Zucker K J, Bradley S J, Hughes H E
Child and Family Studies Centre, Clarke Institute of Psychiatry, Toronto, Ontario.
Can J Psychiatry. 1987 Oct;32(7):602-9. doi: 10.1177/070674378703200719.
This case report describes the psychosexual development of a child with true hermaphroditism who was assigned to the male sex at birth, but reassigned to the female sex at age two months. Given this child's excessive exposure to male sex hormone in utero, relative to physically normal females, one would predict a biological predisposition to behave in a masculine manner. This has occurred since two years of age. In addition, this child has had periodic episodes of gender disturbance, dysphoria, and ambivalence. In contrast, a physically normal fraternal twin sister has been conventionally feminine. A number of psychosocial factors appeared to have exacerbated the biologic predisposition to behave in a masculine manner, and thus may have been responsible for "pushing" this child into varying degrees of gender identity conflict. These included a closer father-daughter than mother-daughter relationship, parental tolerance of cross-gender behavior, and a mother who has been psychologically disturbed since the birth of her children. The heuristic value of this case will be discussed in relation to contemporary models of psychosexual development which emphasize the interaction of biological and psychosocial factors.
本病例报告描述了一名真性两性畸形儿童的性心理发展情况。该儿童出生时被指定为男性，但在两个月大时被重新指定为女性。鉴于此儿童在子宫内过度暴露于雄性激素，相对于身体正常的女性，人们会预测其有以男性化方式行事的生物学倾向。自两岁起这种情况就已出现。此外，该儿童还不时出现性别困扰、烦躁不安和矛盾情绪。相比之下，身体正常的异卵双胞胎姐姐则表现得很传统，具有女性特质。一些社会心理因素似乎加剧了其以男性化方式行事的生物学倾向，因此可能是导致该儿童陷入不同程度性别认同冲突的原因。这些因素包括父女关系比母女关系更亲密、父母对跨性别行为的容忍，以及自孩子出生以来心理就一直有问题的母亲。将结合强调生物因素和社会心理因素相互作用的当代性心理发展模型来讨论该病例的启发价值。
