Search

P. Hegarty (2009) offered several critiques of the articles by G. Rieger, J. A. W. Linsenmeier, L. Gygax, and J. M. Bailey (2008) and K. D. Drummond, S. J. Bradley, M. Peterson-Badali, and K. J. Zucker (2008) that were published in a "Developmental Psychology" special section entitled "Sexual Orientation Across the Lifespan," guest-edited by C. J. Patterson and R. C. Savin-Williams (2008): (a) reliance on a "disease paradigm" (i.e., the use of "medicalizing" language) of lesbian-gay-bisexual-transgender issues at the expense of a "stigma paradigm," (b) endorsement of a developmental linkage between childhood sex-typed behavior and later gender identity-sexual orientation, and (c) various sociophilosophical and applied matters pertaining to the diagnosis of gender identity disorder in children. In this reply, we address these 3 criticisms and argue that an interdisciplinary approach, informed by multiple paradigms, will most certainly facilitate, not impede, the discovery of answers to many questions about psychosexual development for which data are currently lacking. (Contains 2 footnotes.)

Objective: The construct of empathy was examined in 20 boys with gender identity disorder (GID), 20 clinical control boys with externalizing disorders (ECC), 20 community control boys (NCB), and 20 community control girls (NCG). The mean age of the children was 6.86 years (range = 4-8 years). It was hypothesized that boys with GID would show similar levels of empathy to those shown by NC girls and higher levels of empathy than the NC and ECC boys. Methods: Three measures of empathy were administered: a maternal-report questionnaire, a self-report questionnaire, and an in-vivo evaluation in which children's reactions to pain simulations to two adult actors (mother, experimenter) were coded for empathy levels. Results: On the maternal report and in-vivo measures, the NC girls had significantly higher empathy levels than the NC boys, but not on the self-report measure. By maternal report, the NC girls were rated as significantly more empathic than were the GID boys, with a "large" effect size. There were no significant differences between the GID boys and the NC girls on the self-report and in-vivo measures and the effect size differences were "small." No significant differences were observed between the GID and NC boys; however, there were "medium" and "small" effect size differences with boys with GID showing more empathy on the in-vivo and self-report measures, respectively. On the maternal-report measure, the GID boys were rated as significantly more empathic than the ECC boys and there was a trend for the GID boys to show greater levels of empathy than the ECC boys on both the self-report and in-vivo measures. The effect size differences on all three empathy measures were "medium" to "large," with GID boys showing more empathy than ECC boys. Conclusion: Empathy as a dispositional characteristic in the genesis and perpetuation of GID in boys is discussed.

This study provided information on the natural histories of 25 girls with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 8.88 years; range, 3-12 years) and at follow-up (mean age, 23.24 years; range, 15-36 years) were used to evaluate gender identity and sexual orientation. At the assessment in childhood, 60% of the girls met the Diagnostic and Statistical Manual of Mental Disorders criteria for GID, and 40% were subthreshold for the diagnosis. At follow-up, 3 participants (12%) were judged to have GID or gender dysphoria. Regarding sexual orientation, 8 participants (32%) were classified as bisexual/homosexual in fantasy, and 6 (24%) were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. The rates of GID persistence and bisexual/homosexual sexual orientation were substantially higher than base rates in the general female population derived from epidemiological or survey studies. There was some evidence of a "dosage" effect, with girls who were more cross-sex typed in their childhood behavior more likely to be gender dysphoric at follow-up and more likely to have been classified as bisexual/homosexual in behavior (but not in fantasy).

Research on sex differences examines the relationship between left-handedness and gender identity disorder in boys. Findings suggest that left-handedness is a behavioral indication of a deeper neurobiological process related to gender identity disorder in males.

Probands of 444 boys, who were either referred for assessment or were subjects of case studies on gender identity disorder, represented a sibling sex ratio of 131.1:100 (brothers:sisters). This ratio replicated the Blanchard, Zucker, Bradley and Hume findings (1995) of 140.6:100 which suggested that gender identity disorder in boys was due to excess of brothers. To test these findings, related psychosocial and biological studies are recommended.

The purpose of this study was to extend the findings, previously limited to adults, that male homosexuals have a greater than average proportion of male siblings and a later than average birth order. There were 2 matched groups of 156 probands. The homosexual-prehomosexual (HP) group included boys referred to a specialty clinic because of persistent cross-gender behavior plus homosexual adolescents with or without gender identity problems. The controls were male child and adolescent patients referred for reasons other than gender identity disorder, homosexuality, or transvestism. Both predicted results were obtained in comparisons of the HP group with the controls and with expected values for the general population. Psychosocial and biological theories have been advanced to explain why male homosexuals have later births and more brothers, but none are well established.

This study evaluated the presence of clinical range behavior problems and psychiatric diagnoses in 25 girls referred for gender identity disorder (GID) in childhood (mean age: 8.88 years) at the time of follow-up in adolescence or adulthood (mean age: 23.2 years). At follow-up, three (12%) of the girls were judged to have persistent GID based onDSM-IVcriteria. With regard to behavior problems at follow-up, 39.1% of the girls had a clinical range score on either the Child Behavior Checklist or Adult Behavior Checklist as rated by their mothers, and 33.3% had a clinical range score on either the Youth Self-Report or the Adult Self-Report. On either the Diagnostic Interview for Children and Adolescents or the Diagnostic Interview Schedule, the girls had, on average, 2.67 diagnoses (range: 0–10); 46% met criteria for three or more diagnoses. From the childhood assessment, five variables were significantly associated with a composite Psychopathology Index (PI) at follow-up: a lower IQ, living in a non-two-parent or reconstituted family, a composite behavior problem index, and poor peer relations. At follow-up, degree of concurrent homoeroticism and a composite index of gender dysphoria were both associated with the composite PI. Girls with GID show a psychiatric vulnerability at the time of follow-up in late adolescence or adulthood, although there was considerable variation in their general well-being. [ABSTRACT FROM PUBLISHER]