Richard Green

Prenatal ‘female hormone’ administration and psychosexual development in human males

Abstract (1) Considerable data exist from animal research relating prenatal hormone levels to postnatal behaviors in the male. The data from human males are few. One strategy for testing this association is the study of humans exposed prenatally to exogenous ‘pregnancy maintaining hormones’. (2) Fifty-eight young adult males exposed to one of four hormone regimens were matched against nonhormone exposed controls. There were 17 males exposed to diethylstilbestrol (DES), 22 exposed to DES and natural progesterone, 10 to natural progesterone only, and 13 to synthetic progesterone. (3) Subjects were interviewed for various aspects of psychosexual development, and administered the Bem Sex-Role Inventory (BSRI), the Guilford-Zimmerman Temperament Survey (GZTS), the Strong Vocational Interest Blank (SVIB), and the Embedded Figures Test (EFT). (4) Drug, total dosage, and time of drug administration were significantly associated with several aspects of boyhood, adolescent, and adult psychosexual development on interview and with differences in scales of the psychometric tests. (5) The most contrasting boyhood behaviors were between those exposed to progesterone and DES. Progesterone subjects tended to recall boyhood behaviors which departed from the conventional male mode toward ‘femininity’. The DES subjects tended to recall the most conventionally ‘masculine’ boyhoods. During adulthood, DES plus natural progesterone subjects reported a high sex drive while synthetic progesterone subjects reported a low sex drive. Erectile failure was more often reported by subjects exposed to natural progesterone only. (6) Three drug regimens were associated with elevations of the Feminine scale of the BSRI and two with elevations of the feminine scale of the GZTS. (7) The rates of homosexual behavior were comparable for drug and non-drug-exposed subjects.

Masculine or feminine gender identity in boys: Developmental differences between two diverse family groups

Early developmental experiences of 66 boys, ages 4–11, who preferred the clothes, toys, and companionship of girls, preferentially role-played as females, and stated their wish to be girls, were compared with those of 56 conventionally masculine boys, selected on the basis of matched demographic features of their families. The “feminine” boys were more often described as having been “beautiful” infants, and were hospitalized more often during their early years. Mothers reported less physical contact with the “feminine” sons in the first years and less time spent with these sons. Fathers also reported spending less time with “feminine” sons during the first years. There was no difference between groups of parents regarding their wish for a girl or a boy during the pregnancy with this son. There were no major distinctions between the two groups of parents on marital role division or marital satisfaction.

Sex-Typed Motor Behaviors of "Feminine" Boys, Conventionally Masculine Boys, and Conventionally Feminine Girls.

The purpose of this study was to determine whether, in four commonly observed childhood behaviors, the gross impression conveyed by “feminine” boys is distinctive from that of conventional boys, and in the direction of conventional girls. Three samples of children age 4–10 years were included in the study: boys with atypical sexual identity (N=12); age-matched conventionally sex-typed boys (N=8); and age-matched girls (N=7). The children were identically costumed to conceal gender and were videotaped while throwing a ball, walking, running, and telling a story. Videotaped segments of behaviors were randomly presented to four raters who judged the sex of the child on a five point scale which ranged from very likely male to very likely female. The analyses indicate that the sample to which the child belonged was the most important factor in explaining the rating the child received. The “feminine” boys occupied an intermediate position, one that was neither distinctly “feminine” nor distinctly “masculine.”

On the expression of H-Y antigen in transsexuals.

Histocompatibility-Y (H-Y) antigen, the presumptive inducer of the mammalian testis, is present in the cells of normal males and not in the cells of normal females. Recent reports have implied that patients with transsexualism exhibit H-Y antigen phenotypes at variance with those of normal males and females and, thus, that H-Y serology might provide a tool for the diagnosis and study of the transsexual condition. We therefore evaluated blood and testicular cells from 21 male-to-female transsexuals using conventional and monoclonal H-Y antibodies. We found no evidence of abnormal H-Y phenotype. Five of the patients were interviewed postoperatively by two examiners and rated for the diagnosis of transsexualism. Three of the five were rated primary transsexual by one or both examiners, and two were rated secondary transsexual.

Intervention and Prevention: The Child with Cross-Sex Identity

Prevention of conflict over sexual identity is an area that engages research and ethical issues and cuts across lines of contemporary social change. Politicalization has occurred during recent years in a fashion unprecedented in other areas of psychotherapy. It invests the contemporary social fabric as our society refashions acceptable sexual lifestyles.