Sex and Gender in Psychiatry: A View from History

Although physicians have attempted for centuries to uncover the biological differences between men and women with regard to mental illness, they continue to face the challenges of untangling biological factors from social and cultural ones. This article uses examples from history to illustrate three common problems in trying to establish biological differences: identifying factors as sex-based when they are really gender-based; overlooking changes in masculine and feminine roles over time; and placing too great an emphasis on hormones. By using the benefit of hindsight to identify problems from the past, we can think more critically about these issues in the present and the future.     

Socially Assigned Gender Nonconformity: A Brief Measure for Use in Surveillance and Investigation of Health Disparities

Discrimination and violence targeting people perceived as gender nonconforming have been linked to a range of negative health outcomes, and large-scale representative data are needed to begin population surveillance of associated health disparities. A brief self-report measure of gender expression as perceived by others was tested using cognitive interviewing methods in a diverse sample of 82 young adults aged 18–30 years, recruited from the New England region in the U.S. Results identified themes related to item clarity, gender expression variation, undesirability of highest or lowest ends of item range, and tension between self and others’ perceptions. The item performed as expected and is recommended for use on studies of health disparities, including statewide and national public health surveillance tools.     

The Analyst as Comic and the Comic in Analysis: Reply to Commentary

This discussion elaborates aspects of the use of humor and jokes in clinical psychoanalysis. The use of humor, like dreams or other symmetrical processes, facilitates the patient's development of the capacity to symbolize unconscious experience and mitigates the need to evacuate unconscious experiences and fantasies into the external world. In focusing on specific clinical interventions I highlight three dimensions of the process: the concept of coconstruction in the emergence of humor in the psychoanalytic relationship, the authority of the patient's psychopathology and affective and cognitive development, and the analyst's willingness to take the risks of self-exposure and possibly hurting the patient implicit in the use of humor and jokes in the analytic relationship. Different forms of humor are described in relation to the different clinical situations, including mutually created jokes, caricatured enactments, cartoonlike images, and self-depreciating commentary on the analytic process. In using jokes and humor in psychoanalysis we introduce the possibility of pleasure within an intense, intimate moment which allows for the transformation of unacceptable aspects of both patient and analyst as they become joined within a broader human experience.     

Racial Self-Identification: The Effects of Social History and Gender1

Dark and Clark's pioneering study in 1947 demonstrated that Black children were ambivalent about racial self-identification. Subsequent research indicates that during the 1950s, 1960s and 1970s, Black children were increasingly likely to demonstrate a commitment to identifying with a Black stimulus. The present study investigates the extent to which this trend persists in the 1980s and how gender of the child affects her/his racial identification. The results indicate that the 1980s may be a time in history when Black children are growing more ambivalent about racial self-identification, and that Black boys are significantly more likely than Black girls to identify with the white doll. The findings suggest that the current political climate which places Blacks at a significant social and economic disadvantage may reduce children's willingness to identify with a Black stimulus. The gender differences are explored in terms of Black boys' greater likelihood psychologically to try to identify away from Blackness.     

Distinguishing Between Sex and Gender: History, Current Conceptualizations, and Implications

Many psychologists, particularly feminist psychologists, have drawn a distinction between the term sex and the term gender. The purposes of this paper were to review the history of this distinction and to illustrate the varied and inconsistent ways in which these terms are used. Historically, this distinction began with John Money and his colleagues in the 1950s (Money et al. 1955a, b, 1957); they used the term sex to refer to individuals?? physical characteristics and the term gender to refer to individuals?? psychological characteristics and behavior. Two decades later, Rhoda Unger (1979) argued that the widespread use of the term sex implies biological causes and promotes the idea that differences between women and men are natural and immutable. She proposed the use of the term gender to refer to traits that are culturally assumed to be appropriate for women and men. Her work was influential in prompting a widespread shift from the use of the term sex to the use of the term gender in psychological texts. Nevertheless, current definitions of sex and gender vary widely. Some authors use the terms interchangeably. Of those who distinguish between the terms, most construe gender as more related to cultural influences and sex as more related to biology. There are numerous inconsistencies in authors?? definitions, however. Additionally, in some cases, there appears to be a mismatch between how researchers define sex or gender and how they measure it. It seems likely that the distinction between the term sex and the term gender may become less meaningful and important over time.     

Performing Gender: A Content Analysis of Gender Display in Music Videos

This study investigated differences in gender display by male and female performers in music videos. Goffman??s (1976) conceptual framework of gender display was refined and expanded upon as a basis for analyzing 12 nonverbal displays associated with subordination, domination, sexuality, and aggression in music videos by an equal number of male and female lead performers. 34 music videos on U.S. cable stations MTV and MTV2 were divided into 30-second segments, resulting in 253 units that were coded for gender display. Findings revealed that significant gender displays primarily reinforced stereotypical notions of women as sexual objects, and to a lesser degree, females as subordinate and males as aggressive. Implications of music videos?? portrayal of stereotypical gender displays and their role in the construction and maintenance of the gender status quo are discussed.     

