Gender identity

Gender identity (or core gender identity) is a person's own sense of identification as male or female. The term is intended to distinguish this psychological association, from physiological and sociological aspects of gender.[1] Gender identity was originally a medical term used to explain sex reassignment procedures to the public.[ ] The term is also found in psychology, often as core gender identity.[!] "ociology, gender studies and feminism are still inclined to refer to gender identity, gender role and erotic preference under the catch#all term gender. $ender identity is affected by %genetic, prenatal hormonal, postnatal social, and postpubertal hormonal determinants.%[&] 'iological factors include the influence of testosterone and gene regulation in brain cells. "ocial factors are primarily based on the family, as gender identity is thought to be formed by the third year of life.[!] The (iagnostic and "tatistical )anual of )ental (isorders (!* .+,) has fi-e criteria that must be met before a diagnosis of gender identity disorder ($.() can be made. %.n gender identity disorder, there is discordancy between the natal sex of one's external genitalia and the brain coding of one's gender as masculine or feminine.%

Gender identity - below the surface

)ost human beings are considered to be cisgendered, that is, belonging to either the male or female gender on the basis of their biological sex. 'efore the *th century a person's sex would be determined entirely by the appearance of the genitalia, but as chromosomes and genes came to be understood, these were then used to help determine sex. Those defined as women, by sex, ha-e genitalia that is considered female as well as two / chromosomes0 those -iewed as men, by sex, are seen as ha-ing male genitalia, one / and one 1 chromosome. 2owe-er some indi-iduals ha-e combinations of chromosomes, hormones, and genitalia that do not follow the traditional definitions of %men% and %women%. .n addition, genitalia -ary greatly or indi-iduals may ha-e more than one type of genitalia, and other bodily attributes related to a person's sex (body shape, facial hair, high or deep -oice, etc.) may or may not coincide with the social category, as woman or man. 3ecent research suggests that as many as one in e-ery hundred indi-iduals may ha-e some intersex characteristic.[,] Transsexual indi-iduals are those who wish to undergo physical surgery to refashion their primary sexual characteristics, secondary characteristics, or both. Typically this will in-ol-e remo-al of penis, testicles or breasts, or the

fashioning of a -agina or breasts. 2istorically, such surgery has been performed on infants who present with ambiguous genitalia. 2owe-er, current medical opinion is broadly against such procedures, shaped to a significant extent by the mature feedbac4 of adults who regret these decisions being made on their behalf at their birth. $ender reassignment surgery (formerly sex change operations) elected by adults is also sub5ect to se-eral 4inds of debate. 6ne discussion in-ol-es the legal sex#gender status of transgender people, for marriage, retirement and insurance purposes, for example. 7nother in-ol-es whether such surgery is ethically sound. .s it a right people should be free to exercise, or is it a responsibility surgeons should accept only in cases of genuine need8 The most easily understood case in which it becomes necessary to distinguish between sex and gender is that in which the external genitalia are remo-ed # when such a thing happens through accident or through deliberate intent, the libido and the ability to express oneself in sexual acti-ity are changed, but the indi-idual's gender identity may or may not change. 6ne such case is that of (a-id 3eimer, reported in As Nature Made Him by 9ohn :olapinto. .t details the persistence of a male gender identity and the stubborn adherence to a male gender role of a person whose penis had been totally destroyed shortly after birth as the result of a botched genital modification, and who had subse;uently been surgically reassigned by constructing female genitalia. .n other cases, a person's gender identity may contrast sharply with that assigned to them according to their genitalia, and<or a person's gendered appearance as a woman or man (or an androgynous person, etc.) in public may not coincide with their physical sex. "o the term %gender identity% is broader than the sex of the indi-idual as determined by examination of the external genitalia.

