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Fetal Testosterone Predicts Sexually Differentiated Childhood Behavior in Girls and in Boys

January 28, 2009 By 30 Comments

This is an important study from the Psychological Science journal’s early view:

Fetal Testosterone Predicts Sexually Differentiated Childhood
Behavior in Girls and in Boys
Bonnie Auyeung, Simon Baron-Cohen, Emma Ashwin, Rebecca Knickmeyer, Kevin Taylor, Gerald Hackett, and Melissa Hines

ABSTRACT—Mammals, including humans, show sex differences in juvenile play behavior. In rodents and nonhuman primates, these behavioral sex differences result, in part, from sex differences in androgens during early development. Girls exposed to high levels of androgen prenatally, because of the genetic disorder congenital adrenal hyperplasia, show increased male-typical play, suggesting similar hormonal influences on human development, at least in females. Here, we report that fetal testosterone measured from amniotic fluid relates positively to male-typical scores on a standardized questionnaire measure of sextypical play in both boys and girls. These results show, for the first time, a link between fetal testosterone and the development of sex-typical play in children from the general population, and are the first data linking high levels of prenatal testosterone to increased male-typical play behavior in boys.

Here’s the money quote:

Thus, our data are the first documentation that androgen exposure prenatally relates to sexually differentiated play behavior in boys and in girls. In addition, the current results support an organizational, as opposed to current, activational role of testosterone, because play behavior is measured in childhood, when concurrent testosterone levels are low.

Gender non-conformity is the strongest predictor of same-sex attraction in adulthood. This study links prenatal testosterone with later gender typical behavior. The brains of children are organized in ways that react to their environment in socially typical or atypical ways. How such behavior shapes the family environment is unclear, however, it does not appear that the behavior is exclusively a response to parental bonding or modeling.

Filed Under: gender identity, Professional issues, Research news, sexual identity, sexual orientation, transgender Tagged With: , , ,

More on the Dr. Phil Show Little Boy Lost – Sparks fly among guests

January 27, 2009 By 29 Comments

This clip features some give and take between panelists on the Dr. Phil Show episode on gender identity issues. In this segment, Dr. Siegel defends moms by saying there is no evidence that being too close to a boy will make him want to be a girl. Dr. Nicolosi says Siegel is oversimplifying his reparative theory. What do you think?

Lights, camera, action!

Filed Under: gender identity, NARTH, Professional issues, psychology, Religion and sexuality, reparative therapy, transgender Tagged With: , , , , , ,

The Dr. Phil Show on gender identity, Part 3 – Should puberty be delayed?

January 15, 2009 By 141 Comments

Near the end of the Dr. Phil Show on gender identity, two guests who were not on stage provided a mini-introduction to the controversy of using hormones to delay puberty. Dr. Jo Olson and Dr. Eva Cwynar are two prominent doctors who work in the field of gender disorders and endocrinology. And action!

From the Dr. Phil website, here is a rough transcript of their comments.

Dr. Phil turns to two more medical professionals in the audience. Endocrinologist Dr. Eva Cwynar says parents need to wait and see what happens with puberty and not give in to their child’s fantasy of wanting to become the opposite sex. Dr. Jo Olson, pediatrician with the Transgender Clinic of Children’s Hospital Los Angeles, says children are born this way, and she helps kids make the transition through hormone therapy.

“Dr. Olson, at what point do you begin that?” Dr. Phil asks.

“It’s a different process for each child. It’s really important to recognize that young people and their families come in at very different stages of this process. Many of the people we see have actually already gone through puberty, but we do have some patients who are young, in the 12- to 16-year-old age range as well,” Dr. Olson says. “However, I want to say that we don’t just provide hormone therapy for young people, and not all young people who want to transition get hormones. We have a multi-disciplinary approach in our clinic, where they are assessed by a psychologist who is extremely familiar with gender-questioning youth, gender identity disorder and the issues that these young people face, as well as the case manager who understands what these young people go through. And hormones are not the end of the story for every young person.”

“And you work with the family members as well. It’s not just something you do to the child in isolation,” Dr. Phil says.

“Absolutely, and we have many parents who experience this same kind of mourning,” she says, referring to Toni.

“Dr. Cwynar, do you think there’s ever a point when hormone-blocking therapy is appropriate?” Dr. Phil asks.

“I do,” Dr. Cwynar says. “I think that, as everybody mentioned before, there’s a spectrum of this transgender, and I do believe as well that gender is a definition between the eyes and not between the legs, and that there are certain chemical phenomena, chromosomal phenomena, that occur both in utero and as we develop that make us appear as one sex, but is actually a different sex. I prefer waiting through puberty to see what actually happens when the hormones kick in. There are situations where you have distress and suicidal ideations and because of that, hopefully the family will be there for the child to help them get through that process. So, I like to see the whole adolescence be complete, essentially, before I do anything permanent.”

