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This book attempts to present an overview of the complexities of sexual identity with particular emphasis on transsexualism. Green defines sexual identity or gender identity as (1) an individual's basic conviction of being male or female, (2) his behavior culturally associated with masculinity or femininity, and (3) preference for male or female sexual partners. Transsexualism, in this context, refers to an individual with a persisting wish to change sex.
In Green's presentation, the predominant mode of exposition is the vignette of clinical interview—with the mixture of the dramatic and the oversimplified implicit in that approach. His orientation is essentially nonpsychoanalytic; the emphasis is on behavioral manifestations, on simple learning theory schemata, with a deliberate exclusion of fantasy life, mental states, or the unconscious.
The books is introduced by sections devoted to historical and cross-cultural surveys, psychological theories, and biological studies. The theme of sexual transformation is shown to be universal in human culture. Biological studies seem to demonstrate that, in animals, prenatal sex hormone administration influences postnatal sexual behavior. Indications are that in humans, there are no correlations between hormonal levels and sexual identity, although there have been some suggestions that heightened androgen levels may correlate with increased masculine behavior in girls. The author stresses the difficulties implicit in evaluating studies in this area. In any event, there is no support offered for those who would view sexual identity as other than the result of complex interactions of physical, psychological, and social factors. The review of psychological theories, after a survey of early Freudian concepts, for the most part follows Robert Stoller (who provides the foreword to this book). Core gender identity is seen as arising preoedipally—around the second year of life—and is the bedrock on which all later sexual