Advertisement

Assessment and Treatment of Childhood Gender Problems

  • George A. Rekers

Abstract

Sex-role development and the normal processes of gender identification have been investigated by child psychologists for several decades (Maccoby, 1966; Maccoby & Jacklin, 1974; Mischel, 1970; Mussen, 1969). Normal boys occasionally display behaviors that are socially assigned to girls and women, such as using cosmetics or wanting to nurse and bear children. Similarly, but with considerably less risk of social disapproval in our American society, girls sometimes behave as boys and will be referred to as tomboys. This exploration and flexibility of sex-typed behavior, typical of many boys and girls, is a part of the normal socialization process. On rare occasions, however, behavior that may have begun as a curiosity-induced exploration of sex-role stereotypes becomes a compulsive, excessive, and persistent pattern. One such example is the pathological hypermasculinity of boys who are destructive, independent, belligerent, uncontrolled, or aggressive to the point of interpersonal violence and lack gentleness or sensitivity to others (Harrington, 1970). These exaggeratedly “masculine” boys may come to the attention of the child clinical psychologist and require psychological intervention.

Keywords

Gender Identity Gender Behavior Masculine Behavior Feminine Behavior Masculine Play 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. American Psychological Association. Ethical standards of psychologists. As amended, 1972.Google Scholar
  2. Baker, H. J. Transsexualism: Problems in treatment. American Journal of Psychiatry, 1969, 225, 1412–1418.Google Scholar
  3. Bakwin, H. Deviant gender-role behavior in children: Relation to homosexuality.Pediatrics, 1968, 41, 620–629.PubMedGoogle Scholar
  4. Barlow, D. H., Reynolds, E. J., & Agras, W. S. Gender identity change in a transsexual. Archives of General Psychiatry, 1973, 28, 569–576.PubMedCrossRefGoogle Scholar
  5. Bates, J. E., & Bentler, P. M. Play activities of normal and effeminate boys. Developmental Psychology, 1973, 9, 20–27.CrossRefGoogle Scholar
  6. Bates, J. E., Bentler, P. M., & Thompson, S. Measurement of deviant gender development in boys. Child Development, 1973, 44, 591–598.PubMedCrossRefGoogle Scholar
  7. Bates, J. E., Skilbeck, W. M., Smith, K. V. R., & Bentler, P. M. Gender role abnormalities in boys: An analysis of clinical ratings. Journal of Abnormal Child Psychology, 1974, 2, 1–16.PubMedCrossRefGoogle Scholar
  8. Bates, J. E., Skilbeck, W. M., Smith, K. V. R., & Bentler, P. M. Intervention with families of gender-disturbed boys. American Journal of Orthopsychiatry, 1975, 45, 150–157.PubMedCrossRefGoogle Scholar
  9. Bern, S. L. The measurement of psychological androgyny. Journal of Consulting and Clinical Psychology, 1974, 42, 155–162.CrossRefGoogle Scholar
  10. Bene, E., & Anthony, J. Manual for the family relations test. London: National Foundation for Educational Research, 1957.Google Scholar
  11. Benjamin, H. The transsexual phenomenon. New York: Julian Press, 1966.Google Scholar
  12. Benjamin, H. Newer aspects of the transsexual phenomenon. Journal of Sex Research, 1969, 5, 135–144.CrossRefGoogle Scholar
  13. Bentler, P. M. A note on the treatment of adolescent sex problems. Journal of Child Psychology and Psychiatry, 1968, 9, 125–129.PubMedCrossRefGoogle Scholar
