Gender Identity & Selective Advantages Of Being Male, Female, or Both!

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by Steven J. Wamback



          Sex, that is the maleness or femaleness of animals, is determined entirely by biologic (genetic and/or biochemical) factors. Sex role and gender role behaviors, however, are determined by unique combinations of both biologic and environmental controls with timing during critical periods of development often being of considerable or even primary importance. Sexual, that is reproductive and maternal, behaviors involve more biologically-restricted genetic components due to their direct evolutionary selective advantages in ensuring the passing on of parental genes to a greater number of offspring (Daly & Wilson 1983; Dawkins 1977; Hamburg 1974).


          Gender-role behavior, although having a less genetically restricted biological component, is also selectively advantageous in increasing sexual attractiveness (subjectively measured by humans as womanliness/femininity or manliness/masculinity) to members of the opposite sex and is determined by a more plastic combination of both biological and environmental factors which are further reinforced by social learning and ultimately by one of the most powerful psychologic reinforcers of all... orgasm (Heilbrun 1981; Hrdy 1979; Hubbard & Lowe 1979; Kelley 1987; Symons 1979).


          Since human females lack menstrual/ovulatory synchrony, constant gender-role behavior appears to serve the same function as periodic ("mating-season") courtship behaviors in other species. This ensures continual high levels of sexual arousal, penile erection, and female receptivity (Beach, 1976); thus increasing the statistical probability of fertilization during the hidden ovulatory phase of the menstrual cycle and also the probability that the human male will remain nearby and take an active role in the care and defense of his mate and offspring in exchange for future social and orgasmic rewards (Alcock 1984; Symons 1979).


          Human culture, tradition, and social standards define and dictate which "masculine or feminine" behaviors are "appropriate" for each sex in each society (Chafetz 1974; Kagan 1956, 1962, 1971; Kagan and Lemkin 1960; Kagan et al. 1961; Mead 1955;). The adaptive advantages of remaining sexually attractive even when one is not actively seeking copulation "re-motivates" the partner to provide other useful services between copulations and according to Desmond Morris (1967) by being attractive to the opposite sex (even when aided by artificial signalling devices such as clothing, accessories, and mannerisms), one reduces certain antagonistic feelings in other members of the social group.


          The vast bulk of copulation in our species is obviously concerned, not with producing offspring, but with cementing the pair-bond by providing mutual rewards for the sexual partners. The repeated attainment of sexual consummation for a mated pair is clearly, then, not some kind of sophisticated, decadent outgrowth of modern civilization, but a deep-rooted, biologically based, and evolutionarily sound tendency of our species. (Morris 1967)


          The semirestricted (plastic) bio-environmental model of gender-role behavior presented in this chapter suggests that the potential to adopt some form of gender-role behavior is biologically determined; but plastic cultural and social standards as well as reinforced learning select which gender role behaviors are appropriate for each sex. These standards become imprinted initially through identification with a model (Bandura 1965, 1969) during biologically pre-determined critical periods of development (Kagan 1971, p.57; Papilia & Olds 1978); are subsequently reinforced by social acceptance/learning; and are ultimately fixed by sexual arousal, receptivity by a mate/partner, and finally by orgasmic gratification. Because of their high evolutionary value and selective advantages, gender role identification and behavior once established, as well as the corresponding gender identity disorders, are not generally and certainly not easily subject to alteration or extinction.


          Certain pathophysiologic and psychopathologic conditions can give rise to an entire range of anatomical, physiological, and/or psychosociological deviations from established sexual and gender-related norms. Included in this range of variations are genetic and hormonal abnormalities such as Turner's syndrome, Kleinfelter's syndrome, other X-Y cytogenetic syndromes, androgen insensitivity, adreno-genital syndrome, as well as a number of other pathologic variations leading to a "catch-all" cluster of diagnostic entities generally and formerly known as hermaphroditism (currently the term "intersex" is gaining acceptance over "hermaphroditism").


          Intersexual symptomology ranges between slight deviation in secondary sexual characteristics from genetic sex through ambiguous sexual morphology to physical appearance which is entirely discordant with one's chromosomal sex (Ehrhardt & Baker 1973; Ehrhardt & Money 1967; Money 1963, 1967, 1970, 1980, 1986; Money & Ehrhardt 1972; Money & Pollitt 1964; Money et al. 1968). The range of psychiatric and psychosociologic difficulties (gender dysphoria, anxiety, depression, and problems in living) associated with these hereditary and biochemical abnormalities is, as might be predicted, similarly extensive (Hurtig 1992; Meyer-Bahlburg 1982, 1994).


          Gender dysphoria is a catch-all term for a variety of socially discouraged cross-gender behaviors. Individuals who display these behaviors have traditionally been labeled as either transvestic or transsexual depending on their motivation for engaging in cross-gender activities. The most common "symptom" of the gender identity disorders is wearing the clothes of the opposite sex (cross-dressing). Adopting the mannerisms and other stereotyped behaviors of the opposite sex is also common. Barker (1966); Benjamin (1954, 1966, 1967); Brierly (1979); Docter (1988); Feinbloom (1976); and Talamini (1982) have extensively described the cross-gender phenomena.


          The gender identity disorders (GIDs)... mild to severe psychopathologic dissatisfaction with one's genetic or morphological sex, ranging between transvestism and transsexualism ("psychosocial hermaphroditism") in the general absence of obvious biologic abnormalities, can occur at least partially in response to absent, weak, "inappropriate", or dual identification with a sex/gender role-model or models (Bandura 1965, 1969; Brown 1961; Brown & Lynn 1966; Lynn 1959, 1966, 1969, 1974; Morris 1967, p. 93-96). These atypical plastic features are somehow learned, at least in part, and are imprinted on a biological framework which provides for the adoption of some form of gender identity.


          Behavioral symptomology ranges between the occasional need or desire to express certain sex-typed or even stereotypical cross-gender behaviors, such as wearing the clothing, exhibiting the mannerisms, assuming the sexual role, etc. of the opposite genetic sex (Phillips et al. 1980; Pleck 1981; Prince 1967; Richman 1970; Spensley & Bartner 1973; Susann 1988; Talamini 1982) through to an all-consuming need and desire to obtain hormonal and surgical reassignment and live fully as a member of the opposite biological sex (Barker 1966; Benjamin 1954, 1966, 1967; Brierly 1979; Burchard 1965; Docter 1988; Edelstein 1960; Feinbloom 1976; Green 1969, 1974a, 1974b; Stoller 1971).


          The Diagnostic and Statistic Manual; Fourth Edition (APA 1994) classifies the major atypical gender conditions as either: 1) Transvestic Fetishism, 2) Gender Identity Disorder in Children (pre-puberty); 3) Gender Identity Disorder in Adolescents and Adults; or 4) Gender Identity Disorder Not Otherwise Specified. The DSM-IV diagnostic criteria for these entities are reviewed in Table 1. It should be noted that the term "Transsexualism" was formerly used in the DSM-IIIR (APA 1987) but that term does not even appear in the more recent edition. Also, the DSM-IV does not recognize the "Nontranssexual" variety of Gender Identity Disorder which was previously described in the DSM-IIIR. These recent nomenclatural changes, along with the wide variety of terms and interpretations thereof, indicate a great need for standardization of the terminology used to classify and describe transgender behavior and phenomena.


          Levine (1993) describes transvestites as a diverse group who, more often than not, are men who differ in gender identity, sexual orientation, and intention; with a "common soothing image of themselves as women." He suggests that whether cross-dressing occurs among masculine or feminine males, heterosexuals, homosexuals, bisexuals, asexuals, or those with sexual paraphilias (fetishism, sadomasochism, etc.), "their behavior should be considered the expression of their consciously felt femininity." He proposes further that diversity along and between three distinct but related parameters including: 1) desire for hetero-, bi-, or homosexual intercourse; 2) historical pattern and degree of fetishistic sexual arousal by female clothing; and 3) ability or inability to integrate and/or compartmentalize masculine and feminine strivings, are responsible for both science's and society's confusion regarding these individuals. Further, Levine suggests that "when cross-dressers give up all vestiges of male gender role behaviors and successfully live and work full time as women, the appropriate descriptive term for them becomes 'transsexual' " (Levine 1993).


          Blanchard (1985, 1989, 1991, 1993a, 1993b, 1993c) and Blanchard and Collins (1993) have described the phenomenon of autogynephilia in which some men obtain sexual arousal from the thought of themselves as women, and in which female clothing (as compared to transvestic fetishism) carries less importance or none at all. These "naked transvestites" may have erotic interest in either full or partial feminization of their bodies. Partial autogynephilia has been frequently associated with pornography and prostitution. Such individuals are known colloquially as "she-males".


          Blanchard and Collins (1993) have also described the phenomenon of being sexually attracted to transvestites, transsexuals, and "she-males" and have applied the term gynandromorphophilia to the phenomenon. These observations would seem to confound the already-confusing issues of homosexuality and gender dysphoria even further. But, Blanchard (1985, 1989) hypothesizes that there are only two fundamental types of gender disturbance in males: homosexual (aroused by men) and autogynephilic (aroused by the idea of being a woman).