This is among the most controversial of issues and one with which I have had some professional involvement. I will give one example and then some links from past blog posts which address similar gender identity concerns.

Among several similar cases, I recall a family in conflict where the mother wanted to delay puberty for a GID child but the father did not. In short, the child now post-puberty is strongly identified with the biological gender. Delaying puberty would have been a mistake and the earlier wish to consider it vanished. Other cases are not so clear cut and hence the controversy.

Here are some relevant links to past posts:

-Two families, two approaches to gender preferences
-Gender identity disorder research: Q & A with Kenneth Zucker
-Ken Zucker compares ethnic identity conflict and gender identity conflict
-APA issues statement regarding GID and the DSM-V
-The Man Who Would Be Queen – Chapters 1 & 2
-American Psychological Association comments on DSM gender identity issue
-60 Minutes Science of Sexual Orientation: An update from the mother of twins
-60 Minutes Science of Sexual Orientation mother of twins, part 2 (this 2 part series is highly recommended)

Filed Under: gender identity, Media and society, NARTH, Professional issues, psychology, reparative therapy, sexual orientation, transgender Tagged With: , , , ,

More on the Dr. Phil episode on gender identity: Reparative drive theory

January 14, 2009 By 56 Comments

I have some video clips of yesterday’s Dr. Phil Show on gender identity. In this segment, Toni, the mother of a three boys, one of whom is transgender, expresses strong disagreement with Dr. Joseph Nicolosi and Mr. Glenn Stanton. Prior to this clip, Nicolosi outlined his views on response to gender identity issues. From the Dr. Phil website:

“So, what is a parent to do?” Dr. Phil asks. “You’re at home with your little child, they don’t do what other little boys do — and I’m using a little boy as an example. It happens with girls too, but statistics say it’s about five to one boys over girls who have this, but what is a parent to do at that point? Their question is, ‘Do we support his interest, or do we say, “No, no, no. You can’t play with that. You must play with this”?’”

“We see certain patterns, very typical patterns, of an over-involved mother, where the mother and son have a symbiotic relationship,” Dr. Nicolosi explains. “It’s very close, their identities are merged, and the father is out of the picture, and the work that we’re doing is to get the mother to back off, get the father more involved, get that boy to dis-identify with the mother and bond with the father, and in the bonding with the father, he develops that masculine identity.”

Most therapists have encountered families like this. However, they often come in for reasons other than a child’s gender identity. As Dr. Siegel said in a later part of the show, there is no evidence that a mom being close with a son leads to gender identity problems.

In this clip, Nicolosi and Stanton lay out their view of what happens to create a son like Toni’s. Roll the tape for the segment.

If I am following the mother’s explanation, she says she was not close to her son and her fiance became close to him after she backed off. She also notes that she was a single mom to her first son who would be expected to be closer to mom. Apparently, that child has no gender identity issues. And she says, the fiance/father-figure was less involved after the boy transitioned to a female role, but very involved prior to the transition. She further says that she wasn’t enmeshed with him. In other words, the reparative theory predicts a certain constellation but this women disconfirms it.

As noted in my first post on this episode, no middle ground views were presented. Near the end of the show, two reseachers seated in the audience were given a chance to speak. This segment was too short. I hope to post the clip of that exchange in a future post.

For now, I want to point out again the problem with confirmation bias in thinking through highly controversial topics. In this clip, the comments presented by Nicolosi and Stanton were not consistent with the experience of the mother and this son. Is it possible she was in denial? Is it possible that the reparative theorist was in denial? Sorting through this is difficult since both mom and the psychologists have powerful incentives to seek evidence favoring their commitments and views. In an area, like this one, where the science is developing, I advocate a very loose hold on theoretical commitments.

While the scientist can and should take a critical stance, it is true that parents need advice now. I tend to favor waiting until puberty to make decisions about transitioning since the existing research indicates most children do not opt for transition after puberty. However, even that finding is not as clear as Dr. Phil presented. See this interview with Ken Zucker for more on persistence of GID into adulthood.

Stay tuned…

Filed Under: gender identity, Media and society, mental health, NARTH, Professional issues, psychology, reparative therapy, sexual orientation, transgender Tagged With: , , , , ,

60 Minutes Science of Sexual Orientation mother of twins, part 2

May 30, 2008 By 3 Comments

At last, I am posting some follow up comments made by Danielle, mother of the twin boys featured in the 60 Minutes segment, Science of Sexual Orientation. Part one is here and should be read first.