  14. Bentler, P. M. A typology of transsexualism: Gender identity theory and data. Archives of Sexual Behavior, 1976, 5, 567–584.PubMedCrossRefGoogle Scholar
  15. Bieber, I., Dain, H. J., Dince, P. R., Drellich, M. G., Grand, H. G., Gundlach, R. H., Kremer, M. W., Rifkin, A. H., Wilber, C. B., & Bieber, T. B. Homosexuality: A psychoanalytic study. New York: Basic Books, 1962.CrossRefGoogle Scholar
  16. Brown, D. G. Sex-role preference in young children. Psychological Monographs: General and Applied, 1956, 70 (14, Whole No. 421), 1–19.CrossRefGoogle Scholar
  17. Dewhurst, C. J., & Gordon, R. R. The intersexual disorders. London: Failli Tindall & Cas- sell, 1969.Google Scholar
  18. Dupont, H. Social learning theory and the treatment of transvestite behavior in an eight-year-old boy. Psychotherapy: Theory, Research, and Practice, 1968, 5, 44–45.CrossRefGoogle Scholar
  19. Ellis, L. J., & Bentler, P. M. Traditional sex-determined role standards and sex-stereotypes. Journal of Personality and Social Psychology, 1973, 25, 28–34.PubMedCrossRefGoogle Scholar
  20. Evans, R. B. Childhood parental relationships of homosexual men. Journal of Consulting and Clinical Psychology, 1969, 33, 129–135.PubMedCrossRefGoogle Scholar
  21. Evans, R. B. Physical and biochemical characteristics of homosexual men. Journal of Consulting and Clinical Psychology, 1972, 39, 140–147.PubMedCrossRefGoogle Scholar
  22. Evans, T. D. Homosexuality: Christian ethics and psychological research. Journal of Psychology and Theology, 1975, 3, 94–98.Google Scholar
  23. Gray, S. W. Ethical issues in research in early childhood education. Children, 1971, 18, 83–89.Google Scholar
  24. Green, R. Sexual identity conflict in children and adults. New York: Basic Books, 1974.Google Scholar
  25. Green, R., & Fuller, M. Group therapy with feminine boys and their parents. International Journal of Group Psychotherapy, 1973, 23, 54–68.PubMedGoogle Scholar
  26. Green, R., Fuller, M., & Rutley, B. IT-scale for children and Draw-a-Person Test: 30 feminine vs. 25 masculine boys. Journal of Personality Assessment, 1972a, 36, 349–352.PubMedCrossRefGoogle Scholar
  27. Green, R., & Money, J. Effeminacy in prepubertal boys: Summary of eleven cases and recommendations for case management. Pediatrics, 1961, 27, 286–291.PubMedGoogle Scholar
  28. Green, R., & Money, J. Transsexualism and sex reassignment. Baltimore: Johns Hopkins, 1969.Google Scholar
  29. Green, R., Newman, L. E., & Stoller, R. J. Treatment of boyhood “transsexualism” —An interim report of four years’ experience. Archives of General Psychiatry, 1972b, 26, 213–217.PubMedCrossRefGoogle Scholar
  30. Greenson, R. R. A transvestite boy and a hypothesis. International Journal of Psychoanalysis, 1966, 47, 396–403.PubMedGoogle Scholar
  31. Greenson, R. R. Dis-identifying from mother: Its special importance for the boy. International Journal of Psycho-Analysis, 1968, 49, 370–374.PubMedGoogle Scholar
  32. Harrington, C. C. Errors in sex-role behavior in teenage boys. New York: Teachers College Press, 1970.Google Scholar
  33. Hatterer, L. J. Changing homosexuality in the male: Treatment for men troubled by homosexuality. New York: McGraw-Hill, 1970.Google Scholar
  34. Hoenig, J., Kenna, J., & Youd, A. Social and economic aspects of transsexualism.British Journal of Psychiatry, 1970,117, 163–172.PubMedGoogle Scholar
  35. Holemon, E. R., & Winokur, G. Effeminate homosexuality: A disease of childhood. American Journal of Orthopsychiatry, 1965, 35, 48–56.PubMedCrossRefGoogle Scholar
