Psychological Concept Of Gender Identity Psychology Essay

This paper critically analyses the psychological concept of gender identity. From psychological perspectives, gender identity may be defined as an individual’s self-conception as being either male or female (Gilbert 2008, cited in Zastrow and Kirst-Ashman 2009, p.371). Some individuals feel that their biological sex does not reflect their sexual orientations, a situation commonly known as gender dysphoria or gender identity disorder or gender incongruence or transgenderism (Hines 2007, p.12). Yet, researches on this field have brought out the crucial linkage between biological factors and gender roles (Kail and Cavanaugh 2008, p.200). Given the complexity of gender formations and roles, it is very common to develop gender dysphoria (Crooks and Baur 2008, p.62). Those with a prolonged, extreme degree of transgenderism are known as transsexuals. Transgenderism differs from one’s sexual identity because the former is linked with the psychological coefficients of how one views or is viewed one’s gender roles (Bockting and Goldberg 2007, p.83). Varying degrees of interpretations and connotations are normally associated with how transgendered people are seen in societies. Cultural aspects too play a pivotal role in acknowledging individual and social roles for persons with gender dysphoria (Samovar et al. 2009, p.158).

Before further probing into the topic some basic ideas need to be defined. Sex is defined as the biological status of a person like male or female which can be determined by visual inspection during birth. Gender refers to the social status of any person or rather social manifestation of a person’s sex, such as womanhood or manhood (Kendall 2008, p.322). Transgender can be of three types: transgender female persons – those who have female physical attributes but think of themselves as men either partially, or fully; gender crossing females – those who reassign their genders so as to live part or full-time as men; and female-to-male (FTM) transsexed – those who were born females sexually but identity themselves as men and live as men do, but have not fully achieved socially recognizable manhood. Sexual orientation means a form of romantic, emotional and sexual attractions to men, women, both or neither. A transvestite is one who cross-dresses. Nowadays the term “transvestite” and “cross-dresser” are used synonymously (Valentine 2007, p.263).

The exact basis of gender dysphoria is unknown, and there are many debatable possible causes. Sadock et al. argue that gender identity disorders can be caused by other critical ailments such as schizophrenia or other psychotic problems. But there is nothing conclusive as yet to infer linkage of DSM Axis I diagnoses with dysphoria. In fact a number of Axis II personality disorders are common in subjects with gender identity disorders. This is especially applicable to individuals with borderline personality disorders. What is quite remarkable in terms of the apprehended correlation between transvestites and transgendered persons is that some from the latter category have reported to have had sexual arousals with cross dressing (2007, p.721). The weird nature of gender identity disorder makes it imperative to investigate into the matter with regard to all possible outcomes. Research on traditional psychiatric disorders has pointed out that mental retardation and mood disorders are to a great extent hereditary – passed on from parental DNA (Fatemi and Clayton 2008, p.490). But this still does not adequately provide any reasoned grounding to draw the conclusions that genetic factors are responsible behind formation of an individual’s gender identity. According to the International Classification of Diseases, 10th edition, gender identity disorder is attributed primarily to adults. This goes to show how genetic factors are generally not taken into account while studying transgendered persons. However, studies have also unearthed some genetic relation between mother’s DNA and the corresponding infant’s development of transsexualism. Albeit not much is known about the clinical reasons associated with dysphoria, it can be held that a number of social factors often motivate the individual concerned to undergo sex reassignment (Fatemi and Clayton 2008, p.275). Cultural considerations are also important in this regard as many cultures do not welcome clinical or hormonal sex reassignment therapies.

As stated earlier, female gender dysphoria may stem from certain cultural and social inhibitions and prohibitions that woman has to face in everyday life. In milder forms these may provoke a woman to break barriers and participate in some masculine activities. Childhood female gender dysphoria may result from a girl child being sexually and physically abused in front of her male friends.

The fact that signs of gender incongruence develop in early childhood (Wolfe and Mash 2008, p.538) can be substantiated on empirical grounds. During early childhood (mostly before the age of 2 years) a person with gender dysphoria feels that there is some problem with his/her sex and gender identity. For some this may not occur till adulthood. Children may show symptoms like preferring to wear clothes worn by opposite sex or urinating in the fashion done by the opposite sex or enjoy playing games played by the other sex. These symptoms usually do occur in some individuals but a regular and persistent habit needs special investigation. The girl child on reaching puberty may become very depressed seeing the signs of it. As a matter of fact, puberty is a tell-tale sexual sign of a person being affected by gender identity per se (Newman and Newman 2008, p.375). But it is not that conclusive as to what extent adults are affected by gender dysphoria (Seligman and Reichenberg 2007, p.362). Adult transgendered individuals find it threatening to recognize their gender identity publicly and therefore they marry and live like their genetic sex. However, living with this pretence affects their psyche. They may become depressed. Self-abusive behaviour is very common. Some may even try to commit suicide. Various studies have reported that transgender individuals are consistently being subjected to discrimination and violence.