Gender differences in burnout: A meta-analysis

The literature on male-female differences in burnout has produced inconsistent results regarding the strength and direction of this relationship. Lack of clarity on gender differences in organizationally relevant phenomena, such as work burnout, frequently generates ungrounded speculations that may (mis)inform organizational decisions. To address this issue, we conducted a meta-analysis of the relationship between gender and burnout using 409 effect sizes from 183 studies. Results challenge the commonly help belief that female employees are more likely to experience burnout than male employees, revealing instead that women are slightly more emotionally exhausted than men (δ = .10), while men are somewhat more depersonalized than women (δ = −.19). Although these effects are small, they are practically noteworthy when translated into a percent overlap statistic. Moderator analyses further revealed some intriguing nuances to the general trends, such as larger gender differences in the USA compared to the EU. In contrast, gender differences did not vary significantly in male-typed vs. female-typed occupations. Our analyses also suggest discontinuation of the use of overall burnout measures because they are highly consistent with the emotional exhaustion dimension of burnout only.     

Gender differences in rumination: A meta-analysis

Starting in adolescence and continuing through adulthood, women are twice as likely as men to experience depression. According to the response styles theory (RST), gender differences in depression result, in part, from women’s tendency to ruminate more than men. A meta-analysis was performed to evaluate gender differences in rumination in adults (k = 59; N = 14,321); additionally, an analysis of subtypes of rumination – brooding and reflection – was conducted (k = 23). Fixed effects analyses indicated that women scored higher than men in rumination (d = .24, p < .01, SEd = .02), brooding (d = .19, p < .01, SEd = .03) and reflection (d = .17, p < .01, SEd = .03); there was no evidence of heterogeneity or publication bias across studies for these effect sizes. Although statistically significant, the effect sizes for gender differences in rumination were small in magnitude. Results are discussed with respect to the RST and gender differences in depression.     

Emotional Constriction and Risk for Posttraumatic Stress: The Roles of Trauma History and Gender

Research suggests there are qualitative differences in emotionality across gender, with men being more emotionally constrictive than women. Constrictive emotionality has consistently been linked to posttraumatic stress disorder (PTSD) and because men are generally more emotionally constrictive, one could infer they are at increased risk for PTSD. However, research demonstrates that twice as many women are diagnosed with PTSD than men. In an undergraduate sample, men reported significantly greater emotional constriction, but significantly less posttraumatic stress severity in comparison to women. The gender differences in emotional constriction disappeared in a subsample of students who endorsed experiencing an upsetting event. Emotional constriction mediated the relationship between trauma and posttraumatic stress severity, although it was a stronger mediator for women than men.     

Gender Aware Therapy: A Synthesis of Feminist Therapy and Knowledge About Gender

The time has come to integrate feminist therapy and knowledge of gender into principles of counseling for both women and men. Gender Aware Therapy (GAT) is such a synthesis. GAT encourages counselors to facilitate the development of women and men through exploration of their unique gender-related experiences. The foundations, principles, stages, and applications of GAT are described.     

Gender constancy: A methodological and theoretical analysis

Two widely used tests of gender constancy, one verbal and one perceptual, were given to 26 4-to-6-year-old children. Children were classified at different levels of gender constancy, depending on which test was used. These discrepant results were not accounted for by the differences in the way the tests presented (verbally or visually), nor by the tests' differing definitions of gender constancy. The majority of the children answered gender constancy questions as though they were referring to a “pretend,” as opposed to a “real,” situation; such responses decreased scores of gender constancy on both tests. The theoretical and methodological implications of children spontaneously adopting a pretend mode of responding are discussed.     

Contextualizing a Life in Science: Janet Taylor Spence and the History of Women and Gender in American Psychology

The present paper reflects on the life and career of Janet Spence (1923–2015) by situating her experiences within the history of women and gender in American psychology. This history has revealed the structural factors that have affected women’s participation in psychology, the shared themes in women’s interpersonal and professional experiences, and the specific strategies that women have used to navigate an androcentric, and at times overtly sexist, discipline. In spanning the second half of the twentieth century, Spence’s career provides an interesting case study of how these decades of institutional and political change affected a specific woman scientist and her science. I argue that her biography can offer rich insights into the complexly intertwined, and even reflexive, relationships among psychologists, their psychologies, and their contexts.     