          Blanchard's (1989, 1991, 1993a, 1993b) research demonstrates a correlation between degree of gender dysphoria and degree of femininization visualized (or sought) in achieving sexual arousal. Blanchard has concluded that transvestic fetishism is a form of autogynephilia where the most prominent symptom is cross-dressing in the absence (at least momentarily) of any gender dysphoria. Blanchard's model conforms neatly with Docter's (1989) five-stage theory of secondary transsexualism in which an individual either becomes increasingly more gender dysphoric or stabilizes at a particular stage. Future studies should focus on the hypothesis that ultimate resolution of the transsexual conflict and happiness in life may depend upon the individual's personal satisfaction in his/her ability to "pass" well, either naked, dressed, alone in front of a mirror, or out in public.


          As with the relatively rare hermaphroditic (intersexual) syndromes, the much more common gender identity disorders can lead to a host of secondary psychological difficulties ranging from low self esteem, shame, or guilt due to social pressures that are at odds with one's deeply hidden "closeted perversion" of gender identity, to suffering mental and physical abuse from a "homophobic" society, through severe depression that can in some instances lead to self­ mutilation (Greilsheimer & Groves 1979; Martin & Gattaz 1991; van Kammen & Money 1977) or even suicide (Herschkowitz & Dickes 1978; Levine 1994) with hormonal and/or surgical gender-reassignment as the only (but not always effective) therapeutic intervention and recourse.

          The etiologies of the gender identity disorders may be dependent upon pathologic
involvement of either or both of the plastic and restricted behavioral components. If, however, we subscribe to Unger's (1979) contention that the "two-sex" scheme of classification is questionable, and that the factors which define sex vary continuously across a spectrum in a multidimensional fashion, rather than dichotomously in a one or two dimensional way, the "pathology" of transgendered behavior becomes questionable also. The pathology then lies in the individual's inability to effectively manage her/his cross-gender or mixed-gender identification. In that case, treatment should be aimed at the "dysphoria" (and ultimately at subjugating social prejudices) and not the transgender behavior itself.


          Considerable research is needed to ascertain the etiology and optimal treatment modalities for effectively dealing with this host of abnormal sex and gender-related issues as well as the dysphoria, anxiety, and depression that often accompany these conditions. Unger (1979) suggests that, "We can learn a great deal about the processes that mediate sex-related behaviors by examining individuals with characteristics that are supposedly appropriate to the other sex." Past and ongoing research aimed at determining which CNS structures and neural connections are involved in "hard-wiring" both gender and sex-related behaviors tend to support this model of gender role identification and behavior. This ongoing research and its implications for explaining and effectively managing gender identity disorders in humans will be reviewed and discussed in greater detail in the sections that follow.





          In what ways do males and females typically differ from each other?  The answer to this question seems obvious when considering the external morphology of healthy adult humans... Males have straight, muscular, hairy bodies with penises. Females have curvaceous, soft, smooth bodies with vaginas and enlarged breasts. Additionally, males have testes contained in an external scrotum; females have internal ovaries, fallopian tubes, and uteruses. These anatomical, and associated physiological, differences are genetically predetermined and vary only slightly between normal individuals within the respective sexes.


          Aside from gross anatomy and physiology, are there other differences between males and females? The answer to this question also seems obvious, particularly when we consider the ways in which they behave. Males have been stereotypically described as dominant, aggressive, competitive, assertive, industrious, and emotionally dispassionate; whereas females have been stereotypically described as submissive, serene, dependent, emotional, and nurturing. These antiquated cultural stereotypes have largely been subjugated during the Twentieth Century, but not entirely. Even some of the most "liberated" women and the most "enlightened" men behave in ways that can be categorized as stereotypically feminine or masculine.


          Much literature has been devoted to the questions that arise from observations on the behavioral differences between males and females (see Ames 1991; Friedman et al. 1974; Kelly 1987; Lloyd & Archer 1976; Maccoby 1966; Maccoby & Jacklin 1974; Kimura 1992; Mead 1955; Money and Ehrhardt 1972; Parsons 1980; Shaver and Hendrick 1987; Tavris and Wade 1984; Unger 1979; Unger & Denmark 1975). A question frequently addressed by these and similar studies is: Are the observed behavioral differences between the sexes biologically determined and if so, to what extent? Conversely, much research has also attempted to ascertain the extent to which various environmental factors (psychology, sociology, and culture) play roles in the development of sex-typed behavior. Much interesting literature has arisen from the "Nature-Nurture" debate and the fairly new field of Psychobiology. For an excellent review of the Nature-Nurture question, see Brown-Parlee (this volume).


          Brown and Lynn (1966) have outlined three main components of human sex and gender-­related behavior. These include: biological constitution, sex-object preference, and sex-role. In this chapter, this three-part scheme is employed in the review of sex-related behavioral develop­ment. It is necessary, however, to further subdivide "sex-role" into two distinct behavior types: largely restricted sexual behavior, which is directly linked to reproduction and nurturing of offspring, and more plastic gender-role which is characterized by non-copulatory sex-related behaviors. Although this chapter focuses on the development of gender-role behavior, it is, however, necessary to briefly review the other components of human sexuality since they form the framework upon which gender-role and gender identity are developed.






          Of the 23 pairs of chromosomes that comprise the human genome, one pair is directly involved in the determination of an individual's sex. Females have a pair of X chromosomes and males have one X and one Y. Jost (1953) found that by removing undifferentiated fetal rabbit gonads, the resulting rabbits were all phenotypically female, regardless of XX or XY genotypes. The resulting rabbits all had female secondary sex characteristics but lacked penises and accessory male structures. Thus, Jost inferred that sex development in mammals is in the female direction unless acted upon or regulated by a Y chromosomal product. Meyer, Migeon, and Migeon (1975) have further demonstrated this principle by studying 46XY hermaphrodites (intersexed individuals) with testosterone-producing testes, but who lacked androgen binding protein on their cells. These individuals were female in appearance due to estrogens produced in the adrenal glands by default in both males and females.


          Singh and Jones (1982), Eicher and Washburn (1983), Eicher et al. (1982), and Page and co-workers (1985, 1987) have shown that the short arm of the Y chromosome contains the genes that code for male-differentiating factors. Once these Y genes are expressed, masculinization of the embryo ensues. Testes develop and begin producing two hormones... testosterone which brings about the formation of a penis and scrotum, and anti-Mullerian duct factor which destroys tissue that would otherwise differentiate into the uterus, oviducts, and upper portion of the vagina (Gilbert 1988, p. 745; Eicher & Washburn 1986).


          Haseltine and Ohno (1981) and Washburn and Eicher (1983) have postulated that the main determinant of gonadal differentiation is the presence or absence of a cell surface antigen called H-Y. They suggest that H-Y antigen expression involves a complex interaction between Y, X, and autosomal regulatory sites. McLaren and co-workers (1984) have questioned the H-Y antigen hypothesis as they have discovered mice which lack H-Y antigen but have testes, penises, and other male secondary sex characteristics. Burgoyne, Levy, and McLaren (1986) have, however, found that male mice lacking H-Y antigen also lack spermatogenesis. They have concluded that a Y gene that is distinct from the testes determining factor (TDF) gene is needed for spermatogenesis and its product may indeed be H-Y antigen. This has been confirmed by Simpson and co-workers (1987) who have mapped the genetic loci for both H-Y antigen and TDF on the human Y chromosome (see also Vergnaud et al. 1986). Once differentiated, the fetal gonads begin secreting hormones which give rise to secondary sex characteristics, differences between male and female neuroanatomy, and ultimately to differences in behavior.







          This section reviews how the sex hormones, particularly estrogen, progesterone, and testosterone, effect morphological changes in the fetal and neonatal central nervous systems. Evidence, based on some animal models, is provided which demonstrates that these anatomical and physiological changes are directly responsible for some of the observed differences between male and female courting, mating, and reproductive behaviors. Gilbert (1988, p.622) suggests: "Equally fascinating are the observations that many complex behavioral patterns are inherently present in the "circuitry" at birth... There appear, then, to be certain neuronal connections that lead to inherent behaviors in higher vertebrates" (Gilbert 1988). Regarding the means by which  these circuitry changes are effected, MacLusky and Naftolin (1981) observe: "Sexual differentiation and reproductive behavior are largely effected by hormones produced in the gonads. In higher vertebrates, this process induces permanent and irreversible sex differences in the central nervous system function due to gonadal hormones secreted early in development" (MacLusky & Naftolin 1981).


          Male songbirds produce specific courtship "songs" when seeking mates. Thorpe (1958) demonstrated that castrated male finches will not sing. When he injected them with testosterone, Thorpe found that singing behavior resumed even when so injected during the non-mating season. Thorpe concluded that testosterone is involved in song production in male finches. Prove (1978) showed a positive correlation between serum testosterone concentration and singing behavior in male zebra finches.


          Nottebohm (1981) demonstrated a similar correlation for canaries; he postulated a growth in size of song-controlling regions of the brain upon administration of testosterone. Gurney and Konishi (1980) found that when female zebra finch hatchlings are administered estrogen, male song behavior ensues upon maturity. This suggested to them that estrogen is somehow converted to testosterone by the brain. Arnold (1980) performed autoradiographic studies which show that the neurons of song controlling nuclei in the brains of songbirds will incorporate radioactive testosterone; but other brain regions will not. This supported the important role of gonadal hormones in the development of the portions of the nervous system responsible for certain sex-specific behaviors. Thus, a hormonal basis for male reproductive/singing behavior has been clearly demonstrated in birds.


