Gender Development

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Cognition and Gender Development

The OpenLearn Team (2019). Cognition and gender development. OpenLearn. https://www.open.edu/openlearn/body-mind/childhood-youth/childhood-and-youth-studies/childhood/cognition-and-gender-development

Cognitive Processes

children's thinking that is key to the development of their gender

active role of children in shaping their gender identity, children impact it

Social cognitive theory (SCT)

Bandura

development is a complex mix of different factors

'model of causation' - links behaviour, person and environment

all of them influence each other

social experience influences behaviour but observational leaning is impacted by the activeness of the child

Bussey and Bandura (1999)

negative parental and peer's influence children's gender identity to conform to stereotypes

socialisation from birth is full of gender stereotyping ie colours, clothes, etc.

behaving in a way that differs from the gender-consistent role leads to mocking, which causes children to behave in ways that are gender consistent in order to not be teased

evidence of choice/flexibility in behaviour - where cognitive processes come in

children internalise gender-consistent behaviour and no longer need external affirmation or refutation in order to behave that way

Bussey and Bandura (1992)

3-4 year olds, rating how they would feel playing with gender stereotypical toys

3 - they disapproved of gender inconsistent behaviour, but their own feelings were the same for both

4 - they also disapproved, but also judged themselves on the toys

Cognitive-developmental theory (CDT)

more cognitive processes need to be looked at when investigating gender development in children

their idea of their own gender plays a large role in identifying gender roles

self-socialised, not because of rewards/punishments

gender roles are dependent on gender identity

develop gender identity in distinct stages

connection to Piaget - development of cognitive abilities

Kohlberg's stages of gender development

gender labelling

gender stavility

gender consistency

parallel with Piaget

Slaby and Frey (1975)

"set out to determine whether children's attention to same-sex models was influenced by their level of gender constancy."

used a structured Gender Concept Interview to look at children's understanding of gender

supported their hypothesis - higher levels of gender constancy meant selective attention to same-sex models - boys watched men, girls watched male too

link between gender constancy and typing is not strong, immature

Gender schema theory

cognitive processes play a central role in children's gender development

Activity: What's in your gender schema?

"Do you make any automatic assumptions about people based on whether they are male or female to help you manage your everyday interactions? Imagine you are at a party and you meet a person for the first time. You really want to have fun and make a good impression. Would the person’s gender influence the way you approach the situation: how you behave, what you talk about, what you ask questions about, what you joke about etc.?"

yes, I'd feel most comfortable talking to another female, especially at a party

"Now imagine that you had to look after a friend’s 8-year-old for the first time. You really want the child to have fun. Would the child’s gender influence the way you approach the situation: what activities you prepare, what you talk about, what you ask questions about, and so on?"

no, I'd ask them or my friend what the child likes to do. I'd ask about their friends at school and about what their favourite things are

"Think about other everyday situations: going for a job interview, talking to the checkout clerk at a supermarket, meeting a new work colleague, etc. Try and list some of the inferences you make about people simply from knowing their gender."

i think that females will be politer as we are more used to that during our non-work hours anyway

Comment

Summary (quoted from article/page)

"The psychoanalytic perspective highlights the importance of early childhood experience in gender development, but the emphasis on psychosexual dynamics within the family has not received empirical support.

A dominant debate in current research on gender development concerns the relative importance of social and cognitive factors.

Mischel’s social learning approach suggested that children’s gender development is a product of their social experiences. This theoretical approach focuses on reinforcement of gender-typed behaviour by parents and peers, and on children’s observation of gender stereotypes in the world around them.

Bandura’s social-cognitive theory is a more recent version of social learning approaches that highlights the active role of children in their observational learning.

Kohlberg’s cognitive-developmental theory proposed a developmental sequence of stages in children’s concept of gender. Children’s appreciation of the unchanging permanence or ‘constancy’ of gender was thought to underlie their tendency to seek out and adhere to gender role information.

Martin’s and Halverson’s gender schema approach suggests that children form cognitive schemas about gender as soon as they discover their own sex. These schemas drive gender development, guiding children’s attention and memory in such a way that they focus on and remember gender-typed information much more than counter stereotypical information."

