Download Gender Identity Disorder: Am I Male or Female?”

Gender Identity Disorder:
Am I Male or Female?”
By Robert Brennan, M.A. MFTI
Apokata. Psychological Services
220 Montgomery Street, Suite 1098
San Francisco, CA 94103
www.ChristianMentalHealth.com
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Objectives for Today
1. Understand healthy gender identity
2. Undeveloped gender identity patterns
3. Develop compassion for those with
gender identity problems
4. Recovery from gender identity disorder
5. Church response to GID persons
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Characteristics and Symptoms in
Gender Identity Disorder
Definition of Gender Identity Disorder
 Disturbance in sexual desire
– Cause distress
– Interpersonal difficulties
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Definitions
 Gender Identity: Subjective awareness of
maleness or femaleness
 Gender Role or Behavior: Pattern of
outward behavior – most culturally
determined
 Sexual Orientation: Preferred sexual
attraction and object choice
 Cross-dresser: one who wears clothes
designed for the opposite sex.
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Definitions
 Eroticism: Arousal patterns and the
particular stimuli that causes arousal
 Homosexual: of, relating to, or characterized
by a tendency to direct sexual desire toward
another of the same sex.
 Intersexual: intermediate sexual characters
between a typical male and a typical female.
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Definitions
 Transgender: “Cross-dressing”- exhibiting
the appearance and behavioral
characteristics of the opposite sex. This is
often used in describing a transsexual.
 Transsexual: a person with a urge to belong
to the opposite sex that may be carried to the
point of undergoing surgery to modify the sex
organs to mimic the opposite sex.
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Definitions
 Transvestite: a person who adopts the
dress and often the behavior typical of
the opposite sex especially for purposes
of emotional or sexual gratification.
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DSM IV – Definitions
Diagnostic S Manual
Gender Identity Disorder
 A. Strong and persistent cross-gender
identification
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DSM IV
In Children – 4 or More:
 Repeated stated desire to be, or
insistence of being other sex
 In boys, preference for cross-dressing
or simulating female attire
 In girls, insistence on wearing only male
clothing
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DSM IV
 Strong and persistent preferences for
cross-sex roles in make believe play or
persistent fantasies of being the other
sex
 Intense desire to participate in the
stereotypical games or pastimes of the
other sex
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DSM IV
 Strong preference for playmates of the
other sex
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DSM IV
In Girls:
 Rejection of urinating in sitting position
 Assertion that she will grow male
genitals
 Assertion that she does not want to
grow breasts or menstruate
 Marked aversion toward normative
feminine clothing
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DSM IV
In Boys:
 Assertions that his male genitals are
disgusting or will disappear or:
– that it would be better to not have male
genitals
 Aversion toward rough and tumble play
 Rejection of male stereotypical toys,
games, activities
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DSM IV
In Adolescents and Adults
 Stated desire to be the other sex
 Frequent passing as the other sex
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DSM IV
 Desire to live or be treated as the other
sex
 Conviction that he or she has the typical
feelings and reactions of the other sex
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DSM IV
 Persistent discomfort with his or her
sex or sense of inappropriateness in
the gender role of that sex
 Preoccupation with getting rid of
primary and secondary sex
characteristics
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DSM IV
 Request for hormones, surgery or
other procedures to physically alter
sexual characteristics to simulate the
other sex
 Belief that he or she was born the
wrong sex
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DSM IV
 Disturbance is not concurrent with a
physical intersex condition
 Clinically significant distress or
impairment in social, occupational, or
other important areas of functioning.
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Note
 Photographs of individuals used to
illustrate Gender Identity Disorder
characteristics have been removed from the
next 5 slides to protect the identity of the
individuals.