          Similar studies in mammals have also shown that sex-typed behavior is induced by the actions of fetal and artificially administered sex hormones. Phoenix and co-workers (1959) proposed an "organizing action" of prenatally injected testosterone on the subsequent mating behavior of female guinea pigs. Feder, Phoenix, and Young (1966) suppressed female behavior in female rats by administering testosterone prenatally. Similarly, Gray, Lean, and Keynes (1969) elicited masculine behavior in female rats. Tiefer (1970) demonstrated that castrated newborn male hamsters will display female precopulatory behavior (lordosis) upon maturity. They also demonstrated that a single dose of testosterone administered to a neonatal female rat will cause typically masculine behavior to ensue upon maturity. They concluded that these results indicate the bipotentiality of the mammalian brain.


          Reddy, Naftolin, and Ryan (1974) demonstrated that testosterone is converted to estrogen in the hypothalamus and limbic systems of newborn male rats. These portions of the brain regulate hormonal and reproductive behaviors. In normal females, estrogen-binding proteins typically bind estrogen thus preventing masculinization. In normal males, testosterone is apparently converted to estrogen which somehow triggers subsequent masculine behavior.


          Doughty and co-workers (1975) permanently induced masculine behavior by injecting newborn female rats with a single dose of estrogen. This is in accordance with The Conversion Hypothesis which contends that female sexual behavior is intrinsic to the brains of mammals. However, if the brain receives estrogen during a critical period near birth, masculinization will occur. Vreeburg and coworkers (1977) and McEwen and co-workers (1977) have shown that inhibition of the conversion of testosterone to estrogen in neonatal male rats causes both male and female behaviors. Thus, they have concluded that the development of the male nervous system requires both defeminization and masculinization steps.


          Pfaff and McEwen (1983) have demonstrated that estrogen alters the electrical and chemical features of the hypothalamic neurons that bind estrogen. Nabekura and co-workers (1986) have suggested that the mechanism by which estrogen causes changes in neuronal activity in male rats exhibiting lordosis involves an increase in cell permeability to potassium.  McEwen (1992) reports that hormonal effects on brain differentiation occur at the level of gene transcription and are mediated by intracellular hormone receptors which are also DNA binding proteins.  McEwen reports further that environmental stimuli, including stress, and thyroid hormones are probably responsible for individual differences as well as for deleterious disorganizational effects.


          Barfield and Chen (1977) and Rubin and Barfield (1980) have further demonstrated that estrogen stimulates neurons in the brain regions responsible for female reproductive behavior. Ovariectomized rats were given injections of estrogen directly into the hypothalamus, producing lordosis upon presentation to male rats. Ovariectomized control rats did not display this behavior. McEwen (1981) has found that estrogen-sensitive neurons are located in the hypothalamus, pituitary, and amygdala... brain regions that are involved in mediating reproductive behavior.


          Pfaff and Sakuma (1979) have facilitated lordosis by electrostimulation of the hypothalamic ventromedial nucleus of ovariectomized and estrogen-primed female rats. Breedlove and Arnold (1980) have shown that penile thrusting muscles in male rats are controlled by motor neurons originating from a spinal nucleus that specifically concentrates testosterone. In female rats, these muscles are vestigial and possess a greatly reduced number of controlling neurons. Nordeen and co-workers (1985) and Kurz and co-workers (1986) demonstrated that testosterone has two effects on this dimorphic spinal nucleus: First, it prevents normal cell death (senescence) of these cells. (Neonatal females normally lose 70% of these cells whereas males only lose 25%.) And second, testosterone maintains the size and dendritic length of these neurons in adult rats. Castration reduces the size by 50% but these effects are reversed upon the subsequent administration of testosterone (Nordeen et al. 1985; Kurz et al. 1986). Sex differences in brain morphology are reviewed separately in greater detail by Wamback (this volume).


          Considerable research has been conducted by Allen and Gorski (1990, 1991, 1992) and Gorski (1985, 1986, 1993) on the effects of gonadal hormone priming on the relative sizes of several sexually-dimorphic brain regions and structures during perinatal critical periods of development. Rhees, Shryne, and Gorski (1990a, 1990b) have determined that the sexually dimorphic nucleus preoptic area (SDN-POA) of rats has a perinatal critical period of hormonal sensitivity, ranging from about day 18 of gestation through postnatal day 5, during which androgen (testosterone proprionate) significantly increased the volume of the SDN-POA in both male and female rats.


          Allen and Gorski (1992) have determined that the anterior commissure of the human homosexual male brain is 18% larger than in heterosexual women and 34% larger than in heterosexual men. They suggest that this anatomical difference, which correlates with both genetic sex and sexual orientation, may, in part, underlie differences in cognitive function and cerebral lateralization among homosexual men, heterosexual men, and heterosexual women.


          LeVay (1991, 1993, 1994) has also demonstrated differences in the size, number, shape, and distribution of neuroanatomical features between heterosexual females, male and female homosexuals, and heterosexual males. An excellent review of hormonal patterns in homosexuals and transsexuals is presented by Allen (this volume).


          Wallen (1990), Wallen and Lovejoy (1993), and Wallen (this volume) have presented excellent reviews on the hormonal basis of male and female sexual desire and sexual functioning based particularly upon extensive work with rhesus monkeys, other non-human primates, and rodents. Wallen and Lovejoy (1993) point out that, "One of the most striking differences between rodent and human sexual behaviors is the stereotyped nature of the former compared with the great flexibility and lability of human sexual behavior". They suggest that this greater "encephalization" of sexual behavior in "higher" animals complements a corresponding decrease in the roll of hormones in affecting sexual desire and functioning.


          Wallen and Lovejoy (1993) concluded that, "In this view, hormones are not seen as the sole regulators of sexual behavior but as an integral part of the complex of social and physiological systems that coordinate sexual behavior with fertility and social context." It stands to reason that the less directly related a sexual behavior is to the act of copulation, the more likely it is to be influenced by environmental and social stimuli, reinforcement, and motivation.


          In the preceding discussions, several key principles regarding the hormonal/neural basis for sexual behavior differences in animals have been reviewed. These principles are summarized as follows:


1.       Sexual behavior is largely determined by biologic factors (fixed action patterns).

2.       Genetic, hormonal, and neural interactions are involved in the development of          sexual behaviors.
3.       Testosterone and estrogen act differentially upon the male and female nervous         system.
4.       Hormonal priming is required during specific critical periods of development

          in order for "appropriate" feminine or masculine behavior to ensue later on.

5.       Incorrect hormonal priming during certain critical periods of development can

          effect, blend, or reverse the normal behavior patterns predicted for either sex.

6.       In the absence of a Y chromosome, testosterone, or testosterone receptors,

          development is in the female direction; and female behavior patterns will ensue.


          Having briefly reviewed the significance of sex hormones in the development of the more genetically restricted sexual behavior patterns in animals, focus shall now be turned toward the means by which less restricted or more plastic behavioral patterns, including gender-role behaviors, can develop in animals and humans.






          That sexual and copulatory behaviors are genetically restricted, has direct selective advantages in that it ensures the union of gametes, and therefore, the production of offspring. The degree of success in accomplishing this defines reproductive fitness upon which the concept of natural selection is based. Any behavior which ensures that a greater number of parental genes will be passed on to the offspring is likely to have evolved a more restricted genetic component. Alcock (1984, p. 12) suggests that the adoption of "the adaptionist working hypothesis has proved to be the most productive and versatile in the development of testable predictions" (Alcock, 1984; Krebs and Davies, 1981). It follows, then, that other more variable behaviors, that still have definite selective advantages, are likely to also have some degree of genetic restrictedness.


          Even the most plastic (learned) behaviors involve genetically ordained biological components. This section reviews the evidence that basic biological "wiring patterns" can be imprinted upon by environmental stimuli that lead to the development of sex-typed gender-role behavior and that the adoption of gender-role behavior in humans has certain selective advantages that can lead to increased reproductive fitness.


          An example from the studies of predator classification and alarm calls of vervet monkeys is given here to illustrate the concept of semirestricted behavior development: Seyfarth and Cheny (1980) and Seyfarth, Cheny, and Marler (1980) described four different alarm calls used by vervet monkeys to signify the presence of leopards, eagles, pythons, and baboons. The four basic calls appear to be of innate origin since they are common to vervets in geographically isolated populations and are given by infants who have not had sufficient time for learning.


          In a given population, each call specifically represents the presence of a specific predator. However, in different populations, which call is associated with which predator may vary. Infant vervets must learn which innate call is appropriate in their society for each predator. That learning takes place is supported by observations that juvenile vervet monkeys sometimes react inappropriately to given calls and further by infants giving one of the standard calls for an inappropriate or generalized stimulus. Subsequent reinforced learning refines alarm call and predator-avoidance behavior according to the standards of the social group. Studies on maternal imprinting (Lorenze 1970; Zippelius 1972) as well as human language acquisition (Moskowitz, 1978) are further examples of how behavioral learning can become imprinted on innate biological wiring patterns.


          A critical period in development is a period in time during which an event will have its greatest impact. There are physiological critical periods when hormones such as testosterone or estrogen will produce their greatest effects; and behavioral critical periods during which behavior patterns become imprinted or permanently fixed. Marler and Peters (1981) have demonstrated two critical periods in song acquisition in white crowned sparrows. Males must hear an adult song during the period from 10 to 50 days after hatching. Further, they must practice it between 150 and 200 days posthatching if they are ever to acquire full normal adult singing behavior. Chomsky (1972) has also postulated critical periods early in the development of human language, during which infants must be exposed to certain sounds (phonemes), grammatical constructions, and experiences in order for normal adult language to ultimately become entrained. This is normally accomplished before the age of five years... an insufficient amount of time for conditioned learning of human language alone to have taken place.