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Gender Development, Stereotypes and Gender Differences

Objectives for this topic

to discuss what gender development is, with reference to sexual identity and the development of self concept

to look at gender stereotypes and gender differences

to consider a variety of different approaches/theories of gender development

to consider the clinical and wider application of each of these theories

to justify the above explanations and applications by referring to research evidence

Introduction and Overview

often the first thing we notice about people is whether they are male or female

sexual identity is an important component of our self concept

every known culture distinguishes between male and female

cultural contributions = stereotypes about the psychological make up of each sex

20th century psychologists initially channelled their research efforts into the nature of sex differences

the rise of behaviourism then became the main focal point in the field

interest revived in the 70s, driven mainly by feminist psychologists

nature vs nurture debate - to what extent are gender differences due to innate, biological factors (nature) and how much they depend on experience - personal, social and cultural (nurture)

The Vocabulary of Sex and Gender

sex is a multi dimensional variable comprising of:

chromosomal sex

gonadal sex

hormonal sex

sex of the internal reproductive structures

sex of the external genitals

sexual identity refers to biological status as male or female

gender is what culture makes of the display of biological sex, the social interpretation of sex

gender identity is the classification of ourselves as male or female

Maracek et al (2004): "sex is to gender as nature is to nurture; that is, sex pertains to what is biological or natural, whereas gender pertains to what is learned or cultural..."

Sex Identity

sex is a biological term, a child is either male or female

the sex identity of a child can be determined and birth biological factors such as chromosomes and hormones:

male - testosterone - XY

female - oestrogen - XX

for the majority of people, their gender and sexual identities correspond

their biological status as male or female correspond with their own gender classification

baby X (Phyliss Katx) - adults behave differently towards an infant depending on whether they believe it to be male or female

Biological Sex (Biological Approach)

sex determination is said to exist on a "spectrum" - genitals, chromosomes, gonads and hormones are all considered to play a role

for instance, females usually menstruate between the age of puberty and the age of menopause, while men do not

the average height of a male is taller than the average height of a female

one in 4500 people fall between male and female - intersex (pseudohermaphroditism) or hermaphroditism (Liao and Boyle, 2004)

Identifying Sex

there are five factors that go towards determining a baby's sex. These are:

chromosomal sex (XX or XY)

gonadal sex (testes or ovaries)

hormonal sex (oestrogen or testosterone)

internal reproductive structures

external genitals

most people have a combination of these factors that allow doctors and parents to easily decide their sex

Intersex

for some, these factors are not clear cut

between 1 and 2 in every 2000 babies are born with genitals that are ambiguous

this is roughly the same number of children born with cystic fibrosis or Down's syndrome

Gender Identity

gender identity (cognitive)

usually established by the age of 3, deep sense of being a woman, man or a gender that is both, fluid or neither (non-binary)

cisgender = identity is consistent with assigned sex at birth

transgender = identity is inconsistent with sex assigned at birth

gender expression (behavioural and cognitive)

expression of gender through behaviour

this can be seen in clothing, language and other outward signs of expression

whether these are considered male or female is culture dependent

Gender Binaries

the classification of sex and gender into two distinct forms

western culture has come to view gender as a binary concept, with two fixed options: male or female, grounded in a person's anatomy

Gender Differences

vast amounts of research into the psychological and behavioural differences between males and females - demonstrates few differences (Leaper, 2013; Martin and Ruble, 2010)

the most significant difference is in aggression level and type

boys showing higher levels of physical and verbal aggression, whereas girls show more relational aggression (Ostrov and Godleski, 2010)

Gender Roles

gender roles are the activities, attitudes, skills and characteristics considered to be appropriate for males and females

gender roles differ depending on the societal context

roles are acquired through socialisation during childhood

much of the socialisation process e.g., knowledge of language, culture, and understanding of moral rules-will be very similar irrespective of the sex of the child

understanding of gender and its implications differs depending on the child's sex

all societies have carefully defined gender appropriate behaviours, which differ between different cultures

to be masculine or feminine then requires males or females to conform to their respective gender roles

Gender Stereotypes

"the difference between men and women"

Gender Typing

the process by which children acquire an identity and learn gender appropriate roles

begins early in Western cultures, beginning with the way in which people dress their child

gender stereotypes are important factors in acquisition of relevant gender roles (Kohlberg, 1984)

Development of Gender Typing

children develop gender-typed patterns of behaviour as young as 15-36 months

girls tend to conform less strictly to gender role stereotypes than boys - pressure?