Formation of gender identity

The formation of a gender identity is a complex process that starts with conception, but which in-ol-es critical growth processes during gestation and e-en learning experiences after birth. There are points of differentiation all along the way, but language and tradition in many societies insist that e-ery indi-idual be categori=ed as either a man or a woman, although there are societies, such as the >ati-e 7merican identity of a two#spirit, which include multiple gender categories. ?hen the gender identity of a person ma4es her a woman, but her genitals are male, she will li4ely experience what is called gender dysphoria, i.e., a deep unhappiness caused by her experience of herself as a woman and her lac4 of female genitals and breasts. "ome research has been done that indicates that gender identity is fixed in early childhood and is thereafter static. This research has generally proceeded by as4ing transsexuals when they first reali=ed that the gender

role that society attempted to place upon them did not match the gender identity that they found in themsel-es and the gender role that they chose to li-e out. These studies estimate the age at which gender identity is formed at around #!. "uch research may be problematic if it made no comparable attempt to disco-er when non#transsexual people became aware of their own gender identities and choice of gender roles. "ome critics ;uestion this research, claiming that the studies suffer from a sampling bias. The ac;uisition of hormone replacement therapy and sexual reassignment surgery is generally controlled by doctors. 6ne of the ;uestions some doctors as4 to distinguish between %real% transsexuals and others is to as4 them when they first felt identification with the opposite sex. The researchers may then be unintentionally eliminating some sub5ects from consideration when they try to determine a typical time of gender identity formation. There is also a possibility of reporting bias, since transsexuals may feel that they must gi-e the %correct% answers to such ;uestions in order to increase the chances of obtaining hormones. @atric4 :alifia, author of Sex Changes and Public Sex, has indicated that this group has a clear awareness of what answers to gi-e to sur-ey ;uestions in order to be considered eligible for hormone replacement therapy and<or sexual reassignment surgeryA
%>one of the gender scientists seem to reali=e that they, themsel-es, are responsible for creating a situation where transsexual people must describe a fixed set of symptoms and recite a history that has been edited in clearly prescribed ways in order to get a doctor's appro-al for what should be their inalienable right%.

Gender identity and sex

"ome people do not belie-e that their gender identity corresponds to their biological sex, namely transgender people, including transsexual people and many intersexed indi-iduals as well. :onse;uently, complications arise when society insists that an indi-idual adopt a manner of social expression (gender role) which is based on sex, that the indi-idual feels is inconsistent with that person's gender identity. 6ne reason for such discordances in intersexed people is that some indi-iduals ha-e a chromosomal sex that has not been expressed in the external genitalia because of hormonal or other abnormal conditions during critical periods in gestation. "uch a person may appear to others to be of one sex, but may recogni=e himself or herself as belonging to the other sex. The causes of transgenderism are less clear0 it has been sub5ect of much speculation, but no psychological theory has e-er been pro-en to apply to e-en a significant minority of transgender indi-iduals, and theories that assume a sex difference in the brain are relati-ely new and difficult to pro-e,

because at the moment they re;uire a destructi-e analysis of inner brain structures, which are ;uite small. .n recent decades it has become possible to surgically reassign sex. 7 person who experiences gender dysphoria may, then, see4 these forms of medical inter-ention to ha-e their physiological sex match their gender identity. 7lternati-ely, some people who experience gender dysphoria retain the genitalia that they were born with (see transsexual for some of the possible reasons), but adopt a gender role that is consonant with what they percei-e as their gender identity. There is an emerging -ocabulary for those who defy traditional gender identity # see transgender and gender;ueer.