          One of the ways by which behavior patterns can become imprinted during critical periods of development is by identification with a model. Identification is the process by which an individual acquires the characteristics of a model and the belief of the individual that some attributes of a model are also possessed by the individual (Papalia and Olds, 1978). Kagan (1971) has suggested that, "When this belief in similarity is accompanied by vicarious emotional experiences in the child that are appropriate to the model, we say that the child has an identification with the model". Kagan has outlined four interrelated processes that establish and strengthen identification:


1.       Children believe that they share particular physical or psychological  attributes  with the  model.

2.       They experience vicarious emotions similar to those the model is feeling.
3.       They want to be like the model ("Like father, like son").
4.       They behave like the model and adopt the model's opinions and mannerisms.


          Hence, identification with a model is a form of imitation. If a preexisting neural pathway is present upon which the imitated behavior becomes imprinted during a critical period, then the behavior can become "hard-wired" or fixed with a relatively high degree of permanency or resistance to extinction. Such behavior is then refined by subsequent conditioning and social learning. Several examples of how this can occur have already been given; these include: alarm calls in vervet monkeys, song acquisition in birds, and the development of language in humans.


          A multitude of studies indicate that human behavioral patterns including sex and gender­related behaviors are acquired by means similar to those described above. Hetherington (1970) reported that children develop sex-role patterns very early, and these remain remarkably stable throughout life. Kagan (1956); Kagan and Lemkin (1960); Kagan, Hoskin, and Watsons (1960); and Kagan (1962) have described the influence of the parents as models with whom the child identifies first. A child is labeled boy or girl upon the instant of birth. By that time, the parents have already made plans for the differential ways their male or female offspring will be treated. Newborn boys and girls are assigned their "sex-appropriate" colors of toys and clothing, blue and pink respectively; any inappropriately colored objects or items of opposite-sex clothing are put away, "maybe for the next one."


          Maccoby (1966), Rothbart and Maccoby (1966), and Maccoby and Jacklin (1974) have reviewed the extensive literature on the ways male and female children are differentially treated. By the time children are one year old, they know whether they are boys or girls. By the time they are two, they have identified with the same-sex parent (assuming that parent is present or has a strong enough personality to make an impression on the child). If a parental model is absent, the child may still make a same-sex identification through other social contacts with an appropriate model if one is available. Once this identification is made, the child will then deliberately behave in the masculine or feminine way displayed by the model. "Appropriate" behavior is reinforced continually throughout the child's life.


          Even in homes where sex stereotyping is minimized, children quickly learn which behaviors are appropriate for each sex. Freuh and McGhee (1975) have demonstrated the ways in which television, along with other social pressures, encourages children to behave in a "gender-appropriate" fashion. The adaptive­selective advantages for acquiring sex-specific gender role behaviors are discussed and reviewed from an evolutionary perspective in the following section.




          Animals that are ready to mate often take part in mutual ritualistic behaviors between the sexes that we call courtship. Determination of the timing and control of this reproductive readiness is usually through changes in hormone levels which in turn initiate special postures and movements such as nest building, song, present giving, scent laying, harem defense, or "slipping into something more comfortable" as well as employing and responding to other visual, acoustic, olfactory, economic, and tactile stimuli.


          Most mammals, unlike humans, will not mate at just any random time of the year, but have a species-specific periodicity of mating-readiness regulated by physiological cycles. From time to time during these cycles, males and females become sexually active. In most species, there is menstrual/ovulatory synchrony which signals female receptivity (perhaps aided by scent, pheramones, or other chemical messengers) and initiates courtship and mating behaviors. In domestic dogs and cats, there are two or three such estrous periods per year. Many large (monoestrous) animals in temperate climates mate only during the fall such that offspring are born in the spring when temperatures and food supplies will permit optimum survival and growth before the hardships of the following winter set in. In arid climates, breeding is opportunistic and depends on sporadic periods of rain and the subsequent availability of food.


          The selective advantages of such ovulatory/courtship synchrony are numerous: The chances of fertilization with the least expenditure of energy are increased; females will choose the "fittest" mates as indicated by the most attractive displays or the best defense; and offspring will be born during optimal growing seasons. Regarding mating and courtship behavior, Carthy (1972) writes: "If one accepts, as one must, that the perpetuation of the species is the most important end of all of the life activities of animals, then courtship must occupy a central position in the behavioral repertoire of any animal" (Carthy 1972). Dawkins (1977), however, has suggested that it is survival of parental genes (as opposed to species) that defines reproductive fitness. In either case, the reasoning stands and is in keeping with currently accepted views of natural selection.


          The loss of menstrual/ovulatory synchrony in the human female has coevolved with several other unique selectively advantageous traits. Ovulation occurs about midway during the 28-day menstrual cycle, Thus, maximum fertility is achieved 12 times per year and is marked by vague and generally imperceptible physiological changes. Symons (1979) has suggested that this loss of estrus has evolved in response to selective pressures that have necessitated optimal longterm biparental child-rearing practices. A continuous sexual attraction between the sexes is, therefore, of great biological importance; for without strong pair-bonded "marriages", the optimal conditions for the rearing of young would not be obtained. Hence, male orgasm in the absence of fertilization serves as a positive reinforcement that increases the odds for subsequent fertile copulations and continued commitment by the male.


          Hamburg (1974) has suggested that the variability of orgasmic potency in the human female may be an indication of its evolutionary novelty. She does not, however, propose its selective advantage. It would appear that orgasm in the human female further reinforces female receptivity while increasing the odds of successful fertilization and encouraging masculine sex-role behavior... "Was it good for you too, honey?" An affirmative answer to this frequently asked question has value in reassuring the male that he is, in fact, a man and of value to the female; the selectively advantageous behaviors, copulation and pair-bonding, are thereby doubly reinforced by both orgasmic pleasure and social acceptance.


          Human sexuality and gender identity, then, have a duality of purpose. They increase attractiveness to members of the opposite sex which in turn increases the chances of reproductive success; and they serve to reinforce social relationships which further improve the odds of survival of parental genes in the progeny. Wright (1994) provides some interesting evolutionary and sociobiological perspectives on the human pair­bond and the seemingly all-too-frequent covert, and sometimes even blatant, breaking thereof in the forms of cheating, adultery, and divorce.


          The behavior model described in this chapter suggests that consistent gender- appropriate behavior serves the same function in humans that periodic courtship behavior serves in other animals. The added benefits of the social "contract" are unique to higher primates if not to humans exclusively. The selective advantages in maintaining constant "appropriate" gender role distinctions are multitudinous. This might explain the extreme, almost compulsive, importance that humans place on maintaining these gender-role distinctions.


          Consider, for example, the billions of dollars spent annually on fashions, cosmetics, jewelry, beauty and fitness, and "sexy" automobiles. This suggests even further that sexism and homophobia just might serve as intraspecific defense mechanisms which guard the distinctiveness between male and female "territories" because of the considerable selective advantages to be had in maintaining that distinction.


          Certain hormonally directed neural connections probably exist, upon which "appropriate" gender-role behaviors and sexual preferences become imprinted, initially by hormonal priming and subsequently by identification and environmentally-reinforced learning. Since these behaviors are only semirestricted, culture and society dictate which behaviors are appropriate to each sex Oust as vervet monkey society dictates which innate alarm call is to be associated with which predator). We label these behaviors feminine and masculine for females and males respectively.


          Future work is needed to determine which groups of brain cells become "hardwired" during the acquisition and subsequent fixation of gender identity as well as during the development of an entire range of gender variations and pathological conditions.




          There is much that can be learned about normal developmental processes through studying anomalous, ambiguous, or atypical situations (Unger 1979, p. vii). In this section, several abnormal developmental patterns (both physiological and psychosociological) are reviewed in order to gain insight on the issues involved in acquiring sex-specific gender role behaviors.


          Sexual ambiguity includes a myriad of conditions in which an individual's chromosomal sex is at variance with anatomical and/or physiological characteristics. This range of conditions has been grouped under the general heading of hermaphroditism (intersexual conditions). Hermaphroditism can result from a variety of biologic malfunctions including chromosomal aneuploidy (45-X0: Turner's Syndrome, 47-XXY: Klinefelters Syndrome, and although not true hermaphroditism, 47-XXX: metafemales and 47-XYY: metamales), perinatal hormonal imbalances, and hormone insensitivity.


          These conditions can all lead to varying degrees of physical masculinity, femininity, and sexual ambiguity. Studies of such afflicted individuals provide excellent research opportunities for determining biological effects on sex and gender-role identity.  Money, Ehrhardt, and Masica (1968) examined 10 people with androgen insensitivity. All were 46-XY but resembled females and were raised as such. All displayed feminine behavior and attitudes and showed no ambiguity in psychology or sex-roles. Ehrhardt and Money (1967) studied twenty-five 46-XX females with adrenogenital syndrome (masculinization due to excess adrenal testosterone). They all had received genital corrective surgery and were raised as girls. Twenty had been classified as tomboys. This group figured significantly higher for tomboyishness than a same-sized control group.


          Prenatally feminized males adopt gender-roles consistent with their upbringing; while partially masculinized females display more masculine behavior than a control group despite their upbringing. Money (1967, 1970, 1986), Money and Ehrhardt (1972), Money and Pollitt (1964), and Ehrhardt and Baker (1973) have carried out extensive studies on various aspects of sexual ambiguity and gender identity, demonstrating an entire range of sex-related anatomical, physiological, and behavioral combinations.


