The Subtlety of Sex-Atypicality

Memories of sex-atypical behavior and interests in childhood usually differ between homosexual and heterosexual people. However, variation within these broad groups has not previously been explored in detail, especially among women. We utilized data from a postal survey of a nationwide sample of Australian adult twins (n = 4,901, age range: 19–52 years). Among men, 15.2% reported homosexual behavior (ever), 11.5% said they had been sexually attracted to the same sex, and 6.4% said they were not heterosexual; the corresponding figures for women were 7.9, 10.6, and 3.5%. A continuous measure of childhood gender nonconformity (CGN) was sensitive to slight variations in homosexual attraction and behavior. In particular, among both men and women who identified as heterosexual, there were significant differences between complete heterosexuals and those who admitted to only one or a few same-sex behaviors but no homosexual attraction. Among men, CGN scores distinguished between heterosexuals who admitted to same-sex behavior only and those who admitted to some homosexual attraction. The sexual subgroups also differed on a measure of gender atypicality in adulthood. Implications for developmental theories of sexuality are discussed.     

Childhood Gender Nonconformity and Harassment as Predictors of Suicidality among Gay,Lesbian, Bisexual,and Heterosexual Austrians

The role of childhood gender role nonconformity (CGNC) and childhood harassment (CH) in explaining suicidality (suicide ideation, aborted suicide attempts, and suicide attempts) was examined in a sample of 142 lesbian, gay, and bisexual (LGB) adults and 148 heterosexual adults in Austria. Current and previous suicidality, CGNC, and CH were significantly greater in LGB participants compared to heterosexual participants. After controlling for CGNC, the effect of sexual orientation on CH diminished. CGNC correlated significantly with current suicidality in the LGB but not in the heterosexual group, and only non-significant correlations were found for CGNC with previous suicidality. Controlling for CH and CGNC diminished the effect of sexual orientation on current suicidality. Bayesian multivariate analysis indicated that current suicidality, but not previous suicidality, depended directly on CGNC. CH and CGNC are likely implicated in the elevated levels of current suicidality among adult LGB participants. As for previous suicidality, the negative impact of CGNC on suicidality might be overshadowed by stress issues affecting sexual minorities around coming out. The association of CGNC with current suicidality suggests an enduring effect of CGNC on the mental health and suicide risk of LGB individuals.     

Maternally rated childhood gender nonconformity in homosexuals and heterosexuals

Homosexual and heterosexual subjects provided self-ratings of childhood gender nonconformity. Additionally, their mother rated them on several adjectives describing childhood behavior, which included words related to gender nonconformity. Male homosexuals were remembered by their mothers as less masculine and more nonathletic. This finding did not appear to be due to a bias in mothers' memories. Though female homosexuals were recalled as more masculine than female heterosexuals, this appeared to reflect retrospective bias, as mothers who knew of their daughters' homosexuality were more likely to rate them as masculine. Both self-rated and maternally rated childhood gender nonconformity made independent contributions in predicting sexual orientation. Within the homosexual samples, maternal and self-ratings of subjects' childhood gender nonconformity failed to correlate significantly.     

Development of AACAP practice parameters for gender nonconformity and gender discordance in children and adolescents

The American Academy of Child and Adolescent Psychiatry (AACAP) is preparing a publication, Practice Parameter on Gay, Lesbian or Bisexual Sexual Orientation, Gender-Nonconformity, and Gender Discordance in Children and Adolescents. This article discusses the development of the part of the parameter related to gender nonconformity and gender discordance and describes the practice parameter preparation process,rationale, key scientific evidence, and methodology. Also discussed are terminology considerations, related clinical issues and practice skills, and overall organization of information including influences on gender development, gender role behavior, gender nonconformity and gender discordance, and their relationship to the development of sexual orientation.     

