Sexual Psychology – Pop Culture Sexual Health Composition – Due Fri 12/3

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The Psychology of Human Sexuality, Second Edition. Justin J. Lehmiller. © 2018 John Wiley & Sons, Ltd. Published 2018 by John Wiley & Sons, Ltd. Companion Website: www.wiley.com\go\lehmiller2e

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CHAPTER OUTLINE

Introduction, 117 Biological Influences on Gender Identity and Sexuality, 119

Biological Sex Variations, 121 Psychosocial Influences on Gender Identity and Sexuality, 126

Social Interactions and Norms, 126 Physical Environments, 128 Media, 128

Variations in Gender Expression, 130 Transsexualism, 130 Cross-Dressing, 136 Other Identities, 137

Just How Different Are Men and Women?, 137 Sex Differences in Psychology, 138 Sex Differences in Sexuality and Attitudes Toward Sex, 138

Gender and Gender Identity

©iStockphoto.com/Sudowoodo.

Introduction

Gender is between your ears and not between your legs. Chaz Bono

If you were asked to name just one characteristic that is essential in order for someone to be considered a man, what would be it? If you were asked the same question with respect to what

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Figure 5.1 Chaz Bono is a female-to-male transsexual who received international media scrutiny upon announcing that he was transitioning into a man. Chaz and others like him are an important reminder than not everyone fits neatly into a two-category gender system. ©s_bukley, 2013. Used under license from Shutterstock.com.

makes someone a woman, what would you say then? I pose these questions to the students in my human sexuality course each semester and, invariably, the vast majority of them come up with the same two answers: men have penises and women have vaginas. The remaining students usually focus on other physical or biological differences (e.g., the presence of testicles vs. ovaries, production of testosterone vs. estrogen, etc.). Thus, most college students I have encountered seem to believe that what makes you male or female is what you have between your legs. While that is certainly part of the story, there is a lot more to it than that and the goal of this chapter is to get you to think differently about what makes someone a man or a woman and to recognize that not everyone fits neatly into one of these two categories.

Before we begin, it is useful to distinguish between the terms sex and gender. Although many people use these words interchangeably, it is important to recognize that they have very dif- ferent meanings and refer to separate aspects of the self. Sex is the term we use to categorize whether someone is biologically male, female, or intersex. There are three different dimensions of sex we will discuss momentarily: chromosomes, gonads, and hormones. In contrast, gender is a psychosocial term that encapsulates all of the psychological, cultural, and social character- istics we think of as belonging to men, women, and other gender groups. Thus, gender refers to our set of expectations about what makes someone masculine or feminine.

Related to the concept of gender are three other important terms that will come up repeatedly throughout this chapter and later in the book: gender identity, gender roles, and gender stereotypes.

Gender identity refers to an individual’s own psychological perception of being male, female, neither, both, or something in between. Although people’s gender identity is usually consist- ent with their biological sex, this is not always the case. Thus, someone with a biological sex of

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male could identify as female and vice versa. This is a form of transgenderism, a concept we will discuss at length later in this chapter.

Gender roles refer to a set of cultural norms or rules that dictate how people of a specific sex “should” behave. Gender roles create a set of expectations for the things that people of a given sex are supposed to believe and how they are supposed to act within a given culture.

Closely related to gender roles are gender stereotypes, which refer to overgeneralized beliefs about the qualities and characteristics of persons of a certain sex. Stereotypes about gender fall along several dimensions, including psychological traits, role behaviors, and occupations (Deaux & Lewis, 1984).

With these terms in mind, we will turn our focus to the development of gender identity. Spe- cifically, we will discuss biological, psychological, and social factors that affect how we come to know our own gender. Following that, we will discuss variations in gender expression and finish by addressing just how similar vs. different men and women actually are.

On a side note, we will use terms such as “male body” and “female body” throughout this chap- ter to refer to the overall set of physical characteristics that distinguish biological males from biological females. However, as mentioned above, not everyone who has a “male body” identifies as male, just as not everyone who has a “female body” identifies as female. Thus, keep in mind the very important distinction between these biological and psychological aspects of the self.

Biological Influences on Gender Identity and Sexuality

Our biological sex is a function of three separate components: our chromosomes, gonads, and hormone levels. These factors work together to differentiate the bodies and brains of biological males and females. See Table 5.1 for a summary of the typical sequence of biological events that occurs in each sex. Chromosomal sex refers to the specific combination of sex chromosomes contained within our genes. Chromosomal sex is determined at the moment of conception (i.e., when a sperm cell fertilizes an egg). Typically, egg cells carry a single X-chromosome, while sperm cells carry either a single X- or Y-chromosome. If the resulting combination is XX, fetal development will proceed toward the female form; if the resulting combination is XY, develop- ment will proceed toward the male form.

Gonadal sex refers to the specific gonads (i.e., ovaries vs. testes) present within the body. The gonads begin to develop in response to genetic signals approximately six weeks after concep- tion. Once developed, the gonads begin releasing sex hormones. Hormonal sex refers to the major class of hormones released by the gonads: estrogens (primarily released by the ovaries) or androgens (primarily released by the testes). As mentioned in chapter 4, men and women both produce a certain amount of each of these sex hormones, but the female body produces far more estrogens, while the male body produces far more androgens. As a fetus is developing, it is the presence or absence of these hormones that differentiates the internal and external sexual structures of the male and female body.

In addition to influencing development of the internal and external genital structures, hor- mones have a profound effect on how our brains develop in utero. Specifically, hormones can masculinize or feminize the brain before birth in such a way that it creates lifelong effects on our gender identity and sexual behavior. Compelling evidence demonstrating some of these effects comes from studies of rats, which have shown that changing early hormone exposure affects adult rats’ sexual interests and behavior. Scientists have tested this by castrating male rat pups immediately after birth and exposing female rat pups to testosterone immediately after birth. This is equivalent to changing hormone exposure prenatally in humans, because rats are born at a much earlier stage of development than we are. Researchers have found that

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castrated male rats tend to show feminine sexual behavior through their lives (Beach, Noble, & Orndoff,  1969). Specifically, when mounted by an intact (i.e., noncastrated) male rat, a cas- trated male rat will exhibit lordosis, a sexual posture that occurs naturally in female rats in which the back curves upward to assist in copulation. This effect persists even if the castrated rat is given testosterone injections later in life; however, if testosterone is administered within the first week after castration, lordosis behavior is unlikely to develop.

What about the female rats given testosterone injections? They typically exhibit masculine behavior throughout their lives (Whalen & Rezek, 1974). That is, testosterone-injected females will attempt to mount other rats, and when they themselves are mounted, they do not exhibit lordosis; in fact, these rats seem rather indifferent to such sexual advances. Taken together, these findings indicate that, at least in animal studies, there appears to be a critical period of development during which hormones “wire” the brain for sexual behavior.

