Maggie Huff

Abnormal Psych
Presentation Paper
Gender Identity Disorder
Every day since the time that we were born until the present time, gender has been
engrained in our heads to help us realize who we are and what we should be like. "Gender is so
basic to our identity, most people mistakenly assume our sense of being male or female is defined
with absolute certainty by our anatomical sex" (Vitale, p.1). But what if you were male and had
no fatherly figure in your life or had always been raised to be like a girl? I would imagine that
would change your view a bit.
"Contrary to popular belief, one's sense of gender and one's anatomical sex are two
distinct elements; each developing at different times in different parts of the body" (Vitale, p.1).
Sometimes gender and sex have different identities. People who have a Gender Identity Disorder
have this problem. Gender Identity Disorder, sometimes called Transsexuals, is "a disorder in
which a person persistently feels extremely uncomfortable about his or her assigned sex and
strongly wishes to be a member of the opposite sex" (Comer, p. 416). This disorder is most
commonly found in well-to-do people and unfavorable childhood environments (Cauldwell). It is
also found most often in males. The hints and clues usually start during childhood, then from
there they either go away in late childhood or adolescence or they continue on and become a
Gender Identity Disorder as an adult. When studying Gender Identity Disorder I think it's
important to look at the causes and theories, how people with this disorder feel about themselves
and their bodies, and how it affects a person's life and functioning.
While there is no definite, set-in-stone cause of this disorder, there are a few ideas on how
and why it comes about. The first is the biological and hormonal explanation. It is believed that
between the second and twelfth week after birth there is a surge of brain masculinizing hormones
that happens in males only. And if for some reason the surge of the hormone androgen comes too
early or too late, it might only be partially imprinted as male (Vitale, p. 2). There is also a
difference in volume of a portion of the hypothalamus that is essential for sexual behavior. "This

data seems to confirm that one's sense of gender resides in the brain and is physically determined."
(Vitale, p. 2)
Another idea of where transsexualism comes from is childhood experiences. "The
Cogitative-Developmental theory states that gender understanding follows a prescribed timeline.
The pattern put forth is that children recognize that they are either boys or girls by the age of two
or three, followed shortly by recognition that gender is stable over time. By the age of six or
seven children understand that gender is also stable across situations" (Vitale, p. 2). The problem
comes about when a child recognizes his or her sex, but is uncomfortable with his or her gender.
This may stem from the way a child is raised, the activities and behaviors they observe, and the
role models they have to watch and learn from. For example, a somewhat common characteristic
of some transsexuals is that they didn't have a fatherly figure or brotherly role model to follow.
Sometimes they were encouraged to dress up in girls clothing, or sometimes just always played
with girls and did girlie things. They could also see their mother as someone in control and with
power and want to emulate that. In his article, Dr. George A. Rekers stated, "The research
literature of the psychosexual development of normal children has revealed that the father is the
parent whose role behaviors are most likely to generate sex appropriate behaviors in the children
in a family unit." (Rekers, p.6). So when there isn't a father around, I can see how there might be
some confusion in what's appropriate. Sometimes jealousy is a factor as well. At times a child
sees how the opposite sex is treated and the things that they get to do, and they start to be
envious of those behaviors and activities, and therefore try to be more like the opposite sex.
Exploration of both gender roles is normal and important for children for their understanding.
Some boys will do things that our culture would consider feminine like wear a dress or play house
and be the mom. It is when they actually want to be a complete member of the opposite sex that
a gender identity disorder comes into play.
Gender Identity Disorder starts really affecting their life from the start. As children start to
discover the gender they feel comfortable, and realize it isn't the same as their sex, there is major
confusion. As children, the reaction of peers starts being evident when there's a deviation from

