Chapter 4: Theories on development

There are many theories that have been developed to describe the development of one's gender identity.  In this chapter, we will cover both psychoanalytic and social theories of gender development.  We will also discuss what happens when one's gender identity does not match up with his or her biological sex, a condition known as gender dysphoria (previously referred to as gender identity disorder).

Please note:  As has already been discussed, there is an important difference between ‘sex’ and ‘gender’, and they should not be used interchangeably.  However, this is a modern distinction that was not realized during the time that many of the original theories of gender development were being created.  As such, many of the theories we’ll discuss in this chapter do conflate the terms ‘sex’ and ‘gender’.

Sigmund Freud (1856-1939) was an Austrian physician who, along with colleagues such as Josef Breuer, sought to explain common physical ailments as being caused by an unrecognized psychological disturbance.

"Man Lying on the Sofa" by SHVETS Production is in the Public Domain, CC0

To better understand Freud’s concept of gender identity, it’s helpful to review his overall theory regarding personality.   Essentially, he believed that our conscious state of being, i.e., our awareness of our thoughts, feelings, attitudes, etc., constitute only a small percentage of our actual existence.   Instead, a much larger component of our selves exists at the unconscious level, to which we do not have direct access.   (His psychoanalytic therapy techniques were thus designed to uncover what our unconscious is trying to tell us).   According to Freud, there are three components to personality: id, ego, superego.

The id, which is completely at the unconscious level, is driven by the pleasure principle, which seeks immediate and maximum gratification of our most base desires, e.g., sex and aggression.  Since we are not aware of these unconscious desires, the id leaks out libidinal energies in ways that our conscious mind can begin to interpret.

The ego straddles the divide between our conscious and unconscious awareness and is driven by the reality principle, which recognizes that we cannot act directly on the impulses generated by our id.   For example, society would quickly devolve if everyone was constantly seeking sex and aggressing against others.   Instead, through sublimation, the ego transforms these desires into more socially appropriate behaviors, such as an artist drawing nude portraits or an athlete becoming a boxing champion.

Finally, the superego also straddles the divide between our conscious and unconscious awareness and is driven by the morality principle, which is essentially our moral conscience.  The superego is responsible for making us feel guilty for social and moral transgressions as well as making us feel proud for appropriately channeling our base desires.

As such, Freud attempted to describe one's gender identity as the result of competing impulses deriving from our unconscious mind.  

 Freud's primary contribution to gender identity development was his belief that we progress through five stages of psychosexual development, starting at birth and up through our adolescent years. Each of these stages focuses on erogenous zones, or those areas of our bodies from which we derive sexual pleasure. 

• Oral stage (birth to 2 years):  focus is on the mouth and suckling behavior

• Anal stage (2-3 years):  pleasure is derived from being able to control our bowel movements

• Phallic stage (4-5 years):  focus is on one’s external genitalia

• Latent stage (6-13 years):  this represents a period of sexual dormancy (sexuality is inactive)

• Genital stage (13+ years):  pleasure is now derived from shifting our sexual desires onto others

 Of particular importance to gender identity development, according to Freud, is how boys and girls handle unconscious conflicts regarding feelings towards their parents in the phallic stage.  During this stage of development, boys must confront the Oedipus Complex, in which boys have sexual desires for their mothers and view their fathers as potential competitors for the mother’s affection.  (Recall that this all occurs at the unconscious level).  Boys recognize that their fathers are aware of their desire for the mother and harbor fear that the father will attempt to thwart the relationship.   This is referred to as castration anxiety.  Successful resolution in this situation is for the boy to identify with the father and vow to seek out a new female figure in his life in the form of a wife.

"Man Putting His Shoulder Around Boy While His Other Hand Is Inside His Pocket" by Kaysha is in the Public Domain, CC0

Girls also face a similar dilemma during the phallic stage known as the Electra Complex.  Essentially, girls harbor secret desire to be with their father and view their mother as competition.  However, it is also during this stage that girls recognize that they, unlike boys, do not have a penis, which causes them great concern.  As a result, girls develop penis envy.  Successful resolution in this situation for the girl is to identify with the mother and vow to seek out a penis of their own in the form of a husband.

