General Medical Information

Psychological Aspects of Sexual Differentiation Disorders

Sarah E. Herbert

Before describing the psychological impact of sexual differentiation disorders, it would be helpful to define some of the terms that will be used, that is, biologic sex, gender identity, gender role behaviors, and sexual orientation. Biologic sex is made up of a number of different components: chromosomes, gonads, internal genitalia, external genitalia, sex hormones, and secondary sex characteristics. In children and adolescents with disorders of sexual differentiation, these components are not consistently associated with one biologic sex or the other. Gender identity is the individual’s self-designation as male or female, the self-image of his or her biologic sex. Gender role behaviors are those behaviors, attitudes, and personality traits that a society in a given culture and historical period designates as masculine or feminine. These include nonsexual attributes and behaviors that are considered characteristic of one gender or the other, such as physical appearance, dress, mannerisms, speech, emotional responsiveness, and aggressiveness. Gender role identity is the individual’s self-perception as feminine or masculine. Sexual orientation is the person’s erotic preference for persons of the same, opposite, or either sex. Components of sexual orientation include emotional attachments, sexual fantasies, and sexual behavior. Traditionally these have been referred to in our culture as homosexual, heterosexual, or bisexual. An alternative manner of noting sexual orientation that is more easily applicable to individuals with sexual differentiation disorders is to refer to the gender of the person they desire sexually; that is, they are described as androphilic, gynecophilic, or ambiphilic.