females are more likely to imitate the male role - greater status and privilege globally

Influence on Gender Typing

parents' influence on children's gender-typed choices

parental behaviour towards girls and boys

modelling parents' characteristics

parental absence or unavailability

genetics

hormones

brain lateralisation

peers

media

androgyny

Gender Stereotype

a stereotype is a widely accepted judgement or bias regarding a person or group

stereotypes about gender can cause unequal and unfair treatment because of a person's gender

four kinds of gender stereotypes:

personality traits

domestic behaviours

occupations

physical appearance

Gender Stereotypes - Cultural Comparisons

high degree of agreement was found across 30 countries regarding characteristics associated with each gender group (Williams and Best, 1994)

Furham and Mak (1999) reviewed 14 studies, making cross cultural comparisons of gender stereotyping, looking at a range of diverse cultures (sex-role stereotyping is universal)

Gender Differences

few psychological attributes studied by Maccoby and Jacklin (1974) showed clear differentiation between genders (e.g., aggression, verbal/mathematical/spatial skills)

also supported by Ruble and Martin (1998)

Schaffer (2004) found personality and cognitive differences are becoming less evident as society defines sex roles

Eliot (2012) identified that the majority of sex differences are mere biases in temperament and play style

mental abilities overlap in males and females more than they differ

Sex Differences

Biological factors

girls are more physically and neurologically advanced at birth

boys have more mature muscular development, but are more vulnerable to disease and hereditary anomalies

males brains are on average 10% larger than females, males larger muscle mass and body size require more neurons to control them (Zaidi, 2010)

males tend to process emotions using only the left hemisphere as opposed to females who make use of both - this allows for more expression of feelings

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Biological Theories - Biosocial and Evolutionary

Objectives

biological

the influence of hormones

gonadal hormones and intersex conditions

biosocial

social constructivist

evolutionary

parental investment

environmental influence

Influence of Hormones

XX or XY chromosomal make up promotes gonads to develop as either testes or ovaries

hormones from the gonads then provide major biological influences on sexual differentiation

internal and external genitalia (androgens e.g., testosterone)

brain and behaviour (brain lateralisation)

"Infants enter the world with some predispositions to masculinity and femininity and these predispositions appear to result largely from hormones to which they were exposed before birth." (Hines, 2004)

Gorski et al., (1985) - female rates injected with testosterone prior to birth, rats developed ambiguous genitals and parts of brain were male-like, resulted in masculinisation of rates - females attempting to mate with females

comparative study - results cannot be generalised to humans

Sex Determining Region 'Y'

previously accepted view that gonads were originally identical twins in both XX and XY embryos, females = default

SRY gene (sex-determining region 'Y') promotes the development of the testes, promoting secretion of testosterone - primary male androgen

pro-female gene - r-spondin1 tes the development of ovaries, without this females will grow up to be psychologically and physically male - although genitalia will likely be ambiguous (Spinney, 2011)

Case Study - The Batista Family (Imperato-McGinley et al., 1974)

the role of genitalia

there is empirical evidence by Imperato-McGinley et al. (1979) supporting the biological explanation; the role of the external genitalia: into gender development

Imperato-McGinley et al. studied individuals from the Batista family with AIS (a syndrome which prevents the development of male genitalia due to brain cells being unresponsive to testosterone hormones when in the womb)

these individuals could develop male gender identities once external genitalia for males appeared at puberty, despite being raised as females and having a feminine gender identity

the findings support the theory's suggestion that genes lead to sex specific genitalia and this in turn leads to masculine or feminine gender identities and thus increases the theory's internal validity

Intersex - Genetic Disorders

possession of ambiguous internal and external reproductive structures, they are born with gonads that match their chromosomal sex

complete androgen insensitivity syndrome (CAIS)

prenatal development in male is feminised

internal reproductive structures of either sex fail to develop (failure to menstruate) and external genitals fail to differentiate into a penis

typical female external genitals and breast develop in puberty

congenital adrenal hyperplasia (CAH) - most common and most studied

chromosomally normal female produces abnormally high levels of androgens

internal organs are unaffected, external organs are abnormally large

these individuals are usually raised as females (Hines, 2004)

DHT-deficient males

genetic disorder - prevents normal prenatal conversion of testosterone into DHT

DHT is necessary for development of male external genitals

usually incorrectly identified as females and raised as girls (Batista study, 1974)

Beyond Male and Female

from 2013 onwards, children born in Germany with intersex conditions will no longer have to be registered as male or female

instead, their parents can leave the category of sex blank on their birth certificates, indicating an 'intermediate' sex

will such change be of benefit for the children in question? what could be the implications for them in later life?