According to Freud's theory, the Oedipus complex has a significant impact on the development of male identity, as the resolution of the Oedipus complex is said to lead to the formation of a stable male identity. In resolving the Oedipus complex, the male child must renounce his unconscious desires for his mother and identify with his father as a means of acquiring a masculine identity and resolving feelings of rivalry and jealousy.   While the Oedipus complex has been widely criticized and rejected by contemporary psychologists and theorists, it remains a significant concept in psychoanalytic theory and has had a lasting impact on our cultural understanding of male development and identity.

Similarly, the Electra complex has a significant impact on the development of female identity as the resolution of the Electra complex is said to lead to the formation of a stable female identity. In resolving the Electra complex, the female child must renounce her unconscious desires for her father and identify with her mother as a means of acquiring a feminine identity and resolving feelings of rivalry and jealousy.

Critics argue that these theories are overly reductionistic and fail to take into account the complex, dynamic, and context-dependent nature of human development and identity. Moreover, some researchers have pointed out that they are based on a limited sample of privileged, white, upper-class Europeans which does not accurately reflect the experiences and identities of individuals from diverse backgrounds and cultures.  They also argue that they reinforce patriarchal and gender-stereotyped attitudes towards masculinity and femininity and that they fail to account for the diversity of human experience and identity.

Despite these criticisms, both the Oedipus complex and the Electra complex continue to be widely studied and debated and remain influential concepts in psychoanalytic theory and popular culture. By continuing to critically engage with and re-evaluate the concepts of the Oedipus and Electra complexes, we can gain a deeper understanding of the dynamic relationships between gender, identity, and development.

Although Freud was obviously instrumental in transforming psychology into an everyday concept, it is important to note that he (and his theories) were not beyond some pretty valid criticisms.  Foremost, many scholars note how misogynistic Freud’s theories were, meaning that he held a very negative and diminished view of women.   Plus, his theories rely on the existence of the unconscious, which given that we don’t have direct access to it, means it is difficult if not impossible for any empirical studies to be conducted regarding its true influence over our conscious thoughts and behaviors.   Ironically, although Freud helped to popularize the field of psychology, if his theories were put forth today they would not be given any serious consideration, if any consideration at all.

With these criticisms in mind, not everyone was keen to follow Freud's theories and perspectives exactly as he proscribed.  Many extended the framework of how our unconscious mind influences our overall development but addressed the key criticisms of many of Freud's specific theories.  As such, those individuals who believed in the unconscious but took a different approach from Freud were referred to as psychodynamicists.

One such critic was Karen Horney (1885-1952).  She was one of the first German women admitted to medical school where she specialized in psychiatry.  Originally an Orthodox Freudian, she eventually became disillusioned with Freud’s emphasis on sexuality in general, and on his theory of penis envy specifically.

Unlike Freud, Horney rejected the idea that gender differences were solely biologically determined and instead emphasized the role of cultural and social factors in shaping gender roles and expectations.  Horney argued that cultural ideals of femininity and masculinity created a “tyranny of gender” that limited individuals and reinforced gender stereotypes. She believed that societal pressure to conform to traditional gender roles led to feelings of anxiety, frustration, and low self-esteem in both men and women.

Horney also recognized the impact of gender inequality and advocated for the rights of women. She believed that women's oppression was rooted in patriarchal structures and that equality between the sexes could only be achieved through societal change.

Horney heavily criticized the male bias that Freud and others promulgated in their theories.  She believed that our social interactions growing up were more important for shaping our identities and personalities than was our handling of unconscious, biological instincts.  To counter the notion that females suffer from penis envy, she developed the concept of womb envy, contending that the male envy of pregnancy, childbirth, and motherhood gives rise to an unconscious tendency to devalue women.

Penis envy suggests that female psychosexual development is characterized by feelings of inadequacy and frustration caused by the lack of a penis. According to Freud's theory, girls initially see themselves as having the same anatomy as boys, but when they realize that they lack a penis, they experience feelings of inferiority and resentment.