Gender and Aggression in Marital Relationships: A Life-Span Perspective

This study examines the relationship between age, gender, and marital aggression by comparing conflict resolution strategies, physical aggression, and injury across 6,185 married young, middle and older aged men and women. We found a consistent age effect such that younger participants used more maladaptive conflict resolution strategies, engaged in more physical arguments, and sustained more injuries than older participants. In terms of gender differences, women compared to men used calm discussions less (the least reported by women who were young) and heated arguments more. Analyses on the relation among age, gender, and injuries showed that more young and middle-aged women than men reported that they had sustained injuries at the hands of their spouse and more young men than women reported inflicting injury on their spouse. The results are discussed in relation to research on gender differences in intimate violence and the association of age and intimate aggression in general.     

Gender and Group Process: A Developmental Perspective

Until recently, the study of gender development has focused mainly on sex typing as an attribute of the individual. Although this perspective continues to be enlightening, recent work has focused increasingly on children's tendency to congregate in same-sex groups. This self-segregation of the two sexes implies that much of childhood gender enactment occurs in the context of same-sex dyads or larger groups. There are emergent properties of such groups, so that certain sex-distinctive qualities occur at the level of the group rather than at the level of the individual. There is increasing research interest in the distinctive nature of the group structures, activities, and interactions that typify all-male as compared with all-female groups, and in the socialization that occurs within these groups. Next steps in research will surely call for the integration of the individual and group perspectives.     

Gender Differences in Family Stories: Moderating Influence of Parent Gender Role and Child Gender

One hundred and twenty families and their 4-year-old children participated in a study on family stories. The participants were primarily White (91%), with the remainder Black (4%), Hispanic (2%), and Asian (2%). The parents were primarily middle class and upper class, with approximately 5% identifying themselves as from a lower socioeconomic background. Parents were asked to tell their son or daughter stories about when the parent was growing up. All parents completed measures of child behavior and a subset of parents completed the Bem Sex Role inventory. Stories were coded for the strength of affiliation, achievement, and autonomy themes. No gender differences were found for parents or child in the strength of affiliation themes. Fathers told stories with stronger autonomy themes than did mothers, and sons were more likely to hear stories with themes of autonomy than were daughters. An interaction was found between gender type of parent and gender of child for strength of achievement theme. Traditional gender-typed parents told stories with stronger achievement themes to their sons, and nontraditional gender-typed parents told stories with stronger achievement themes to their daughters. Exploratory analyses were conducted examining the relations among story theme, parent gender type, and child behavior. Higher levels of externalizing behaviors were found in boys whose fathers endorsed strong masculine attitudes, but told stories with weak achievement themes. Higher levels of internalizing behaviors were found in girls whose mothers told stories with strong affiliation themes, but endorsed weak feminine attitudes. Family stories are proposed to be one aspect of socialization that includes an interaction between child and parent characteristics.     

Gender Role and Feminism Revisited: A Follow-Up Study

In this follow-up to our earlier study (Toller, Suter, & Trautman, Gender role identity and attitudes towards feminism, Sex Roles, 51, 85–90, 2004) we examine the interrelationships among gender role, support for feminism, and willingness to self-label as feminist. Ten percent of college students previously surveyed participated in qualitative interviews, which elicited characterizations of feminists, whether students self-identified as feminist, suggestions for garnering support for feminism, and for interpretation of the initial study’s findings. Students were asked to speculate why we found that highly masculine men and highly feminine women were neither likely to self-identify as feminist nor to support the feminist movement and why more feminine men and more masculine women were found to be more willing to self-label as feminist and more likely to support the feminist movement.     

Gender Role Attitudes and Careers: A Longitudinal Study

Data from the Monitoring the Future Study were used to examine the impact of early gender role attitudes on later career outcomes for women and men. We also examined the impact of marriage, children, and labor market outcomes on changes in gender role attitudes. Women’s early gender role attitudes predicted their later work hours and earnings. Women’s work hours predicted their later gender egalitarianism. Children were negatively associated with later gender egalitarianism for both women and men. Findings indicated that gender role attitudes influence subsequent behavior, but they may also be adjusted to accommodate to situational constraints.     

Gender differences in math and english achievement: A longitudinal study

This study investigated gender-related developmental trends in math and English achievement as measured by classroom grades and standardized test scores. The sample consisted of 30 males and 30 females followed from 6th through 12th grade. Previous research suggests that developmental trends in male and female achievement may differ as a function of assessment context. Thus, it was hypothesized that female math and English classroom grades would remain stable over time but that achievement test scores in both subject areas would decline. For males, it was hypothesized that performance in both assessment contexts would remain stable. Results confirmed these hypotheses. Results also suggest that school-related responsibility is related to performance in both assessment contexts for females but not for males. The need to consider personal goals when assessing differences in academic ability and performance capabilities is discussed.