          The significance of these and similar studies is that sex role, erotic preference, and gender identity cannot be clearly defined in terms of "black or white"; various and numerous "shades of gray" occur and must be accounted for in analyzing sex, sex role, erotic preference, gender identity, and gender role behaviors. Figure 1 is a schematographic representation of the multidimensional nature of sex, sexual orientation, and gender identity.


          Docter (1988) has proposed a five-stage-on-a-continuum theory of cross-gender behavior that ranges from fetishism (wearing an article of cross-sex clothing for erotic value) to secondary (developed) transsexualism; with primary transsexualism being the long-standing (since early childhood) "homosexual" type. "Sissiness" and "tomboyishness" in children are milder manifestations of gender dysphoria that may or may not lead to more intense cross-gender behavior (Newman 1976; Wrate & Gullens 1986).


          Burich and McConaghy (1977) compared 29 self-identified transsexuals and 35 self­identified transvestites by measuring penile volume changes in response to sexual stimuli and compiling biographical data. They found that in comparison to transvestites, the transsexuals were younger, were single, cross-dressed fully, reported greater homosexual interest, had feminine core identities, and desired sex reassignment surgery more often than the transvestite group. The transvestites had more heterosexual interest, greater masculine core identity, cross-dressed only partially, and showed more fetishistic sexual arousal than the self-proclaimed transsexual group. The authors concluded that transvestism and transsexualism are separate clinical entities.


          The very existence of a diversity of gender identity disorders lends further support to the semirestricted biobehavioral model for gender role behavior. The plastic components allow for considerable variation and error. If gender identification occurs early in life and becomes imprinted, there should be great difficulty in "treating" gender identity disorders. This has been shown to be the case. Many attempts have been made at "curing" cross-gender behavior. Talamini (1982) reports that psychoanalysis as well as other traditional psychiatric and psychological methods have failed.


          Blakemore (1965), Barker (1965), and Gershman (1970) have reported success by using electroshock aversion therapy, but a long-term follow-up of these cases by Rosen and Rehm (1977) has shown the effects of faradic aversion to be temporary. In all cases, transvestic behavior has resumed. This indicates a deep "programming" of gender-role behavior, since similar clinical interventions have been used successfully in the treatment and extinction of other seemingly obsessive and compulsive behaviors.


          One of the most obvious observations about the gender identity disorders is that they historically appear to occur with greater frequency in males although female-to-male transgender phenomena have been receiving greater press in recent years. That development, in the absence of testosterone, is in the female direction offers a tempting explanation for such behavior if we suppose that some hormone insufficiency or excess has occurred during the life cycle of the individual.


          Money (1972) has found that this is not generally the case, but he suggests that prenatal hormonal imbalances coupled with postnatal psychologic factors may be responsible for such behaviors. This is in keeping with the proposed model, but it seems that gender identity disorders can occur in the absence of any obvious hormonal abnormalities.


          The absence of a strong male role-model and the presence of a strong feminine female model may be sufficient to imprint feminine behavior on young boys. Biller (1960, 1970) and Biller and Bahm (1971) have described the effects of father absences and maternal encouragement on the sex-role development of male children. Feminine behavior and sissiness have been shown to occur more frequently in such socially deprived male children (Koch 1956; Greenson 1966; Stoller 1966, 1967; Halle, Schmidt, and Meyer 1980; Newman 1976; Wrate & Gulens 1986).


          Blanchard and Sheridan (1992a, 1992b) demonstrated correlations between homosexuality and several variables, including: birth order, number of siblings, and sex ratio of siblings, in a sample of 670 subjects with gender identity disorders who had been referred to the Clark Gender Identity Clinic in Toronto Canada. They found that male homosexual gender dysphorics had significantly later birth orders than non-homosexual men. Further, Blanchard and Sheridan found that Homosexual men had greater numbers of siblings and that those siblings had higher ratios of brothers to sisters (131 brothers per 100 sisters) than homosexual women who in turn had greater numbers of siblings than non-homosexual gender dysphoric men. They have reviewed a number of possible interpretations including maternal stress leading to insufficient androgen levels caused by increased maternal "immunization" against testosterone by successive male fetuses.


          Other interpretations offered include: environmental factors due to family size, sibling ratio, and birth order such as lower educational levels achieved, greater opportunity for and experience from sex-play and experimentation with same-sex siblings, and a lower socio­economic status due to larger family size. It would also seem that differential treatment of "baby" sons by a families full of older brothers or possible identification with older brothers by a younger sister who also receives reinforcement from them for such behavior could also have some effect on erotic preference and gender identity development. Family demographics might play an important role in affecting sex role and gender identity, at least from the "nurture" perspective and is certainly worthy of consideration and future research.


          Dorner et al. (1991) have described a "gene- and environment-dependent etiogenesis of homosexuality and transsexualism". They report that, "The higher the androgen levels during brain organization, caused by genetic and/or environmental factors, the higher is the biological predisposition to bi- and homosexuality or even transsexualism in females and the lower it is in males. They propose that 21-hydroxylase deficiency, associated with prenatal stress, can cause the androgen excess that leads to atypical sexual orientation and/or gender role behavior in genetic females.


          Based on studies of positive and negative estrogen feedback effects on luteinizing hormone (LH) secretion, Dorner et al. (1983) concluded that androgen deficiency during a critical period of sexual brain differentiation can give rise to a predominantly female­differentiated brain in genetic males leading to increased incidence of bi-, homo-, and trans­sexual behavior. Similarly, Meyer-Bahlburg and McEwen (1995) have recently reported that the daughters of women who received the synthetic estrogen DES (diethylstilbestrol) during pregnancy are more likely to exhibit bisexual or homosexual tendencies.


          Eicher and co-workers (1980) found in a study of eleven 46-XY male to female and eleven 46-XX female to male transsexuals, that 8 of the genetic males were H-Y antigen negative and 9 of the genetic females were H-Y positive. They interpreted these findings as evidence of gene translocation or exchange during meiosis of the father's spermatogonia. Eicher et al. (1980) inferred that the existence of H-Y negative 46-XY males and H-Y positive 46-XX females provides evidence of "genuine morphological transsexualism" which, in turn, explained the transgendered behavior in 17 of the 22 subjects they studied. An attempt to replicate these findings using conventional and monoclonal antibodies by Wachel (1986), however, found no evidence of abnormal H-Y phenotype in blood or testicular cells of 21 male-to-female transsexuals.


          Buchner (1970) and Green (1974) have proposed that cross-gender behavior serves as a defense mechanism that rationalizes socially unacceptable homosexuality. This, however, does not seem likely since transvestism, transsexualism, and homosexuality appear to be equally stigmatized by society. The uninformed public does not generally differentiate between the three distinct phenomena (Antill 1987).


            Although cross-gender behavior may involve homosexuality (one feminine behavior is relating sexually with males), gender identity disorders frequently occur before sex-object preference is clearly developed. Children appear to develop gender identities before they develop obvious sexual desires and certainly before they become sexually active. Self-report by Candace Susann (1988), a genetic male transvestite, demonstrates several common themes in transgendered case histories and exemplifies the psychosexual reinforcement value of sexual arousal and orgasm:


Somehow I always felt like I was a girl but I knew that it was wrong... so I was four years old the first time I gave in to the urge to wear women's clothes. Mother had lots of beautiful things... I continued to dress up in secret for the next two years, sometimes getting tiny little erections and always experiencing warm wonderful feelings inside... But during that time, I had a recurring dream. It always involved seeing a pretty little girl with long curly hair and wearing a white ruffled dress with lots of lacy petticoats underneath... Whenever I had this dream, my little penis would be hard. As I grew older, her face became more distinct. By the time I was twelve, I knew that the little girl in my dreams was me... I put on the slip; and as I slid the pantyhose up over my erect penis, a fluid shot out soaking them while my body tingled with both pleasure and fear. I had accidently discovered the orgasm while putting on Mother's pantyhose! (Susann, 1988).


          On the basis of his research, Blanchard (1993b) proposes that it is unlikely that erotic fantasies of having a woman's body are the end result of some progression that begins with erotic fantasies of wearing women's clothes. Is it possible that wearing women's clothes progresses from imagining, feeling, or believing that one is, or has the body of, a woman? Some interesting insights might be obtained from future research which should focus on certain genetic women who engage in or enjoy behaviors generally and stereotypically attributed to transvestic men such as wearing "too much" make-up, collecting shoes, shopping for or at least fantasizing about a closet full of beautiful dresses and drawers full of sensuous lingerie.


          This future research might address the motivation of such women who "dress to the nines" and become sexually aroused upon seeing themselves in a mirror or who step out for the evening, pleased with the image that they have created, in order to see themselves in the "mirror" of other admiring eyes. Perhaps by addressing why some women behave in stereotypical ways we might learn why or how transvestites and transsexuals develop certain patterns of stereotypically "feminine" behavior, for it is women of this particular type with whom most transvestites and many transsexuals identify.


          Additional future work might also address the adaptive and selective advantages of sexual vanity in both men and women. Many non-transgendered persons and most transvestites appear to exhibit behavior that borders on narscisism. This would make sense in terms of the internalization of sex object hypothesis. Perhaps a greater understanding of this apparent vanity or intense preoccupation with one's physical and sexual attractiveness would provide behavioral insights on certain seemingly hypersexual end-members of stereotypical masculine and feminine behavior in both non-transgendered and transgendered individuals such as the don Juan, he-man,  vamp, vixen, "butch" or "lipstick" lesbian, drag queen, shemale, and fetishistic transvestite.