Penis envy is thought to drive girls towards a desire for a penis, or the equivalent (such as power, status, or achievement), as a means of compensating for their perceived lack. This theory has been widely criticized and challenged, both for its lack of empirical evidence and for its sexist and heteronormative assumptions.   Contemporary psychologists and psychiatrists have largely discredited penis envy as a valid concept, and it is not widely accepted or used in modern psychological or psychiatric theory.

Womb envy is a psychoanalytic theory that suggests that male psychosexual development is characterized by feelings of inadequacy and frustration caused by the lack of a womb. According to this theory, boys initially see themselves as having the same anatomy as girls, but when they realize that they lack a womb and the ability to bear children, they experience feelings of inferiority and resentment.

Womb envy is thought to drive boys towards a desire for a womb, or the equivalent (such as nurturing and caregiving abilities), as a means of compensating for their perceived lack. This theory is similar to the concept of penis envy but is less well-known and less widely discussed.

Like penis envy, womb envy is a controversial and disputed concept and it is not widely accepted or used in modern psychological or psychiatric theory.  For the most part, contemporary psychologists and psychiatrists have largely discredited both penis envy and womb envy as valid concepts.  Instead, current understanding of gender and sexual development focuses on a more nuanced and complex understanding of gender identity, gender expression, and sexual orientation that acknowledges the diversity of human experience and does not rely on outdated or reductionist theories.   As such, modern psychiatrists do not have a replacement for either of these concepts as they are no longer considered to be relevant or useful in understanding human gender and sexual development.

Psychoanalytic theories relied on the notion that our ability or inability to resolve unconscious conflicts during our psychosexual stages of development was responsible for our gender development.  In contrast, social learning theories are based on the assumption that "gendered" development is primarily the result of social factors of which we are consciously aware.

These theories, as applied to gender, are largely based on Albert Bandura's social learning theories more generally.  Bandura is the Stanford professor perhaps most well-known for his Bobo Doll studies conducted back in the 1960s in which children imitated the behavior of adult role models.  In these studies, children were placed in a room in which an adult was interacting with an inflatable punch toy.  In half the cases, the adults would gently push and tap the toy; in the other half, the adults would aggressively beat, kick, and hammer the toy.  Later, when the child was placed in a separate room where the same punch toy was present, children were significantly more likely to interact with the toy in the same manner they had observed the adult figure doing so.

In general, social learning theory is a psychological theory that explains how individuals acquire new behaviors, attitudes, and values through observation and imitation of others. It suggests that people learn from observing the actions and consequences of others as well as from direct experience, and that this learning occurs in a social context. 

Social learning theory suggests that people pay attention to what others are doing, remember what they see, try to imitate it, and are motivated to do so based on the perceived outcomes or rewards. Social learning theory also incorporates the idea that individuals have cognitive, behavioral, and emotional self-regulatory processes that influence their learning.

This theory has been applied in many different areas, including education, psychology, marketing, and more. For example, in education, social learning theory has been used to explain why peer-led group work can be effective in facilitating learning and why role models can be powerful in shaping behavior. In psychology, it has been used to explain why aggression and other problematic behaviors can be learned through observing others and helps to provide a framework for understanding how individuals acquire and maintain new behaviors, attitudes, and values through the observation and imitation of others, as well as through direct experience and self-reflection.

An interesting component to social learning theory is that, if our environment changes, then the social factors that influence our development can also change.  According to Bandura, children progress through four stages while forming their understanding of gender identity.

The first stage is attention.  In this stage, boys and girls simply observe and pay attention to the behaviors of others in their environment, particularly their parents, noting general similarities and differences between males and females.  The second stage is memory.  In this stage, the observations previously made regarding such behavior is committed to memory.  The third stage is imitation.  In this stage, children start to imitate or reproduce the behaviors they have observed, with boys more likely to imitate the behaviors of other males in their environment and girls more likely to imitate the behaviors of other females in their environment.  The last stage is motivation.  In this stage, boys and girls intentionally engage in behaviors they think will produce the desired consequences by doing so, such as boys being praised for engaging in traditionally masculine activities and girls being praised for engaging in traditionally feminine activities based on their prior observations.

