A Further Contribution to the Study of Gender Identity1

Clinical studies underway for several years to help clarify the concept of gender identity have recently brought forth further data that may add a few clues to a search for sources of masculinity and femininity. Before presenting these new data, however, it may be useful to review the findings and concepts presented earlier.

At the Stockholm Congress in 1963, the concept of gender identity, its sources and its earliest stages, were described (Stoller, 1964). At that time I felt that the earliest stages in the development of gender identity were produced by the parental attitudes toward the infant's sex, the infant's growing awareness of its external genitalia, and a biological force. Regarding the latter, I said then (and still feel) that I did not know what produced this force2, that it silently augments the developing gender identity in the normal, can be overwhelmed by post-natal psychological experiences in certain abnormal people, but on the other hand in rare cases may be so strong that even in the face of the child being reared in the wrong sex, it may overpower the effects of such rearing.

To help with the task of trying to understand the sources and development of gender identity, I have been studying people with marked abnormalities of sex and gender. The paper in 1963 summarized data on patients who appeared to have developed their gender identities in a manner very different from that which is almost always the case in humans, wherein gender identity is produced primarily by post-natal psychological experiences. The patients presented were felt to be examples of a powerful biological force at work which contradicted the effects of rearing. At birth, the patients seemed anatomically normal but nonetheless, from earliest childhood on, acted and felt as if they were members of the opposite sex. At puberty, their developing secondary sex characteristics were those of the sex to which they had always felt themselves to belong rather than the