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Now it's time
to look at gender identity issues which some people with Intersexed conditions
are known to have. As a baseline lets start with people (genetic 46XY) who
have CAIS.
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From - Complete Androgen Insensitivity Syndrome: Long-Term
Medical, Surgical, and Psychosexual Outcome, Amy B. Wisniewski, Claude J.
Migeon, Heino F. L. Meyer-Bahlburg, John P. Gearhart, Gary D. Berkovitz,
Terry R. Brown and John Money, May 2000:
"Self-perceived femininity and masculinity. Women
with CAIS overwhelmingly reported a high degree of femininity along
with a low degree of masculinity throughout development."
"Satisfaction with sex of rearing.
CAIS women unanimously reported satisfaction with being a woman
(100%). Two participants (18%) questioned their physical status as
women, but none reported a desire to change sex to that of a man."
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From - Psychological outcomes and gender-related development
in complete androgen insensitivity syndrome. M Hines, SF Ahmed,
and IA Hughes (Abstract):
"Women recruited through the
database versus the support group did not differ systematically,
and there were no statistically significant differences between
the 22 women with CAIS and the matched controls for any psychological
outcome. These findings argue against the need for two
X chromosomes or ovaries to determine feminine-typical psychological
development in humans and reinforce the important role of the androgen
receptor in influencing masculine-typical psychological development.
They also suggest that psychological outcomes in women with CAIS are
similar to those in other women."
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Please note that
the above two reports indicate that all the participants in the study,
although genetically 46XY have feminine gender identities. Remember the
studies done by Dr. Reimer shown on the previous page which report attempts
at trying to raise boys as girls who had normal prenatal hormone exposure
to testosterone and the subsequent failures. Now lets look at some psychological
reports which include people who have PAIS, Partial gonadal dysgenesis
and other Intersexed conditions.
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This study done in 2002
on the psychosexual characteristics of a number of 46XY intersexed
people including PAIS and partial gonadal dysgenesis
indicates the following 176):
"Results.Thirty-nine (72%) of
54 eligible patients participated. The causes underlying genital
ambiguity of participants included partial androgen insensitivity syndrome
(n = 14; 5 men and 9 women), partial gonadal dysgenesis (n = 11; 7 men
and 4 women), and other intersex conditions."
Participants Currently Living as Men Physical Appearance
at Birth:
"Classification of the appearance
of the external genitalia ranged from Quigley grade 2 to 4 (mean:
3.4)."
Participants Currently Living as Women Physical Appearance
at Birth:
"Classification of the appearance
of the external genitalia ranged from Quigley grade 3 to 4 (mean:
3.6)."
Comparison of Men’s and Women’s Responses Satisfaction
With Parent/Physician-Assigned Gender:
"Sixteen participants (76%) were
mainly satisfied with their male sex of rearing established by
physicians and parents. Five participants (24%) reported dissatisfaction
with their male sex of rearing, one of whom preferred to think of
himself as intersex and one reassigned her gender to that of a woman
in early adulthood. Fourteen participants (78%) were mainly satisfied
with their physician/parent-established female sex of rearing. Four
participants (22%) reported dissatisfaction with their female sex
of rearing."
"It is possible that those who
refused to participate were particularly dissatisfied with their
sex assignment established by parents and physicians and their medical
or surgical treatment; in addition, some preferred not to discuss
their intersex condition. Finally, establishing a cause underlying
the genital ambiguity of participants in the present study also proved
difficult, particularly in cases of PAIS."
Note the percentages of individuals dissatisfied with
their sex of rearing.
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| Another study indicating some intersexual
children switch gender roles later on in life: Psychological
consequences 188): "Sex assignment of
children born with ambiguous genitalia is a difficult and responsible decision
based on limited empirical evidence regarding future development of gender
identity/role, sexual orientation, and sexual functioning. The limited follow-up
studies indicate that this is a reasonable policy, although a limited number
of subjects will experience gender dysphoria later in life and will cross
over to the other sex."
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| And another 192) "Despite the sex assignment,
genital organ correction soon after birth, psychological counseling
of parents and intensive psychotherapy of the children, general
psychopathology developed equally in all 4 groups (39% of total
group). Although 87% of the girls with a physical intersex condition
developed in line with the assigned sex, 13% developed a gender identity
disorder though only 1 girl (2%) failed to accept the assigned sex.
Gender identity disorder and deviant gender role were in evidence only
in girls with CAH and girls of the ambiguous group. Biological and social
factors seem responsible for the development of gender identity disorder,
such as pre- and postnatal hormonal influences on the brain enabling
deviant gender role behavior to develop, and an inability on the
part of parents to accept the sex assignment."
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| The Androgen Insensitivity
Syndrome Support Group (AISSG) web site also describes the seven grades of AIS and provides
support access for those with mild PAIS, raised as males but who have
a feminine gender identity.
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If we look at
the physical similarities between DES exposure, AIS and Gonadal dysgenesis
and then we look at the gender identity problems some of these people
face why would we not expect similar gender identity problems to occur
with genetic males exposed to DES in utero?
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