  36. Kando, T. M. Sex change: The achievement of gender identity by feminized transsexuals. Springfield, 111.: Charles C Thomas, 1973.Google Scholar
  37. Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. Sexual behavior in the human male. Philadelphia: W. B. Saunders, 1948.Google Scholar
  38. Lebovitz, P. S. Feminine behavior in boys: Aspects of its outcome. American Journal of Psychiatry, 1972, 128, 1283–1289.PubMedGoogle Scholar
  39. Litin, E. M., Giffin, M. E., & Johnson, A. M. Parental influence in unusual sexual behavior in children. Psychoanalytic Quarterly, 1956, 25, 37–55.PubMedGoogle Scholar
  40. Lukianowicz, N. Survey of various aspects of transvestism in the light of our present knowledge.Journal of Nervous and Mental Disease, 1959, 128, 36–64.PubMedGoogle Scholar
  41. Maccoby, E. E. (Ed.). The development of sex differences. Stanford, Calif.: Stanford University Press, 1966.Google Scholar
  42. Maccoby, E. E., & Jacklin, C. N. The psychology of sex differences. Stanford, Calif.: Stanford University Press, 1974.Google Scholar
  43. Mischel, W. Sex-typing and socialization. In P. H. Mussen (Ed.), Carmichael’s manual of child psychology, 3rd ed., Vol. II. New York: Wiley, 1970.Google Scholar
  44. Money, J. Sex-errors of the body: Dilemmas, education, counseling. Baltimore: Johns Hopkins, 1968.Google Scholar
  45. Money, J. Critique of Dr. Zuger’s manuscript. Psychosomatic Medicine, 1970a, 32, 463–465.Google Scholar
  46. Money, J. Sexual dimorphism and homosexual gender identity. Psychological Bulletin, 1970b, 74, 425–440.PubMedCrossRefGoogle Scholar
  47. Money, J., & Ehrhardt, A. A. Man and woman, boy and girl: The differentiation and dimorphism of gender identity from conception to maturity. Baltimore: Johns Hopkins University Press, 1972.Google Scholar
  48. Money, J., Hampson, J., & Hampson, J. L. An examination of some basic concepts: Evidence of human hermaphroditism. Bulletin of the Johns Hopkins Hospital, 1955, 97, 301–319.PubMedGoogle Scholar
  49. Money, J., & Primrose, C. Sexual dimorphism and dissociation in the psychology of male transsexuals. Journal of Nervous and Mental Disease, 1968, 147, 472–486.PubMedCrossRefGoogle Scholar
  50. Mussen, P. H. Early sex-role development. In D. A. Goslin (Ed.), Handbook of socialization theory and research. Chicago: Rand McNally, 1969.Google Scholar
  51. Myrick, R. D. The counselor-consultant and the effeminate boy. Personnel and Guidance Journal, 1970, 48, 355–361.CrossRefGoogle Scholar
  52. Patterson, G. R. Families: Applications of social learning to family life. Champaign, 111.: Research Press, 1971.Google Scholar
  53. Patterson, G. R., & Gullion, M. E. Living with children: New methods for parents and teachers. Champaign, 111.: Research Press, 1968.Google Scholar
  54. Pauly, I. Male psychosexual inversion: Transsexualism: A review of 100 cases.Archives of General Psychiatry, 1965, 13, 172–181.PubMedCrossRefGoogle Scholar
  55. Pauly, I. Adult manifestations of male transsexualism. In R. Green & J. Money (Eds.), Transsexualism and sex reassignment. Baltimore: Johns Hopkins, 1969.Google Scholar
  56. Prince, C. V., & Bentler, P. M. A survey of 504 cases of transvestism. Psychological Reports, 1972, 31, 903–917.PubMedCrossRefGoogle Scholar
  57. Rabban, M. Sex-role identification in young children in two diverse social groups. Genetic Psychology Monographs, 1950, 42, 81–158.PubMedGoogle Scholar
