Penile malformation, gender identity and sexual orientation

Gender identity and sexual orientation were investigated in 34 men operated for hypospadias in childhood and in 36 matched control subjects. Independent psychiatric assessments from semi-structured interviews, and double-blind formalized psychological ratings from the Rorschach, yielded similar findings. The probands were less secure in their maleness but were similar in sexual orientation as compared to the controls. A third blind, independent measure of unconscious gender identity, the Franck Drawing Completion Test, gave further evidence of uncertain gender identity in the patients. A self-administered inventory, the Gough Femininity Scale, showed a tendency for the patients to take more feminine sex roles. The findings are discussed from psychoendocrinological as well as psycho-analytical view points. The need for early psychological preventive measures for hypospadic boys and their parents is stressed.