WHAT TYPES OF SEX-ROLE BEHAVIOR SHOULD BEHAVIOR MODIFIERS PROMOTE?

Rekers and Lovaas (1974) reported a study using reinforcement procedures aimed at modifying the behavior of a 5-yr-old who engaged in cross-gender behavior. The use of traditional sex-role concepts in forming target behaviors is criticized and androgynous behavior is suggested as an empirically based alternative. The pathological nature of the behavior that the study was designed to prevent is also questioned, as is the ability to predict sex-role behavior from a 5-yr-old child's current behavior. These issues are raised in the context of the more general question, whom should the therapist serve?     

Early intervention for female sexual identity disturbance: Self-monitoring of play behavior

This study is the first experimental demonstration of sex-typed play behavior change in a young girl with sexual identity disturbance. The 8-year-old child was treated with a self-monitoring procedure combined with a behavioral prompting technique that was gradually faded out. Self-monitoring in the clinic resulted in a high, stable rate of appropriate sex-typed play, and this effect generalized to a different set of sex-typed toys over time. The treatment effects did not generalize to the home environment. The self-regulation intervention was subsequently adapted to the home setting, resulting in a replication of the treatment effects across settings. After the removal of the self-monitoring interventions, a high level of feminine sex-typed play persisted. Pretreatment, posttreatment, and follow-up psychological testing demonstrated a reversal of a pronounced cross-gender identity to a normal female sexual identity.This study was supported by United States Public Health Service research grant MH29945 awarded to Dr. Rekers at the Logos Research Institute, Inc., by the National Institute of Mental Health. Appreciation is expressed to Dr. Vernon Van de Riet for his independent clinical psychological diagnosis.     

BEHAVIORAL TREATMENT OF DEVIANT SEX-ROLE BEHAVIORS IN A MALE CHILD1

This study demonstrated reinforcement control over pronounced feminine behaviors in a male child who had been psychologically evaluated as manifesting “childhood cross-gender identity”. The clinical history of the subject paralleled the retrospective reports of adult transsexuals, including (a) cross-gender clothing preferences, (b) actual or imaginal use of cosmetic articles, (c) feminine behavior mannerisms, (d) aversion to masculine activities, coupled with preference for girl playmates and feminine activities, (e) preference for female role, (f) feminine voice inflection and predominantly feminine content in speech, and (g) verbal statements about the desire or preference to be a girl. The subject was treated sequentially in the clinic and home environments by his mother, trained to be his therapist. The mother was taught to reinforce masculine behaviors and to extinguish feminine behaviors, by using social reinforcement in the clinic and a token reinforcement procedure in the home. During this treatment, his feminine behaviors sharply decreased and masculine behavior increased. The treatment effects were found to be largely response-specific and stimulus-specific; consequently, it was necessary to strengthen more than one masculine behavior and weaken several feminine behaviors, in both clinic and home settings. A multiple-baseline intrasubject design was used to ensure both replication and identification of relevant treatment variables. Follow-up data three years after the treatment began suggests that the boy's sex-typed behaviors have become normalized. This study suggests a preliminary step toward correcting pathological sex-role development in boys, which may provide a basis for the primary prevention of adult transsexualism or similar adult sex-role deviation.     

The behavioral treatment of a “transsexual” preadolescent boy

Behavioral treatment procedures were developed to suppress feminine sex-typed behaviors and to increase masculine sex-typed behaviors in an 8-year-old boy with “childhood cross-gender identity.” The boy's clinical history paralleled the retrospective reports of adult transsexuals, including (1) feminine voice inflection and predominantly feminine content in speech, (2) verbal self-reference as “sissy” and “fag” and statements about his preference to be a girl, (3) feminine hand and arm gestures and “swishy” gait, (4) an aversion to masculine play activities, (5) a strong preference for girl playmates and taking a feminine role in play and role-playing, and (6) improvised cross-dressing. With a multiple-baseline intrasubject design across stimulus environments and across behaviors, the subject was treated sequentially in the clinic, at home, and in the school. The boy's mother was trained to administer a token economy program in the home, and the school teacher was taught to apply a response-cost procedure in the classroom. The initial treatment effects were found to be largely response specific and stimulus specific, necessitating treatment for a number of behaviors in the three major environments. Followup data 12 months after treatment termination suggest that the boy's sex-typed behaviors have become essentially normalized. This treatment holds promise for correcting pathological gender identity development in boys and for relieving the associated emotional adjustment problems.     