One especially important area of the brain that appears to be affected by prenatal hormone exposure is the hypothalamus. As discussed in the preceding chapter, the hypothalamus is a portion of the limbic system located deep within the brain that plays an important role in regu- lating sexual behavior, among many other things. One portion of the hypothalamus in which there are reliable sex differences is the preoptic area (POA), which tends to be larger in adult men than adult women (Hofman & Swaab, 1989). Rat studies have found that the POA controls copulatory behavior (Balthazart & Ball, 2007) and that it undergoes a critical period, such that testosterone injections only affect its size until the fifth day after birth; injections beyond that have no effect on POA size (Rhees, Shryne, & Gorski, 1990). Another portion of the hypothala- mus that differs between men and women is the bed nucleus of the stria terminalis (BNST). The BNST tends to be larger in men (Allen & Gorski, 1990), perhaps also as a result of specific hormone exposure at certain stages of development. Research in humans suggests that size of the BNST is related to gender identity. Specifically, the number of neurons present in the BNST of male-to-female transsexuals more closely resembles the number found in biological females than biological males, while the size of the BNST of female-to-male transsexuals more closely resembles biological males than biological females (Kruijver et al.,  2000). This suggests that early hormonal exposure may potentially organize the brain toward a specific gender.

As you can see, chromosomes, gonads, and hormones are all linked to the development of our sexual and gender identities. In order to develop typical male and female bodies, brains, and behaviors, all of these factors must work together and build on each other in a very specific sequence. If anything falls out of that sequence, the end result can be very different. What hap- pens when things do not unfold according to the typical male or female schedule? The result is intersexuality.

Table 5.1 Typical sequence of biological sex differentiation.

Level of sex differentiation Male Female

Chromosomal sex XY XX Gonadal sex Testes Ovaries Hormonal sex Androgens Estrogens Sexual anatomy Fully developed penis and scrotum, as

well as their corresponding internal reproductive structures

Fully developed vulva, as well as its corresponding internal reproductive structures

Sexually dimorphic brain

Larger preoptic area and bed nucleus of the stria terminalis (BNST)

Smaller preoptic area and bed nucleus of the stria terminalis (BNST)

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Biological Sex Variations

Although people in most Western cultures think of biological sex as having two categories (i.e., male and female), the reality is that sex is much more complex. There are several variations on sex because some people are born with bodies and genitals that do not appear completely male or female, but rather have features of both. A person who possesses both male and female biological traits is intersexed. Although you may hear some intersexed individuals referred to as hermaphrodites, that term is generally not used anymore because it is considered outdated, offensive, and inaccurate. You may also see other sexuality texts refer to intersexed individuals as having “ambiguous” genitalia because their genitals appear to be somewhere in between a penis and a vulva however, keep in mind that any ambiguity is on the part of the perceiver. To intersexed persons, there is nothing “ambiguous” about what is between their legs.

Being intersexed is more common than most people realize. The prevalence of specific sex variations differs, but overall, intersexed individuals represent approximately 2% of live births (Blackless et al.,  2000). So much of what we know about the impact of biology on gender and sexuality comes from research on these individuals because they can tell us what effect chromo- somes, gonads, and hormones likely have in relation to gender identity and sexual expression. We will consider some of the most common sex variations in this section and discuss what they have told psychologists about the origin of gender. See Table 5.2 for a summary of these sex variations.

Klinefelter’s Syndrome Klinefelter’s syndrome is one of the most common sex variations, occurring once in every 1,000 male births (Blackless et al., 2000). It results when a Y-carrying sperm fertilizes an egg that possesses two X-chromosomes. Although they possess both the typical male (XY) and female (XX) chromosome combinations, individuals with Klinefelter’s syndrome are anatomi- cally male in terms of their genital appearance, but their testes are usually smaller than average and sperm production tends to be very low. In addition, their bodies often have feminized fea- tures, including increased breast tissue and a rounded body shape (Bock, 1993).

Figure 5.2 Prenatal hormone exposure is theorized to alter brain structures that contribute to both our gender identity and sexual orientation. ©Natalia Merzlyakova/123RF.COM.

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With respect to gender, individuals with Klinefelter’s syndrome tend to identify as male, although some adopt other identities (Intersex Society of North America, 2012). In terms of sexuality, same-gender attraction is no more common among Klinefelter’s males than it is among biological (i.e., XY) males; however, overall interest in sex tends to be low (Bock, 1993). Testosterone injections can enhance sexual desire and increase masculinization of the body among those who wish to pursue hormone treatment (Bock, 1993).

Turner’s Syndrome Turner’s syndrome is a less common sexual variation in which an individual is born with a single X chromosome. In such cases, the second sex chromosome is missing or damaged. Individuals with Turner’s syndrome have a feminine body appearance, although they tend to be shorter than average and typically have little breast development (Morgan, 2007). External genitals appear feminine, but internally the ovaries are underdeveloped and may only appear as streaks of tissue, which means that menstruation does not occur at puberty and sexual repro- duction is not possible (i.e., they are infertile; Morgan, 2007).

Table 5.2 Biological sex variations.

Type of variation Brief description Gender identity Sexuality

Klinefelter’s syndrome

XXY chromosome combination. Anatomic male with some female features. Low interest in sex.

Usually male Same-gender attraction no more common than it is among biological (i.e., XY) males

Turner’s syndrome Single X-chromosome. Feminine body and genital appearance, but no functioning internal reproductive structures. Sex life depends on when puberty is induced by physician.

Female Not linked to same-gender attraction

Complete androgen insensitivity syndrome

XY male insensitive to androgens. Feminine genital appearance. Usually not detected until puberty.

Female Most are attracted to men

Partial androgen insensitivity syndrome

XY male who does not respond completely to androgens. Genitals appear to be a mix of male and female structures.

Can be male or female Sexual attraction is variable

5-Alpha-reductase deficiency

XY male unable to convert testosterone to DHT. Possesses testes, but has feminized genital appearance until puberty.

Usually female during childhood, male starting at puberty

Most are attracted to women

Congenital adrenal hyperplasia

XX female with adrenal glands that produce excessive androgens. Masculinized genital appearance. Can also occur in XY males, but they are similar to unaffected males in most regards.

Usually female with masculine interests

Most are attracted to men, but prevalence of same- gender attraction is high

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Individuals with Turner’s syndrome usually identify as female and tend to have more stereotypically feminine interests (Boman, Mollet, & Albertsson-Wikland, 1998). Just like Klinefel- ter’s syndrome, Turner’s syndrome is not linked to same-gender attraction. Many of these women go on to lead active sex lives; however, the age at which puberty is induced via hormone injections (a necessity because no ovaries are present) has an important effect on how their sexuality devel- ops, and it is important that physicians do not delay its induction too long (Carel et al., 2006).

Androgen Insensitivity Syndrome Androgen Insensitivity Syndrome (AIS) occurs when a biologically male fetus is insensitive to the production of its own androgens. As a result, despite possessing the XY chromosome combination, testes, and high levels of masculinizing hormones, the end result is a body and genitals that have a feminine appearance. AIS can be either complete or partial (Androgen Insensitivity Syndrome, 2010). In cases of complete AIS, the child appears to be a typical female at birth and has a shallow vagina. A diagnosis of AIS is generally not made until adolescence when it is discovered that menstruation has not occurred, although it may be detected earlier if an undescended testicle appears as a mass in the groin or abdomen. Individuals with complete AIS are usually raised as girls and almost always adopt a female gender identity (Mazur, 2005). As adults, most become sexually active and the vast majority report sexual attraction to men

Figure 5.3 World running champion Caster Semenya became the focus of significant media attention after it was discovered that she has androgen insensitivity syndrome. Some people argued that she should not be allowed to complete as a woman because she is technically a chromosomal male. Intersex issues and sports have since become a huge source of controversy. Do we use biology, psychology, or both in making decisions about whether someone should compete against men or against women? ©Chell Hill (Own work) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons.