  58. Randell, J. An emerging entity. International Journal of Psychiatry, 1970, 9, 275–277.PubMedGoogle Scholar
  59. Rekers, G. A. Pathological sex-role development in boys: Behavioral treatment and assessment. Dissertation Abstracts International, 1972, 33, 3321B. (University Microfilms No. 72–33, 978).Google Scholar
  60. Rekers, G. A. Stimulus control over sex-typed play in cross-gender identified boys. Journal of Experimental Child Psychology, 1975, 20, 136–148.PubMedCrossRefGoogle Scholar
  61. Rekers, G. A. Atypical sex-role development: Assessment, intervention, and ethics. Invited paper presented at the Western Regional Conference, Society for Research in Child Development, Emeryville, Calif., April 1976.Google Scholar
  62. Rekers, G. A. Atypical gender development and psychosocial adjustment. Journal of Applied Behavior Analysis, 1977a, 10, in press.Google Scholar
  63. Rekers, G. A. Sexual problems: Behavior modification. In B. B. Wolman (Ed.), Handbook of treatment of mental disorders in childhood and adolescence. Englewood Cliffs, N.J.: Prentice-Hall, 1977b.Google Scholar
  64. Rekers, G. A., Amaro-Plotkin, H., & Low, B. P. Sex-typed mannerisms in normal boys and girls as a function of sex and age. Child Development, 1977a, 48, 275–278.CrossRefGoogle Scholar
  65. Rekers, G. A., Bentler, P. M., Rosen, A. C., & Lovaas, O. I. Child gender disturbances: A clinical rationale for intervention. Psychotherapy: Theory, Research, and Practice, 1977b, 14, 1–8.Google Scholar
  66. Rekers, G. A., & Lovaas, O. I. Experimental analysis of cross-sex behavior in male children.Research Relating to Children, 1971, 28, 68. (Abstract)Google Scholar
  67. Rekers, G. A., & Lovaas, O. I. Behavioral treatment of deviant sex-role behaviors in a male child.Journal of Applied Behavior Analysis, 1974, 7, 173–190.PubMedCrossRefGoogle Scholar
  68. Rekers, G. A., Lovaas, O. I., & Low, B. P. The behavioral treatment of a “transsexual” preadolescent boy. Journal of Abnormal Child Psychology, 1974, 2, 99–116.PubMedCrossRefGoogle Scholar
  69. Rekers, G. A., & Varni, J. W. Self-monitoring and self-reinforcement processes in a pre- transsexual boy. Behaviour Research and Therapy, 1977, 15, 177–180.PubMedCrossRefGoogle Scholar
  70. Rekers, G. A., Willis, T.J., Yates, C. E., Rosen, A. C., & Low, B. P. Assessment of childhood gender behavior change. Journal of Child Psychology and Psychiatry, 1977c, 18, 53–65.PubMedCrossRefGoogle Scholar
  71. Rekers, G. A., & Yates, C. E. Sex-typed play in feminoid boys vs. normal boys and girls. Journal of Abnormal Child Psychology, 1976, 4, 1–8.PubMedCrossRefGoogle Scholar
  72. Rekers, G. A., Yates, C. E., Willis, T. J., Rosen, A. C., & Taubman, M. Childhood gender identity change: Operant control over sex-typed play and mannerisms. Journal of Behavior Therapy and Experimental Psychiatry, 1976, 7, 51–57.CrossRefGoogle Scholar
  73. Rosen, A. C. The intersex: Gender identity, genetics, and mental health. In S. Plog & R. Edgerton (Eds.), Changing perspectives in mental illness. New York: Holt, 1969.Google Scholar
  74. Rosen, A. C., Rekers, G. A., & Bentler, P. M. Ethical issues in the treatment of children. Journal of Social Issues, 1978, 34, in press.Google Scholar
  75. Rosen, A. C., Rekers, G. A., & Friar, L. R. Theoretical and diagnostic issues in child gender disturbances. Journal of Sex Research, 1977, 13, in press.Google Scholar