Sex Differences in Referral Rates of Children with Gender Identity Disorder: Some Hypotheses

From 1978 through 1995, a sex ratio of 6.6:1 of boys to girls (N = 275) was observed for children referred to a specialty clinic for gender identity disorder. This article attempts to evaluate several hypotheses regarding the marked sex disparity in referral rates. The sexes did not differ on four demographic variables (age at referral, IQ, and parent's social class and marital status) and on five indices of general behavior problems on the Child Behavior Checklist; in addition, there was only equivocal evidence that boys with gender identity disorder had significantly poorer peer relations than girls with gender identity disorder. Although the percentage of boys and girls who met the complete DSM-III-R criteria for gender identity disorder was comparable, other measures of sex-typed behavior showed that the girls had more extreme cross-gender behavior than the boys. Coupled with external evidence that cross-gender behavior is less tolerated in boys than in girls by both peers and adults, it is concluded that social factors partly account for the sex difference in referral rates. Girls appear to require a higher threshold than boys for cross-gender behavior before they are referred for clinical assessment.     

The Assessment and Treatment of Gender-Disturbed Boys by Guidance Counselors

This article discusses the guidance counselor's occasional involvement in the assessment and treatment of male children exhibiting gender disturbances. Boyhood gender disturbances are differentiated into two different but closely related syndromes: cross-gender identification and gender behavior disturbance. Specific diagnostic procedures and issues are discussed, among them the rationale for psychoeducational intervention. The article considers the developmental problems suffered by gender-disturbed boys and examines the relatively poor prognosis for untreated individuals. The text outlines specific treatment interventions to increase the child's range of masculine behaviors so there is a reasonable balance between masculine and feminine behavior. Reasonable sex-role flexibility and satisfaction with one's own biological sex status are the treatment goals.     

Children's appraisals of sex-typed behavior in their peers

Four experiments evaluated the effect of variations in sex-typed behavior in hypothetical peers on children's ratings of friendship. In all four studies, the children were heterogeneous with regard to social class, ethnicity, and race. In Experiment 1, children (71 boys, 90 girls) in Grades 3–6 read five stories about a target boy and in Experiment 2 (102 boys, 137 girls) about a target girl who displayed four sex-typed behaviors that ranged from exclusively masculine to exclusively feminine. In Experiment 1, boys preferred the exclusively masculine boy most as a friend. With each addition of a feminine behavior (and corresponding subtraction of a masculine behavior), the friendship ratings became increasingly negative. In contrast, the girls preferred the exclusively feminine boy most as a friend and, with each addition of a masculine behavior, the friendship ratings became increasingly negative. In Experiment 2, the converse was found although girls' ratings of friendship were less sharply affected by the target girl's sex-typed behavior than was observed for boys' ratings in Experiment 1. In Experiment 3, children (33 boys, 38 girls) in Grades K—2 were read three stories about a target boy, accompanied by detailed chromatic illustrations, whose four sex-typed behaviors were exclusively masculine, equally masculine and feminine, or exclusively feminine. The boys had significantly more favorable friendship ratings than the girls; however, in contrast to Experiments 1 and 2, the target boy's sex-typed behavior did not affect friendship ratings of either boys or girls. Experiment 4 (28 boys, 27 girls) repeated the procedure of Experiment 3 with children in kindergarten and Grade 1; in addition, the children made forced-choice friendship ratings for each of the three possible story pairs. In contrast to Experiment 3, boys' friendship ratings were affected by the target boy's sex-typed behavior, as observed in Experiment 1, but girls' friendship ratings were not. However, in the forced-choice situation, the boys significantly preferred the exclusively masculine boy whereas the girls significantly preferred the exclusively feminine boy. The results were discussed in relation to the influence sex-typed behavior has on modifying the effects of a peer's sex on affiliative preference and sex differences in appraisals of cross-gender behavior, including the concept of threshold effects.     