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(Wisniewski et al.,  2000). On a side note, you may have noticed that I have avoided talking about heterosexuality and homosexuality in relation to being intersexed because such labels are difficult to apply in these cases. For example, a person with complete AIS is technically a biological male with a (usually) female gender identity. So if that person is exclusively attracted to men, does that make this individual gay or heterosexual? In such cases, it is best to allow the individual to report their own sexual identity rather than to arbitrarily designate one.

Partial AIS usually results in an incomplete masculinization of the genitalia. Consequently, a child with partial AIS may possess genitals that are not clearly identifiable as male or female. In some cases, a penis does clearly develop, but the urethral opening may appear on the underside of the penis near the corona rather than at the tip of the glans (a physical variation known as hypospadias; Androgen Insensitivity Syndrome, 2010). Doctors and parents are often confused about how to raise children with partial AIS. A gender is usually “assigned” to the child and in some cases, the child’s genitals may be surgically altered to remove any perceived “ambiguity.” For an in-depth discussion of treatment guidelines for intersexed children, see the Digging Deeper 5.1 box. Gender identity and sexuality is more variable in cases of partial AIS. For example, while it is possible to identify as male and be attracted to women (Gooren & Cohen- Kettenis, 1991), other identities and patterns of attraction are possible.

5-Alpha-Reductase Deficiency Related to AIS is 5-alpha-reductase deficiency (5αRD). This occurs when a biologically male fetus is unable to convert testosterone into dihydrotestosterone (DHT) due to insufficient lev- els of the 5-alpha reductase enzyme. DHT is necessary for the development of male external genital structures. Thus, without DHT (or with levels lower than usual), the end result is a fem- inized genital appearance. Depending upon the amount of feminization, external appearance may be completely female, a mix of male and female structures, or incomplete male. Regardless of external appearance, however, male gonads are present internally.

In most cases, babies with 5αRD are raised as girls and adopt a female gender identity during childhood. However, upon reaching puberty, testosterone production ramps up and their bodies start to become more masculine. Specifically, the testes usually descend, the genital structures begin to grow into a small penis, and male secondary sex characteristics develop (e.g., chest and facial hair, deepening of the voice, etc.). At this point, most individuals with 5αRD switch from a female to male gender identity (Mendonca et al.,  1996). Those who switch to a male identity are usually sexually interested in women (Imperato-McGinley, Peterson, Gautier, & Sturla, 1979). Men with 5αRD may be capable of penetrative intercourse and produce viable sperm, but this varies across persons.

Congenital Adrenal Hyperplasia Congenital adrenal hyperplasia (CAH) occurs when a person’s adrenal glands produce exces- sive amounts of androgens from before birth throughout the individual’s life. This can happen in both men and women. In affected men, physical and psychological development follows the typical male pattern. However, affected women become more masculine both physically and psychologically. At birth, a female child with CAH will have genitals that appear to be either par- tially or (in some cases) completely masculine, although internally, female gonads are present.

Most biological females with CAH end up adopting a female gender identity; however, they tend to have interests that are more common among men (Meyer-Bahlburg, Dolezal, Baker, Ehrhardt, & New, 2006). For example, they express more interest in working with things (e.g., in areas like technology) than in working with people (Beltz, Swanson, & Berenbaum, 2011). In terms of sexuality, most females with CAH report attraction to men, but some studies have found higher rates of same-gender attraction and bisexual orientations (Meyer-Bahlburg, Dolezal, Baker, & New, 2008).

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Digging Deeper 5.1 Can Gender Really Be “Assigned” At Birth?

A few decades ago, psychologist John Money advanced his theiry in oender neltraoity. His idea was that with respect to gender, everyone is initially a blank slate. In Money’s own words: “It seems that every child is born with some predisposition to go both ways. Which way it will finally go is determined by its environment” (Brewington, 2006). Money put this theory to the test when he was contacted by a very concerned mother who did not know what to do after her son’s penis was destroyed during a circumcision that went horribly wrong.

Money advised the parents to raise their little boy, Bruce, as a girl. On Money’s advice, Bruce was castrated, renamed “Brenda,” and given female sex hormones during adolescence. Money recommended that gender affirmation surgery be performed at a later age to create a vagina. Dr. Money followed the case for years afterward and personally met with Brenda annually to eval- uate her progress. According to Money’s reports published in leading sex journals, Brenda’s tran- sition was a smashing success and the theory of gender neutrality had been supported. However, the facts of the case did not match what Money claimed.

In reality, Brenda did not see herself as a girl. She did not want to wear dresses and she preferred to play with boys. She felt depressed and confused, had a hard time fitting in, and later became suicidal. As a teenager, Brenda rebelled against the hormone treatments and refused the surgery to complete her transition. At that point, her parents told her the truth about what had happened. Shortly thereafter, Brenda adopted a male gender identity, started calling himself David, and eventually underwent surgery to become the man he felt he was always supposed to be.

The Brenda/David story is fascinating on multiple levels, but the main thing it tells us is that gender is not something that we can simply assign at birth. In David’s case, not only did his doc- tors and parents try to “teach” him a specific gender, but they modified his genitals and gave him hormone treatments. This was not enough to override his feeling that he was supposed to be a man, suggesting that gender identity is likely “wired” in our brains before birth.

This case, combined with a number of other studies suggesting a neurological basis for gender identity (e.g., Kruijver et al., 2000), has fundamentally changed the way physicians and families are approaching intersexed children. Traditionally, when a child was born with genitals that were not clearly male or female, the doctors and parents would “pick” a gender and perform genital- altering surgery to make the child’s body a match for their assigned sex (Bomalaski, 2005). This is problematic because many intersexed individuals switch away from their assigned gender iden- tity later in life and are upset to learn that their genitals were irreversibly altered without their consent. Numerous cases like this have led to a growing movement for intersex rights.

Biologist Milton Diamond (the whistle-blower in the Brenda/David case) has been at the fore- front of this movement and has put forth a set of treatment recommendations for intersexed children (Diamond & Sigmundson,  1997). His approach starts by considering these cases sexual “differences” or “variations” instead of “disorders” because there is nothing inherently pathological about being intersexed and there is no reason an intersexed person cannot live a completely nor- mal life. Diamond recommends avoiding genital-altering surgery in infancy, especially if the sole purpose is cosmetic and is not medically necessary. He also recommends providing ongoing coun- seling and support for intersexed children and their parents, communicating openly and honestly, avoiding secrecy, as well as refraining from creating any stigma or shame about the issue. Although Diamond has been advocating this approach for decades, there remains relatively little consensus today among medical experts regarding how specific intersex variations should be handled.

For more information on the intersex movement and treatment guidelines, check out the Intersex Society of North America website (www.isna.org).

Note: Reprinted with permission from ee and Pesyihioioy (www.lehmiller.com).

