What You Can Change . . . And What You Can't*: The Complete Guide to Successful Self-Improvement (49 page)

4
. B. Kuiper and P. Cohen-Kettenis, “Sex Reassignment Surgery: A Study of 141 Dutch Transsexuals,”
Archives of Sexual Behavior
17 (1988): 439–57; M. Ross and J. Need, “Effects of Adequacy of Gender Reassignment on Psychological Adjustment: A Follow-up of Fourteen Male-to-Female Patients,”
Archives of Sexual Behavior
18 (1989): 145–53.

5
. I want to call the reader’s attention to an alternative theory: R. Pillard and J. Weinrich, “The Periodic Table Model of the Gender Transpositions:
Part I
. A Theory Based on Masculinization and Defeminization of the Brain,”
The Journal of Sex Research
4 (1987): 425–54, is an oddly brilliant attempt to explain the variations in sexual identity and behavior with two simple principles: masculinization and defeminization, both influenced by genes, hormones, and nurture. So speculative is this theory (and mine as well) that I leave it to future research to pass judgment.

6
. J. Money and J. Dalery, “Iatrogenic Homosexuality: Gender Identity in Seven 46XX Chromosomal Females with Hyperadrenocortical Hermaphroditism Born with a Penis, Three Reared as Boys, Four Reared as Girls,”
Journal of Homosexuality
1 (1976): 357–71; J. Money, M. Schwartz, and V. Lewis, “Adult Heterosexual Status and Fetal Hormonal Masculinization and Demasculinization: 46XX Congenital Virilizing Adrenal Hyperplasia and 46XY Androgen-Insensitivity Syndrome Compared,”
Psychoneuroendocrinology
9 (1984): 405–14; J. Money, “Sin, Sickness, or Status?”
American Psychologist
42 (1987): 384–99.

7
. V. Lewis and J. Money, “Gender Identity/Role: GI/R Part A: XY (Androgen-Insensitivity) Syndrome and XX (Rokitansky) Syndrome of Vaginal Atresia Compared,” in L. Dennerstein and G. Burrows, eds.,
Handbook of Psychosomatic Obstetrics and Gynecology
(New York: Elsevier, 1983), 51–60.

8
. Sexologists lump the homosexual-versus-heterosexual “choice” into the same category (“sexual-object choice”) as the “choice” of body parts, fetishistic objects, and erotic situations (S-M, pedophilia, flashing, etc.). I break these into two separate categories, sexual orientation and sexual preferences, because I think they are different processes. The homosexual/heterosexual “choice” is deeper, dictated earlier in life, and more inflexible than the sexual preferences for body parts, inanimate objects, and arousing situations.

9
. S. Levay, “A Difference in Hypothalamic Structure Between Heterosexual and Homosexual Men,”
Science
253 (1991): 1034–37. Further evidence for differing brain structures in a nonreproductively related area was found by L. Allen and R. Gorski, “Sexual Orientation and the Size of the Anterior Commissure in the Human Brain,”
Proceedings of the National Academy of Sciences
89 (1992): 7199–7202. Here the anterior commissure was significantly larger in homosexual men than in heterosexual women, who in turn had more tissue here than heterosexual men had.

10
. The examples that follow are not intended to be hormonally or anatomically accurate; they are merely schemata to illustrate what the architecture underlying separate processes for identity, sexual organs, and orientation would have to be like.

11
. The breakthrough article speculating roughly in this way is L. Ellis and M. Ames, “Prenatal Neurohormonal Functioning and Sexual Orientation: A Theory of Homosexuality-Heterosexuality,”
Psychological Bulletin
101 (1987): 233–58. So provocative was this piece that I was forced to change an entire course in midstream to discuss it at length when it came out in 1987.

For the literature on twins and homosexuality, see E. Eckert, T. Bouchard, J. Bohlen, and L. Heston, “Homosexuality in Monozygotic Twins Reared Apart,”
British Journal of Psychiatry
148 (1986): 421–25. M. Bailey and R. Pillard, “A Genetic Study of Male Sexual Orientation,”
Archives of General Psychiatry
48 (1991): 1089–96, is the landmark study in this area. While this points directly to a genetic in addition to a fetal-hormone mechanism, homosexuality still might be entirely fetal in origin. Identical twins do not have identical intrauterine environments. One twin is often bigger than the other. Could it be that identical twins do not get identical hormonal baths? No one knows yet.

