III. Reflections on ‘Masculinity-Femininity’ based on Psychological Research and Practice in Intersex

Bibliographic Data

ID12260409
AuthorsLih-Mei Liao (Camden and Islington Mental Health and Social Care Trust in London), Lih‐mei Liao (Camden and Islington NHS Foundation Trust, corresponding author)
Year2005
Volume15
Issue4
Pages424-430
Publication date2005-10-03
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFeminism & Psychology (JOURNAL)
Journal identifiersISSN: 0959-3535 • E-ISSN: 1461-7161
PublisherSAGE Publishing (PUBLISHER • US)
DOI10.1177/0959-353505057614
OpenAlexW2091701066
LanguageEN
Citations received3
References cited14

I was recently asked by Carrie, a young woman who attends my clinic: ‘Is my football playing and my being bi and all that to do with the CAH or just me?’ According to current medical classification, Carrie is ‘intersex’, a term applied to people whose chromosomal, gonadal and/or genital characteristics do not clearly correspond to one of our categories of ‘male ’ and ‘female’. Intersex is associated with atypical differentiation of the reproductive system during embryonic and foetal life. The condition that affects Carrie is called congenital adrenal hyper-plasia or CAH for short. For these individuals, diminished function of an enzyme (usually 21-hydroxylase) hinders the ability of the adrenal gland to convert precursor molecules into cortisol and aldosterone while conversion to testos-terone remains normal. As the body pushes the adrenal gland harder to correct the low cortisol level, more and more testosterone is made. These mechanisms have two key sets of consequences for individuals with CAH. First, steroid replace-ment is required from birth – without this, CAH can be fatal. Second, the excess androgens are associated with atypically early physical maturation in boys, and presentation of ambiguous genitalia in girls. As a result of exposure to excess prenatal androgens, a baby girl with CAH may be born with a clitoris that is enlarged so that it resembles a small penis, and/or vaginal lips that are fused to give a scrotal appearance, and/or absence of the vaginal orifice. Internally though, baby girls with CAH have ovaries, uterus, and an upper vagina. Regardless of the degree of ‘masculinization’, it has been standard practice to assign them female and to surgically ‘correct ’ the genitalia early on. Genital surgery in infancy and childhood is currently the most contro-versial aspect of the medical management of intersex (see Kessler, 1998). The importance of girls and women with CAH to psychologists is obvious, for

Femininity · Masculinity · Sociology · Gender Roles and Identity Studies · Gender Studies · Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities · Psychology · Sexual Differentiation and Disorders

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