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What Do These Biological Sex Variations Tell Us About Gender Identity? Together, all of these sexual variations tell us that biology and genetics play an undisputable role in the development of both gender identity and sexuality. First, it should be clear that when biological events do not follow the typical male or female pattern, it is not always easy to predict the identity a person will adopt later in life. Second, out of all of the potential biological variables, prenatal sex hormone exposure may be the most important of all. For example, in both 5αRD and AIS, we have biological males with XY chromosomes and testes whose bodies do not get the full effect of androgen exposure. However, one of these cases usually results in a female identity (AIS) and the other in a male identity (5αRD). This is perhaps because in AIS, the entire body (including the brain) is not responsive to androgens, which means the brain never has an opportunity to become masculinized. In contrast, in 5αRD, the lack of DHT pre- vents external genital masculinization, but does not necessarily preclude masculinization of the brain. Thus, it may be the impact of hormones on the brain that explains why these sexual variations typically result in different gender identities. CAH also highlights the important role that prenatal hormones may play in organizing the brain toward a certain gender by showing that greater androgen exposure in women is linked to developing more masculine interests.

At the same time, however, these sexual variations also do not tell the entire story. For exam- ple, in the case of Turner’s syndrome, we see that a female gender identity can develop in the absence of a second sex chromosome, ovaries, and female sex hormones. Likewise, in the case of 5αRD, it would appear that a female gender identity can be learned at least temporarily during childhood. Thus, there is certainly room for psychosocial factors to contribute to the development of gender as well.

Psychosocial Influences on Gender Identity and Sexuality

Take a look at infant pictured on the next page. Can you guess this baby’s biological sex? If you are like most of my students, about half of you probably guessed male and the other half guessed female. In the absence of physical and environmental cues that “announce” a child’s sex (e.g., wearing the color pink versus the color blue), it is difficult to answer this question with any degree of certainty. As you will see below, there are a vast number of social factors that teach us about our gender identity and gender role at a very young age. These same factors then encour- age us to conform to a very specific set of gendered expectations throughout our lives.

Social Interactions and Norms

Social interactions are among the first things to shape our perceptions of gender, and interac- tions with our parents in particular are among the most influential. A child’s gender is seem- ingly very important to parents, given how “it’s a boy” and “it’s a girl” is often announced and celebrated before a child ever even comes into the world. If you have taken a course in devel- opmental psychology, you probably already know that from the moment a child is born, the way parents interact with that child is completely different depending upon whether it is a boy or a girl. As some particularly compelling evidence of this, dozens of studies have been conducted in which adult men and women were given the opportunity to interact with an infant that was presented as either male or female (for a review of the research in this area, see Stern & Karraker, 1989). In reality, all adults were interacting with the same infant. Researchers found that infants presented as male and female were often (but not always) treated differently, and these differences usually fell along very sex-stereotypic lines. For example, adults verbal- ized more and engaged in more nurturing play when the child was perceived to be a girl com- pared to a boy. Likewise, adults tended to choose dolls and other feminine toys when playing

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with girls, but trucks and tools when playing with boys. Thus, the simple knowledge of a child’s sex appears to prompt a set of beliefs about gender-appropriate behaviors and traits that can creep into social interactions, sometimes completely outside of conscious awareness (Rubin, Provenzano, & Luria, 1974). This may lead children to engage in gender-stereotypic behavior through a self-fulfilling prophecy in which parents’ expectations elicit and reinforce gendered behavior, effectively making gender stereotypes come true. Of course, in an age where more mothers are in the workplace and more fathers are becoming stay-at-home dads, things are changing somewhat, and there are certainly many parents who make a concerted effort not to teach their kids strict gender roles. However, gendered expectations for children persist, and they are often conveyed subconsciously.

Beyond parents, social interactions that occur in school with peers and teachers further rein- force these ideas about gender. For example, gender-segregated play begins very quickly in childhood and continues through adolescence. This means that boys typically play with other boys, and girls with other girls. Children who violate this norm are often looked down upon and have a hard time fitting in (as we saw in the Brenda/David case described in the Digging Deeper 5.1 box). Research shows that the more time children spend in sex-segregated play, the more gender-typed their behaviors become (e.g., girls playing “house” and boys playing super- hero games; Martin & Fabes, 2001).

Teachers play a vital role in reinforcing societal and cultural gender expectations among students. For example, teachers tend to be more tolerant of bad behavior in boys than in girls, and they tend to give boys more attention (Leaper & Friedman, 2007). Teachers also harbor ste- reotypes about the academic abilities of the sexes, such as believing that math comes easier to boys (Riegle-Crumb & Humphries, 2012). This can have important implications for students’ academic outcomes and ultimately their chosen career paths. Research has found that teachers’ beliefs about their students’ abilities subtly and unintentionally affects how well students do in school (e.g., some students may be given more time and attention than others; Rosenthal & Jacobson,  1968). This is essentially another self-fulfilling prophecy taking place. Also, to the extent that teachers subtly encourage mathematical and science abilities in their male students

Figure 5.4 Can you guess the sex of this child? It is much harder to predict an infant’s sex when they are not surrounded by gendered social cues. ©Paul Hakimata/123RF.COM.

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but not in female students, it may lead fewer women to pursue careers in these areas because they do not have the opportunity to develop their skills to the same level.

Socialization within religious contexts further reinforces gender role beliefs. The writings and teachings of many religious traditions propagate themes of male dominance and female submissiveness. Likewise, many religions do not permit women to serve as clergy or in lead- ership roles, which can send a very visible and powerful statement that men are the ones in charge. Consistent with this idea, research finds that religiosity is typically a strong predictor of holding traditional gender-role attitudes (e.g., Morgan, 1987).

Physical Environments

The physical environment in which we grow up can have a profound influence on our gender role beliefs. For instance, what is your earliest memory of what your bedroom looked like as a child? If you do not remember, try to track down a picture of your room and see what sort of gendered cues it contained. Probably, many of you will find that your room was blue (if you are male) or pink (if you are female). You will probably also see that the clothes you wore and the selection of toys at your disposal was fairly typical for your gender. Speaking of toys, check out the toy section the next time you are in a big store. You will likely notice that the store has made it glaringly obvious which aisles are meant for boys and which are meant for girls. As a child walking down the toy aisle designated for your gender, you are told in a not-so-subtle way what your likes and interests “should” be. At the same time, these toy aisles put pressure on parents to select gender-appropriate gifts for their children.

Media

Last but not least, the media plays a part in conveying gender role information to children. By the time most students graduate from high school, they will have spent more hours watching TV than they spent at school (American Academy of Child & Adolescent Psychiatry,  2011). When you factor in time spent on the Internet, at the movies, playing video games, and lis- tening to music, there is simply no comparison for the amount of influence the media has.

Figure 5.5 Teachers’ expectations for their students’ performance can influence academic achievement and later career interest in gender-stereotypic ways. ©michaeljung, 2013. Used under license from Shutterstock. com.

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When it comes to sex and gender, the media tends to present men and women in highly gender- stereotyped ways. As just a few examples of this, see Table 5.3 for a look at what some of the research on this topic has found. These stereotypical portrayals do not go unnoticed by children and adolescents either. For example, studies have found that holding more traditional gender- role beliefs is associated with more frequent watching of music videos (Ward, Hansbrough, & Walker, 2005) and toy commercials in children and adolescents (Pike & Jennings, 2005).