Is gender dysphoria dysphoric? Elevated depression and anxiety in gender dysphoric and nondysphoric homosexual and bisexual men in an HIV sample

Few if any studies before the AIDS epidemic suggested that male homosexuals may on average have higher levels of depression than male heterosexuals. However, several samples of homosexual and bisexual men in HIV studies suggest that depression and anxiety are high in these populations, and that this psychiatric morbidity began before the AIDS epidemic. We tested the hypothesis that high childhood gender nonconformity (CGN) is associated with depression and anxiety, and so might account for differences in these variables among samples of homosexuals. A total of 254 homosexual or bisexual male subjects were assessed for depression, anxiety, and associated symptoms using various self-report and interview measures, as well as for CGN (using the Freund Feminine Gender Identity scale, FGI). For comparison purposes only, we also evaluated the subjects for the DSM-III diagnosis of Ego-Dystonic Homosexuality. Highly gender nonconforming men (high FGI scores) were more likely to have current symptoms of anxiety and depression by self-report, and to have had a lifetime history of depression by clinical interview. This association was more often due to FGI items dealing with childhood than adulthood. When the FGI was broken into subscales by a prior factor analysis, stepwise regression suggested that the subscale measuring core gender identity nonconformity (so-called gender dysphoria) was more reliably associated with depression and anxiety than were the factors measuring nonconformity in the areas of masculine and feminine gender roles, or genitoerotic (sexual) roles. This subscale was also the only FGI measure correlating with Ego-Dystonic Homosexuality. AIDS (CDC stage and HIV serostatus) and age did not account for these findings. We conclude that the often-reported higher levels of depression, anxiety, and associated symptoms among homosexual and bisexual men in AIDS studies are more common in the subgroup of such men who are gender dysphoric. Theoretical and clinical implications of these data are discussed.The principal support for the HNRC is provided by NIMH Center grant 5 P50 MH45294 (HIV Neurobehavioral Research Center). Additional support is provided by 5 R01 MH43298, 5 R01 MH45688, 1 R01 MH46255, 1 R01 NS27810, and the Henry M. Jackson Foundation. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.The HNRC Group includes: Igor Grant, M.D., Director; J. Hampton Atkinson, M.D., Co-Director; Robert A. Velin, Ph.D., Center Manager; Edward C. Oldfield III, M.D., James L. Chandler, M.D., Mark R. Wallace, M.D., and Joseph Malone, M.D., Co-Investigators Naval Hospital San Diego; J. Allen McCutchan, M.D., P.I. Medical Core; Stephen A. Spector, MD., P.I. Virology Core; Leon Thal, M.D., P.I. Neurology Core; Robert K. Heaton, Ph.D., P.I. Neuropsychology Core; John Hesselink, M.D. and Terry Jernigan, Ph.D., Co-P.I.s Imaging Core; J. Hampton Atkinson, M.D., P.I. Psychiatry Core; Clayton A. Wiley, M.D., Ph.D., P.I. Neuropathology Core; Richard Olshen, Ph.D. and Ian Abramson, Ph.D., Co-P.I.s Biostatistics Core; Nelson Butters, Ph.D., P.I. Memory Project; Renée Dupont, M.D., P.I. SPECT Project; Thomas Patterson, Ph.D., P.I. Life Events Project; Sidney Zisook, M.D., P.I. Mood Project; Dilip Jeste, M.D., P.I. Psychosis Project; Hans Sieburg, Ph.D., P.I. Dynamical Systems Project; and James D. Weinrich, Ph.D., P.I. Sexology Project.     

ISO 15189:2012 和ISO 15189:2022 的不符合对照分析及换版策略

摘要:目的通过 分析ISO 15189:2012与ISO 15189:2022 版标准的不符合项,为实验室换版工作提供改进策略。方法收集 24家实验室32次现场评审的522项ISO 15189:2012不符合项目,并将其对应到ISO 15189 :2022版标准的相关条款。基于标 准要求、文献研究和实验室现状,探讨ISO 15189换版的工作策略。结果每次现场评审平均 16条不符合项,最少8条,最多 31条。这些不符合项主要集中在ISO 15189:2022版7.3检验过程(165条)、6.5 设备校准和计量学溯源(43条). .6.6试剂和耗 材(40条)等条款要求。而对于风险管理、患者相关要求、即时检验等新增或加强的条款要求,不符合项相对较少。结论ISO 15189:2022版标准的不符合项主要集中在检验过程环节,建议实验室利用数字化、智能化技术手段,加强这一环节的管理,以 顺利实施新版标准要求,并通过组织培训、差距分析、文件修订、全员参与实施、加强风险管理和持续改进等策略,确保换版工 作的顺利推进。     