Relationship to gender role

See also: Gender role

There are probably as many shades and complexities of sexual identity and gender identity as there are human beings, and there are an e;ual number of ways of wor4ing those gender identities out in the intricacies of daily life. "ocieties, howe-er, tend to assign some classes of social roles to %male% indi-iduals, and some classes of social roles to %female% indi-iduals (as society percei-es their sexes). .n some societies, there are other classes of social roles for, e.g., surgically neutered physiological male. "ee 2i5ra (.ndia), for example. "ometimes the connection between gender identity and gender role is unclear. The original o-ersimplification was that there are unambiguously male human beings and unambiguously female human beings, that they are clearly men and clearly women, and that they should beha-e in all important ways as women and men %naturally% beha-e. (:ompare 2eteronormati-ity) .n-estigations in biology and sociology (see 'iology of gender) ha-e strongly supported the -iew that %the sex between the ears is more important than the sex between the legs%, and the implication has been that people with masculine gender identities will gi-e external representation of their gender identities by adopting gender roles that are considered appropriate to men in their society, and, similarly, that people with feminine gender identities will adopt gender roles that are considered appropriate to women. .t may be -ery difficult to determine, howe-er, whether a specific drag ;ueen is someone who has a female gender identity and is learning a female gender role, or whether that person is someone with a male gender identity who en5oys adopting a female gender role. "ome, such as 3u@aul, refuse to be categori=ed0 others use terms li4e gender;ueer or %gender fluid%. "imilarly, it may be -ery difficult to determine whether a specific drag 4ing is someone who has a male gender identity and is learning a male gender role, or whether that person is someone with a female gender identity who en5oys adopting a male gender role.

"ome famous people 4nown for their cross#dressing or androgynous appearances in the *th century include @at (ardis, (ame Bdna, $ladys 'entley, (a-id 'owie, @ete 'urns, Bddie .==ard, 'oy $eorge, >orman .ceberg, 4.d. lang, 7nnie Cennox, 9aye (a-idson, )arilyn )anson, )arlene (ietrich, )ylDne Earmer, $ac4t, $race 9ones, @atric4 ?olf, )arc 'olan, 'rian )ol4o, @at, @hranc, )adonna, @rince, "usan @owter, Fate 'ornstein, and Fristen )c)enamy.

Conceptual origins
(uring the 1G,*s and 'H*s, psychologists began studying gender de-elopment in young children, partially in an effort to understand the origins of homosexuality (which was still -iewed as a mental disorder at the time). .n 1G,+, the $ender .dentity 3esearch @ro5ect was established at the I:C7 )edical :enter for the study of intersexuals and transsexuals. @sychoanalyst 3obert "toller generali=ed many of the findings of the pro5ect in his boo4 Sex and Gender: On the De elopment o! Masculinity and "emininity (1GH+). 2e is also credited with introducing the term gender identity to the .nternational @sychoanalytic :ongress in 1GH!. @sychoendocrinologist 9ohn )oney was also instrumental in the de-elopment of early theories of gender identity. 2is wor4 at 9ohns 2op4ins )edical "chool's $ender .dentity :linic (established in 1GH,) populari=ed an interactionist theory of gender identity, suggesting that, up to a certain age, gender identity is relati-ely fluid and sub5ect to constant negotiation. 2is boo4 Man and #oman$ %oy and Girl (1GJ ) became widely used as a college textboo4, although many of )oney's ideas ha-e since been challenged.[H] )oney's famous case study was (a-id 3eimer. )oney wrote that 3eimer's sex reassignment pro-ed that gender identity is socially constructed. 3eimer later went public with accusations that he had always identified as male, and that )oney had largely fabricated his results.[J]

Sexual differentiation and neurobiology

There is still much that is unclear regarding the de-elopment of the brain and our (core) gender identity. .t is 4nown that sex hormones can influence beha-iour, eg. aggression and libido which are under direct influence of testosterone and power moti-ation which is under the influence of estrogen.[+] 7nimal experiments (particularly rodent research) has led to a series of theories on prenatal hormonal influences on gender as well as theories regarding hormone#independent brain de-elopment.

] Hormonal influences
)elissa 2ines postulated three models of action of hormonal influences on gender in ** .

The :lassic )odel of hormonal influences states that presence of testicular

hormones (testosterone) during early fetal life causes a masculine de-elopment of rodents, while absence of testicular hormones causes a feminine de-elopment.

