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At the most basic level it is how we identify ourselves
Male or Female
Typical Gender Identity Development
Discriminate male vs. female voices Habituate with one category of faces
Discriminate male vs. female faces Begin to correlate male and female faces with genderrelated objects
Intermodal associations for male faces and voices
Stereotyped knowledge Recognize labels associated with faces
Gender labeling Generalized gender imitation Gender typed toy category awareness
Gender labeling for majority
Gender labeling Nonverbal gender identity
Developmental Theories Social-Cognitive Theory Triadic Reciprocal Causation Environmental events Personal factors Behavior patterns Children are active participants in selecting and creating environments .
activities or traits . Cognitive Developmental Theory Gender constancy Similar to idea of conservation Gender identity Knowledge of being a boy or a girl Gender stability Identity does not change over time Gender consistency Identity is not changed by changes in appearance.
Higher levels of gender constancy are associated with increased responsiveness to gender related information and more rigid application of norms Active construction of meaning .
Gender Schema Theory Cognitions about gender are central to development Schemas are prone to errors or distortion Work to attain consistency between schemas and behaviors .
healers.History-Transgender Present in all society from early times Some cultures seen as positive and acceptable Well-defined social roles: shaman. entertainers. storytellers Society determines treatment .
Gender Identity Influences Parent¶s gender schemas Biological sex Social/Cultural norms .
000 children born have ambiguous genitalia Often referred to as intersexed Variety of causes/conditions Hermaphrodites.Biology Estimates that 1 in 1. XYY Congenital Adrenal Hyperplasia Other Conditions Hypospadias Microphallus .XX/XY Genetic errors Turner¶s Syndrome-X0 Klinefelter¶s Syndrom-XXY Also-XXX.
frequently with hormonal support These terms are sometimes used interchangeably MTF: male to female transsexual FTM: female to male transsexual .Terminology Transsexuals-persons who seek sex reassignment surgery Transgendered: individual who lives (full or part time) as a member of a gender that is incongruent with his/her anatomic sex.
gender is clear and sexual orientation varies .Caution Do not confuse transsexual or transgender with transvestite or homosexual Transvestite: gets sexual arousal from cross dressing.
advocated early surgery What initially looked like successes were later seen as having poor outcomes Biology plays larger role than initially thought .John Money Leader in issue of transgendered individuals Felt gender identity was learned and in place by age 3 Gender identity is resistant to change.
Case of David Reimer Born mentally and physically healthy twin boy Penis was destroyed during circumcision Parents were told to raise him as a girl and advised by John Money to have David undergo reassignment surgery .
³Brenda´ Surgery performed at 22 months Estrogen therapy .
Brenda¶s Adolescence Did not feel like a girl Ostracized by peers Age 13 suicidal depression Parents told her the truth at age 15 .
³David´ Assumed male identity at age 15 Testosterone injections Double mastectomy Two phalloplasty operations .
later developed schizophrenia David committed suicide in 2004 .Consequences Married and father to 3 stepchildren Brother committed suicide in 2002 Trouble with accepting new relationship with brother rather than sister Mental disturbance.
poor mental health Focus is on binary expression Male/Female Surgery on children Pronoun usage Legal issues .Sociocultural Issues Emphasis remains medical/biological model Illness.
mammograms Multiple caregivers Gynecologist and urologist .Medical Issues Second puberty Hormonal therapies Will need both traditional male and female care Can¶t undo what has been done Health maintenance Same needs as age matched peers Prostate checks.
behavior. identity Not necessarily congruent .Sexual Orientation Erotic affinity for and engaging in sex with Those of the opposite sex (heterosexual) Those of the same sex (homosexual) Those of either sex (bisexual) Components Desire.
A Range of Issues in ³Orientation´ Categories of sexual desire Gender role attributes Forms of sexual behavior Personal and social identities Degrees of normality/abnormality .
for most people who experience the ³default´ orientation of heterosexuality Homosexuality is distinct from gender identity disorder and paraphilia .³Orientation´ and homosexuality Orientation is not an issue. at least in any conscious way.
