high femininity, low masculinity; females with high masculinity, low femininity - Androgynous: females and males with both high masculinity and high femininity - Undifferentiated: females and males with both low femininity and low masculinity

Question 6

What is the definition of transgender identity?

Answer 6

• Transgender is a gender or umbrella term describing people whose gender identity is not congruent with the usual gender role for their assigned sex. Eg. Biological sex is female, but gender identity is masculine. Importantly, sexual orientation is not in definition, so they can be any.

Question 7

What are transgender categories?

Answer 7

• Transsexual: person who identifies oneself as a member of biological sex opposite to that assigned at birth. Feel that gender identity and true sex don’t match one’s assigned or recognized biological sex. - Androgynous - Bi-gender: move back and forth between distinct feminine and masculine gender roles - Cross-dresser

Question 8

What are issues in medical care for transsexual people?

Answer 8

• Gender reassignment therapy (outdated term = sex change): including HRT, major surgery, minor surgery - Health insurance (policies and discrimination) - Transphobia - Treatment of children who strongly identify as transsexual (supportive vs psychotherapy (to alter gender identity) approaches)

Question 9

What are issues in mental health care with transgender people?

Answer 9

• Addressing confusion/questions on gender identity - Addressing inner conflict/emotional distress on gender identity - Addressing effects of trauma due to social prejudice, discrimination and violence - Addressing steps/stages of coming out - Controversy over mental health eval and therapy before reassignment therapy - Controversy over gender identity diagnostic disorder

Question 10

Define sexual orientation. What are typical classifications of sexual orientation? What other models exist? Explain.

Answer 10

• Pattern of emotional, romantic, sexual and spiritual attraction to males, females, both, or neither. - Typical classification: Heterosexual, homosexual, bisexual or asexual. - Other models: - A.) discrete, dichotomous categories: heterosexual and homosexual - B.) single continuum model (Kinsey scale): based on attraction, fantasy and behavior – placed on scale that provides varying degrees of heterosexuality, homosexuality - C.) dual continuum model (DeCecco): based on same sex (low-high) and opposite sex (low-high). Dimensions rate for emotional, affectional and physical attraction as well. - D.) multivariate model (Klein): 7 variables rated 0-6 from exclusively heterosexual to homosexual – variables: sexual behavior, emotional attraction, sexual fantasies, sexual attraction, social preference, lifestyle/world/community, self-identification

Question 11

What identity developmental process do LGBTQ people undergo? What are the stages? When does each resolve and what are roles of healthcare providers?

Answer 11

• LGBTQ individuals undergo an extra developmental process - Need for entering this process results from: stigma (homophobia and heterosexism), isolation, lack of support - Stages: a.) Awareness stage: becoming conscious of same-sex attractions and or inclinations, accompanied by feelings of badness. Resolution of stage: acknowledgement and acceptance of same-sex attractions. Healthcare provider role: struggling, conflicted, confused pt should be referred to supportive psychotherapist with specialized LGBTQ populations b.) Acknowledgement stage: moving from acknowledgement to self to acknowledgement to others, includes coming out. Resolution: increased self-acceptance characterized by successful self-disclosure and skillful coping. Healthcare provider role: referral to specialized therapist, coming out support group. c.) Exploration stage: awkwardness and intensity in relationship, experimental with range of sub-culture, possible relapse into maladaptive coping. Resolution: increased capacity for intimacy and stability, reduced intensity and frequency of shame-based responses. Healthcare provider role: counsel regarding safer sex practices, therapist if signs of internalized homophobia and maladaptive coping, connect with GSA in school or LGBTQ centers d.) Intimacy stage: increasing stability, satisfying friendships and romantic relationships, sound decision-making around disclosure, effective coping e.) Integration stage: energy directed into new areas of life, awareness of integration as ongoing process, balancing sexual orientation/gender identity and other culture identities

Question 12

What are issues in mental health services with LGBTQ individuals that should be addressed?

Answer 12

• Address confusion / questions re: sexual orientation. Help clarify and come to own conclusion - Address inner conflict/emotional distress re: sexual orientation - Address effects of trauma and minority stress d/t social prejudice, discrimination and violence - Address stages of coming out - Address frequent spiritual and religious struggles - Therapists/healthcare providers must assess and reduce/eliminate own residual homophobia, assess and correct for heterosexist biases, consider whether or not disclosure of own sexual orientation is valid and appropriate

Question 13

Describe the Kinsey scale.

Answer 13

0: exclusively heterosexual attraction and experiences 1: primarily heterosexual, with occasional homosexual attraction and experiences 2: mostly heterosexual, with fairly frequent homosexual attraction and experiences 3: equally attracted to same and opposite sex partners, engage in both sexual experiences 4: mostly homosexual, with fairly frequent heterosexual attraction and experiences 5: primarily homosexual, with occasional heterosexual attraction and experiences 6: exclusively homosexual attraction and experiences