As you can see, gender-role information and expectations are conveyed to us from the moment we come into being through a number of different sources. Repeated exposure to these ideas leads us to internalize these gendered beliefs, which then become self-perpetuating. However, despite the amount of pressure exerted by these sources to conform to a specific gen- der identity and role, not everyone follows their socially prescribed role. This often happens for intersexed individuals, but it also happens for transgender persons.

Figure 5.6 The physical environments that surround us as children cue us in as to what our interests and activities “should” be. ©HONGQI ZHANG/123RF.COM.

Table 5.3 Gendered presentations of men and women in the media.

An analysis of G-rated films released between 1990 and 2005 revealed that only 28% of speaking characters were female (this included both real life and animated characters). Likewise, 83% of narrators in these films were male. An analysis of films across all rating categories released between 1990 and 2006 found that women were more likely to be presented as parents and as part of a committed relationship compared to men. This same analysis found that women were more than five times as likely to be depicted in sexy and revealing attire than men. Together, these results suggest that women are usually only presented in either a very traditional or highly sexual manner. An analysis of female leads from 13 of the most popular G-rated films released between 1937 and 2006 found that all of the women were valued and praised for being beautiful and that their primary focus was finding love. An analysis of 1,034 TV shows spanning 12 different networks airing in 2005 found that male characters outnumbered female characters two to one in children’s programming. In addition, female characters were more than four times as likely as male characters to be dressed in a sexy fashion.

Source: Smith (2008).

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Variations in Gender Expression

The general term for someone whose behaviors, physical appearance, or identity is not consist- ent with societal gender expectations is transgender. Transgender is a broad umbrella term that has been defined by different people in different ways; generally speaking, though, we are talk- ing about instances in which one’s gender identity or expression differs from social expectations for a given sex. By contrast, those whose gender identity and expression is consistent with their biological sex are often referred to as cisgender. In this section, we will consider two of the most common transgender variants: transsexualism and cross-dressing (i.e., transvestism). In my experience teaching about human sexuality, I have found that students frequently confuse the terms transsexual and transvestite, so before you go any further, check out the Digging Deeper 5.2 box for a more in-depth understanding of these terms.

Transsexualism

Transsexual persons have a gender identity that does not match their biological sex. Thus, a male-to-female (MTF) transsexual is someone who is born male but perceives herself as female, whereas a female-to-male (FTM) transsexual is born female but perceives himself as male. When the incongruence between one’s physical sex and one’s psychological gender identity results in persistent unhappiness and discomfort, this is known clinically as gender dysphoria.

Figure 5.7 The most popular and iconic female characters in television and film, such as Cinderella, tend to perpetuate stereotypical notions of how women are “supposed” to be. ©dean bertoncelj, 2016. Used under license from Shutterstock.com.

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Digging Deeper 5.2 Cross-Dressing and Gender-Bending: Separating Science Fact from Fiction.

Every year around Halloween, people descend upon movie theaters to catch midnight screen- ings of The Riiky Hirrir Piitlre hiw. This film tells the story of Dr. Frank-N-Furter, a mad scientist and self-described “sweet transvestite” from the planet Transsexual. Throughout the film, Frank dresses as a woman and has sex with anything (human, alien, or creature) that moves. The film is definitely an experience, to say the least. However, as a social psychologist, I cannot help but wonder what kind of impressions this movie leaves on audiences when it comes to the subject of transgenderism. Do viewers walk away thinking transvestites and transsexuals are one and the same? Do they think transvestites—like Frank—are willing to have sex with anyone or anything? Let us set the record straight on these important questions.

First, and this is a key point, a transvestite engages in cross-dressing for purposes of sexual arousal, but does not have a desire to change sexes (Langstrom & Zucker, 2005). In other words, transvestites dress as members of the other sex because it turns them on. While some dress entirely as the other sex, others wear only a single piece of the other sex’s clothing (e.g., a male transvestite might wear just panties or a bra). Transvestism is often (although not always) a type of netiesh, where a certain object or action is necessary in order to “give yourself over to absolute pleasure” (if I may borrow a line from Riiky Hirrir).

In comparison, transsexuals do not necessarily cross-dress because they find it arousing (although research suggests that at least some do; Blanchard, 2005); instead, transsexuals most commonly report feeling as though they are trapped in the body of the “wrong” sex (Cole, O’Boyle, Emory, & Meyer, 1997). It is for this reason that transsexuals sometimes undergo surgical proce- dures to change their body’s appearance to a form consistent with their psychological identity. If I may borrow one more line from Riiky Hirrir, Dr. Frank-N-Furter’s advice to a transsexual would probably be: “Don’t dream it, be it.”

Figure 5.8 There are a lot of misconceptions about transvestites and transsexuals. This stems at least in part from inconsistent and misleading media portrayals. ©jackmalipan/123RF.COM.

(Cintinled)

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Digging Deeper 5.2 (Continued)

As for Riiky Hirrir’es depiction of Frank’s sexuality, viewers are likely to walk away thinking that he is bisexual or perhaps pansexual (more on this in chapter  6); in reality, however, most transvestites are heterosexual, married men (Doctor & Prince,  1997). Moreover, most of these men hide their transvestic tendencies from the rest of the world, as opposed to putting them on display as Frank does in this film. Most transvestites engage in this behavior in private and do not cross-dress when they leave home. This tends to be a private, momentary activity that is accom- panied by immediate sexual gratification. In fact, transvestites are often so secretive about their behaviors that they do not even let their romantic partners know about them.

In short, feel free to enjoy a late-night screening of The Riiky Hirrir Piitlre hiw, but keep in mind that most of what this film has to say about human sexuality is a matter of science fiction.

Note: Reprinted with permission from iienie in Reoatiineshixes (www.scienceofrelationships.com).

Up through the DSM-IV-TR (American Psychiatric Association, 2000), an entry called gen- der identity disorder (GID) was listed. In the DSM-5, published in 2013, the GID name was replaced with “gender dysphoria,” and is now diagnosed according to the following criteria:

● Incongruity between one’s expressed gender and one’s physical characteristics. ● A desire to get rid of one’s primary and secondary sex characteristics, and to have the pri-

mary and secondary sex characteristics of the other sex. ● A desire to be the other sex and be treated as such. ● A belief that one’s feelings and behaviors are typical of the other sex. ● Clinically significant distress or impairment in addition to feelings of incongruence. Gender

dysphoria is not considered a clinical problem unless the patient is distressed.

Although the “disorder” label has been dropped and gender dysphoria is only diagnosable to the extent that there is significant distress or impairment, the fact that this diagnostic label exists at all is highly controversial among professionals in the field and transsexuals themselves (Mayer-Bahlburg, 2010). For one thing, many people believe that including gender dyspho- ria in the DSM serves to stigmatize all transsexuals. Additionally, the primary treatments for gender dysphoria are gender affirmation surgery (in adults) and puberty-blocking drugs (in adolescents). However, these are not psychiatric treatments, and this, some have argued, calls into question whether this should even be thought of as a psychological issue (McHugh, 2004). Moreover, many transsexual persons are not distressed because of their identity, and being transsexual does not necessarily prevent one from leading a normal life. On the other hand, some argue that a diagnostic category is valuable in that it offers the opportunity for health insurance coverage for treatment, guides research in the area, and prevents transsexuals from being misdiagnosed with other labels (Mayer-Bahlburg, 2010).