It is possible that bisexuality—or, strictly speaking, the capacity for bisexuality—has as its substratum just a bit of androgen insufficiency in utero. Future research will tell. But it is important that most of the development of bisexuality is in adolescence and adulthood, not in utero. People not infrequently become actively bisexual when exposed to homosexuality during their teens and twenties. For this reason I include bisexuality as a sexual preference, and exclusive homosexuality as a sexual orientation.

12
. Evidence is not completely lacking. A. Ehrhardt, H. Meyer-Bahlburg, L. Rosen, et al., “Sexual Orientation After Prenatal Exposure to Exogenous Estrogen,”
Archives of Sexual Behavior
14 (1985): 57–75, found increased bisexuality and homosexuality among women whose mothers had taken DES, which has masculinizing effects, during pregnancy.

In the genetic study of lesbianism, unlike the study of male homosexuality, sisters were just as concordant for lesbianism as fraternal twins, suggesting no clear role for fetal hormones. M. Bailey, R. Pillard, M. Neale, and Y. Agyei, “Heritable Factors Influence Sexual Orientation in Women,”
Archives of General Psychiatry
50 (1993): 217–23.

13
. In the original study (M. Feldman and M. MacCulloch, “The Application of Anticipatory Avoidance Learning to the Treatment of Homosexuality. 1. Theory, Technique, and Preliminary Results,”
Behaviour Research and Therapy 2
[1966]: 165–83), the authors found marked improvement in 58 percent of the men who started therapy and 69 percent of the men who completed therapy. In an automated follow-up, only 31 percent of the men who started therapy and 42 percent of the completers improved markedly. “Heterophobes” and men completely indifferent to women did not improve. See S. James, A. Orwin, and R. Turner, “Treatment of Homosexuality. 1. Analysis of Failure Following a Trial of Anticipatory Avoidance Conditioning and the Development of an Alternative Treatment System,”
Behavior Therapy
8 (1977): 840–48. See also N. McConaghy, M. Armstrong, and A. Blaszczynski, “Controlled Comparison of Aversive Therapy and Covert Sensitization in Compulsive Homosexuality,”
Behaviour Research and Therapy
19 (1981): 425–34. They also find about 50 percent success, but argue that no change in sexual orientation has occurred. The best overall review is H. Adams and E. Sturgis, “Status of Behavioral Reorientation Techniques in the Modification of Homosexuality: A Review,”
Psychological Bulletin
84 (1977): 1171–88.

14
. R. Baenninger, “Some Consequences of Aggressive Behavior: A Selective Review of the Literature on Other Animals,”
Aggressive Behavior
1 (1974): 17–37.

15
. T. Templeman and R. Stinnett, “Patterns of Sexual Arousal and History in a ‘Normal’ Sample of Young Men,”
Archives of Sexual Behavior
20 (1991): 137–50.

16
. This is the view propounded by Richard von Krafft-Ebing. His
Psychopathia Sexualis
(New York: Physicians’ and Surgeons’ Book Company, 1922) is a great and eminently readable compilation. I number him with Freud, Kinsey, Masters and Johnson, and John Money among the great liberators in this field.

17
. For example, see D. Raphling, “Fetishism in a Woman,”
Journal of the American Psychoanalytic Association
37 (1989): 465–91. The S-M study is N. Breslow, L. Evans, and J. Langley, “On the Prevalence and Roles of Females in the Sadomasochistic Subculture: Report of an Empirical Study,”
Archives of Sexual Behavior
14 (1985): 303–17.

18
. I recommend the first chapter of the explosive
Sexual Personae
(New York: Vintage, 1991), by the bete noire of feminism, Camille Paglia, for the view that promiscuity is normal in men but an illness in women. As for evidence, see David Buss’s cross-cultural studies about sexual attractants in men versus women, reported in his “Sex Differences in Human Mate Preferences: Evolutionary Hypotheses Tested in 37 Cultures,”
Behavioral and Brain Sciences
12 (1989): 1–49.

