Transcript 5 Gender Dysphoria 2012-13 2

Gender Dysphoria
Gender Identity Disorder – GID
Introduction..
GID Dr Phil
jerry
Clip Documentary clip
What is Gender Dysphoria... ??
…… it is a psychiatric disorder, occurring when
an individual “feels” uncomfortable with their
biological sex and wishes to change it.
Prejudice and negative feelings of anxiety and
distress can be experienced, leading to
depression, self harm and even suicide.
Gender Dysphoria...
• It affects more males than females (On average,
men are diagnosed with gender dysphoria five
times more often than women) and it is
estimated that 1in 11,000 people have the
condition.
• The role of hormones is used to alter their
physical features of the person i.e. give them a
more masculine or feminine appearance with the
ultimate remedy being gender re-assignment
surgery.
Gender Dysphoria...
• This is a complex condition. People who have
it believe that they were somehow born into
the wrong body, and they often prefer to live
as a member of the opposite sex.
• There is confusion between their sex, their
gender identity and their gender role.
Remember these definitions ..
Sex
Whether someone is biologically male or female. Males have the
sex chromosomes XY and females and the sex chromosomes XX.
Gender
identity
Whether someone
Gender
role
feels male or female.
Whether someone behaves in a stereotypical or socially/
culturally male or female way.
Research Evidence for Gender
Dysphoria
• Biological i.e. genes and hormones
(nature)
Environmental ..
• Social learning theory (SLT) could also
play a part with an absence of or
inappropriate role models to imitate.
(nurture)
By the way ..
The term ‘transsexual’ should not however be
confused with transvestism or cross-dressing,
which involves dressing as the opposite sex for
emotional or sexual pleasure.
Transvestites are content with their gender identity but
enjoy the fantasy of pretending to be a member of the
opposite sex.
GID LAPTOP ACTIVITY
1. In pairs - using laptops - find answers to following
questions
2. Put into word document
3. Email me answers
4. Then collated into handout
Questions
1.
2.
3.
4.
5.
What is GID and how does it affect individuals behaviour?
What are the role of hormones in people with Gender Dysphoria?
What are the role of genes in people with Gender Dysphoria?
What is the environmental – SLT explanation for GID?
How does the nature versus nurture debate feature in the GID
topic?
6. How does the ‘Batista family’ case study support the role of
hormones in explaining GID?
7. Describe two supporting pieces of research for the role of genes
in explaining GID.
8. What have researchers (e.g. Rekers, 1995; Bennett ,2006) found
about the role of SLT in explaining GID?
9. What have researchers (e.g. Wallien and Cohen- Kettenis ,2008;
Zucker et al, 2008) found about the short-term nature of GID ?
10. Describe what ethical and other issues you could include in a
report on GID?
GID Essay Plan
Beginning of A01 - Question 1
End of A02/3 - Question 10
Answers
Biological Explanations
The role of genetics
• Attention has centred on gene variants of the
androgen receptor that influence the action of
testosterone and is in the masculinisation of
the brain.
• More research is needed, especially to identify
what types of environmental factors are
required to elicit an influence and the
biological processes through which genetic
effects may be medicated.
The role of hormones
• Many gender dysphorics take opposite sex
hormones as part of their treatment but little
is known effects of this process.
• What evidence there is does not indicate any
substantial differences in hormone levels in
individuals with gender dysphoria.
Gender Dysphoria...
The role of hormones continued:
• There is evidence from case studies of children
suggesting that hormones determine gender
identity but there are problems in generalising
from such samples to the general populations
and there is also the possibility that it is the
gender rearing that is crucial in determining
gender identity and not genetic/chromosomal
sex.
Research ..
Support for genes.
• Hare et al (2009) examined the genes in a group
of men and found that those with GID were likely
to have a ‘faulty’ androgen receptor gene
implying that the gene may be involved in a
failure to masculinise the brain during
development in the womb again strongly
suggesting that GID is caused more by biological
factors than psychological ones.
Support for hormones ..
• Kula and Slowikowska - Hilczer (2000)
performed a meta-analysis and found that
animal studies indicated sex hormones
present during pregnancy influence sexual
behaviour in adulthood suggesting that
hormones affect masculinisation and
feminisation of a child’s brain in the womb.
However ..
• Gladue 1985 reported that there were few, if,
any hormonal differences between gender
dsyphoric men, heterosexual men and
homosexual men, evidence against the
influence of hormones on gender dysphoria.
Similar results are found with women.
However .. (SLT)
Rekers (1995) reported that the lack of
stereotypical male role models can cause GID
in boys more so than biological factors. This
study of 70 boys strongly supports the
importance of SLT.
Also - SLT
• Alternatively, parents may have wished for a child of the
opposite sex, therefore unintentionally reinforcing genderinappropriate behaviours (Ceglie, 2000).
• In later life, peers and teachers would punish genderinappropriate behaviour, contributing to the discomfort and
unhappiness experienced by such individuals, perhaps
producing a defensive boomerang effect, where the individual
defends their acquired identity when under attack.
However (not SLT)..