Effects of recalled childhood gender nonconformity on adult genitoerotic role and AIDS exposure

The connections between childhood gender nonconformity (assessed by the Freund Feminine Gender Identity Scale, or FGI) and adult genitoerotic role (assessed by a sex history) were examined. The core sample was a group of 106 men who had sex with other men before 1980 and who are currently enrolled in two longitudinal studies of AIDS. Although other workers have cautioned against assuming a priori that childhood gender role is inherently related to adult preferences for particular sexual acts, our data suggest that there is at least a statistical association between these two concepts. In particular, the FGI (and many of its factors and items) are significantly associated with preferences for receptive anal intercourse and, less clearly, with oral-anal contact — but not with oral-genital intercourse or insertive anal intercourse. Suggestions for AIDS prevention and safe-sex awareness are made on the basis of these findings. The data also suggest that in sex research involving homosexual men, the correct genitoerotic role distinction is not insertive vs. receptive behaviors, or even insertive vs. receptive anal intercourse, but receptive anal intercourse vs. all other behaviors.The principal support for the HNRC is provided by NIMH Center grant 5 P50 MH45294 (HIV Neurobehavioral Research Center). Additional support is provided by 5 R01 MH 43298 (Neuropsychiatric Sequelae of HTLV-III Infections), 5 R29 MH45688 (Object-Oriented Simulation of HIV- and CNS/HIV Infection), R01 MH46255 (Psychosocial Moderators of Disease Progression in AIDS), 1 R01 NS27810 (Role of Immune Responsiveness in HIV Encephalopathy), and the Henry M. Jackson Foundation (Psychiatric Natural History Study: Factors Related to Human Immunodeficiency Virus Transmission and Morbidity).The San Diego HIV Neurobehavioral Research Center (HNRC) group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the San Diego Veterans Administration Medical Center, and includes Igor Grant, M.D., Director; J. Hampton Atkinson, M.D., Co-Director; James D. Weinrich, Ph.D., Center Manager; James L. Chandler, M.D., Joseph L. Malone, M.D., and Charles A. Kennedy, M.D., Co-Investigators Naval Hospital San Diego; J. Allen McCutchan, M.D., P.I. Medical Core; Stephen A. Spector, M.D., P.I. Virology Core; Leon Thal, M.D., P.I. Neurology Core; Robert K. Heaton, Ph.D., P.I. Neuropsychology Core; John Hesselink, M.D. and Terry Jernigan, Ph.D., Co-P.I.s Imaging Core; J. Hampton Atkinson, M.D., P.I. Psychiatry Core; Clayton A. Wiley, M.D., Ph.D., P.I. Neuropathology Core; Richard Olshen, Ph.D. and Ian Abramson, Ph.D., Co-P.I.s Biostatistics Core; Nelson Butters, Ph.D., P.I. Memory Project; Renée Dupont, M.D., P.I. SPECT Project; Thomas Patterson, Ph.D., P.I. Life Events Project; Sidney Zisook, M.D., P.I. Mood Project; Dilip Jeste, M.D., P.I. Psychosis Project; and Hans Sieburg, Ph.D., P.I. Dynamical Systems Project.     

Retrospectively measured individual differences in childhood sex-typed behavior among gay men: Correspondence between self- and maternal reports

Male sexual orientation is strongly associated with childhood sex-typed behavior, but there are also marked within-orientation differences. Gay men show increased variance compared to heterosexual men on retrospective measures of childhood sex-typed behavior. Individual differences among gay men for their degree of sex-typed behavior may have important implications. However, there has been little attention given to the reliability or validity of retrospective measures of such differences that are most common. Gay men and their mothers completed questionnaires assessing the men's sex-typicality during childhood. Results of structural modeling analyses found that mothers' and sons' reports were significantly associated, both regarding the general level of sex-typed behavior and the specific behaviors, supporting the validity of retrospectively measured individual differences for those characteristics.