the norm. "If there is any confusion in the child, he or she quickly learns from adults and peers
that certain gender-expression behaviors are inappropriate for that individual." (Vitale, p. 2)
Some children internalize their dilemma and make efforts to "display the gender behavior expected
of them, while expressing their internal sense of gender through secret play, cross-dressing and
cross-gender fantasies" (Vitale, p.2). In adolescents, frustration starts to occur because their
bodies are developing in ways that they don't want it to. For example, the male will start to gain
muscle mass when they want to have breasts.
"Without fail, the subsequent development of secondary sex characteristics
counter to the individual's desires increases anxiety .Often, frustration and determination to
finally resolve the problem becomes the individual' driving force in life. This is especially true
for gender dimorphic males. Since the obvious first effort is to accept the physical evidence of
their genitalia as reality, it is very common to see many of these people push through these early
years of adulthood by engaging in stereotypical, even super male activities. Since outward
behavior has no permanent influence on internal gender understanding, these activities serve
only to complicate the individuals social involvement, resulting in anxiety about expressing his
true felt gender. This anxiety state is characterized by feelings of confusion, shame, guilt and
fear" (Vitale, p. 2).
To illustrate this let me tell you about "Earl." Earl is a female who wants very badly to be
a male. She started out as a child envying the way the guys were treated in her family. Every
once in a while when she was little, she was dressed in boys clothes and she loved it. She had no
desire to be a girl. She grew up thinking that she was a boy and appeared to be more puzzled
than determined to be a male. By the time she was 18 years old, she wore only guy's attire. She
had at least one homosexual encounter because she completely considered herself male. She
stated to her doctor her desires to have surgery to make her a full male. She wanted her breasts
and ovaries removed and her vagina closed so she could get a penis somehow. The doctor
explained that it was impossible with her being completely healthy in all those areas. She was
disappointed and was still confident she should be getting it done. She also felt she should be able

to court females just like any male. She ended up binding her breasts down as small as she could
and shaved in order to grow a beard. She loved being referred to as "he" and "sir" and was
narcissistic and reveled in just seeing and feeling herself in the role of a male. (Cauldwell). This
example gives a good idea of the extent that people with this disorder want to be and believe they
are the opposite sex. While every case is different, there are certain characteristics that are the
same in almost every case.
To help these people better cope with this disorder there are a couple of different options.
One of the options is hormone treatment. Males are injected with estrogen so they can develop
breasts and have loss of facial and body hair. Females receive treatments of testosterone. By
injecting either male or female hormones into the body, it causes them to have certain
characteristics of that sex. Another option, which is highly controversial right now, is sex-change
surgery. The person undergoing this procedure must have hormone treatments for one to two
years before they undergo surgery. For men they amputate the penis and create an artificial vagina.
The procedure for a woman to become a man is called phalloplasty and has not been perfected
yet. While there isn't really a "cure," these things provide a way for them to better adapt to the
sex they want to be. I also need to mention that not many studies have been done on the
psychological effects a surgery like this could have. Some can be psychologically stable after
surgery while others are not able to adapt well to the huge change that they have made to their
bodies.
It is also interesting that some tests have shown that this disorder runs in the family. This
may be something that is wrong biologically. There have been some studies that show that people
with gender identity disorder do have some abnormalities in their brains. They is a certain cluster
of cells that are different in the man and womens brain near the hypothalamus. These cells in
people with gender identity disorder match that of the opposite sex. No extensive human studies
have been done, but scientists know that these cells do regulate sexual behavior in male rats.
People with Gender Identity Disorder are interesting to me. I can't imagine being
confused about my gender and having a huge desire to be a member of the opposite sex. It would

be hard to look around and see how things are "supposed to be" but feel completely opposite of
that. I can see how confusing that would be. I also cant imagine how dissatisfied I would be
with my body. Going through adolescence is tough enough but being mad about the natural
changes that were happening and not being able to stop or prevent it from happening would be
extremely frustrating. It's important that we realize that these people aren't bad people and they're
not sick or perverted, they just have a problem that most likely started during childhood because
of some confusion. Their sense of gender and their genitalia were somehow confused and
different from how they feel biologically.
We also need to understand that this is completely different from being homosexual.
Homosexual people are attracted to the same sex. While people with Gender Identity Disorder
believe that they should be of the opposite sex. So it is natural for then to feel like they should be
attracted to what they believe is the opposite sex of them. Once a person's gender is established, it
is unchangeable (Vitale, p. 3). "The only variable is the individual's ability to tolerate the inherent
anxiety of feeling missexed" (Vitale, p. 3).
It is important for us to have a better understanding and not shun these people because
they need acceptance. They are already very confused and unhappy with their bodies. Often they
become suicidal because they cant get away from prejudice. They also feel out of control and
become depressed and anxious. Hopefully more research can be done on this disorder so we are
better able to help those with it.