From an observational perspective, Bandura noted that children were more likely to imitate the behaviors of their same-sex peers.  For example, Bandura (1961) noticed that boys would more readily imitate aggressive behavior if committed by another male but not if committed by another female.  This is largely driven by the principles of operant conditioning in which boys and girls are rewarded for engaging in behaviors that are considered gender appropriate and punished for engaging in behaviors that are not considered gender appropriate. 

It is in this arena that children also start to gain an understanding of gender roles.  Gender roles consist of behaviors that are most frequently associated with one sex versus the other and which can be readily observed in social environments.   For example, there have been traditional differences in the frequencies in which men and women have divided household chores, engaged in child-care activities, and other such tasks.  According to the evolutionary perspective, biological differences are responsible for the formation of gender roles and help explain why men are typically more dominant whereas women are typically more nurturing, and that these differences would be difficult if not impossible to change.   According to the biosocial perspective, however, these differences are due to social and cultural norms which shape the behaviors of men and women as they grow up and are thus capable of change.

Social learning theory suggests that individuals can learn new behaviors by observing others and the consequences of their actions. If a behavior is consistently followed by positive reinforcement (e.g., praise, rewards), individuals are more likely to repeat that behavior in the future. Conversely, if a behavior is consistently followed by negative consequences (e.g. punishment, criticism), individuals are less likely to repeat that behavior.

Social learning theory has been applied to a wide range of fields, including education, therapy, and criminal justice, and has been used to explain a variety of behaviors, including aggression, substance use, and prosocial behavior. It has also been incorporated into other psychological theories, such as cognitive-behavioral theory and social cognitive theory.

Social learning theory can be applied to explain how individuals learn and internalize gender roles, expectations, and stereotypes. According to this theory, individuals learn about gender through observing and imitating others in their social environment, as well as through the reinforcement of gender-typed behaviors.

For example, a child who observes their parents or peers consistently rewarding boys for rough-and-tumble play and punishing girls for being too aggressive may develop a gender schema that associates masculinity with physical aggression and femininity with passivity. This learning process can then influence the child's subsequent behaviors and attitudes towards themselves and others based on gender.

Social learning theory also suggests that individuals may reinforce gender roles and expectations through their own behavior and reinforcement of others. For example, a teacher who consistently praises boys for their athletic abilities and girls for their kindness may reinforce gender stereotypes and reinforce the gender schema of students.  Overall, social learning theory highlights the role of the social environment and the power of observation, imitation, and reinforcement in shaping individuals' gender identities and behaviors.

Critics of social learning theory have pointed out that Bandura’s model focuses solely on behaviors and not on any thoughts or feelings that children have associated with those behaviors.  Do children feel a sense of pride for engaging in gender appropriate tasks?  Do they feel shame for engaging in gender inappropriate tasks?  Also, unlike other stage models of development, there is no recognition of how old children are at each stage of this model or whether children progress through it in a similar manner.  When playing on the playground, do children of the same age focus on the same things—watching the mechanics of kickball versus the social interactions of the children engaged in the game?

To address these concerns, others specifically incorporated the important role of cognition in the formation of one’s gender identity.  Many cognitive theories of gender development are based on Jean Piaget's stage-theory of cognitive development, which suggests that children progress through age-related qualitative changes of cognitive understanding as we develop.

Lawrence Kohlberg (1927-1987) was an American psychologist who similarly theorized that children develop a sense of gender identity in cognitive stages.  In 1966, Kohlberg proposed a cognitive-developmental theory which focused specifically on the thoughts that children formulate regarding what constitutes a gender construct.  Qualitative changes in a child’s cognitive functioning are directly associated with their changing understanding of sex and gender.

According to Kohlberg, children develop their understanding of gender identity and gender roles through a process of socialization, in which they learn and internalize gender-related norms and expectations from their parents, peers, and other social institutions. He argued that this process occurs in stages, and that children progress from a basic awareness of gender and gender differences to a more sophisticated understanding of gender roles and their cultural and social implications.