Brain Structures

the change occurring in puberty for the Batista boys is attributed to a flood of testosterone

their ability to adopt male gender roles and identity post puberty suggests testosterone pre-programmed masculinity into their brains

males - larger amygdala and parietal lobe

females - larger hippocampus, limbic cortex and frontal lobe

neuroplasticity could account for the claimed structural differences between male and female brains

BUT Kimura (1999) argues overall variation between male and female brain structure can be smaller than deviation within sexes

Halpbern et al. (2012): "It is important to emphazise... that finding sex differences in brain structure and functions does not suggest these are the sole cause of the observed cognitive differences between males and females."

it is likely that the brain reflects the differences in life experience between males and females, due to the importance learning has on brain development

Biosocial Theory

Edley and Wetherell (1995) on determining the basis of masculinity and femininity:

"It requires us to separate what cannot be separated: men (& women) are the product of a complex system of factors and forces which combine in a variety of ways to produce a whole range of different masculinities (& femininities)"

emphasis on the interaction between biological and social factors

Baby X Experiments

does the way parents and other adults treat a typical child influence their concept of gender?

Condry and Condry (1976) video tape of a nine month old baby playing with various toys (e.g., jack-in-the-box) was shown to 200 adult participants and they were asked to describe the baby's emotions

to some the baby was introduced as 'David', and to others as 'Dana'

appearance was neither obviously masculine or feminine

results showed there was clearly an influence of the baby's presumed gender

'David's' response of crying in reaction was labelled as anger, whereas 'Dana's' exact response was listed as fear

male and female differences observed tend to be due to stereotyped views shaped by societal expectations

"Anatomy is Destiny" - Money and Ehrhardt (1972)

how an infant is labelled sexually determines how it is raised or socialised

thus determining the individual's gender identity/gender role/sexual orientation

CAH individuals initially raised as boys - genitals were surgically corrected, they were reassigned as girls and showed preference for female role

CAIS individuals study showed strong preference for female role

both support view that gender of rearing is more important than biological sex

Social Role Theory - Eagly and Wood (1999)

social constructionists argue that constructions of gender differ across time and culture

so the idea of what 'manliness' is like would be very different in the 1940s to now

selective pressures only cause physical sex differences which bring about psychological sex differences

psychological sex differences are a result of different roles men and women are assigned, these differences are not innate

men are assigned the role of 'hunter' because they are physically stronger

women bear children (a physical attribute) so they are assigned the role of 'homemaker'

psychological differences (such as aggression, empathy) then emerge from these social role assignments

Eagly and Wood (2002) suggest hormonal differences between men and women may be a consequence of social roles and psychological sex differences, rather than the cause

testosterone is not the cause of greater male aggressiveness but instead it is the effect of the fact men engage in more athletic, competitive events

human behaviour is said to be an outcome of a particular society or culture

there is no objective reality, no real difference between men and women

gendered behaviour is best understood in the social context it has occurred in

Conclusion

biosocial theory argues that the interpretation of biological sex within a specific social and cultural context influences the treatment given to the child, and it is this which leads to the development of gender role behaviour and gender identity

Evaluating Biosocial Theory

recognition for biological (nature) and social influences (nurture)

provides explanation for why gender behaviour may be different between and within cultures and change over time

social constructionists argue that ideas about gender are constructed rather than natural and are distributed through language

this theory sees gender-related behaviour as flexible rather than fixed, making it much less deterministic

offers opportunities to create and develop aspects of the self which may be otherwise constrained by traditional ideas of masculinity and femininity

Evolutionary Theory

Luxen (2007) claims behaviour is less important as physical characteristics

selective pressure directly creates psychological as well as physical sex differences

Luxen claims very young children display preference for gendered toys, suggesting biological preference rather than a socially constructed one

