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Gender identity in XY intersexuality
Vivian Sobel1, Julianne Imperato-McGinley
1Department of Medicine/Endocrinology, Weill Medical College of Cornell University, 1300 York Avenue, New York, NY 10021, USA.
Summary
This review examines XY intersex conditions, including 5alpha-reductase-2 deficiency and androgen insensitivity, exploring nature versus nurture in gender identity development and implications for psychiatric care.
Area of Science:
- Endocrinology
- Genetics
- Psychiatry
Background:
- XY intersex variations involve genetic male (XY) individuals with atypical sexual development.
- Conditions discussed include 5alpha-reductase-2 deficiency, 17beta-hydroxysteroid dehydrogenase-3 deficiency, and androgen insensitivity (complete and partial).
Purpose of the Study:
- To review specific XY intersex syndromes.
- To explore the interplay of biological factors (androgens) and environmental influences (sex of rearing) on gender identity.
- To discuss clinical implications for psychiatrists.
Main Methods:
- Literature review of XY intersex syndromes.
- Analysis of case presentations and their impact on gender identity.
- Examination of theories regarding gender identity formation.
Main Results:
- Each syndrome presents unique challenges in understanding gender identity determinants.
- Gender role reversal is a notable phenomenon in some of these conditions.
- The relative contributions of 'nature' (hormonal) and 'nurture' (social environment) are explored.
Conclusions:
- Understanding XY intersex conditions is crucial for comprehending gender identity development.
- Psychiatric management requires sensitivity to the complex biological and social factors influencing patients.
- Further research into the determinants of gender identity is warranted.