Around 2-4 years of age, children form a gender identity when they start to recognize that there are two sexes, that they are one of those two sexes, and that others can be labeled as being one of those two sexes.  For example, a boy realizes that he is a boy and that his friend Tom is also a boy whereas his sister Kate is a girl.  However, given the limited cognitive abilities of children of this age, these labels are based primarily on a person’s physical appearance.  Boys typically wear jeans and have short hair; girls typically have longer hair and wear skirts and dresses.  From the perspective of a child this age, if a boy were to grow out his hair and put on a skirt, he would become a girl.

"Kids Posing in Casual Clothes" by Antoni Shkraba is in the Public Domain, CC0

 Around 4-6 years of age, children’s cognitive capacity has increased enough to the point where they recognize that a person’s sex is fixed.  Thus, gender stability is the recognition that a boy will grow up to be a man and that a girl will grow up to be a woman.   Children also have rather rigid interpretations of gender behaviors during this stage.

The final stage of gender identity development is gender constancy, in which the child now recognizes that changes to someone’s physical appearance does not alter that person’s sex.  In other words, a boy could have longer hair and still remain a boy and a girl could put on jeans and still remain a girl.  According to Kohlberg, gender is thought of as a cognitive construct instead of being formed by social or cultural norms.

Kohlberg's work on gender identity and gender role development was influential in shaping our understanding of how children develop a sense of self and gender, and how gender influences behavior, attitudes, and values. However, like his theory of moral development, his work on gender has been criticized for being overly cognitive and for overemphasizing the role of individual development at the expense of the cultural, historical, and social contexts that shape gender identity and gender roles. Despite these criticisms, Kohlberg's contributions to our understanding of gender identity and gender role development remain important and continue to be studied and discussed in the field of psychology and beyond.

 Again, please note that Kohlberg should have used the term “sex” instead of “gender” in each of the above stages of development.

Cognitive developmental theory, specifically the work of psychologist Jean Piaget and developmental psychologist Lawrence Kohlberg, can be applied to the study of gender development. These theories suggest that children's understanding of gender develops over time as they move through different stages of cognitive development.

According to Piaget's theory of cognitive development, young children initially view gender as a simple, physical characteristic. However, as they mature and reach the concrete operational stage, they begin to understand gender as a more complex, social category that can vary across individuals and cultures.

Kohlberg's theory of moral development, on the other hand, suggests that children's understanding of gender roles and expectations also evolves as they progress through stages of moral reasoning. Kohlberg proposed that as children mature, they move from a simple, preconventional understanding of gender roles to a more complex, postconventional understanding that recognizes the social and cultural construction of gender.

Overall, cognitive developmental theory suggests that individuals' understanding of gender is not static, but rather evolves and changes over the course of childhood and adolescence as their cognitive abilities and moral reasoning develop. This highlights the importance of considering the developmental context when studying gender development and the role of cognitive processes in shaping individuals' gender identities and behaviors.

As an extension of cognitive theories of gender development, in the 1980s American psychologist Sandra Bem (1944-2014) proposed the Gender Schema Theory which asserts that children learn about male and female roles from the culture in which they live.  A criticism of both the social and cognitive theories of gender development is that they limit the extent to which children can vary from the same-sex role models in their environments.  By focusing on what aspects of gender identity a child finds most relevant, Bem’s (1981) gender schema theory offers a broader range of gender expression.

Gender schema theory relies on schemas.  According to Bem (1981), “A schema is a cognitive structure, a network of associations that organizes and guides an individual’s perception.  A schema functions as an anticipatory structure, a readiness to search for and to assimilate incoming information in schema-relevant terms” (p. 355).  As children grow up, their concept of gender is tied directly to their self-esteem and forms a core aspect of their identity.  There is an understanding that one’s sex may or may not align with their gender identity.  The manner in which their individualized notion of their gendered identity is either consistent or inconsistent with societal expectations for males and females results in sex typing, or “the process by which a society thus transmutes male and female into masculine and feminine” (Bem, 1981, p. 354).

