Androgen and psychosexual development: Core gender identity, sexual orientation, and recalled childhood gender role behavior in women and men with congenital adrenal hyperplasia (CAH)

Objective: Females with the severe classic forms of congenital adrenal hyperplasia reportedly have a higher frequency of atypical gender identity, nonheterosexual sexual relationships, and cross-gender role behavior. Comparable data and quality-of-life measures among those with the milder, more prevalent form, nonclassic congenital adrenal hyperplasia, are scarce. We aimed to assess health-related quality of life, gender identity, role, and sexual orientation in women with nonclassic congenital adrenal hyperplasia via a prospective, questionnaire-based, case-control study. Methods: Thirty-eight women with nonclassic congenital adrenal hyperplasia (median age 34 years; range, 18 to 44 years) and 62 age-matched female controls were recruited. Outcome measures included the Multi-Gender Identity, Sexuality, and World Health Organization (WHO) quality-of-life questionnaires. Results: Sociodemographic parameters (marital status, number of children, and educational level) were similar for both groups, as were most measures of the Multi-Gender Identity, Sexuality, and WHO quality-of-life questionnaires. However, “sometimes-feeling-as-a-man and sometimes-feeling-as-a-woman” were more frequently reported in the study group compared to the controls (7/38 [18.4%] vs. 3/62 [4.8%], respectively; P = .02). Furthermore, more nonclassic congenital adrenal hyperplasia women reported first falling in love with a woman (4/37 [10.8%] vs. 0/58 [0%]; P = .02). Conclusion: Our findings suggest possible subtle differences in gender identity and sexual orientation between adult nonclassic congenital adrenal hyperplasia females and controls. Quality of life was not impaired in individuals within the study group. The impact of exposure to mildly elevated androgen levels during childhood and adolescence on the female brain warrants more in-depth assessment in further studies. Abbreviations: CAH = congenital adrenal hyperplasia; Multi-GIQ = Multi-Gender Identity Questionnaire; NCCAH = nonclassic congenital adrenal hyperplasia; QoL = quality of life

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Gender-role behaviour and gender identity in girls with classical congenital adrenal hyperplasia

BMC Pediatrics ◽

10.1186/s12887-021-02742-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sumudu Nimali Seneviratne ◽

Umesh Jayarajah ◽

Shamaali Gunawardana ◽

Malik Samarasinghe ◽

Shamya de Silva

Keyword(s):

Gender Identity ◽

Gender Role ◽

Congenital Adrenal Hyperplasia ◽

Exploratory Analysis ◽

Childhood And Adolescence ◽

Healthy Children ◽

Adrenal Hyperplasia ◽

Related Factors ◽

Increased Risk ◽

And Gender

Abstract Introduction Girls with classical congenital adrenal hyperplasia (CAH) are exposed to excess fetal adrenal androgens in-utero, and often born with masculinised genitalia. They are conventionally reared as females, but show more “boyish” gender-role behaviour (GRB) and gender-identity (GI) issues in childhood and adolescence. Male-rearing is also reported mainly due to delayed treatment and/or socio-cultural factors. We compared GRB/GI in girls with CAH with healthy age matched children, and explored for associations with socio-demographic and diagnosis/treatment related factors. Methods GRB and GI were assessed using the Gender Identity Questionnaire for children (GIQC) in 27 girls with classical CAH at a specialised clinic, and compared with 50 age-matched healthy controls, with exploratory-analysis based on socio-demographic and diagnosis/treatment-related factors. Results Girls with CAH had lower total GIQC scores compared to healthy children (3.29 vs. 4.04, p = < 0.001) with lower GRB score (3.39 vs. 4.23, p < 0.001), and tendency for lower GI score (3.19 vs. 3.5, p = 0.08). Exploratory analysis showed no differences based on diagnosis/treatment factors including age, degree of virilisation at diagnosis and surgical procedures. and only subtle changes based on ethnicity and maternal education. Discussion/conclusion Girls with CAH managed at a specialised centre showed more masculinised GRB and tendency for ambiguous GI, which did not vary upon diagnosis/treatment related factors, suggesting that prenatal androgen exposure was the likely contributor. Clinicians should be vigilant about the increased risk of gender-related problems in girls with CAH, irrespective of sociocultural background and despite early treatment.

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Inferences Regarding the Personality Traits and Sexual Orientation of Physically Androgynous People

Psychology of Women Quarterly ◽

10.1111/j.1471-6402.2000.tb00196.x ◽

2000 ◽

Vol 24 (2) ◽

pp. 148-160 ◽

Cited By ~ 12

Author(s):

Laura Madson

Keyword(s):

Sexual Orientation ◽

Gender Role ◽

Personality Traits ◽

Gay Men ◽

Psychological Characteristics ◽

Male And Female ◽

Role Behavior ◽

Gender Role Behavior ◽

Verbal Descriptions ◽

Within Subjects

Three studies investigated inferences about physically androgynous (PA) people. In Experiments 1 and 2, participants rated the personality, gender-role behavior, occupation, and sexual orientation of male, female, and PA targets in a within-subjects design. Targets were presented in color photos in Experiment 1 and in verbal descriptions in Experiment 2. Experiment 3 used verbal descriptions in a between-subjects design. In all three studies, participants inferred that the traits and behaviors in the PA targets were less gender-typed than those in the male and female targets. Participants also inferred that the PA targets were more likely to be homosexual and less likely to be heterosexual than the male and female targets. These results indicate that people draw conclusions about psychological characteristics from a person's physical appearance, but challenge Brewer's (1988) and Fiske and Neuberg's (1990) descriptions of how gender affects this process. Assumptions about PA people may also reinforce butch/fem stereotypes of lesbians and gay men.

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Sexual differentiation of gonadotrophin secretion, sexual orientation and gender role behavior

Journal of Steroid Biochemistry ◽

10.1016/0022-4731(87)90193-2 ◽

1987 ◽

Vol 27 (4-6) ◽

pp. 1081-1087 ◽

Cited By ~ 22

Author(s):

Günter Dörner ◽

Friedemann Döcke ◽

Franziska Götz ◽

Wolfgang Rohde ◽

Fritz Stahl ◽

...

Keyword(s):

Sexual Orientation ◽

Gender Role ◽

Sexual Differentiation ◽

Role Behavior ◽

Gonadotrophin Secretion ◽

Gender Role Behavior ◽

And Gender

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PSYCHOLOGICAL AND PEDAGOGICAL SUPPORT FOR THE GENDER IDENTITY FORMATION AT THE STAGE OF PRESCHOOL

Vestnik Altaiskogo Gosudarstvennogo Pedagogiceskogo Universiteta ◽

10.37386/2413-4481-2021-4-70-76 ◽

2021 ◽

pp. 70-76

Author(s):

E.S. Praizendorf ◽

◽

I.S. Morozova ◽

Keyword(s):

Gender Identity ◽

Gender Role ◽

Identity Formation ◽

Important Condition ◽

Role Behavior ◽

Gender Role Behavior ◽

Spatial Environment

The article reveals the features of the cognitive, emotional and behavioral components of preschoolers’ gender identity. An important condition for the formation of gender identity is the qualitative content of the developing subject-spatial environment. Psychological and pedagogical support for the formation of gender identity at the stage of preschool childhood is to create conditions for the successful assimilation of gender-role behavior in the play activities of preschoolers.

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