The $radient )odel describes a more gradual effect of hormonal influences on beha-iour. >ormal -ariations in hormones cause mo-ement along a male and female gradient within each sex. Therein we assume that a greater amount of hormones administered in animal tests, creates a more dramatic change in beha-ior. The )odel of 7cti-e Eemini=ation Theory postulates that o-arian hormones are, opposed to the pre-ious mentioned models, needed to induce, in some degree, the female sexual differentiation. .t is thought that o-arian hormones cause a lesser, but present effect of mild -irili=ation to some brain areas.[G]

.n fact, all these models re-eal different aspects of reality. The :lassic )odel can be explained in a human context through the human disease :ongenital 7drenal 2yperplasia (:72). This disease causes o-erproduction of male hormones in females and males, due to a steroid en=yme deficiency (often :1@ 1). The influence of testosterone on the female fetus causes -irili=ation, showing in external sexual genitalia in -arious degreesA clitoral hypertrophy, labial fusion and sometimes appearing as fully ambiguous genitalia. The beha-ior of :72 girls is often described to be %tomboyish%, more masculine due to the early influences of testosterone. The ma5ority of these females, howe-er, ha-e a female gender identity.[1*]

Sexual differentiation of the human brain

"e-eral brain areas ha-e been found to be sexually dimorphic0 they differ between males and females. The "exually (imorphic >ucleus of the @re6ptic 7rea ("(>#@67) for example, shows a sexually dimorphic difference fa-oring males0 the "(> is normally se-eral times larger in males. ?hen female rats are pre# and postnatally exposed to testosterone or to (synthetic) estrogens, the "(>#@67 appeared similar in si=e.[11] "imilar to the "(>, the .nterstitial >ucleus of the 7nterior 2ypothalamus (.>72#!) was found to be almost ! times as big in males[1 ]. 7lso the 'ed >ucleus of the "tria Terminalis ('>"T) has been said to ha-e a sex difference. .t appeared ., times larger in men.[1!] "urprisingly, a particular part of the '>"T, the '>"T posteriomedial bed nucleus ('>"Tpd), has been found to be female#si=ed in male#to#female transsexuals.[1&] Eurthermore, in a female#to# male transsexual, the number of somatostatin neurons in the '>"Tpd was found to be in the normal male range.[1,]

Non-

estern gender identities

See also: &hird gender and &'o(Spirit

Fa!afafine

.n some @olynesian societies, fa'afafine are considered to be a %third gender% alongside male and female. They are biologically male, but dress and beha-e in a manner considered typically female. 7ccording to Tamasailau "ua'ali'i (see re!erences), fa'afafine in "amoa at least are often physiologically unable to reproduce. Ea'afafine are accepted as a natural gender, and neither loo4ed down upon nor discriminated against.[1H]

Hi"ra
.n the culture of the .ndian subcontinent, a hi5ra is usually considered to be neither a man nor a woman. )ost are biologically male or intersex, but some are biologically female. The hi5ra form a third gender, although they do not en5oy the same acceptance and respect as males and females in their cultures. They can run their own households, and their occupations are singing and dancing, wor4ing as coo4s or ser-ants, sometimes prostitutes (for men), or long#term sexual partners for men. 2i5ras can be compared to trans-estites or drag ;ueens of contemporary western culture.[1J]

#anith
The xanith form an accepted third gender in 6man, an .slamic, gender# segregated society. The xanith are male homosexual prostitutes whose dressing is male, featuring pastel colors (rather than white, worn by men), but their mannerisms female. /anith can mingle with women, and they often do at weddings or other formal e-ents. /aniths ha-e their own households, performing all tas4s (both male and female). 2owe-er, similarly to men in their society, xaniths can marry women, pro-ing their masculinity by consummating the marriage. "hould a di-orce or death ta4e place, these men can re-ert to their status as xaniths at the next wedding.[1+]
Gender identity disorder ($.() is the formal diagnosis used by psychologists and physicians to describe persons who experience significant gender dysphoria (discontent with the biological sex they were born with). .t is a psychiatric classification and describes the problems related to transexuality, transgender identity, and trans-estism. .t is the diagnostic classification most commonly applied to transexuals.