Behavior Problems and Psychiatric Diagnoses in Girls with Gender Identity Disorder: A Follow-Up Study.

This study evaluated the presence of clinical range behavior problems and psychiatric diagnoses in 25 girls referred for gender identity disorder (GID) in childhood (mean age: 8.88 years) at the time of follow-up in adolescence or adulthood (mean age: 23.2 years). At follow-up, three (12%) of the girls were judged to have persistent GID based on DSM-IV criteria. With regard to behavior problems at follow-up, 39.1% of the girls had a clinical range score on either the Child Behavior Checklist or Adult Behavior Checklist as rated by their mothers, and 33.3% had a clinical range score on either the Youth Self-Report or the Adult Self-Report. On either the Diagnostic Interview for Children and Adolescents or the Diagnostic Interview Schedule, the girls had, on average, 2.67 diagnoses (range: 0-10); 46% met criteria for three or more diagnoses. From the childhood assessment, five variables were significantly associated with a composite Psychopathology Index (PI) at follow-up: a lower IQ, living in a non-two-parent or reconstituted family, a composite behavior problem index, and poor peer relations. At follow-up, degree of concurrent homoeroticism and a composite index of gender dysphoria were both associated with the composite PI. Girls with GID show a psychiatric vulnerability at the time of follow-up in late adolescence or adulthood, although there was considerable variation in their general well-being.

Troubled meditations on psychosexual differentiation: reply to Hegarty (2009).

P. Hegarty (see record 2009-09998-015) offered several critiques of the articles by G. Rieger, J. A. W. Linsenmeier, L. Gygax, and J. M. Bailey (see record 2007-19851-006) and K. D. Drummond, S. J. Bradley, M. Peterson-Badali, and K. J. Zucker (see record 2007-19851-005) that were published in a Developmental Psychology special section entitled "Sexual Orientation Across the Lifespan," guest-edited by C. J. Patterson and R. C. Savin-Williams (2008): (a) reliance on a "disease paradigm" (i.e., the use of "medicalizing" language) of lesbian-gay-bisexual-transgender issues at the expense of a "stigma paradigm," (b) endorsement of a developmental linkage between childhood sex-typed behavior and later gender identity-sexual orientation, and (c) various sociophilosophical and applied matters pertaining to the diagnosis of gender identity disorder in children. In this reply, we address these 3 criticisms and argue that an interdisciplinary approach, informed by multiple paradigms, will most certainly facilitate, not impede, the discovery of answers to many questions about psychosexual development for which data are currently lacking.

A follow-up study of girls with gender identity disorder.

This study provided information on the natural histories of 25 girls with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 8.88 years; range, 3-12 years) and at follow-up (mean age, 23.24 years; range, 15-36 years) were used to evaluate gender identity and sexual orientation. At the assessment in childhood, 60% of the girls met the Diagnostic and Statistical Manual of Mental Disorders criteria for GID, and 40% were subthreshold for the diagnosis. At follow-up, 3 participants (12%) were judged to have GID or gender dysphoria. Regarding sexual orientation, 8 participants (32%) were classified as bisexual/homosexual in fantasy, and 6 (24%) were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. The rates of GID persistence and bisexual/homosexual sexual orientation were substantially higher than base rates in the general female population derived from epidemiological or survey studies. There was some evidence of a "dosage" effect, with girls who were more cross-sex typed in their childhood behavior more likely to be gender dysphoric at follow-up and more likely to have been classified as bisexual/homosexual in behavior (but not in fantasy).