  76. Rosen, A. C., & Teague, J. Case studies in development of masculinity and femininity in male children.Psychological Reports, 1974, 34, 971–983.PubMedCrossRefGoogle Scholar
  77. Sherman, J. A., & Baer, D. M. Appraisal of operant therapy techniques with children and adults.In C. M. Franks (Ed.), Behavior therapy: Appraisal and status. New York: McGraw-Hill, 1969.Google Scholar
  78. Skilbeck, W. M., Bates, J. E., & Bentler, P. M. Human figure drawings of gender- problem and school-problem boys. Journal of Abnormal Child Psychology, 1975, 3, 191–199.PubMedCrossRefGoogle Scholar
  79. Socarides, C. W. Homosexuality and medicine. Journal of the American Medical Association, 1970, 212, 1199–1202.PubMedCrossRefGoogle Scholar
  80. Stoller, R. J. A contribution to the study of gender identity. International Journal of Psychoanalysis, 1964, 45, 220–226.PubMedGoogle Scholar
  81. Stoller, R. J. Passing in the continuum of gender identity. In J. Marmer (Ed.), Sexual inversion: The multiple roots of homosexuality. New York: Basic Books, 1965.Google Scholar
  82. Stoller, R. J. Male childhood transsexualism. Journal of the American Academy of Child Psychiatry, 1968a, 7, 193–209.PubMedCrossRefGoogle Scholar
  83. Stoller, R. J. Sex and gender: The development of masculinity and femininity. New York: Science House, 1968b.Google Scholar
  84. Stoller, R. J. Parental influences in male transsexualism. In R. Green & J. Money (Eds.), Transsexualism and sex reassignment. Baltimore, Md., Johns Hopkins University Press, 1969.Google Scholar
  85. Stoller, R. J. Psychotherapy of extremely feminine boys. International Journal of Psychiatry, 1970–1971, 9, 278–280.PubMedGoogle Scholar
  86. Sutton-Smith, B., Rosenberg, B. G., & Morgan, E. R. Development of sex differences in play choices during preadolescence. Child Development, 1963, 34, 119–126.PubMedGoogle Scholar
  87. Thoresen, C. E., & Mahoney, M. J. Behavioral self-control. New York: Holt, 1974.Google Scholar
  88. Varni, J. W., & Rekers, G. A., Behavioral self-control treatment of “cross-gender identity” behaviors. Paper presented at the meeting of the Association for the Advancement of Behavior Therapy. San Francisco, California, December, 1975.Google Scholar
  89. Wahler, R. G. Setting generality: Some specific and general effects of child behavior therapy. Journal of Applied Behavior Analysis, 1969, 2, 239–246.PubMedCrossRefGoogle Scholar
  90. Walinder, J. Transsexualism: A study of forty-three cases. Goteborg, Sweden: Scandinavian University Books, 1967.Google Scholar
  91. Zuger, B. Effeminate behavior present in boys from early childhood: 1. The clinical syndrome and follow-up studies. Journal of Pediatrics, 1966, 69, 1098–1107.PubMedCrossRefGoogle Scholar
  92. Zuger, B. Gender role determination: A critical review of the evidence from hermaphroditism. Psychosomatic Medicine, 1970a, 32, 449–467.PubMedGoogle Scholar
  93. Zuger, B. The role of familial factors in persistent effeminate behavior in boys.American Journal of Psychiatry, 1970b, 226, 1167–1170.Google Scholar
  94. Zuger, B., & Taylor, P. Effeminate behavior present in boys from early childhood: II. Comparison with similar symptoms in non-effeminate boys. Pediatrics, 1969, 44, 375–380.PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1977

Authors and Affiliations

  • George A. Rekers
    • 1
    • 2
  1. 1.Fuller Theological SeminaryGraduate School of PsychologyPasadenaUSA
  2. 2.University of CaliforniaLos AngelesUSA

Personalised recommendations