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Much else can be said of Person and Ovesey's paper, “Psychoanalytic Theories of Gender Identity” in the April 1983 issue of The Journal, but here I shall limit myself to their contention that gender role (and gender identity) is determined by sex assignment and rearing. It is on this that they base their conclusions concerning the origin of later sexual deviations and other clinical considerations.
They give short shrift to the report of Imperato-McGinley and colleagues (1974) of a group of Santo Dominican boys brought up as girls owing to 5∞-reductase deficiency, who at puberty readily changed to their genetic and hormonal male sex. They mention it, calling it the one major study contradicting their conclusion that by the third year of age, sex change is immutable, which must follow if sex is determined by assignment and rearing. They do not mention that Gajdusek (1976) made another observation, of a group of boys in Papua, New Guinea, who were raised as girls yet were able to switch to a masculine gender role after puberty.
Person and Ovesey also fail to mention two other cases reported by Imperato-McGinley et al. (1979, 1980), of boys, both unambiguously raised as girls — one because of 5∞-reductase deficiency and the other because of 17β-hydroxy-steroid dehydrogenase deficiency — who recognized and accepted their maleness following puberty.
Person and Ovesey have thus uncritically accepted the thesis of Money et al. (1955) that sex identity is determined by sex assignment and rearing even when contrary to chromosomal and hormonal factors. They make no reference to an earlier examination by Zuger (1970) of the data given by Money et al. in support of their conclusions, which examination found the data to be unacceptable on methodological and clinical grounds.
I believe that by adding the above data, which dispute their conclusions, Person and Ovesey would be giving a better-balanced account of our present knowledge regarding the factors determining gender identity.