In terms of gender identity, individuals fall under one of four categories:

• Sex-typed individuals:  process information consistent with their sex
• Cross-sex-typed individuals:  process information inconsistent with their sex
• Androgynous individuals:  process information related to both sexes
• Undifferentiated individuals:  struggle to process information from either sex

To discourage the application of rigid gender stereotypes as a child develops, Bem suggests limiting the amount of sex typing that children are exposed to so that they feel comfortable forming a gender identity that they are most comfortable with as opposed to what some societal and cultural norms may dictate is appropriate.

Gender schema theory is a cognitive framework that explains how individuals acquire, organize and apply gender information in their social environment to form their gender identity. According to this theory, gender schemas, or mental frameworks about gender-based traits, behaviors, and roles, develop early in life through observation and interaction with others, and guide subsequent processing of gender-relevant information. The theory suggests that individuals use gender schemas to categorize themselves and others, and that this categorization affects their thoughts, feelings, and actions in gendered situations.

Gender schema theory proposes that children learn gender roles and expectations from their social environment and that this learning influences their behavior and perceptions. For example, a child who consistently observes men playing with trucks and women playing with dolls may develop a gender schema that associates trucks with masculinity and dolls with femininity.   Often these schemas include masculine traits such as assertiveness, dominance, competitiveness, physical strength, and independence, as well as feminine traits such as emotional expressiveness, nurturing, submissiveness, physical delicacy, and dependence.

As children grow up, their gender schemas continue to shape their understanding and processing of information about gender, influencing their attitudes and behaviors towards themselves and others based on gender. This can lead to the reinforcement of gender stereotypes and gender-based biases.  However, gender schema theory is not deterministic and individuals can challenge and change their gender schemas as they interact with new experiences and information.

Several variations on the term ‘gender’ have become much more common recently.   For example, the term cisgender refers to individuals whose gender identity matches up with their assigned sex at birth, such as a person who was born a biological female who identifies as female as an adult.  Some identify as transgender, which is when a person’s gender identity does not match up with their assigned sex at birth, such as a person who was born a biological female who identifies as a male as an adult.  According to the Centers for Disease Control (2022), approximately one million Americans (about 0.6% of the population) currently identifies as transgender.  Relatedly, the term non-binary refers to individuals whose gender identity is neither male nor female.

Some transgender individuals may experience gender dysphoria, which occurs when a great amount of psychological stress is caused by the inconsistency between their current gender identity and their assigned sex at birth, which can occur at any point in one’s life starting generally about puberty.   As explained by the American Psychiatric Association (2013), gender dysphoria "involves a conflict between a person's physical or assigned gender and the gender with which he/she/they identify. People with gender dysphoria may be very uncomfortable with the gender they were assigned, sometimes described as being uncomfortable with their body (particularly developments during puberty) or being uncomfortable with the expected roles of their assigned gender."  

"Portrait of Woman Behind Plastic Foil" by Danila Chertov is in the Public Domain, CC0

 As stated by Dr. Jack Turban from the American Psychiatric Association, “The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides for one overarching diagnosis of gender dysphoria with separate specific criteria for children and for adolescents and adults.

The DSM-5 defines gender dysphoria in adolescents and adults as a marked incongruence between one’s experienced/expressed gender and their assigned gender, lasting at least 6 months, as manifested by at least two of the following:

• A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics)
• A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
• A strong desire for the primary and/or secondary sex characteristics of the other gender
• A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)
• A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)
• A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)

In order to meet criteria for the diagnosis, the condition must also be associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The DSM-5 defines gender dysphoria in children as a marked incongruence between one’s experienced/expressed gender and assigned gender, lasting at least 6 months, as manifested by at least six of the following (one of which must be the first criterion):

• A strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one’s assigned gender)
• In boys (assigned gender), a strong preference for cross-dressing or simulating female attire; or in girls (assigned gender), a strong preference for wearing only typical masculine clothing and a strong resistance to the wearing of typical feminine clothing
• A strong preference for cross-gender roles in make-believe play or fantasy play
• A strong preference for the toys, games or activities stereotypically used or engaged in by the other gender
• A strong preference for playmates of the other gender
• In boys (assigned gender), a strong rejection of typically masculine toys, games, and activities and a strong avoidance of rough-and-tumble play; or in girls (assigned gender), a strong rejection of typically feminine toys, games, and activities
• A strong dislike of one’s sexual anatomy
• A strong desire for the physical sex characteristics that match one’s experienced gender

As with the diagnostic criteria for adolescents and adults, the condition must also be associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning” (Turban, 2020).