The concept of sexual identity Reflects belief that sexual desire and behavior are core characteristics and defining of selfhood Reflects how personal narratives and constructs organize and explain experience Despite variability in individual histories. experience of identity is widespread and meaningful to people .
History Late 19th. move away from primarily moral and religious views Late 20th century different not necessarily seen as an ³illness´ Removal of homosexuality as a mental disorder (1973) 1969 Stonewall Rebellion-Gay Liberation Movement . early 20th centuries see scientific interest in sex.
not pathological Kinsey-continuum. complex and multifaceted . biological. developed a scale of sexual preference going from heterosexuality to bisexuality to homosexuality Garnets-orientation is flexible.Historical Conceptualizations Von Kraft-Ebing-degenerative sickness Ellis-inborn.
9% males identify attraction after the age of 15 Estimates may be as much as 18% females and 21% males identify attraction after the age of 15 .Prevalence Difficult to determine exact numbers Differentiation between same sex sexual behavior and sexual identity 8.6-11.1% females and 7.
brain development differences Associative Learning Sexual desire is conditioned. chromosomes. genes.Etiology-Theories Biological Explanations -hormones. often during early chance experiences that are sexually arousing Timing of sexual maturity and peer group Early development leads to increased chance of homosexual interests Peer groups alone Exotic becomes erotic Peer groups and gender identity Rejection by peer group due to nonconformity with traditional roles .
Model of Gay/Lesbian Identity Development-Cass (1979. 1996) Identity confusion Identity comparison Identity tolerance Identity acceptance Identity pride Identity synthesis .
Coleman¶s Model Pre-coming out Coming out Exploration First relationships Integration .
. anxiety and selfdestructive behavior." . including depression.. since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient.Reparative Therapy "There is no published scientific evidence supporting the efficacy of 'reparative therapy' as a treatment to change one's sexual orientation.. "The potential risks of 'reparative therapy' are great.
The evidence Sampling ³activist´ populations Success defined as reducing or eliminating homosexual behavior rather than creating or increasing heterosexual attractions. Only self reports of patients or therapists' subjective impressions have been available Careful study yielded 3% ³conversion´ .
Coming out Most gay men first acknowledge they are probably gay between the ages of 12 and 17 Most young lesbian women first acknowledge they are probably lesbian between the ages of 16 and 20. Commonly a process as much as an event .
socioeconomic status) Gender as a social factor . race.g.Issues of social environment ³Homophobia´ Including ³internalized homophobia´ Absence of role models Importance of all the other characteristics that influence social experience (e.
Homophobia 4 Assumptions Homosexuality is sinful/immoral It is ³unnatural´ It is a chosen behavior that can be changed It can be taught to others .
Caution Homosexuality does not equal pedophilia Evidence is to the contrary Of 175 adult males in Massachusetts of sexual assault against a child.. none had an exclusively homosexual adult sexual orientation (Groth and Birnbaum 1978) Homosexual males responded no more to male children than heterosexual males responded to female children (Freund et al. 1989) .
Health Care Challenges of communication Patients hesitant to be forthcoming Providers uncomfortable and avoidant Apart from STDs in men. little comorbidity Increase in adolescent suicide X3 Substance abuse more common but substance dependency is not .
but isolated or situational experiences of response to the other sex are not all that unusual People clearly do not in any realistic way experience sexual orientation as a ³choice´ Homosexuality is not gender reversal .Some cautions and misperceptions Most people respond exclusively to one sex or the other.
How little we know No specific biological or psychological basis is established Arguably ingrained at an early age and essentially immutable No meaningful psychological differences associated with orientation No physiological differences in sexual response cycle .
Challenges to adjustment Awareness of being different from others Restricted access to social support Social disapproval Added complications in formation of personal identity Religious and moral issues Absence of models for romantic behavior .
Rural populations May be even more isolated Religious practices may be more homogeneous in these communities How do you connect with others? .
let them teach you Understand your own feelings and get help when your personal beliefs interfere with providing appropriate care .Expectations of Physicians First do no harm Care and respect for the patient is essential If you don¶t know something.
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