Projective test findings for boys with gender disturbance: Draw-A-Person Test, IT scale, and Make-A-Picture Story Test.

With 66 boys, aged 3 yr. to 17 yr. who were referred for potential gender-identity disorder, this study examined intrapsychic manifestations as reflected in their projections to the Draw-A-Person Test, the Brown IT Scale for Children, and the Shneidman Make-A-Picture Story Test. Without access to these projective test findings, an independent clinical psychologist provided a diagnostic rating on the severity of gender disturbance on a five-point diagnostic rating scale, based on clinical interviews of the child and his parents and a systematic behavioral assessment based on previously published normative standardization data. For each of the three projective measures, significant correlations were found between the clinician ratings on severity of gender disturbance and the test findings in the feminine direction (D-A-P, r = .44; IT Scale, r = .64; M-A-P-S, r = .35). These results validated the use of intrapsychic phenomena of fantasy and self-perception as measured by these projective tests for the diagnosis of gender disturbance in male children and adolescents.

The relationship of measures of sex-typed play with clinician ratings on degree of gender disturbance.

Forty-nine boys, aged 3 to 11 years, who were referred for an evaluation of a potential gender identity disorder of childhood, were assessed with a standardized in vivo behavioral observation of sex-typed play in an alone condition and with the parent-report Bates-Bentler Games Inventory. Without access to these measures of sex-typed play, an independent clinical psychologist rated each of the subjects on a 9-point scale that indicated the degree of severity of a gender disturbance, based upon child and parent interviews and a complete psychological test battery. The percentage of feminine play in the behavioral observation procedure was found to be correlated significantly with the clinician rating of degree of gender disturbance (r = .55). The Games Inventory was found to differentiate significantly the gender-disturbed boys from the nonclinical reference group on its feminine/preschool games, masculine nonathletic games, and athletic games subscales and on its composite index of feminine play preference; however, only the composite index (and none of the 3 subscales) was correlated significantly (r = .34) with degree of severity of gender disturbance.

Relationship of maternal report of feminine behaviors and extraversion to clinician's rating of gender disturbance.

50 boys, aged 3 to 16 yr., referred for psychotherapy for a gender-identity disorder were assessed by two parent-report instruments completed by their mothers--The Gender Behavior Inventory for Boys for preadolescent subjects and a modified form of the Parents' Evaluation of Child Behavior. Without access to these data, an independent clinical psychologist provided a diagnosis of the severity of a gender disturbance on a 5-point rating scale, based on clinical interviews and a psychological test battery. The gender-disturbed boys scored significantly above the mean of the standardized normal boys on the Gender Behavior Inventory for Boys Feminine Behavior subscale and significantly below the mean on the Extraversion subscale of the Gender Behavior Inventory. The ratings of severity of gender disturbance were significantly correlated .34 with Feminine Behavior subscale scores and -.50 with the Extraversion subscale scores. On the Parents' Evaluation the number of observed feminine behaviors listed was significantly correlated .57 with rated severity of gender disturbance but not with the Feminine Behavior subscale scores on the Gender Behavior Inventory.

Differentiation of adolescent activity participation.

The sex typing or lack of it among 133 adolescent activities was investigated. Twenty-seven percent (32) of the activities on an Adolescent Activity Questionnaire showed very clear participation differences for male and female adolescents (11 to 18 years old). The initial two factors extracted in a principal components factor analysis were easily interpreted as feminine and masculine activities. Discriminant function analysis of 15 items from the first three factors yielded an 8-item function on the basis of which every sample member was correctly classified as male or female. Masculine activities included more sports-related activities and activities dealing with mechanics and building, whereas feminine activities were domestic in nature and included more sedentary activities (e.g., reading, writing in diaries).