The psychoanalytic treatment of a preschool boy with a gender identity disorder

A three-year, nine-month-old boy began analysis by wishing he was a girl and pretending he was a superheroine. Over the course of almost five years, the cross-gender defense against fear of loss of the object, anal loss, and castration by the object reorganized in all libidinal phases through early latency. Developmental arrests seemed to occur during the anal rapprochement and oedipal phases that led to observable cross-gender strivings by two and a half years of age. The role of early childhood illness, narcissistic vulnerability, mother's childhood wish for a sister, the mother's adult wish for a daughter, a shared fantasy between mother and child, identification with the perceived power and beauty of mother and grandmother, pathological sibling rivalry that influenced identification with his sister, were demonstrated in his play during sessions. Interwoven in the background was the impact of an emotionally absent father, a dying grandfather, and an accident-prone uncle. This paternal matrix seemed to discourage budding masculinity and encourage feminine identifications. The analyst's approach and the child's responses to interpretation of the transference manifestations, cross-gender behavior, fantasies, and play are presented. Finally, the gradual resolution of the conflicted wish to be a girl was supplanted by the emergence of appropriate gender identification. A two-year followup appeared to confirm his postanalytic gender stance and continuing consolidation of stable gender development.     

Editor's Note: Societal changes and expression of concern about Rekers and Lovaas' (1974) Behavioral Treatment of Deviant Sex-Role Behaviors in a Male Child

In an early study in the Journal of Applied Behavior Analysis, Rekers and Lovaas (1974) evaluated the Behavioral Treatment of Deviant Sex-role Behaviors in a Male Child. They investigated the use of reinforcement and punishment to target non-gender-conforming behaviors of a 5-year-old male child. This study was considered by some to be controversial and concerning, even near the time of publication (Nordyke et al. 1977; Winkler, 1977). The concerns focused on the ethicality of selecting non-gender-conforming behavior as a target response and the use of punishment for this type of response, particularly at the behest of parents when the young child was not seemingly distressed. The study has subsequently been used as empirical support for conversion therapy creating concerns about misinterpretation of the original article and harm to the LGBTQ+ community. This editorial reviews the concerns originally presented by Nordyke et al. (1977) and Winkler (1977) and issues an official Expression of Concern about the various harms that have been associated with this paper.     

Gender role identity and dating behavior: What is the relationship?

The influence of gender role identity on dating behaviors of college students was examined using the Bem Sex Role Inventory and a behavioral questionnaire constructed by the author. One hundred and ninety-seven students were classified as androgynous, undifferientated, feminine, or masculine based on their Bem Sex Role Inventory scores. A behavioral questionnaire was used to generate two self-report behavioral indexes: the masculine dating behavior and feminine dating behavior indexes. Results indicated that high-masculine individuals (androgynous and masculine individuals) scored higher on the masculine dating behavior index and that high-feminine individuals (androgynous and feminine individuals) scored higher on the feminine interactional index. The results of this study support the hypothesis that gender role identity influences self-reported dating behavior of college students.     

Preadolescents' Social Judgments: The Relationship Between Self-Endorsement of Traits and Gender-Related Judgments of Female Peers

The present study investigated therelationship between preadolescents' and earlyadolescents' inferences and judgments of a target girl,their self-endorsement of traditionally feminine andmasculine traits, the gender of the playmates and thegender-typedness of the game. Preadolescents and earlyJewish Israeli adolescents males and females (n = 251)were shown a video film portraying a female targetplaying a feminine, masculine or neutral game witheither boys or girls and then made a variety ofinferences and judgments about the target. The gender ofthe playing partners and the gender-typedness of thegame were found to influence preadolescents'inferences of female targets' traits, roles andoccupations, but not their motivational-emotionaljudgments. Gender differences emerged such that theinferences of boys were more often in accordance withtraditional gender stereotypes. Selfendorsement oftraits did not seem to influence preadolescents'judgments, except in those of the cross-gender children.The results are discussed within the framework of genderschema theories.     

