Heterosexual and homosexual gender dysphoria

Blanchard, Ray; Clemmensen, Leonard H.; Steiner, Betty W.

doi:10.1007/bf01542067

Cited by 145 publications

(89 citation statements)

References 27 publications

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“…One factor that likely contributes to this discrepancy is clinical heterogeneity. According to the Blanchard typology, there are two fundamentally different types of transsexualism (Blanchard et al, 1987). In the group commonly referred to as 'homosexual' or 'early-onset' individuals with GD, the sexual orientation is directed toward the natal sex, symptoms usually start early in childhood ('early onset') and physical differences have been observed with respect to individuals sharing their natal sex (e.g.…”

Section: Discussionmentioning

confidence: 99%

Regional volumes and spatial volumetric distribution of gray matter in the gender dysphoric brain

Hoekzema

Schagen

Kreukels

et al. 2015

Psychoneuroendocrinology

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The sexual differentiation of the brain is primarily driven by gonadal hormones during fetal development. Leading theories on the etiology of gender dysphoria (GD) involve deviations herein. To examine whether there are signs of a sex-atypical brain development in GD, we quantified regional neural gray matter (GM) volumes in 55 female-to-male and 38 male-to-female adolescents, 44 boys and 52 girls without GD and applied both univariate and multivariate analyses. In girls, more GM volume was observed in the left superior medial frontal cortex, while boys had more volume in the bilateral superior posterior hemispheres of the cerebellum and the hypothalamus. Regarding the GD groups, at whole-brain level they differed only from individuals sharing their gender identity but not from their natal sex. Accordingly, using multivariate pattern recognition analyses, the GD groups could more accurately be automatically discriminated from individuals sharing their gender identity than those sharing their natal sex based on spatially distributed GM patterns. However, region of interest analyses indicated less GM volume in the right cerebellum and more volume in the medial frontal cortex in female-to-males in comparison to girls without GD, while male-to-females had less volume in * Corresponding author. the bilateral cerebellum and hypothalamus than natal boys. Deviations from the natal sex within sexually dimorphic structures were also observed in the untreated subsamples. Our findings thus indicate that GM distribution and regional volumes in GD adolescents are largely in accordance with their respective natal sex. However, there are subtle deviations from the natal sex in sexually dimorphic structures, which can represent signs of a partial sex-atypical differentiation of the brain.

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Section: Discussionmentioning

confidence: 99%

Regional volumes and spatial volumetric distribution of gray matter in the gender dysphoric brain

Hoekzema

Schagen

Kreukels

et al. 2015

Psychoneuroendocrinology

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“…They offer four alternatives, i.e., sexually attracted to males, to females, to both, and to neither. This subdivision is largely based on the work of Blanchard and colleagues (e.g., Blanchard, 1989;Blanchard, Clemmensen, & Steiner, 1987). These specifiers were recently challenged by Veale, Clarke, and Lomax (2008), but their critique was rebuked by Lawrence and Bailey (2008) and by Lawrence (in press).…”

Section: Specifiersmentioning

confidence: 99%

“…Over the years, various sexuality related subcategories have been proposed (e.g., Blanchard, 1989;Blanchard et al, 1987;Buhrich & McConaghy, 1978;Freund, Steiner, & Chan, 1982;Money & Gaskin, 1970-1971Sørenson, 1981; for a review, see Lawrence, in press). In clinical writings, there seems to be agreement that transsexual subtypes do exist, although there is no agreement on the number and kind of relevant subtypes.…”

Section: Specifiersmentioning

confidence: 99%

The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

2009

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Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by similarities and differences of the terms transsexualism and GID, the inability of the current criteria to capture the whole spectrum of gender variance phenomena, the potential risk of unnecessary physically invasive examinations to rule out intersex conditions (disorders of sex development), the necessity of the D criterion (distress and impairment), and the fact that the diagnosis still applies to those who already had hormonal and surgical treatment. If the diagnosis should not be deleted from the DSM, most of the criticism could be addressed in the DSM-V if the diagnosis would be renamed, the criteria would be adjusted in wording, and made more stringent. However, this would imply that the diagnosis would still be dichotomous and similar to earlier DSM versions. Another option is to follow a more dimensional approach, allowing for different degrees of gender dysphoria depending on the number of indicators. Considering the strong resistance against sexuality related specifiers, and the relative difficulty assessing sexual orientation in individuals pursuing hormonal and surgical interventions to change physical sex characteristics, it should be investigated whether other potentially relevant specifiers (e.g., onset age) are more appropriate.

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“…While in Holland the sex ratio has remained more or less stable at 3:1 for many years (1), more recent research in Sweden has shown a smaller difference between the sexes of about 1.4:1 (2,3). Findings from the United States (4,5), Canada (6) and Belgium (7) con®rm that transsexualism is being found increasingly almost equally frequently in both sexes. In view of the lack of any reliable ®gures for Germany (West), the aim of our investigation was to discover whether there has been a similar reduction in the sex ratio here.…”

Section: Introductionmentioning

confidence: 99%

Sex ratio of transsexuals in Germany: the development over three decades

Garrels

Kockott

Michael

et al. 2000

Acta Psychiatr Scand

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Objective: The higher incidence of man‐to‐woman transsexuals compared to woman‐to‐man transsexuals varies markedly from country to country. This is the first survey of the sex ratio to be made in Germany. Method: It covers 1785 patients who between 1964 and 1998 were diagnosed as transsexual at the four largest German centres offering treatment. Results: From 1970 to 1994 the sex ratio remained constant at 2:1 in favour of man‐to‐woman transsexuals. Over the past 4 years, however, it has altered considerably and reached 1.2:1. Conclusion: Up to 1994 our results do not support the assumption that transsexualism is gradually becoming equally prevalent in both sexes. The drop in the sex ratio after 1994 can be explained either as a reduction of an overhang of male‐to‐female transsexuals or as an artificial phenomenon caused by recent developments in therapy and by the views of transsexuals' groups on the treatment they are offered.

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Heterosexual and homosexual gender dysphoria

Cited by 145 publications

References 27 publications

Regional volumes and spatial volumetric distribution of gray matter in the gender dysphoric brain

Regional volumes and spatial volumetric distribution of gray matter in the gender dysphoric brain

The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

Sex ratio of transsexuals in Germany: the development over three decades

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