Gender dysphoria can have a profound impact on an individual's sense of self and their gender identity. It can cause individuals to feel as though they are living in a body that is not their own and to experience a sense of disconnection from their own gender and sense of self. This can lead to feelings of anxiety, depression, and self-doubt, and can impact an individual's ability to form meaningful relationships and engage in daily activities.

For some individuals with gender dysphoria, their gender identity may become a central aspect of their self-concept and sense of self-worth, and they may experience significant emotional distress as a result of the mismatch between their gender identity and their body. 

Treatment for gender dysphoria often involves a combination of medical, psychological, and social interventions.  Medical treatments may include hormone therapy to help the individual's physical appearance better align with their gender identity, as well as surgeries such as genital reconstruction or chest surgery.  However, not all individuals with gender dysphoria choose to undergo medical or surgical interventions, and treatment should be tailored to each individual's specific needs and preferences.

Psychological treatments may include individual or group therapy to help individuals address the emotional and psychological challenges associated with gender dysphoria such as anxiety, depression, or low self-esteem. Therapists may also provide support and guidance to individuals as they navigate their gender identity and transition, as well as educate family and friends about gender dysphoria.  Social interventions may include assisting the individual in legally changing their name and gender marker, as well as helping them navigate social and workplace discrimination.

Representation of gender dysphoria in the media has varied greatly over time and across different countries and cultures. In some instances, gender dysphoria has been portrayed in a positive light, with individuals with gender dysphoria being depicted as courageous, resilient, and deserving of respect and dignity. However, in other instances, gender dysphoria has been portrayed in a negative or stereotypical manner, perpetuating myths and misconceptions about the condition.

In the past, individuals with gender dysphoria were often portrayed in the media as mentally ill, immoral, or sexually deviant. However, more recently, there has been a shift towards a more nuanced and positive portrayal of gender dysphoria in some areas of the media. This has included increased representation of individuals with gender dysphoria in movies, TV shows, and other forms of media, as well as more media coverage of the issues and challenges faced by the transgender community.

Often, gender dysphoria is confused with being transgender, but they are not the same.  Transgender is a term used to describe individuals whose gender identity differs from the sex they were assigned at birth. This can refer to a wide range of experiences including individuals who identify as the opposite gender, those who identify as non-binary or genderqueer, and those who identify as a gender different from the one they were assigned at birth.

Gender dysphoria, on the other hand, is a medical condition characterized by significant distress and discomfort due to a mismatch between an individual's gender identity and their birth-assigned sex. This distress can result in a range of symptoms, including anxiety, depression, and feelings of disconnection from one's own body.  While many transgender individuals experience gender dysphoria, not all individuals who are transgender experience this condition. Additionally, some individuals who experience gender dysphoria may not identify as transgender as they may feel that their gender identity aligns with their birth-assigned sex but that their body does not accurately reflect their gender identity.  Therefore, it is important to recognize that transgender and gender dysphoria are separate concepts and that the experiences of individuals with gender dysphoria can be unique and complex. 

Similarly, gender dysphoria and sexuality are distinct, but related concepts.  Sexual attraction and gender identity are separate aspects of a person's identity and do not necessarily have a direct relationship to each other. For example, a person who experiences gender dysphoria and identifies as a transgender woman may be attracted to men, women, both, or neither. Similarly, a person who does not experience gender dysphoria may be gay, lesbian, bisexual, heterosexual, or asexual.

Some individuals with gender dysphoria may experience additional difficulties related to their sexual orientation, such as discrimination or rejection from friends, family, or partners because of their gender identity or expression. Additionally, some individuals with gender dysphoria may experience additional challenges related to accessing appropriate healthcare, including gender-affirming medical interventions, because of stigma or discrimination based on their gender identity or sexuality.