          If the gender role as courtship hypothesis is correct, then it would seem that stereotypical feminine behavior, as well as the bravado and machismo exhibited by some normal males, "butch" lesbians, and female-to-male transsexuals, might serve as an important element, perhaps no more than a hypersexual end-member on the continuum, of the human courtship ritual. For example, the wearing of high heel shoes is an orthopedically dangerous but quite common optional practice among normal women. However, even a casual inspection of fashion magazines, television, beauty pageants, pornography, prostitutes, and even most transvestites would seem to indicate that such practice was absolutely mandatory and appears to be appreciated equally by admiring men, normal women, and people in drag.


          Cross-gender behavior has been institutionalized in several societies. Female impersonation as a form of entertainment has become acceptable in Western Culture. Munroe, Whiting, and Holly (1969) have examined some of the sociological and anthropological aspects of cross-gender behavior. Levy (1971) has described the "community function" of Tahitian male transvestites. Forgey (1975) and Williams (1986) have studied the institution of Berdache (transvestism in association with shamanhood) in North American Plains Indians.


          Coleman, Colgan, and Gooren (1992) have described a similar phenomenon, Acault, in Myanmar (Burma). Similarly, the Hijra of India have been described by Nanda (1985). Mead (1955) has described entire cultures where male and female gender-roles (as stereotyped by Western Culture) are reversed. The significance of these studies is that cross-gender behavior is a universal phenomenon and that gender-role is defined, at least in part, by plastic cultural standards.




          In this chapter, a semi restricted biobehavioral developmental model for the acquisition of gender-role behavior has been described. The key features of this model are summarized below:


1.       Sex is normally determined by XX or XY chromosomes.

2.       Y chromosomal products induce male development.
3.       The absence of Y chromosomal products allows femaleness to ensue.
4.       Testosterone and estrogen differentially affect certain neurons during critical periods of development.
5.       Sex differences in brain function affect differences in behavior.
6.       Semi restricted behaviors are imprinted on innate "wiring" patterns.
7.       Imprinting can occur by identification with a model during critical periods.
8.       Reinforced learning refines imprinted behavior.
9.       The potential to adopt some form of gender identity in humans appears to be innate.
10.           Which behaviors are appropriate for each sex are determined by society and culture.
11.          Human gender-role behavior serves the same function as periodic courtship rituals   in other animals.
12.     Selective advantages include increased sexual attraction and reinforced          pair-bonding.
13.     Both male and female sexual attraction and orgasm further reinforce these      behaviors.
14.     Sexism and homophobia may serve as social regulators for maintaining selectively advantageous sex-role distinctions.
15.     Hermaphrodites and Intersexuals adopt gender identities contingent upon both degree of sex reversal and upbringing.
16.     Variations and/or errors in "nature or nurture", genetics, biochemistry, environmental factors, maternal or fetal stress, and family demographics as well as subsequent reinforced learning may lead to variations in sex phenotype, erotic     preference, and gender identity under normal, atypical, and pathologic conditions.
17.     The gender identity disorders may involve slight hormonal deviations but       identification with an opposite-sex model and psycho-socio-sexually reinforced        learning (i.e. arousal and orgasm) are probably sufficient to cause them or at least   contribute to their development.
18.     Future work is needed to determine which neural connections become "hardwired" in fixing gender-role behavior and how best to manage situations where genetic sex,    physical appearance, and/or gender identity are at odds with each other as well as with biological and sociological norms.




          A number of treatment options are currently available for gender disturbed persons and these vary with the degree of gender dysphoria as well as with certain other predictors of treatment outcome. In the most severe cases of disturbed gender identity, hormonal and surgical gender reassignment may be the most effective treatment. Blanchard and Sheridan (1990) report that operated transsexuals improve both before and after surgery. Preoperative improvement includes both mood and social adjustment, most probably due to "coming out" of the proverbial closet, trial living in the preferred gender role, and decreasing the sense of helplessness experienced while living in the "wrong" gender.


          Post-surgical improvement appears to relate with the degree of success of the simulation of the anatomical sex of the preferred gender. According to Blanchard and Sheridan (1990), "The better the surgical result, other things being equal, the better the post-operative adjustment". Careful re-surgical screening, including a 2-year "real-life test" (Clemmensen 1990) and observations on certain other prognostic factors which include biological sex, erotic preference, and social class serve to aid the clinician in determining the patient's fitness for, or the ruling out of, sex reassignment surgery (Blanchard and Sheridan 1990).


          In less severe cases of gender dysphoria or in those for which surgical reassignment has been ruled out, hormonal treatment alone (as opposed to that with surgery) may provide relief from gender dysphoria by effecting the secondary sexual characteristics of the desired gender (e.g. breast development in biological males and facial hair in biological females) as well as certain psychotropic (or possibly psychosomatic) effects such as the "calming" effect reported upon estrogen administration to some gender dysphoric biological males (Newman and Stoller 1974; Stermac 1990; Steiner 1990).


          Other even less invasive management strategies include individual psychotherapy, marital counseling, group therapy (see Stermac & Blanchard 1991), and the process of gender reorientation which involves a combination of such therapies as voice, deportment, cosmetic, and fashion training as well as the experience gained from living, working, and (hopefully) being accepted in the adopted cross-gender role (Blanchard & Sheridan 1990; Stermac 1990).


          In the least gender dysphoric cases such as uncomplicated transvestic fetishism the therapy of choice might involve individual, marital, and/or group therapies which help the transgendered patient and his/her family to manage the situation by providing appropriate cross­dressing opportunities, setting limits to the behavior, or joining social organizations where such individuals feel comfortable cross-dressing, enjoy social activities cross-dressed, and discuss their problems with others (and their spouses) in similar situations (see IFGE 1995).


          John Money (1985) proposes that a new, three-term paradigm, specifically Nature/Critical Period/Nurture is needed to adequately explain the phenomenology of intersexuality and the differentiation of gender role/identity in individual cases. He suggests that this complete theory of the differentiation of all of the constituents of masculinization or femininization of gender identity needs to be both "multivariate and sequential" in type. According to Money (1985), this theory must be applicable to all of the syndromes of intersexuality and cross-gender identity phenomena including hermaphroditism, transvestism, homosexuality, and transsexualism, as well as to the genesis of "normal" heterosexual gender identity, erotic preference, and associated behaviors.


          In this chapter, a number of potential areas for future research in both the biological and psychosociological realms have been proposed which could potentially lead to a unified theory of normal and abnormal gender identity development. Additional research in the fields of sociobiology and neuroendocrinology should provide further evidence either for or against this proposed biobehavioral model of gender identity and its implications for the gender identity disorders. Because of the dynamic multidimensional nature of sex, sexual behavior, sex object preference, and gender identity in humans and in consideration of the relative resistance to extinction of sex-related behaviors and gender-role identity, appropriate "treatment" for atypical conditions might best be directed at treating the secondary psychological difficulties and the actual "dysphoria" associated with being "different" rather than attempting to treat the difference itself



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Halbreich, U.;  Wamback, S.J.;   Kahn, L.S.  2005.  Clinical Psychotropic Effects of Gonadal Hormone Administration in Women.  (Chapter 12. pp 303-330)  In: O.M. Wolkowitz and A.J. Rothschild (Eds.) Psychoneuroendocrinology: The Scientific Basis of Clinical Practice.  Washington, D.C.:  The American Psychiatric Press, Inc.  2005.












A few articles and essays by our good friend 


Miss Suzi of  Buffalo, New York.  


Thank you Miss Suzi for sharing! 


(www. and





My Mother’s Closet


By Candace Suzanne  (Your Miss Suzi)


My earliest memories of pleasure in feminine delights coincide with my remotest memories of practically anything at all. Mother was just so beautiful and she had a closet full of the most wonderful things way back in the early 1960s (which is as close as you will ever get to finding out Miss Suzi's actual age, teehee!). Precious moments were spent lying across Mother's bed each morning watching as she sat poised at her glamorous dressing table applying makeup, fixing her hair, and working her feminine magic.



We engaged in warm and casual chit chat as she worked and I took in her many beauty secrets and vicariously absorbed into my young psyche the pleasure she derived from her efforts and her satisfaction in her results each time she completed her feminine ritual. Those were OUR special times together and the memories of those special times have remained vividly etched upon my brain.


When Mother had finished her daily makeup, she would slide up and garter her sheer full-fashioned, reinforced heel and toe nylons. With the sweet swishing sound of the accordion-pleated hem of her lacy slip brushing across her nylon stockings, she would step to her wonderful closet to select her dress and shoes for the day. Whether she chose a long slim wool skirt and sweater or full-skirted swirling shirtdress, Mother always found just the right shoes to match classic stiletto pumps with very pointed toes and heels at least four inches tall. 

Then, with precise rhythmic clicking of high heels, she would walk briskly but elegantly toward the mirror, turn, and then looking back at herself over her shoulder turn again. The self-satisfied look in hers eyes as she vouged and modeled her day's attire, inspired me then and even to this day inspires me still. Mother would then ask, knowing full well what my, answer,, would be, "Does Mommy look pretty?" Then with a generous hug and kiss for her little one, off she would go to the office where she worked so hard to support me, her only child and my dear Nana, who kept our home and who watched over me.