Differential Parental Investment

Trivers (1972) - males and females differ in the amount of resources they invest in offspring

female parental investment is considered to be more significant than males

eggs are generally more costly to produce than sperm

requires a lengthier course of gestation

requires a large amniotic sac taking priority over mother's own nutritional intake over several months, mother sacrifices part of her nutritional intake to feed her offspring

sexual selection - females tend to be more selective than males, as a bad investment in a mate would be more costly for a female

men can father young at much less investment - just one act of sexual intercourse

Kenrick et al. (2004) - Xavante hunter gatherers study, only 1 of 195 women was childless at age 20, 6% of men were childless by 40, one male fathered 23 children, highest number of children for a female was 8

Male Parental Investment

women directly invest their bodily resources during their reproductive peak in their 20s, this ending with menopause (Dunson et al., 2002)

consistent with this, men's preferred female physicality have been linked to indicators of youth (Ridley, 1993)

men indirectly invest resources in their offspring (e.g., food, money and protection) - these resources do not necessarily diminish with age (Buss, 1989)

Environmental Influences

"an evolutionary perspective doesn't assume that human behaviour is based in rigid reflexes and closed instincts, but does assume domain-specific biases relative to what is learned and how information is connected..." (Kenrick et al., 2004)

mothering is sensitive to environmental constraints, where a female is not in a position to provide adequately for her child, she might be faced with a difficult decision

Hardy (1999) - ethnography of South American Ache foragers saw one mother abandoning their child due to the death of the child's father - meaning their was no provision of external resources for survival, newborn children were also sacrificed if there was close birth to older child, threatening older child's milk supply

infanticide is observed on all continents - mother-child murder is the trade off between environmental conditions and protection of their lifestyle (Daly and Wilson, 1988)

Evaluating Evolutionary Approach

force against gender equality since it implies sex differences are innate and cannot be changed by altering social context

very deterministic

lack of recognition for cultural and social influences

claims pure influence is a result of biological or environmental causes

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Cognitive and Behaviourist Theories

Objectives

social learning theory (SLT)

cognitive developmental theory (CDT)

cultural relativism

Social Learning Theory (SLT)

observational learning enforces gender role stereotypes (Perry and Bussey, 1984)

children acquire knowledge of gender roles without any action

child observes models being reinforced or punished - operant conditioning

socialising agents such as parents, teachers, peers and the media convey messages of importance of gender role appropriate behaviour (Durkin, 1995)

socialising agents model appropriate and inappropriate behaviour and children consequentially conform or will not conform to gender norms displayed

Influence of Parents

parents will present their offspring with instruction appropriate gender role activities (Bandura and Walters, 1963)

boys and girls are given different toys, have their rooms decorated differently and are even spoken to in different terms (Rubin et al., 1974)

boys tend to be positively reinforced more for behaviours reflecting independence, self-reliance and emotional control

girls are viewed to be more nurturing, empathetic, and emotionally expressive and are more likely to be reinforced for this (Block, 1979)

father's have been found to reinforce sex-typed behaviours more than mothers, especially with their sons (Siegal, 1987)

Karraker et al. (1995) claims a decline in parents sex-typing their offspring from birth - findings showed little difference between male and female reinforcement of sex-typed behaviour

Evidence to Support SLT

modelling

boys more likely to imitate aggressive male models than girls - Bobo Doll Study (Bandura et al., 1961)

children more likely to imitate behaviour of gender appropriate model, even if model is not of same gender as child (Bussey and Bandura, 1984)

activities

children encouraged to join parents in gender-appropriate activities, e.g., cooking and shopping for mothers and daughters (Lytton and Romney, 1991)

parenting

parents tend to allow sons to be more aggressive towards others, than daughters (Sears et al., 1957)

parents were observed to intervene more when daughters were being aggressive than when their sons were (Huston, 1983)

Evidence Against SLT

lack of consistency in evidence to support reinforcement of gender roles (Maccoby and Jacklin, 1974)

very few gender differences in overall parental warmth, interaction and encouragement of achievement (Lytton and Romney, 1991)

Hetherington (1967) - children prefer to imitate behaviour of parent they spend most time with, lack of findings to support preference for gender-appropriate parent

no correlation between the extent to which parents engage in sex-typed behaviour and strength of sex-typing in their offspring (Smith and Daglish, 1977)

assumption that child already knows their gender and learns gender appropriate behaviour accordingly (Durkin, 1995)

Cognitive Developmental Theory (CDT) - Kohlberg (1984)

the child's active construction of an understanding of their surroundings through interaction and experience

Piaget's (1950) basic principle of cognitive development through "discovering" the world

children's realisation that they are male or female causes them to identify with members of their own gender

rewards and punishments influence child behaviour but do not cause gendered behaviour to occur

reinforcement provides information that they are behaving in the way society has deemed appropriate (Bandura, 1977)

when explaining how gender identity and roles develop, cognitive psychologists emphasis the role of thinking processes

they are interested in how children gather and make sense of information about gender and how their understanding of gender changes over time (a developmental perspective)

cognitive psychologists assume that changes in gender role behaviour reflect changes in how children understand and think about gender

these changes in understanding, in turn, reflect

the accumulation of information about gender gathered from the environment

developmental changes in the child's brain that allow it to process information in more sophisticated ways

Gender Constancy - Kohlberg (1966)

when children achieve "gender constancy" they place value on their own gender and seek to act in ways that is constant with their gender

only at this point do children identify with adults who posses qualities they perceive to be central to their masculinity or femininity (Perry and Bussy, 1979)

gender development is primarily driven by maturity

Kohlberg's (1966) theory proposes that a child's understanding of gender moves forward in stages, at each stage the child thinks in characteristic ways about gender, as the child moves through the stages, its understanding of gender becomes more complex:

age 2-3 - children acquire a gender identity, they recognise that they are either male or female

age 3-6 - gender stability - gender is stable over time, but heavily influenced by external features such as hair and clothing

age 6 or 7 - gender constancy - gender is constant over situations; people cannot change their gender by changing their appearance or behaviour

Evidence to Support CDT

Munroe et al., (1984) found children progressing through Kohlberg's 3 stages of development in several different cultures (evolutionary link?)

Ruble et al., (2004) found pre schoolers were influenced by gender-typed advertisements, high rates of influences with children with higher gender consistency, clear response of stereotypes shown in media

Damon (1977) - participants of 4, 6, and 9 years old were read a story about George who likes to play with dolls. 4 and 6 year olds said this was okay, whereas the 9 year old showed understanding of "gender appropriate behaviour" stating that it was not okay

Evidence Against CDT

CDT is descriptive and does not explain as to why gender develops in this particular way

poor explanation of individual differences in children, e.g., some girls will not conform to gender roles

does not offer explanation for change of gender identity over time

ignores external influences, like reward and punishments from parents

offers little explanation of how gender typed an individual can be - e.g., how masculine or how feminine? - why does this vary?

Cultural Relativism

most direct challenge to biological approach

if gender differences were only due to biological influences, we would see the same differences cross culturally

cultural relativism = gender roles are culturally determined

most cultures distinguish between 'men's' and 'women's' work - biological factors influence this sex-typing

economic lives of men and women recently became more similar

'androgyny' (Bem, 1974) - refers to individuals who have developed both masculine and feminine sides

consideration for sexual orientation and the idea that emotional relationships are not a result of a single norm

Conclusions

all theories discussed over the last 2 lectures should be seen to be complimentary explanations

"The human brain was designed by the same natural forces that shaped other natural phenomena, but it is a brain designed to think, learn, and construct cultures. To isolate or ignore any of these facets limits our understanding of human behaviour..." (Kenrick et al., 2004)

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Gender Dysphoria

Objectives

gender dysphoria

explanation

signs and symptoms

treatments/therapies

Revision of Terms

transgender - an umbrella term for people whose gender is different from the sex they were assigned at birth

transgender woman/trans woman/MTF - someone assigned male at birth but living as a woman. They may use the acronym MTF (male to female) or may wish to simply be known as a woman

transgender man/trans man/FTM - someone assigned female at birth but living as a man. They may use the acronym FTM (female to male) or may wish to simply be known as a man

non-binary - non-binary people do not identify as either male or female, they may feel both, something in between, have a gender that changes over time or not relate to any gender

Gender Dysphoria

"Gender dysphoria is a condition where a person experiences discomfort or distress because there is a mismatch between their biological sex and gender identity. It;s sometimes known as gender identity disorder (GID), gender incongruence or transgenderism." (NHS, 2017)

while biological sex and gender identity are the same for the majority of people, this is not the case for everyone

the Gender Identity Research & Education Society (GIRES) estimates that 1% of the British population are gender non-conforming to a degree

the number of trans women and men are roughly equal

traditionally thought of as a psychiatric disorder

sometimes referred to as 'gender identity disorder' - now not considered to be a mental ailment

note - your sense of your own gender is not the same as your sexual orientation

gender non-conforming is an umbrella term that encompasses transgender but can also be used to describe those who feel they are neither only male or only female (genderqueer)