  There are several organizations that focus on gender dysphoria and support individuals with gender dysphoria and their families. Some of these organizations include:

• World Professional Association for Transgender Health (WPATH): An international professional organization dedicated to promoting evidence-based care for individuals with gender dysphoria and advocating for their rights and equality.
• Human Rights Campaign (HRC): A civil rights organization that works to end discrimination and advance equality for the LGBTQ+ community, including individuals with gender dysphoria.
• The Trevor Project: A national organization providing crisis intervention and suicide prevention services to LGBTQ+ youth, including those with gender dysphoria.
• Gender Spectrum: A national organization that provides education, training, and support to families, schools, and organizations to promote gender inclusivity and support individuals with gender dysphoria.
• National Center for Transgender Equality (NCTE): A national advocacy organization working to advance the rights and dignity of individuals with gender dysphoria and transgender communities.

These organizations offer a range of resources, including information about gender dysphoria, support groups, advocacy, and legal services. They provide valuable support and advocacy for individuals with gender dysphoria and work to promote equality and understanding of the experiences of individuals with gender dysphoria.

"Crop woman dusting lamp during housework" by Karolina Grabowski is in the Public Domain, CC0

Traditional gender roles in the United States in the 1950s and 1960s had men working outside the home to earn money and women staying home to clean and care for the children.  In what ways have such gender roles changed in the past few years?  Are the gender roles defined for men and women in today’s society as different as they were just a few decades ago?  In what ways have they changed or stayed the same?

Psychoanalytic theory and gender schema theory are two different perspectives that offer different explanations for human behavior.  Psychoanalytic theory, developed by Sigmund Freud, emphasizes the role of unconscious conflicts and childhood experiences in shaping behavior and emotions. According to this theory, individuals often act out unconscious feelings and desires through their behavior, and these behaviors can be seen as a manifestation of unresolved conflicts or unconscious impulses.

Gender schema theory, on the other hand, is a cognitive perspective that focuses on how societal messages about gender roles and expectations shape individuals' understanding of their own gender identity. This theory suggests that individuals internalize gender schemas, or mental frameworks, about what it means to be male or female, and these schemas influence their thoughts, behaviors, and attitudes.

With this distinction in mind, imagine a scenario where the parents of a third-grade child are getting a divorce and as a result he starts bullying other students in his class.   A psychoanalyst might describe the bullying behavior as a result of the child's unconscious conflicts related to their parents' divorce. The psychoanalyst might believe that the child is acting out unconscious feelings of anger, frustration, and insecurity related to the loss of the family structure and the uncertainty about their future. According to psychoanalytic theory, this behavior may be seen as a manifestation of the child's unconscious conflicts related to the divorce.

On the other hand, a therapist following gender schema theory might describe the bullying behavior as a result of the child's adherence to traditional gender roles and expectations. The therapist might believe that the child is exhibiting bullying behavior as a way to assert their masculinity and dominance over others, in line with societal expectations of what it means to be a "real man." According to gender schema theory, this behavior is seen as a manifestation of the child's internalized gender schemas, which are shaped by societal messages about gender roles and expectations.

In this scenario, a psychoanalyst might focus on exploring the child's unconscious conflicts related to their parents' divorce, while a therapist following gender schema theory might focus on exploring the child's adherence to traditional gender roles and expectations. Both perspectives can provide valuable insights into the child's behavior, and both may lead to different treatment approaches.

For example, a psychoanalyst might use techniques such as free association, dream analysis, and transference to explore the child's unconscious conflicts related to the divorce, while a therapist following gender schema theory might use techniques such as role-playing and discussion to challenge the child's internalized gender schemas and to help them develop a more nuanced understanding of their own gender identity.

While both perspectives may offer valuable insights into the child's behavior, they approach the situation from different theoretical frameworks and may lead to different treatment approaches. As always, it is important to consider multiple perspectives and theories in order to gain a comprehensive understanding of the individual's behavior and to develop effective treatment strategies.

Bem, S. L. (1981). Gender schema theory: A cognitive account of sex typing.  Psychological Review, 88, 354-364.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition (2013). American Psychiatric Association.

Turban, J. (2020, November).  What is gender dysphoria?  American Psychiatric Association.   https://psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria