Self-monitoring and self-reinforcement processes in a pre-transsexual boy

Young boys with normal male physical status who manifest feminine gender-role behavior and verbalize a cross-gender identity are high-risk for later adult sexual adjustment problems, e.g., transsexualism and homosexual conflicts (Bakwin, 1968; Lebovitz, 1972; Stoller, 1968; Zuger, 1966). In the only published experimental treatment studies on child gender disturbance in which replication procedures were used, Rekers and his colleagues empirically demonstrated external stimulus control and reinforcement control over pronounced feminine behavior in young boys with serious gender identity and behavior disturbance (Rekers and Lovaas, 1974; Rekers, Lovaas and Low, 1974; Rekers, Willis, Yates, Rosen and Low, in press; Rekers, Yates, Willis, Rosen and Taubman, 1976). To potentially minimize the previously reported stimulus specificity of the extrinsic reinforcement effects, this study introduces, for the first time, behavioral self-control strategies to decrease feminine behavior in a cross-gender identified boy. A 6-year-old boy was taught to self-monitor his own sex-role behavior, and then to self-reinforce gender-appropriate responding. A behavioral cueing procedure was used during the initial phases of the training of self-monitoring.