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Prevalence
 Prevalence of Gender Identity Disorder
 M→F = 1 in 10,000
 F→M = 1 in 30,000
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Gender Identity Formation
Stages
Stage 1 (Birth to Four years old)
– Parental Same-Gender Attachment
Stage 2 (Kindergarten to Elementary
School)
– Social Same-Gender Attachment
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Gender Identity Formation Stages
Stage 3 (Elementary to Middle School)
– Social Opposite-Gender Attachment
Stage 4 (Middle to High School)
Social Same-Gender Attachment
Stage 5 (High School to College)
– Social Opposite-Gender Attachment
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Gender Identity Formation Stages
 Stage 6 (Beyond College & Marriage)
– Navigate a mutually nurturing committed
relationship through Marriage & Parenting
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Gender-Identity-Imprinting
Stage
 Imprinting: An Opportune-Window of time
for Gender Identity to take place
– Successful attainment: Secure Gender Identity
– Attainment failure: Incomplete Gender Identity
 When Imprinting period is passed, child
becomes more vulnerable in Gender Identity
Copyright © Melvin W. Wong, Ph.D.1999
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Interruptions in Gender
Development
1.
2.
3.
4.
5.
Childhood Traumatic Experience
Sexual Violation and Verbal Abuse
Opposite-Sex Peer Friendship
Same-Sex Peer Friendships
Breakdown of Family System
(Source: Melvin W. Wong, PhD)
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Family Tree Diagram
Father
Mother
Daughter
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Son-1
Son-2
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Healthy Relationship
Father
Mother
Daughter
Son-1
Son-2
Son separates from mom
for psychological
individuation successfully
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Healthy Relationship
Father
Mother
Daughter
Son-1
Son-2
Son attempts to attach
to father for GenderIdentity formation
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Unhealthy Relationship Begins
Father
Mother
Daughter
Son-1
Son-2
Son’s attempts to attach
to father was rebuffed
and he experiences
rejection and hurt
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Unhealthy Relationship
Defensive Detachment Begins
Father
Mother
Daughter
Son-1
Son-2
Son’s attempts to defend
against more pain from
rejection by defensively
detaching from father’s
relationship emotionally
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Unhealthy Relationship
Defensive Attachment Begins
Father
Mother
Daughter
Son-1
Son-2
Son has no choice but
to re-attach with mom
for emotional security
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Unhealthy Relationship
Defensive Attachment Continues
Father
Mother
Daughter
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Son-1
Son-2
Son has no choice but
to re-attach with mom
for emotional security
Forming Defensive
Attachment
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Unhealthy Relationship
Defensive Attachment Intensifies
Father
Mother
Daughter
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Son-1
Son-2
Son generalizes
defensive detachment
to defensively attach to
girls and women: Nonaggressive & softer
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Unhealthy Relationship
Defensive Attachment Intensifies
Father
Mother
Daughter
Girl 1
Girl 2
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Son-1
Son-2
Generalization
intensifies. Father
becomes a stranger
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Unhealthy Relationship
Defensive Attachment Intensifies
Father
Mother
Daughter
Girl 1
Girl 2
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Son-1
Son-2
Generalization
intensifies. Men are
unfamiliar
Girlfriend
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Unhealthy Relationship
Defensive Attachment Solidifies
Grandma
Father
Mother
Daughter
Men are objectifiedcurious-sexualized
Girl 1
Girl 2
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Son-2
Son-1
Girlfriend
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Unhealthy Relationship
Defensive Attachment Solidifies
Aunt 1
Grandma
Father
Mother
Daughter
Men are objectifiedcurious-sexualized
Girl 1
Girl 2
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Son-2
Son-1
Girlfriend
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Fathers of Gender Confused
Alcoholic
Mentally Abusive
Absent, remote, uninvolved
18%
28%
72%
Unaffirming
93%
(Source: Focus on The Family)
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Mothers of Gender Confused
Mentally Abusive
Unaffirming
28%
93%
(Source: Focus on The Family)
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Treatment
Therapeutic Approaches to Treatment of GID
• Gender Identity Disorder is an Identity
problem and not a sexual disorder per se
• While sexual issues are symptoms; the key
to treatment is to resolve developmental
issues
• The focus is in the area of Gender security
development
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Treatment
Therapeutic Approaches to Treatment of GID
 Different for each age group
 Younger the child, the easier & more effective
is the treatment
 Diagnose early
 Average referral is three and a half year-old
 Remember: Most are victims of sexual abuse
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Church Response to GID
 Reconcile personal gender phobia
 Create a safe environment for GID persons
to receive healing
 Share personal brokenness and gender
difficulties
 Include GID persons in Church life
 Seek to understand GID persons life
 Rejection / abuse is basis for GID
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Resources
 Exodus Int. web site:
http://www.exodusnorthamerica.org
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