Sex-typed motor behaviors of “feminine” boys,conventionally masculine boys,and conventionally feminine girls

The purpose of this study was to determine whether, in four commonly observed childhood behaviors, the gross impression conveyed by “feminine” boys is distinctive from that of conventional boys, and in the direction of conventional girls. Three samples of children age 4–10 years were included in the study: boys with atypical sexual identity (N=12); age-matched conventionally sex-typed boys (N=8); and age-matched girls (N=7). The children were identically costumed to conceal gender and were videotaped while throwing a ball, walking, running, and telling a story. Videotaped segments of behaviors were randomly presented to four raters who judged the sex of the child on a five point scale which ranged from very likely male to very likely female. The analyses indicate that the sample to which the child belonged was the most important factor in explaining the rating the child received. The “feminine” boys occupied an intermediate position, one that was neither distinctly “feminine” nor distinctly “masculine.”     

Effects of mixed reinforcement contingencies on adults' control of children's behavior

Two severely retarded boys, each a member of a different play group, experienced three regimes of reinforcement from adults [contingent, noncontingent, and mixed (contingent and noncontingent)]. The agent of contingent reinforcement acquired stimulus control of the subjects' behavior; the noncontingent agent did not. The agent of the mixed schedule of reinforcement did not gain control, but aspects of his behavior came to function as cues. The mixed adult's withholding reinforcement in the absence of the target behavior (cooperative play) evoked cooperative play, whereas his presenting free reinforcement resulted in the subjects' remaining in their inactive, baseline positions.     

An Experimental Examination of the Effects of Sex and Masculinity/Femininity on Psychological, Physiological, and Behavioral Responses During Communication Situations

The purpose of this study was to examine the effects of biological sex and masculinity/femininity on physiological (blink and heart rates), emotional (anxiety and mood), and behavioral responses (behavioral ratings of communication skills) during communication situations. Participants were 46 students in a Japanese university. They were categorized into 3 gender types—androgynous, stereotypical, and cross-gender on the Masculinity–Humanity–Femininity Scale (Ito, 1978) and the Social Skills Inventory (Riggio, 1986). The communication situations consisted of 2 experimental tasks (question-asking and self-introduction in front of a video camera). These two tasks were conducted in both Japanese and English. The results suggested that the cross-gender-type participants (feminine men and masculine women) showed increased blink and heart rates. For the behavioral ratings, the cross-gender type and the androgynous gender type were judged to have better communication skills than the stereotypical gender type. There was no significant difference in emotional responses among groups. The interaction of biological sex and masculinity/femininity may be associated with interpersonal adjustment and its stress responses.     

Boyhood Femininity,Gender Identity Disorder,Masculine Presuppositions,and the Anxiety of Regulation

This paper details the diagnostic discourse that has accumulated around feminine boys, including the traditional presuppositions of Gender Identity Disorder (GID). The GID discourse is examined for the ways in which it is built upon unquestioned beliefs about masculinity. Distinct from most modern considerations of gender, no effort has been made to critically theorize gender when thinking about feminine boys; masculinity is as masculinity was. Consequently, we are left with modes of diagnosis and treatment that are out of synch with modern social life, and a set of ideas that do not proceed from an adequate understanding of the range that is masculinity. New sustaining ideals are in play, and in accord with these ideals an argument is made for a new mode of psychotherapeutic address. The traditional individual trauma explanation for GID is questioned. Particular emphasis is given to the ways in which this traditional GID discourse fails to reckon with how masculinity is held in place by the strong arm of regulatory anxiety. A new position that incorporates a greater appreciation for the role of social trauma and melancholia is offered. It is argued that a theory that offers insight into the workings of melancholia as it builds the feminine boy affords a more robust set of ideas through which to contemplate the boy. In turn, we come upon a better avenue of psychotherapeutic action—one that does not employ behavioral strategies that reinforce social exclusion.     

