ONTOGENESIS OF SEXUAL BEHAVIOR 



1409 



TABLE 23.3 



Gonads and rearing contradictory: 30 cases 



the sexual status of the gonads and the sex 

 of assignment and rearing^ (Table 23.3). In 

 all but 3, psychologic studies revealed a 

 gender role fully concordant with the sex of 

 rearing. As a prognosticator of a person's 

 gender role and orientation, gonadal struc- 

 ture, per se, thus proved to be unreliable; 

 again gender role was in greatest accord 

 with the assigned sex and rearing. 



3. Hormonal Sex 



It is of course necessary to consider hor- 

 monal sex separately from gonadal histol- 

 ogy, for ovaries do not always secrete effec- 

 tive estrogens, nor testes effective androgens. 

 The ovaries of females with hyperadreno- 

 corticism are suppressed in function and, al- 

 though their adrenals produce an excess of 

 estrogens as well as of androgens, the an- 

 drogenic activity dominates, inducing ex- 

 cessive virilization of the body. The gonads 

 of simulant females with ijiguinal testes 

 produce, in most instances, estrogens which 

 feminize the body. 



The data on 21 patients who went into or 

 beyond puberty or, in the cases of patients 



wuth hyperadrenocorticism, a precocious pu- 

 berty-equivalent in which hormonal influ- 

 ences induced secondary sexual changes 

 contradictory of the sex in which the indi- 

 vidual had been living, are summarized in 

 Table 23.4. In all patients the contradiction 

 was subsequently corrected with hormonal 

 therapy and with plastic surgery when indi- 

 cated. 



Of the 31 patients whose sex hormones 

 and secondary sexual body development 

 contradicted their assigned sex and rearing, 

 only 5 became ambivalent with respect to 

 their gender role. Four of the 5 had been 

 reared as girls. One of these, a man in his 

 thirties when studied by Dr. John Money, 

 had acted on his own initiative and changed 

 to live as a man from the age of 16 onward. 

 The other four, although living as women, 

 displayed disordered gender role as evi- 

 denced by some degree of bisexual erotic in- 

 clination. The impracticability of publishing 

 here the extensive psychiatric and psy- 

 chologic records of these 5 patients requires 

 the authors to submit, instead, their con- 

 sidered opinion that these 5 patients do not. 