Danielle said this in her initial email:

I often wonder “if” I had told Adam that “yes” he could be a girl when he became old enough would he have stayed on that track of thought? However, at the urging of his therapist I told him I understood he was a girl yet he was really a boy and couldn’t be a girl.

Wanting to be clear, she wrote to elaborate:

This was my response when he was three years old. We thought it would be confusing for that age of a child to hear he could be a girl but not until he was older. Later in his life I was up late watching a tv show about transgender surgery. Adam had awaken and was watching the show behind me – I didn’t know he was there. I heard a gasp. When I turned around there was my Adam staring intently at the tv. He asked me in a shocked whisper “Can I do that surgery and be a girl?” I told him “yes” he could but not until he was 18 years old. He became very excited. You have to understand the differences in his age. I believe the information I gave him at each step was based on age appropriate responses. He did stare at me for a bit and asked me if I would really let him do something like that if he wanted. I assured him I would if it would make him happy. He wanted to know why I would help him change his body. I informed him because I loved him and I didn’t want him to be sad or hurt. He asked me if I really loved him that much. My response was a very sound “yes!” that seemed to please him very much.

The last time Adam and I talked about him being able to change his body into a girls body Adam was indecisive. Again, I believe it’s the age/stage of his life and awareness of all around him. This conversation occurred after Tyra Banks had issued an invitation to be on her show. At that time Adam advised me he wasn’t sure what he wanted to do. He didn’t know if he should change his body so he could be a girl, stay with a boys body, if he was straight sexually or gay. Again, I believe his answer and confusion to be age appropriate. I declined the show offer because I didn’t want him to expose himself when he was so unclear about his future. I didn’t want to “lock” him into any particular role. That was when I decided to proceed with the hormone therapy to give him more time and maturity to decide what he wanted for himself. However he was already fully into developing so we decided not to go ahead with the treatments.

We are in the process of working on another television project. I am allowing Adam to participate because I believe the show will allow him to show his confusion and be himself as he is for a 12 year old. This lead us to another conversation about the issue. For all of his wise wisdom he informed me he still didn’t know what he wanted to do. “After all Mom, I’m only 12. I’m not suspose to know 100% for sure where my sexuality belongs. I’m suppose to be able to explore and decide later” And that’s where I have left it. For him to be a normal 12 year old child, maturing, developing and exploring the possibilities of his future. I’m here to guide him, support him, and show him all the possibilities of the future. I can love him, hold him, praise him and catch him if he falls. That’s my role as a parent.

I then wrote to her to clarify how these thoughts related to her parenting decisions, specifically with his name and school. She said:

The issue of what name to use during school was never really discussed. I wouldn’t have allowed him to use a girls name at school even if he had pushed me to do so. He was “Adam” and that was that.

During school hours he could wear what he wanted as long as it followed the school dress code. He only asked to wear a dress to school a few times. My response was always that his brother couldn’t wear his fireman clothing so he couldn’t wear his dresses to school however, he did wear them around the house. He did wear a girls black sweater with gold thread for two years. He wore girls tennis shoes all his life because of the color and sparkles and still wears them. He would wear girl shirts; however, in today’s fashion world, sometimes it’s difficult to tell the difference except in color. In his younger years, he wore girl jeans with sparkles but only for about an year then he didn’t want to wear them anymore. But the really feminine clothing was only at home. My life was easier dealing with this issue because I had twins. His twin wanted to be a fireman. He had everything to do with a fireman just like Adam had everything to do with being a girl. My rule was that the girl clothing (dresses, heels, jewelry, skirts, femme blouses, makeup) and the fireman clothing stayed home when we went to the library, grocery store, grandma’s, church, school and so on. My main reason for my restrictions were due to my parents who are totally against Adam’s gender issues. However, his Nana didn’t care what he wore so he could take his dresses to her house and wear them over there. I did have an issue at school once where the principal asked me if I could get Adam a different book bag (his was pink) and buy him different shoes (his were white with a pink logo on them). I advised her that he wasn’t breaking any rules by his choices so I wouldn’t make him give them up. I told her I could give in to him and allow him to wear dresses to school if she really wanted to push me since there isn’t a dress code that says he can’t. She backed off after that. However, I wouldn’t have ever allowed him to wear a dress to school anyway. Yes, I had restrictions about what he wore and did in society but he did have a bit of freedom by his choice of shoes.

I again want to thank Danielle for her candid comments. I have received emails from parents and professionals who are glad for this glimpse into how one parent reasons through these difficult issues.

Filed Under: gender identity, Professional issues, sexual orientation, transgender Tagged With: , , , , ,
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