• Bennett (2006) pointed out that while SLT can
explain the development of non-gender
typical behaviours it cannot explain the
strength of such beliefs about one’s gender
and resistance to any form of psychological
therapy.
• This suggests that.. biology is a stronger factor.
However.... (short-term)
Wallien and Cohen- Kettenis (2008) performed
a longitudinal study on a group of children
with GID. They found that when the children
were aged around 19 only 40% of them were
still gender dysphoric. These were the
individuals that had exhibited (showed) the
most extreme symptoms.
However ….(short-term)
Wallien and Cohen- Kettenis (2008) continued:
They also tended to have a homosexual or
bisexual orientation, indicating that that the
majority of children exhibiting gender
dysphoria only do so in the short term and
there is an association between being
homosexual or bisexual and having childhood
gender dysphoria.
Therefore …..
Wallien and Cohen- Kettenis (2008) continued:
This study therefore suggests that..
homosexuality and GID are linked i.e. a child
with homosexual feeling feels more
comfortable identifying with the opposite sex
rather than accepting the fact that they are
gay/lesbian.
Short-term...
Zucker et al (2008) performed a longitudinal
study on gender dysphoric females referred to
a clinic between 2 and 3 years of age. Only
12% were still gender dysphoric at age 18. A
study on equivalent males found 20% still had
the condition as adults, again suggesting that
the majority of people exhibiting gender
dysphoria do so only in the short term.
Support for biology (nature)
• Bennett (2006) Reported that 2% of more
than 300 MZ (monozygotic) twins showed
some evidence of gender dysphoria based on
self report measures.
• Applying statistical modelling techniques to
their data Coolidge et al (2002) concluded that
62% of the variance in GID symptoms was
attributed to biological factors and 38% to
environmental factors.
Support for biology (nature)
Hines (2004) stated that: “the strong persistent
desire to change sex and the willingness to
undergo surgery and hormone treatment
despite formidable obstacles including in
some cases social stigmatisation and job loss
suggests a biological imperative”.
Support – hormones ...
• There is strong evidence to support the fact
that hormones determine gender as in the
Batista family however it is difficult to
generalise the findings of the study.
Case Study - Batista family
• Dominican Republic there lived a family called the Batistas.
• Over the years several daughters were born to this family and they grew
into lovely little girls.
• However at around 12 years of age something very odd started to
happen.
• One of the girls went to see his mother – “Mummy – something a bit odd
is happening to me down below”
• “What do you mean?” said the mother
• “Well it’s a bit embarrassing mum but I seem to have started growing a
little willy!”
• “How odd” said the mother – “I have also noticed that your chin is
getting a bit hairy and you are starting to develop a deeper voice!”
• “Oh my goodness I seem to be turning into a boy!” said the child
Case Study - Batista family
•
•
•
•
•
And so it was … as the weeks went by the little girl gradually changed into a boy
and had to swap all her girly toys and clothes for boyish ones.
The family went to see a doctor and said “What is going on here, doc!”
After some investigation and genetic tests the doctor told the family. “How funny!
It appears that you have been a male all along. It’s just that a genetic defect
passed down to you from one of your ancestors meant that you did not have the
usual amount of testosterone released when you were a foetus so your testes and
penis did not grow. But now you have reached puberty you have had a big release
of testosterone and they have started to grow.”
The whole family was very happy to have a new son, and held a party to celebrate!
And it also happened to 3 other young girls in the family who also had the genetic
abnormality.
They have all taken on male roles, have men’s jobs, have married women, and are
accepted as men in spite of the fact that they were reared as girls and supposedly
thought of themselves as girls for 12 or so years (i.e. they had a female gender
identity).
But ....
• The findings of this study are further
complicated by the fact that some of the girls
were intersex and may have been raised as
boys due to their ambiguous genitalia
Homework Activity
• Find out who Gwen
Araujo and Brandon
Teena were and what
happened to them?
Tuesday Dec.18th
Exam Question...
1. Outline one explanation for GID (4 marks)
2. Critically consider explanations of gender
dysphoria
(4 +16 marks)
Plan
A01- 4 marks
• Briefly describe main features of either;
1. Role of genes – gene variants of the
androgen receptors …. Or …
2. Role of environment (SLT) – the lack of male
role models and parents unintentionally
reinforcing gender-inappropriate behaviours
(Ceglie, 2000).
Plan
A02- 16 marks
Compare SLT with hormones genes using research, e.g..
• IDA - Nature versus nurture
• Support for hormones – Batista family case
study + Kula (2000)
• Support for genes – Hare et al , Hines (2004)
• Support for environment (SLT) - Rekers (1995)
• Not SLT – Bennett (2006)
Overall GID Topic Summary
AO1
• Define GID – “individual feels uncomfortable with their biological
sex and wishes to change it.”
Nature versus Nurture explanations ..
• Role of hormones - many gender dysphorics take opposite sex
hormones
• Role of genes – gene variants of the androgen receptors
• Role of environment (SLT) – the lack of male role models/parents
A02/3
• Support for hormones – Batista family case study + Kula (2000)
• Support for genes – Hare et al , Hines (2004)
• Support for environment (SLT) - Rekers (1995)
• Not SLT – Bennett (2006)