Relatively few studies have explored the prevalence of transsexualism, and those that have are subject to limitations because many transsexuals keep their identities hidden as a result of widespread prejudice and discrimination. However, transsexualism is thought to be relatively rare, estimated at less than 1 in 10,000 among those whose birth sex is male and less than 1 in 30,000 among those whose birth sex is female (Zucker, Lawrence, & Kreukels,  2016). These numbers indicate that transsexualism is less common than being intersex and that MTF trans- sexuals significantly outnumber FTM transsexuals.

The origin of transsexualism is not well understood, although some research suggests that there may be a genetic component, with twin studies finding that concordance rates for

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gender dysphoria are higher for monozygotic (identical) twins than they are for dizygotic (non-identical) twins (Zucker et al., 2016). This suggests that transsexualism is heritable to some degree. In addition, while transsexualism is not linked to any kind of chromosomal or physical anomalies, a review of the accumulated scientific literature has found that certain brain struc- ture and brain wave patterns are associated with transsexualism, suggesting a neurological basis that potentially stems from prenatal hormone exposure (Smith, Junger, Derntl, & Habel, 2015). However, these results are far from definitive and more research is needed because most studies to date have included very small samples and some have produced inconsistent results. Another major limitation of this research is that the hormone therapy many transsexuals are taking can change their brain structures (Hahn et al., 2015), thereby making it unclear whether the results of some studies have simply been reflecting outcomes of hormone treatment.

Studies have typically found that a majority of FTM transsexuals report attraction to women (Chivers & Bailey, 2000), while a majority of MTF transsexuals report attraction to men (Rehman, Lazer, Benet, Schaefer, & Melman, 1999). Thus, most transsexuals appear to be attracted to people who match their biological sex. This presents a complication for research- ers studying the origins of transsexualism, because scientists have to try and untangle corre- lates of gender identity from correlates of sexual orientation. Interestingly, it is worth noting that some research has found that the brain structures of MTF transsexuals are different for those who are attracted to women compared to those who are attracted to men (Guillamon, Junque, & Gomez-Gil, 2016). This supports a long-held belief among sex researchers that there may be different “types” of transsexualism that can be distinguished based upon their pattern of sexual attraction. This research also suggests that transsexualism may have multiple origins.

We must await future research to learn more, but for now, please keep in mind that the transsexual community is incredibly diverse, and patterns of sexual attraction and sexuality labels vary widely. This means that FTM and MTF transsexuals can be attracted to men or to women, they can be bisexual, they can have sexual interests outside of the traditional gender binary, or they can be asexual (i.e., lacking in sexual interest). A few psychologists have also argued that some transsexual persons may be aroused by the prospect of seeing themselves as the other sex (Blanchard, 2005). To be perfectly clear, research does not suggest that all or even most transsexual persons experience this—just that some do. This is known as autogynephilia when a biological man is aroused by the mental image of being a woman and autoandrophilia when a biological woman is aroused by the mental image of being a man. This arousal can stem from the thought of completely transitioning to the other sex or from a partial transition in which one possesses a mixture of both male and female anatomic features (e.g., having breasts and a penis; Blanchard, 1993). While autoandrophilia has been the subject of relatively scant scientific and public attention, the concept of autogynephilia has attracted great controversy. For example, many in the trans community argue that it does not reflect their lived experiences and worry that it sexualizes and pathologizes trans women. Fully exploring this controversy is beyond the scope of this textbook; however, for a closer look at this issue, I recommend Galileo’s Middle Finger by Alice Dreger, which carefully reviews the research on this topic and documents the major controversies.

Gender Affirmation Surgery As mentioned in the preceding section, the primary treatments offered to gender dysphoric adults are not psychiatric in nature. In fact, providing psychotherapy alone as a way of relieving distress of this nature is generally ineffective. Instead, gender dysphoric adults tend to be better served by attempts to bring their body in line with their gender identity. Many options are now available for accomplishing this, thanks to recent medical advances.

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One increasingly common option is gender affirmation surgery, previously known as sex reassignment surgery. At present, it is not possible to simply walk into a doctor’s office and request sex reassignment. There is usually a lengthy prequalification process that consists of (1) psychological evaluations and interviews to determine the individual’s motivations and identify potential conflicts; (2) a transition period of up to one year where the patient lives as a member of the desired gender for all intents and purposes; and (3) hormone therapy to begin adjusting the patient’s body to match their desires (e.g., MTF transsexuals would be given estrogen to reduce body hair and stimulate breast growth, while FTM transsexuals would be given testosterone to increase growth of body and facial hair and halt menstruation). Genital surgery is usually only performed after all of the preceding criteria have been met.

For MTF transsexuals, the main surgical process involves removing the penis and scrotum and reusing the skin to create a functional vagina with labia (vaginoplasty). In this surgery, the urethra is rerouted to permit urination as a biological female would experience it. Surgical procedures such as breast implants, Adam’s apple reduction, and voice box operations (to raise voice pitch) may also be performed, depending upon the patient’s wishes.

For FTM transsexuals, the surgical process usually includes a complete hysterectomy (i.e., removal of the ovaries, fallopian tubes, and uterus) and mastectomy (i.e., removal of the breasts). Genital modification can be accomplished in one of two ways. One possibility is a metoidi- oplasty, in which the clitoris is turned into an erectile phallus (Perovic & Djordjevic,  2003). Specifically, the clitoris is straightened and lengthened, moved slightly to approximate the location of a typical male penis, and the urethra is routed through it. Because the clitoris is homologous to the penis and contains actual erectile tissue, the result is a phallus capable of erection through sexual stimulation. However, the size of the phallus may not be sufficient for penetrative intercourse because it is only a few centimeters long. If a larger phallus is desired, a phalloplasty may be performed instead in which skin taken from other parts of the body is transplanted to the genital area to create a functional penis with the urethra running through it. Although the end result is much larger with a phalloplasty, these phalluses are not capable of erection on their own because they contain no erectile tissue. As a result, a penile implant must be inserted (for more on penile implants, see chapter  13). In both metoidioplasty and phalloplasty, the labia are usually sutured together to create a scrotum, and testicular implants may be inserted.

In both FTM and MTF surgeries, the original sensory pathways in the genital region are retained and reused as much as possible to maximize the ability to be sexually responsive afterward. Indeed, orgasm is often possible after such surgeries (Lawrence,  2005; Lief & Hubschman,  1993). However, the ability to orgasm usually declines among MTF transsexu- als, but increases among FTM transsexuals. One caveat to this is that FTM transsexuals given metoidioplasty tend to have more orgasmic capacity afterward than those given phalloplasty, because metoidioplasty retains more of the original nerve pathways.

The outcomes of gender affirmation surgery are generally favorable. Genital surgeries can produce results that are not only functional, but appear very physically accurate, which helps to explain why levels of satisfaction are generally very high post-surgery (Lief & Hubschman, 1993). Even in cases where orgasmic capacity is lost or declines, sexual satisfaction is usually still higher after surgery than it was before. While the vast majority who undergo gender affirma- tion procedures experience improvements in quality of life, about 1 in 5 do not; reports of regrets are uncommon, though (Zucker et al., 2016).