19
. W. Marshall, A. Eccles, and H. Barbaree, “The Treatment of Exhibitionists: A Focus on Sexual Deviance Versus Cognitive and Relationship Features,”
Behaviour Research and Therapy
29 (1991): 129–35; B. Maletzky, “‘Assisted’ Covert Sensitization in the Treatment of Exhibitionism,”
Journal of Consulting and Clinical Psychology
42 (1974): 34–40.

20
. A thorough review is found in J. Bradford, “Organic Treatment for the Male Sexual Offender,”
Annals of the New York Academy of Sciences
528 (1988): 193–202.

21
. There are large literatures on all these points. Two good reviews are A. Huston, “The Development of Sex Typing: Themes from Recent Research,” in
Developmental Review
5 (1985): 1–17; and M. Sedney, “Development of Androgyny: Parental Influences,”
Psychology of Women Quarterly
11 (1987): 31–326. The classic in this field is E. Maccoby and C. Jacklin,
The Psychology of Sex Differences
(Stanford, Calif.: Stanford University Press, 1974).

22
. See the Sedney and Huston reviews (cited immediately above) for good coverage of the studies that try and fail to coax young children into androgyny.

23
. H. Meyer-Bahlburg, J. Feldman, P. Cohen, and A. Ehrhardt, “Perinatal Factors in the Development of Gender-Related Play Behavior: Sex Hormones Versus Pregnancy Complications,”
Psychiatry
51 (1988): 260–71; S. Berenbaum and M. Hines, “Early Androgens Are Related to Childhood Sex-Typed Toy Preferences,”
Psychological Science
3 (1992): 203–6. J. Money and A. Ehrhardt,
Man and Woman, Boy and Girl
(Baltimore: Johns Hopkins University Press, 1972), is an excellent general reference for the precursor studies.

24.
J. Reinisch, unpublished study cited in C. Gorman, “Sizing Up the Sexes,”
Time
(20 January 1992), 45–46.

25
. The most comprehensive recent overview is J. Hyde, “Meta-analysis and the Psychology of Gender Differences,”
Signs: Journal of Women in Culture and Society
16 (1990): 55–73.

The spatial score may have a biological component. Astonishingly, women’s scores go up by between 50 and 100 percent when their estrogen level is low, and men’s scores go up when their testosterone level is low. See I. Silverman and M. Eals, “Sex Differences in Spatial Abilities: Evolutionary Theory and Data,” in J. Barko, L. Cosmides, and J. Tooby, eds.,
The Adaptive Mind: Evolutionary Psychology and the Generation of Culture
(Oxford: Oxford University Press, 1992), 487–503. It is also intriguing that while men are better at rotating three-dimensional objects (perhaps related to navigating the savannah while hunting), women are apparently better at the spatial task of remembering the place of objects (perhaps related to foraging).

26
. J. Hall,
Nonverbal Sex Differences: Communication Accuracy and Expressive Styles
(Baltimore: Johns Hopkins University Press, 1984).

27
. Alan Feingold of Yale University has written a landmark article on this topic, containing exhaustive data reanalysis of the major ability tests: “Sex Differences in Variability in Intellectual Abilities: A New Look at an Old Controversy,”
Review of Educational Research
62 (1992): 61–84.

28
. A. Feingold, “Sex Differences in Variability in Intellectual Abilities.”

29
. There is an alternate explanation of the narrowing of sex differences: renorming. Every few years, the big test makers (ETS, California Achievement, etc.) renorm their tests to try to make them better and “fairer.” To do this, they sometimes throw out items on which there is a sex difference or a race difference and substitute items that do not differ empirically. If this is what is going on in the reduction of the ability-score differences, it is sheer artifact. The ability differences remain, but we can no longer see them as clearly.

30
. W. Masters and V. Johnson,
Human Sexual Inadequacy
(Boston: Little, Brown, 1970), is a classic, but too technical to be a good read. H. Kaplan,
The New Sex Therapy
(New York: Brunner-Mazel, 1974), is a better choice for the layman. For a skeptical view, see B. Zilbergeld and M. Evans, “The Inadequacy of Masters and Johnson,”
Psychology Today
14 (1980): 28–43.