Increased Awareness

"The increase in referrals to gender identity services runs parallel with society becoming more accepting of transgenderism." (Lyons, 2016)

Signs and Symptoms

to be "formally diagnosed". an individual must have the following symptoms for six months:

consistently expressing feminine traits though they have the physical traits of a boy or masculine traits if they have the physical traits of a girl

strongly preferring friends of the sex they identify with

rejecting the clothes, toys and games typical of their own sex

refusing to urinate in the way that their own sex typically does

expressing that they want to have genitals that match their gender identity

having distress about the body changes that happen during puberty

Diagnostic Assessment

a diagnosis of gender dysphoria can usually be made after an in-depth assessment carried out by a number of specialists

this may take place over several sessions, carried out a few months apart and may involve discussions with family or friends

the assessment is designed to determine whether the individual has gender dysphoria and what the individual's needs are

the assessment also includes a general overview of the individual's physical and psychological wellbeing

For under 18 year-olds (NHS, 2017)

whether there is a clear mismatch between biological sex and gender identity

whether the individual has a strong desire to change their physical characteristics as a result of any mismatch

how they are coping with any difficulties of a possible mismatch

how their feelings and behaviours have developed over time

what support they have, such as friends and family

Transition

the process of changing one's appearance and/or body to reflect the true internal gender identity

it can include behavioural. legal, medical and surgical interventions

Treatment

according to Carroll (2015), there are four possible outcomes for patients who present with the dilemma of gender dysphoria:

an unresolved outcome

acceptance of one's given gender

engaging in a cross-gender role on a part time basis

making a full-time transition to the other gender role

once a formal diagnosis of gender dysphoria is established and comorbid disorders are addressed - a gender specialist will facilitate treatment according to agreed goals:

triadic therapy

psychotherapy

after treatment and follow up care

administered by a group of healthcare professionals (e.g. clinical psychologists and paediatric endocrinologists - specialists in hormone conditions in children)

For under 18 year-olds

referred to a child and adolescent Gender Identity Clinic

treatment in initial stages is mostly psychological, rather than surgical

this is because the majority of children with suspected gender dysphoria tend not to have the condition once they hit puberty

once a child has reached puberty and they have been formally diagnosed with gender dysphoria, they can be treated with hormone therapy

gonadotrophin-releasing hormone (GnRH) is a synthetic hormone used to suppress hormones naturally secreted by the body

this therapy will suppress puberty and physical changes from occurring

GnRH is thought to be a fully reversible treatment and can be stopped

For adults

individuals 17 years and above can be admitted to an adult gender clinic

these clinics can offer ongoing treatment, support and assessment including (NHS, 2017):

mental health support, such as counselling

cross-sex hormone treatment

speech and language therapy - to help alter your voice to sound more typical of your gender identity

hair removal treatments, particularly facial hair

peer support groups, to meet other people with gender dysphoria

relatives' support groups, for your family

Triadic Therapy (Wylie, Eden and Watson, 2012)

triadic therapy consists of:

sustained experience of living in an identity congruent gender role

administration of the hormones of the desired gender

surgery to change the genitalia and other sexual characteristics

Social Gender Role Transition

sustained experience living in the desired gender role is an important part of preparing for gender reassignment (World Professional Association for Transgender Health, 2011)

specialists play a vital role in helping patients coping with appearing as the opposite gender in social life (Bockting, 2008)

this experience allows the patient to get informed on how life will be as their desired gender, allowing them to make an informed decision about their gender reassignment

the length of transition tends to be between one to two years

Hormone Therapy

trans man will take testosterone (masculinising hormones)

trans women will take oestrogen (feminising hormones)

these usually need to be taken indefinitely, even if you have genital reconstructive surgery - this would be the second stage

this therapy may be all the patient needs for dealing with their gender dysphoria