Treatment of Gender Dysphoric Children Gender dysphoria is increasingly being recognized in children by parents and doctors alike. For gender dysphoric children who have not yet gone through puberty, there is a small but growing trend to administer puberty-blocking drugs, medications that halt the development of secondary

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sex characteristics (Spiegel, 2008). In FTM boys, these drugs inhibit breast development, increase height and muscularity, and prevent menstruation. In MTF girls, these drugs inhibit growth of facial and body hair, restrict growth of the Adam’s apple, and maintain a higher pitch voice. In effect, these drugs prevent bodily changes that can be difficult to adjust surgically once puberty has taken place. Puberty blockers are taken until about age 16, when the individual begins taking hormones of the desired sex. If desired, genital surgery can follow once the individual reaches adulthood. This treatment approach has not been around long, with puberty blockers having been administered only since 2004, but some early data have found that such treatment is linked to improvements in psychological well-being (De Vries et al., 2014).

At the same time, this treatment approach is highly controversial. For one thing, little is known about the long-term health implications of blocking puberty due to the newness of this treatment, and some scientists are concerned about potential implications for fertility, as well as neurological development. Some have also questioned whether children can truly compre- hend the effects of these drugs, which produce physical changes that cannot easily be undone— among other things, the hormonal changes produced by these drugs may affect bone density. Compounding these concerns is the publication of multiple longitudinal studies finding that, among children referred to clinics for gender dysphoria, these feelings “desist” (i.e., end) for a majority of them by adulthood (e.g., Drummond et al., 2008; Steensma et al., 2013). In fact, this research suggests that the modal (i.e., most common) outcome for children who meet criteria for gender dysphoria is that they grow up to be gay or bisexual cisgender adults Thus, it is not always clear in which cases childhood gender dysphoria will persist long-term and, therefore, when puberty-blocking treatment is indicated. Although intensity of gender dysphoria is one of the strongest predictors of whether these feelings persist (Steensma et al., 2013), it remains difficult to accurately predict which children will remain gender dysphoric long-term, which makes some doctors hesitant to prescribe puberty-blocking treatments.

Attitudes Toward Transsexualism In most parts of the world, sex is viewed as a binary construct. That is, people tend to think that you can be either male or female, with nothing in between. Generally speaking, if you have a penis you are expected to be a man, whereas if you have a vulva you are expected to be a woman. Visit the Your Sexuality 5.1 box to consider just a few of the many ways that society not-so-subtly tells you how to behave based upon your genital anatomy. Persons who violate these social norms are typically marginalized. Prejudice against transsexuals and transgen- der persons more broadly (known as transphobia) is very common. Transphobia is strongly correlated with homophobia (i.e., prejudice against nonheterosexuals), but people appear to feel more negatively about trans persons than they do about gay men, lesbians, and bisexuals (Norton & Herek, 2013). In addition, men tend to be more transphobic and homophobic than women. Transphobia has a number of important consequences. For one thing, it leads many trans persons to keep their identities secret. For another, research has found that transsexual- ism is linked to elevated rates of depression, anxiety, and suicidality (Zucker et al., 2016), which are thought to stem in large part from their all-too-frequent experiences with transphobia.

That said, some cultures adopt a much broader view of gender and are more accepting of per- sons who do not fit neatly into the gender binary. One example of this would be the two-spirit phenomenon documented in dozens of Native American tribes (Jacobs, Thomas, & Lang, 1997). The idea behind two-spirit is that both male and female spirits are presumed to occupy a single person’s body. Historically, two-spirits were respected in their tribes and in many cases were revered and held important social positions; however, this has changed somewhat as Christian values have crept into many tribes and displaced traditional beliefs (Murg,  2011). Aside from the two-spirit concept in North America, third genders exist in many other parts of the world, including India, Pakistan, and Indonesia.

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Cross-Dressing

Another subtype of transgenderism is cross-dressing. Cross-dressing is a broad term that refers to the act of wearing clothing typically associated with the other sex. One variant of cross-dressing is transvestism, which refers to the act of obtaining sexual gratification from wearing clothing of the other sex (for more on transvestism, see the Digging Deeper 5.2 box and chapter  14). However, not everyone who cross-dresses does so because it is a turn-on.

Your Sexuality 5.1 Where Do Transgender and Intersexed Individuals Fit in a Gender Binary World?

Most societies fail to accept or accommodate people who do not fit neatly into the male or female category. Just think about it—many things in this world are divided into men’s versus women’s. Consider the following examples:

● Almost all public restrooms, as well as locker rooms at gyms and fitness clubs, are labeled “Men” or “Women.”

● Most school and professional sporting leagues, not to mention the Olympics, are divided into male-only and female-only categories.

● Clothing stores sell clothes for men/guys or clothes for women/ladies. Very few items are explicitly labeled “unisex.”

● Toy stores do not explicitly label their aisles “boy” or “girl,” but it is usually obvious which toys are “meant” for which sex based upon their location and the surrounding color scheme.

What other examples can you think of where society presumes that everyone is part of the gender binary? Can you imagine how stressful and challenging it might be to fall outside of this binary world- view, especially when it comes to something as simple as using the bathroom in a public setting?

Figure 5.9 Drag queens are men who dress up as women for show. Unlike male-to-female transsexuals, drag queens do not truly wish to change their sex. ©Peter Kim, 2016. Used under license from Shutterstock.com.

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Thus, keep in mind that while the terms “cross-dresser” and “transvestite” are overlapping, they are not synonymous. Also, please note that the term “transvestite” is considered offensive in some parts of the transgender community. The use of this term in this book is not meant to be offensive and is only used to distinguish the subtype of cross-dressers who experience arousal as a function of their behavior.

Aside from sexual arousal, some cross-dressers engage in this behavior for performance art. Examples of this would be drag kings (women who dress as men) and drag queens (men who dress as women), people who cross-dress primarily for entertainment or as a career. On a side note, although cross-dressing of this nature often seems to coincide with being gay or bisexual, this is not always the case. Heterosexuals can and do participate in drag.

Other Identities

Transgender persons may adopt a number of other identities beyond those already men- tioned, although somewhat less is known about these identities from a scientific standpoint. Collectively, these identities can be described as non-binary or genderqueer, both of which are umbrella terms for gender identities that go beyond the two-gender system of male and female; however, these umbrella terms can also used to describe one’s own personal gender identity, too. For example, androgynous persons possess both masculine and feminine psy- chological characteristics simultaneously (please note that this does not necessarily imply being intersexed). Bigender, trigender, and pangender persons possess two or more gender identities and may change their gender role behavior depending upon the context. Agender and nongender individuals think of themselves as being genderless. Genderless persons used to be referred to as asexual; however, the term asexual is now used exclusively to represent a lack of interest in partnered sex (see chapter 6). This is far from a comprehensive list, but as you can see, transgender is a broad term that encompasses a multitude of perspectives on gender.

Just How Different Are Men and Women?

