Development of male gender identity/role and a sexual orientation towards women in a 46,XY subject with an incomplete form of the androgen insensitivity syndrome
- 165 Downloads
Transsexualism and homosexuality have been theorized to originate in the male from insufficient androgenization of the brain. For verification of this hypothesis clinical science must rely on subjects with an abnormal prenatal/perinatal endocrine history. A case of a 33-year-old 46,XY subject with an incomplete form of androgen insensitivity syndrome (AIS) is presented. In adulthood the only genital sign of masculinization is a clitoris of 4 cm; the vagina is normal size. The diagnosis AIS was verified by androgen receptor studies. At birth there was confusion as to the sex of the newborn. Originally, the subject was assigned to the male sex, but this decision was reversed 5 days after birth and the subject was reared as a girl. At age 30 the subject applied for gender reassignment treatment to the male sex. Upon psychological evaluation the gender identity was unambiguously male and the sexual orientation was exclusively towards women. The estrogen feedback effect on LH, regarded by some as a marker of the sexual differentiation of the neuroendocrinium was negative before orchiectomy but positive after orchiectomy. Our observation demonstrates that in 46,XY subjects a male gender identity and a sexual orientation towards women can develop with a strikingly lower-than-normal level of biological action of androgens.
Key wordsgender identity sexual orientation androgens
Unable to display preview. Download preview PDF.
- Dörner, G. (1980). Sexual differentiation of the brain.Vitamin Horm. 38: 325–381.Google Scholar
- Evans, B.A.J., Jones, T. R., and Hughes, I. A. (1984). Studies of the androgen receptor in dispersed fibroblasts: Investigation of patients with androgen insensitivity.Clin. Endocrinol. 20: 93–105.Google Scholar
- Feder, H. H. (1984). Hormones and sexual behavior.Ann. Rev. Psychol. 35: 164–200.Google Scholar
- Griffin, J. E., Punyashthiti, K., and Wilson, J. D. (1976). Dihydrotestosterone binding by cultured human fibroblasts. Comparison of cells from control subjects and from patients with hereditary male pseudohermaphroditism due to androgen resistance.J. Clin. Invest. 57: 1342–1351.PubMedGoogle Scholar
- Klein, F., Sepekoff, B., and Wolf, T. J. (1985). Sexual orientation: A multi-variate dynamic process.J. Homosex. 11: 35–49.Google Scholar
- Lindgren, T. W., and Pauly, I. B., (1977). A body image scale for evaluating transsexuals.Arch. Sex. Behav. 6: 639–646.Google Scholar
- Luteijn, F., Starren, J., and van Dijk, H. (1974).Handleiding Nederlandse persoonlijkheidsvragenlijst (NPV) Swets en Zeitlinger, Lisse, the Netherlands.Google Scholar
- Naftolin, F., Pujol-Amat, P., Corner, C. S., Shane, I. M., Palomi, P. E., Kohlinksky, S., Yen, S.S.C., and Bobrow, M. (1983). Gonadotropins and gonadal steroids in androgen insensitivity testicular feminization syndrome. Effects of castration and sex steroid administration.Am. J. Obstet. Gynecol. 147: 491–496.PubMedGoogle Scholar
- Van Look, P.F.A., Hunter, W. M., Coirker, C. S., and Baird, D. R. (1977). Failure of positive feedback in normal men and subjects with testicular feminization.Clin. Endocrinol. 7: 353–357.Google Scholar
- Van Strien, T. (1981). Beeld en zelfbeeld van vrouwen.De Psycholoog 16(11): 758–771.Google Scholar
- Wilson, J. D., George, F. W., and Griffin, J. E. (1981). The hormonal control of sexual development.Science 211: 278–1284.Google Scholar