Surgery

Trans man surgery may involve:

a bilateral mastectomy (removal of both breasts)

a hysterectomy (removal of the womb)

a salpingo-oophorectomy (removal of the fallopian tubes and ovaries)

phalloplasty or metoidioplasty (construction of a penis)

scrotoplasty (construction of a scrotum) and testicular implants

a penile implant

Trans women surgery may involve:

an orchidectomy (removal of the testes)

a penectomy (removal of the penis)

vaginoplasty (construction of a vagina)

vulvoplasty (construction of the vulva)

clitoroplasty (construction of a clitoris with sensation)

breast implants

facial feminisation surgery (surgery to make your face a more feminine shape)

Smith et al (2004) study of 325 transgender adolescents and adults found a 91.6% overall satisfaction rate of "very satisfied" with their body appearance, 8.4% were "satisfied", none reported they were unsatisfied

NHS longitudinal study over 20 years established a 96% overall satisfaction rate of people who had genital reconstructive surgery (NHS, 2017)

After Care

despite high satisfaction rates of people who have had genital reconstructive surgery, individuals may subject to prejudice or discrimination because of their condition

individuals may suffer feelings of (Dietert and Dentice, 2009):

isolation - due to lack of understanding about what they are going through from others

stress - centred around not being accepted by society and being afraid to socialise as a result

discrimination - particularly in the workplace

Gender Recognition Act (2004) details a number of laws and guidelines that protect transsexuals and outline how they should be treated by medical professionals (NHS, 2016)

Psychotherapy

psychotherapy has been indicated to be essential to up to a third of patients with gender dysphoria (Seikowski, 2007)

important - psychotherapy does not serve to "cure" the individual of their gender dysphoria

therapy serves to help the individual feel comfortable in their gender identity, helping to put measures in place to succeed in education, relationships, and the work place (World Professional Association for Transgender Health, 2011)

it offers support in coping with the challenges and changes occurring during different points of transitioning

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Gender Dysphoria Activity - 07/03/2021

Use Library+ to access the eBook "Gender" by Leanne Franklin

Provide the following:

Full APA reference to the eBook

Describe one piece of information about gender dysphoria, from this book, that is not covered in the lecture slides

Describe one piece of information about the psychology of gender development that has not been covered in the previous three weeks

Franklin, L. (2012). Gender. Palgrave Macmillan. http://search.ebscohost.com/login.aspx?direct=true&db=cat02278a&AN=adc.199021&site=eds-live&authtype=sso&custid=s2173719

One piece of information about gender dysphoria from this book that is not covered in the lecture slides is that after puberty, most people no longer feel gender dysphoria because it is a part of the transitioning period, which most people experience during puberty (Franklin, 2012).

One piece of information about the psychology of gender development that has not been covered in the previous three weeks is that according to Freud's psychoanalytic approach, passing the Oedipus/Electra stage is necessary for a child's gender development because it will help create a link between them and their same-sex parent (Franklin, 2012).

Find a video that provides a clinical/medical explanation of gender dysphoria

Provide the following:

The link to the video

An explanation of how you identified that this was a valid and reliable source

An outline one piece of information from this video that is not covered in the lecture slides

Bilgi, N., Emami, P., Gondal, I., & Pishva, S. A. (2019). Gender dysphoria: definition, diagnosis, treatment and challenges [YouTube Video]. In YouTube. https://www.youtube.com/watch?v=W669-8aQzTk

I identified that this video was valid and reliable as it was created by four students on McMaster University's Demystifying Medicine YouTube channel.

One piece of information from this video that is not covered in the lecture slides is that gender dysphoria does not equal gender non-conformity (GNC), as GNC is not a mental disorder and gender dysphoria is due to the distress it causes (Bilgi et al., 2019).

Find a second video that provides a personal explanation of gender dysphoria

Provide the following:

The link to the video

A summary of the individual’s explanation of their experience of gender dysphoria

Link one aspect of the person’s explanation to the lecture slides on gender dysphoria

https://www.nhs.uk/conditions/gender-dysphoria/

Jay felt uncomfortable in his body (gender dysphoria) but did not realise he was trans until he was in his 20s. He eventually realised that he was a man and was relieved because he finally understood what he was feeling, but also felt like everything would be different and nobody would support him. He transitioned medically and is now incredibly happy with his life and is completely comfortable with who he is.

One aspect of Jay's experience that links to the lecture slides on gender dysphoria is his medical transition. He went to his GP, saw a psychiatrist, started hormone therapy (testosterone), and chose to have a mastectomy to help his dysphoria.