After Mother had gone off to work, and with Nana busy in the kitchen, it was my turn to practice what I had learned. First, a visit to Mother's bureau drawers to retrieve lace slip, nylons, panties, and six-garter rubber girdle then on to the wonderland of her amazing closet filled with beautiful dresses and racks of neatly arranged high heeled shoes. I was in heaven with the combined aromas of leather shoes, latex rubber foundations, and Mother's perfume swirling about my little nylon-clad legs and too-loosely girdled body.


I still recall the distinct sounds of the rustling and swishing of much-too-large lingerie and the scuffing and clicking of oversized high heels on hardwood floors as I attempted, to,,,, mimic Mother,',s,,,, modeling, and vogueing, in her,, full-length bedroom mirror Satisfied, even at that early preschool age of three years, that I even though supposed to be a boy was in fact, a pretty pretty girl just like Mommy.


Throughout my life, I have had this strange reoccurring dream in which I find myself anxiously entering dimly-lighted attics, basements, and closets filled with wonderful and beautifully feminine dresses, sensual lingerie, and lots of pretty shoes. Although the settings and the contents of these dreamland wardrobes have changed and evolved over the years, I know now that my passionate and repeated reveries represent memories conjured up from the excitement of my early childhood and taboo play in Mother's feminine boudoir and in her amazing closet.


It is precisely that exciting energy and feminine sensuality that I carefully tried to recreate in my Buffalo, New York Studio and Boutique between 1998 and 2005.   It was my goal to create a fantasyland,,,,, atmosphere that stirs,, up,,,, sweet, emotions of feminine, bliss at, the, first peek through my welcoming front door beautiful feminine clothing of all kinds, dresses, gowns, lingerie, wigs and high heels in a safe comfortable atmosphere.  Over the years I grew into my feminine persona and gravitated away from “The Community” in new and exciting social settings and... in romance.


Over the years, I have discovered that the true essence of femininity is Nurturing and Caring… the way a mother instinctively nurtures a child or the way a loving woman sensuously and selfishlessly pleases her man or the way sisters watch out for and help each other to grow strong and wise.  So much more than just the clothing, which I now know is really only an outward symbol and expression of the real feminine spirit and which only comes from within.


Hugs & Kisses,  Love Suzi





By Candace Suzanne  (Your Miss Suzi)



Dear Miss Suzi,  


I am a bit confused regarding the proper words to use when describing shemales and such.  I do not know the difference between TV, CD, TS, etc. but I am an admirer of all lovely ladies and I do not want to hurt anybody’s feelings by saying or asking the wrong thing.  Perhaps you can help?


Sincerely, Robert, Syracuse, NY



Dear Robert, 


    Thank you so much for your very thoughtful letter indeed.  First of, all,,, your statement that you admire “all lovely ladies,” is much appreciated because for all transgendered people, acceptance, in their desired gender roll is more important than being identified as a TV, CD, TS, TG, Shemale, etc.  The goal for all of these groups is to be accepted and treated as women (except, of course, for those relatively few genetic women who wish to and sometimes do become men).  M2F and F2M are shorthand for Male-To-Female and Female-To-Male respectively.  It appears that M2F is much more common than F2M situations. 


     Transgender or TG is used to describe ALL of the phenomena of and the people who do behave in ways socially appropriate for, or believe they are members of, the opposite genetic and anatomical sex.  One such behavior mightbe men wearing women’s clothes… and doing so for any number of reasons.



    Wearing clothing that is socially appropriate for the opposite sex is known as crossdressing.  Those who do so are known as crossdressers or, CDs,,.  The Latin words for crossdressing and crossdressers are Transvestism and Transvestites (trans=cross+vestum=dress).  As a, group, most people who identify themselves as crossdressers or transvestites (CDs and TVs) are men who like being men and live mostly as men but dress in women’s clothes, when they can, because they find doing so to be some combination of physically relaxing, emotionally comforting, or even sexually arousing. 



    They are most likely to be (but are not necessarily always) straight married men whose most frequent and greatest fantasy is to be accepted in a “lesbian” type relationship with a genetic woman.  Some, however, do experiment with or prefer dating men or even other TG girls.  Some TVs and CDs find out that their motivation lies much deeper than just wearing the clothes.



    Transsexuals or TSs are people who believe that they are or should be members of the opposite sex.  They are not satisfied with their genetic sex and sex characteristics and often, take,, steps (hormones and/or,,,,,, surgeries,) to, alter their anatomy and change their lives in order to live in the gender role that, they prefer.  TSs differ from TVs and CDs in that they still feel like women even when they are naked or dressed as men.  When dressed as women, they do not feel that they are crossdressing (even though they actually are), but feel that they are dressed appropriately for their preferred gender. 



Those who have had Sex- Reassignment Surgery (SRS) sometimes refer to themselves as “Post-ops”.  Those who are hoping to have or are waiting for SRS are called “Pre-ops”.  Another group has emerged from all of this… Those who wish to and do live as women, take hormones and/or have breast augmentation, but do not wish to have their genitalia surgically altered.  These “Non-ops” are often referred to as Shemales because they, as much as possible, look and live like women but still have male genitalia and prefer to keep them.  M2F pre-op transsexuals are essentially, albeit temporarily, or even, reluctantly shemales… as long as their male genitalia are still intact.



  Drag Queens are usually (but not necessarily) gay men who prefer to be men but who dress as and emulate women for entertainment or prostitution purposes.  It seems that the word “drag” is an acronym quoined by William Shakespeare who annotated his play scripts with DrAG for Dressed as a Girl.  Drag is the art, the illusion, the costumes, the fantasy, and the magic of female impersonation.



 There is quite a bit of overlap between all of these transgender groups and a certain amount of interchangeability and variability between the appropriate terminology as well as individual changes in “TG-status” over a person’s lifetime.  That is to say… People change.  This certainly adds to confusion about and even within the transgendered community and is especially confusing for the general public at large. 


Regardless of labels, All transgendered people are seeking social and self,-acceptance while, being true to their, own selves.  Many have lived and continue to live in shame, guilt, and fear and do not need, any further insult from others as they struggle to liberate themselves from the repression, suppression, and depression found in their sad dark and lonely closets.



 So, please remember, when you see or meet someone whom you suspect is dressed in the clothes of, or assumes the role of, their preferred gender and which you suspect is opposite from that to which they were born… First of all… You do not know for sure!  Nor do you have a right to know.  Asking or checking are both rude and out of the question as well.  A person’s genitalia are private and none of anyone else’s business (at least not until later) anyway. 



And second… Good manners, political correctness, human kindness, and common decency dictate, that if someone appears to be or wishes to be of a certain gender, we should treat her with the same respect and compassion due to anyone,, who, does,,,,,, not wish, to harm us in any way,.  The proper pronouns and titles appropriate for her preferred gender should always be used: girl,, lady, woman, miss, ma’am, she, her, and hers all apply.




Now Miss Suzi is going to let you gentlemen admirers out there in on a little secret.  If you want to meet and date a special lady (TV, CD, TS, Shemale), forget those terms unless or until she chooses to explain the details later after a very politely and discreetly asked question or two; BUT any rudeness or reminders of her undesired or hidden masculinity (no matter how much YOU may want to get at those she-male parts right away) will only serve to leave you all alone and wondering what it might have been like to share an evening with the “woman” of your dreams. 



Again, just as with any woman worth having, transgendered women desire and deserve to be treated as they wish… as women.  So please do use your very best manners, warmth, charm, and romance to make her your,, special girl,,,.  Both,, you and,,, she will be glad you did,!


Thank you for asking, Miss Suzi








By Candace Suzanne  (Your Miss Suzi)



Dear Miss Suzi, I have been fantasizing a lot lately about crossdressers, transsexuals, and shemales. I have never, met, one before, and I, would like,, to get,, involved with, one, sexually for, the first time. The idea of kissing a penis is very exciting to me. I have responded to personal ads on the Internet and in magazines but so far I have not had any luck meeting one. Am I doing something wrong? Jack, Rochester, NY,




Dear Jack,Yes, you are. And I might be able to help you dear, but there are a few things you must know first. These are things that will improve your chances with both natural born women and with transgendered women. Unfortunately, most men just do not get it. They frequently behave in ways that actually prevent them from achieving their wildest fantasy with a woman of exceptional quality.


Believe me, there are some gorgeous shemales and women out here... who remain alone... NOT because we don’t get all kinds of opportunities, but because we are often insulted and put off by the ways some men think of, speak to, and treat us. It really is very, simple,; but 99,% of,, men, who want a, particular, woman (,,either GG or TG,), really screw it up, for themselves and end up making love with a magazine or a computer screen when perfectly willing and able women are quite readily available.


If you have any amount of sensitivity or enlightenment, I, might be able to help you. But I have spent hours and hours trying to explain to some men what women really want... and most still just don’t get it. So, they either end up alone, or with a prostitute, or with some hairy pathetic desperate man in a dress, instead of with the woman of their dreams. The one who really understands these things will be quite busy on Friday night… and I won’t be home either, if you get my drift. Are you with me so far, Jack?


The most important thing you need to know is that we are WOMEN, LADIES, GIRLS... first. NOT... TV, CD, TS, TG, DQ, Shemale etc… but WOMEN. We put our hearts, and souls, and fortunes into being WOMEN (at least as much as anyone with a Y-,chromosome can,,)… but, NOT into, being, TVCDTSTG, shemales, etc,,. Your, fascination with a penis is fine,... BUT if you focus on that without responding primarily to the femininity of the WOMAN, you will be rejected, scorned, and giggled about when the girls talk about you later. We call guys who focus on the, penis “cocksuckers and penis chasers”... and we avoid them like the plague.