Masculinity unraveled: the roots of male gender identity and the shifting of male ego ideals throughout life

A model of masculine gender identity development is presented that demonstrates how a male's sense of his masculinity and the ambiguities of his gender are being reworked throughout his life. Of factors shaping the boy's sense of masculinity early on, particular emphasis is placed on the role of the involved father, the nature of the parental relationship, and the mother's recognition and affirmation of her son's maleness. While healthy masculine gender identity is founded predominantly on the boy's unique struggles in separating from his mother, it does not result from what has been traditionally viewed as the boy's disidentification from her (and from the feminine more generally). Indeed, boys who need to violently repudiate their identifications with their mother are more susceptible to a fragile, rigid masculine identity and narcissistic psychopathology. A case example of a young adult man illustrates the impact of identifications with both parents. The interplay of early masculine identity development and later life challenges confronting the adult male is briefly noted. "Masculine" ego ideals shift across developmental junctions until, ultimately, a more mature sense of masculinity emerges: the phallic wish to deny differentiation and maintain unlimited possibility is renounced and mourned and certain real limits concerning sex, gender, and generational differences are accepted. This reshaping of the "masculine" ego ideal consequently involves the transformation of a man's previously adaptive "phallicism" into more realistic, "genital" ego ideals-an achievement involving interplay between masculine and feminine identifications and the integration of antithetical elements no longer so unconsciously gendered.     

Humiliation and Transgender Regulation: Commentary on Paper by Ken Corbett

This commentary reads Ken Corbett's “Boyhood Femininity” alongside the Lawrence King case to examine shame as a means of regulating gender nonconforming boys. Corbett describes the dominant clinical discourse on feminine boys that understands them to be “nonconforming, extreme, and disordered” and notes that such discourse depends on the presupposition that boys must be masculine. This discourse is at once ontological and normative, asserting both that boys are naturally masculine and that they need to become masculine, a paradoxical imperative that may account for the ways in which the discourse is haunted by anxiety about the location, durability, and persistence of masculinity. In responding to the framing of boyhood femininity as a disorder, Corbett inverts the diagnosis; as a response to the reading of gender variant youth as inappropriately arrested in their psychosexual development, he diagnoses the profession itself as suffering from a “developmental lag” and suggests that the diagnosis that condemns a femme boy to psychic stagnation and unhappiness projects its own failure to see beyond normative gender presumptions onto the phenomenological life of the feminine boy. Corbett asks us to consider boyhood femininity as the scene of gender's emergence rather than as the site of its failure.     

Parents' Attitudes and Expectations About Children's Cross-Gender Behavior

The goals of the present study were to assessparents' attitudes toward crossgender boys and girls, aswell as to explore possible reasons for differentialevaluations. A total of 224 White parents of five-year old children completed questionnaires probingtheir attitudes toward cross-gender behavior inchildren, and their expectations regarding the futureadult behavior of typical boys, typical girls,cross-gender boys and cross-gender girls. The resultsrevealed that cross-gender boys were more negativelyregarded than crossgender girls and thatmen perceivedmore societal acceptance of cross-gender boys thanwomen. Cross-gender children were predicted tocontinue to show cross-gender behavior in adulthood andto be less psychologically welladjusted as adults thantypical boys and girls. Cross-gender boyswere expected to be less psychologicallywell-adjusted than cross-gender girls. When predictingfuture sexual orientation, cross-gender boys were deemedto have a greater likelihood of being gay thancross-gender girls of being lesbian. Men expectedcross-gender boys to be more likely to show male-malesexual behavior than typical boys inadulthood while women predicted typicalgirls to be more likely to show female-female sexual behavior in adulthoodthan cross-gender girls.