To round out this chapter, let us consider one of the most controversial topics in this area: sex differences. Most of you are probably well aware of the stereotype (and very popular book of the same name) “Men are from Mars, Women are from Venus.” Stories about sex differences appear frequently in the popular media, from front page headlines, to rela- tionship advice columns, to self-help books. The media is pushing the idea that men and women want fundamentally different things when it comes to sex and relationships, and also that men and women use completely different language to communicate. These ideas are selling to the tune of millions of books and billions of dollars. But is this really true? Are men and women so different as to suggest that they are from different planets? Although people have staked out very different positions on this topic, a review of research in this area makes it clear that the Mars/Venus analogy is a hyperbole. The reality is that while there are indisputably some differences between men and women, these differences are typically smaller than we have been led to believe, and sociocultural factors offer a very plausible explanation for many of them. In other words, men and women are not from dif- ferent planets, but they are certainly socialized very differently. Below, we will examine the degree to which men and women are similar or different with respect to several aspects of their psychology and sexuality and consider some of the explanations that have been offered for the differences observed.

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Sex Differences in Psychology

In this section, we will consider the degree to which sex differences exist in personality, level of aggression, and communication style. With respect to personality, many studies have compared men and women in the context of The Big Five personality factors of openness to experience, con- scientiousness, extraversion, agreeableness, and neuroticism. To review the definitions of these traits, see Table 1.4 in chapter 1. Generally speaking, research has yielded sex differences that are either inconsistent or very small for extraversion, openness to experience, and conscien- tiousness; in contrast, larger and more reliable sex differences have emerged with respect to agreeableness and neuroticism (Costa, Terracciano, & McCrae, 2001; Feingold, 1994). Thus, the main areas men and women seem to differ in terms of personality concern the fact that women tend to be (1) more trusting and compliant, and (2) experience more anxiety and negative affect than men. Although we cannot say for sure why these personality differences exist, the fact that sex differences in the Big Five vary considerably across cultures (Schmitt, Realo, Voracek, & Allik, 2008) suggests that such differences are a product of culture and society, not genetics.

With respect to aggression, there has been a longstanding assumption that men are more aggressive than women in almost all ways, and most early research in social psychology seemed to support this idea. However, recent work has found that there are sex differences in cer- tain types of aggression. Specifically, men are more inclined than women to aggress in very direct and physical ways, while women are more inclined than men to aggress in more indi- rect and verbal ways (e.g., by spreading rumors or gossip; Hess & Hagen,  2006). In addition, when you take into account contextual factors such as provocation (i.e., when someone incites another person to become aggressive, such as through taunting), sex differences in aggression become much smaller (Bettencourt & Miller,  1996). At least part of the reason that men are more aggressive overall is that they are provoked more often. Together, these findings suggest that men may not be genetically predisposed to be more aggressive than women; rather, it may be that society expects men and women to act out their aggression in very different ways and allows men more opportunities to be aggressive.

Lastly, in terms of communication style, studies have found differences in terms of how men and women communicate verbally and nonverbally. For instance, men tend to interrupt their conversation partners more than women; however, the degree to which this difference is observed varies across different social situations, which suggests that this is a situational effect rather than a stable individual difference between men and women (Anderson & Leaper, 1998). As another example, women tend to be better at men in decoding the emotion behind facial expressions (Hall & Matsumoto, 2004). Although there are numerous other studies suggesting that women have a greater ability to decode nonverbal cues such as this, it is not clear whether women are “hardwired” to pick up on others’ emotions or if this is simply a reflection of the fact that we expect women to be more sensitive to other people’s feelings than men.

Sex Differences in Sexuality and Attitudes Toward Sex

Research has also examined how men and women differ with respect to their attitudes toward sex, their sexual behaviors, and their sexuality. For instance, men have more favorable atti- tudes toward “hooking-up” and are more willing to have sex with someone they have just met (Petersen & Hyde,  2010). In terms of sexual behaviors, a few of the biggest areas men and women differ include frequency of masturbation and use of pornography. Perhaps not surpris- ingly, men masturbate more, and utilize far more porn, than women (Petersen & Hyde, 2010). In addition, men report having a higher sex drive and more daily thoughts about sex (Fisher, Moore, & Pittenger,  2012). However, there is no truth to the common stereotype that men

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think about sex every seven seconds. Just think about it: if the average guy is awake for 16 hours and thinks about sex every 7 seconds, he would have 8,228 sexy thoughts per day! The reality is that when asked to tally their daily thoughts about sex, men average 34 sexual thoughts per day, or about twice per hour (Fisher et al., 2012). In contrast, women average about 19 sexual thoughts per day, or just over once per hour.

We will come back to these and a number of other sex differences throughout the book; however, as they come up, keep in mind that there are many possible explanations for them and they are not necessarily a function of men having a stronger libido than women, as many people assume. For instance, the evolutionary perspective argues that men and women have evolved distinct mating strategies due to differences in the parental investment required to create a child (i.e., it is more work for women than it is for men). One implication of this is that men should have more permissive attitudes toward casual sex than women because it is more reproductively advantageous for men to have multiple partners. In contrast, the sociocultural perspective argues that most sex differences are a reflection of patriarchal gender roles and a sexual double standard that inhibits female sexuality. As some evidence of this, survey research has found that women report having had more sexual partners when they think their answers will be anonymous compared to when they think their answers might become known to others (Alexander & Fisher, 2003). Not only does this finding highlight the important role of psycho- social factors on women’s reported sexual attitudes and behaviors, but it tells us that some sex differences may be overstated due to social pressure on women to underreport their true sexual experiences. We will revisit some of the competing explanations for sex differences in sexual attitudes and behaviors in chapter 7.

One other important area men and women seem to differ is in their sexuality. Specifically, research suggests that women have more erotic plasticity than men. That is, female sexuality is more flexible and responsive to social and cultural factors than male sexuality. Evidence for this comes from a variety of studies indicating that (1) women have a nonspecific genital response

Figure 5.10 Are men inherently more aggressive than women, or does society just promote and accept male aggression more than female aggression? ©sportpoint, 2016. Used under license from Shutterstock.com.

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pattern (i.e., they demonstrate genital arousal in response to a wider range of sexual stimuli; Chivers, Rieger, Latty, & Bailey, 2004), (2) women are more likely to report a bisexual orienta- tion (Chandra, Mosher, & Copen, 2011), (3) women’s sexual identity is more likely to change over time (Diamond, 2008), and (4) women are far less likely to develop fetishes or become fix- ated on one specific sexual object. Why is this the case? As with all of the other sex differences discussed above, it is not entirely clear. However, the evidence seems to point to differences in how sexuality is organized in the brains of men and women. In the following chapter, we will begin our discussion of sexual orientation paying specific attention to how it is expressed dif- ferently in men and women and considering some of the possible reasons why.

Key Terms

sex gender gender identity gender roles gender stereotypes chromosomal sex gonadal sex hormonal sex lordosis hypothalamus intersexed

Klinefelter’s syndrome Turner’s syndrome androgen insensitivity

syndrome (AIS) 5-alpha-reductase deficiency

(5αRD) congenital adrenal

hyperplasia (CAH) self-fulfilling prophecy transgender cisgender

transsexual gender dysphoria gender affirmation surgery vaginoplasty metoidioplasty phalloplasty transphobia two-spirit cross-dressing transvestism

Discussion Questions: What is Your Perspective on Sex?

● In competitive and professional sports, should participants be grouped according to biologi- cal sex or gender identity? Is it ever necessary for sports to categorize participants based on sex and gender?

● Are puberty-blocking drugs an appropriate treatment for children experiencing gender dys- phoria? Why or why not?

● Do you think that most sex differences in attitudes and personality are a function of bio- logical differences between men and women or a result of different social interactions and expectations?

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