Gender dysphoria is labeled as a psychiatric disorder and the DSM-IV diagnostic criteria for Transsexualism include (a) a strong and constant cross-gender identification (not for any perceived cultural advantages of being the other sex); (b) a persistent uneasiness with his/her sex or sense of incongruity in the gender role of that sex; (c) no concurrence with a physical intersex condition; and (d) clinically significant impairment in social, occupational, or other important areas of functioning. The transgender can undergo hormonal and surgical treatment available to modern medical that can improve their quality of life and also their slandered of living. Before operation or hormone therapy a person may require psychopharmacologic agents but afterwards they are usually not needed. Hormonal therapy consists of giving higher amount of cross sex hormones, i.e., estrogen, progesterone for MTF’s and testosterone for FTM’s. Since these are given in doses much higher than normally present in the body, it may lead to adverse effects like pulmonary embolism for those receiving higher amount of estrogen and acne and increased blood viscosity for those receiving large amount of testosterone. To reduce the dose of hormone, GnRH analogues can be used, which suppresses the release of endogenous sex hormones from the pituitary. Hortmonal therapy is mainly required to enhance the physical transition. Sex reassignment surgery for FTM’s involves mastectomy where female breasts are removed and the chest is shaped into a masculine form; hysterectomy where the uterus is removed; Bilateral Salpingo-oophorectomy (BSO) where both the fallopian tubes and the ovaries are removed and finally genital reconstruction is done by the help of phalloplasty and scrotoplasty operations. For an MTF, it involves vaginoplasty operation where a vagina with mucous membrane is created and for further feminization of one’s body. People may opt for breast augmentation and facial feminization surgeries (Sadock and Sadock 2008).

Now, there is a debate on when one should go for sex reassignment surgery. Some say this therapy should be postponed till the person reaches adulthood. This is because adolescents do tend to change their minds quite often. On the contrary, some believe that it should be done before puberty so that the child doesn’t have to suffer anxiety and depression usually faced by a transgender.  It is found is numerous occasion that the transgender individual does not experience the symptoms in adulthood. Since irreversible effects are produced due to the hormonal therapy, MTFs generally donate their sperms and FTMs go for cryopreservation of their egg.

Transgendered individuals have faced discrimination not only in medical institutions like hospitals but in legal fields as well. Some physicians, psychologists and psychiatrists consider that the main goal of treatment of gender dysphoria should be to convince transgendered individuals to remain in the gender of their genetic sex. This seems impossible for most of the transgendered individuals. This should not be the approach even after proper evaluation and the patient should be brought under a hormonal therapy and then only after further investigation, should be referred for SRS. Many transgender individuals have been diagnosed with HIV/AIDS and so transgender community health centres are coming up with excellent mental and medical health care check up systems. Also studies have shown that great promise in National HIV Behavioural Surveillance programme. The need for the physicians to be more educated about transgender came up when about 46% transgender participating in nation wide population control trial came up with such an opinion. Most legal systems recognise two traditional genders properly and thus the transsexuals may get discriminated in this context. These are not only related to family issues like marriage, inheritance of property but also others like insurance, medical benefits, etc. The extent of legal recognition varies from country to country. In the United Kingdom, government passed the Gender Recognition Act 2004, which gave full legal recognition and respect to the transgender people. Here, the applicant needs not have to undergo the Sex Reconstruction Surgery but he/she has to be a proven case of gender dysphoria disorder and ought to have lived for minimum of two years in the acquired gender. Additionally, the concerned individual must have a wish to live in the same throughout the rest of his/her life (Makadon et al. 2008).

Psychological research into transsexuals has not made much progress. Due to poor research tools and subjectivity of the acquired evidences (such as clinical interviews that often present the problem of circular reasoning, as prior knowledge of the subject often misleads the investigator into inferring something which may not be true all the time). Though the psychopathological aspect of gender dysphoria has not been much probed into because of lack of sufficient psychometric methods, well-established treatment methodology has been developed and can help transsexuals lead a happy and successful life like any other individual given that society and their family members do not show ignorance, irresponsibility and insensitivity to the situation.