Sure, you might be just crazy with desire to touch or kiss her penis...(teeheehee!)  And you just might get to… if you play your cards right, Jack… BUT if SHE finds out that THAT is your MAIN goal... she will be insulted... and you will never enjoy the fullest completion of your wildest desires. It is better to respond primarily to her femininity and the qualities that she has in common with women (her eyes, her legs, her breasts, her smile, her taste in clothes).


Even genetic women resent being wanted for just one or two of their parts. Any woman, whether GG or TG, wants to be wanted for ALL of her parts, and, feminine,, qualities… the, WHOLE,, package… not just, her,, genitalia. Your motivation for wanting, her is very important to her and it behooves you to desire her for the reasons that she wishes to be desired for, that is, if you really do want to get lucky with her at all. You like pretty eyes and legs and breasts and smiles,, don’t you, Jack?


Phrases like "never had one" "always wanted to meet one" are rude and insulting. This means you are thinking in terms of: TV, CD, TS, TG, DQ, Shemale, or Penis... like a hunk of sirloin steak... NOT about the woman, the girl, or her femininity. Every woman of quality wants to be wanted for the “right” reasons… her beauty, her charm, her femininity, her mind, the power of her womanhood, and all of her other most feminine qualities. Responding appropriately to these is the best way to go, which is what really turns HER on… and gets YOU lucky! You do ultimately want to get lucky, don’t you? You’re not just teasing yourself, are you, Jack?


If you,, told, your wife, or girlfriend,,... ",You have legs, like a,, man, I am so turned on"... she would, throw you out on your ass with a lousy “compliment” like that.   So reminding a "special" girl of her masculinity in any way is equally insulting.


You might consider yourself to be “bisexual” and in fact, you just might be, Jack… But telling her, that devalues her femininity. She wants to be wanted by a man who loves WOMEN and who knows how to treat a woman right. The facts that you are bisexual and that she is transgendered might be quite true, but she does not want to hear about it. Just as an overweight woman does not want to hear that she is fat or that you want her because she is obese (even if you are really wild for fat women), because it ends up as kind of an insult in her mind anyway.


Do you see? A compliment inappropriately delivered is really no compliment at all; in fact, some compliments end up sounding like insults to the person receiving them. “Baby, you have a big, penis,,!” just does not cut, it,. Even, "Hey,, baby, you',re hot,,!" may be okay but is not as gratifying, to her as hearing words like "You are beautiful… I would love to take you out… May I kiss you?" One mindset gets you nowhere at all; and the other gets your wildest dreams fulfilled.


Warmth, charm, good manners, romance, gentle compliments, thoughtful, little gifts and notes, more kind compliments, affectionate hugging, kissing, hand-holding, and caressing are what both genetic women and transgendered women are looking for and are what will ultimately get you lucky… and the wildest kind of lucky that you can possibly imagine... if that is what you really want. If you want any special lady to be “not so ladylike” for a while… Treat her like a Lady… It works!


I hope that this helps you a bit, Jack. I will be glad to teach you more if I am not just butting my head against a stubborn/unyielding wall of whatever it is that keeps many men (But Not All) from experiencing what they, claim to, really, want. I am quite, glad, to help you, to,, understand,, these things, Jack… if you really do care,... darling. Just treat her like the woman of your dreams and then your wildest dreams will all come true. Good Luck!


Thank you for asking, Miss Suzi






By Candace Suzanne  (Your Miss Suzi)


Dear Miss Suzi,


I am a transgendered girl and new to the Western New York area,. I am currently out of work and seeking employment. I was wondering if you have any suggestions that will help me in my search. I am not a performer, so drag is out of the question. Do you know of any places in Buffalo where a transgendered girl might apply for employment?


Thank you for your help, Elaine, Buffalo, NY



Dear Elaine,


Thank you for your kind introduction. Welcome to Buffalo darling. It is my pleasure to meet you indeed. Looking for work, are you dear? Well, me too. This retail nonsense is just not cutting it. I, have, been, running Miss Suzi’s, for 3, years now, and I’m, still not,, getting, paid for it, teeheehee! But seriously... This is, America... You can find work wherever you're both needed and qualified, can’t you? No one would ever dare to discriminate against the transgendered (or any other bio-socio-ethno-cultural group) now, would they?


Prospective employers cannot ask about your sex... and I do not believe that, anyone is actually allowed to take a peek either, are they? I think that would be rude... and probably is illegal to boot! Therefore, prospective employers do not know what sex you are because they are not allowed to ask or check. Now, there may be a company dress code, which, like all workplace things, cannot be discriminatory in any way, right?


So, for reasons of safety and standard company policy, there may be a dress code in place consisting of particular options for all employees with possible suggested sets of options for women and for men… even though assuming, or, asking if,,, someone is either one or,, the other of those,, is,, discriminatory and, probably illegal. As long as you stick to the, company’s dress code for all employees, you should be fine, don’t you think? Why would any employer want to discriminate against a qualified individual who does her or his job well and sticks to the company’s (non-discriminatory) policies regarding job performance, employee safety, and a standard, company dress code?


Okay, So am I looking at the world through rose-colored glasses or what? Well, just call me Pollyanna (Miss Pollyanna, that is!). My instinct is that all of this might be much easier once one has one’s foot in the door. Because once you are in, you are able to prove yourself by simply performing your job well (Of course, good communications skills and a spirit of cooperation with coworkers, yada yada yada, will go a long way on any job as well). The problem lies, then, in getting in the door. I can think of only two possible scenarios… the, honest, route and, the dishonest route,.


In the, honest route,, you,,, appear at the, interview dressed and groomed in a way that is “,appropriate” for your chosen or preferred gender in that business setting or perhaps even an androgynously toned-down version, which is still honest to both yourself and to the rest of the world who sees you. In my “rose-colored” world, the prospective employer has reviewed your résumé, checked out your, references, sees that you look sharp and communicate well, and tells you to start Monday morning.


But… in the real world, however, she or he looks at you, guesses which gender you are “supposed to be”, sees that you have chosen otherwise, and tells you that the position has been filled but “we’ll keep your résumé on file”.


In the dishonest route, you bite bullet and disguise yourself as the gender you are “supposed to be”. You show up for the interview (15 minutes early, of course), the prospective employer has read your résumé, has checked your, references,, looks at you,, sees that you, look sharp and,, communicate,,, effectively, makes, assumptions about your supposed and displayed, gender, finds them to appropriately match her or his prejudicial expectations, and tells you to start Monday morning… Only after which, you begin the gradual process of coming out and transforming your appearance to your preferred gender… slowly and deliberately… one step at a time, while keeping your nose, firmly to the grindstone and doing your job the very best way you know how.


It is sad that people should ever have to lie or hide any part of themselves that would otherwise be true and honest and sincere in order to not upset the delicate sensibilities of a world that has not been enlightened quite enough yet to accept transgendered people (and ALL people) with the warm, accepting, open arms that we all deserve.


Yes, the world is changing. Tremendous strides are being taken every day. Some of our brave sisters (and brothers) are, pioneering the ways, for us to follow. Old, ideas are, being, challenged,. Laws and,,, policies are changing,. The words “transgender”, “gender preference,” and “gender identity” are being added to legislation and corporate policies that prohibit discrimination against us on the job and in society.


General Motor’s employee relations representatives recently stopped by my boutique to discuss some of the issues that affect transgendered people in the workplace with, a view to establishing new policies that will protect us from unfair and discriminatory practices there in the future.


So, Elaine, you have some decisions to make regarding the approach you will take on your quest for employment. How honest or dishonest are you willing to be? Honest enough to risk NOT getting the job (unless my rose-colored Pollyanna vision really does have some hopeful merit)? Or dishonest enough to secure the job and ensure your financial livelihood in a dog-eat-dog world where we do whatever we must in, order to survive? I, wish you all the best and,, encourage you, to please network, in, our,, community. There are, some real heroines and heroes among us who, can help. Good luck to you dear… See you at work soon!


Your Suzi





This page does not contain or allow or promote or condone Nude Photography Pornography or Pornographic Photos Shemale Photos Transsexual Photos Nude Transvestite Photos Crossdresser Photos TV Photos CD Photos TS Photos TG Photos Photography Sex Porn Pornography Porno Shemale Dating Naked Shemales Prostitution Escorts Escort Services Gender Identity Disorder Photos of  Drag Queens are NOT allowed here. Our goal is to promote dignity  for the transgendered community and gentleman admirers.  We do NOT allow:  Nudity Sexuality Homosexuality Bisexuality Bi-Curious Breasts Penis Vagina Sex Change Sex-change Photos Before and After Photos.  Only clean wholesome content and sexy fashion photos are shown here.  Women's clothing and Women's shoes and High Heels Stilettos and Nylon Stockings and Nylons and Sexy Lingerie and women's underwear French Maid Uniforms Short Skirts Mini Skirts garters girdles corsets and garterbelts lace latex and crenolines and petticoats are the uniforms for "Special Girls".  These are the most desired and stereotypical Transgender fashions and crossdresser fashions.  That is just the way it is.   Boobs are people who use the wrong words for breasts and other body parts. This page is dedicated to greater understanding of transsexuality and an appreciation of those who are so disposed and their gentle admirers. We are not sluts whores or prostitutes. You can be sexy without being dirty. Enjoy!