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Roshan GM, Talaei A, Sadr M, Arezoomandan S, Kazemi S, Khorashad BS. Recalled pre-school activities among adults with gender dysphoria who seek gender confirming treatment-An Iranian study. Asian J Psychiatr 2019; 42:57-61. [PMID: 30954930 DOI: 10.1016/j.ajp.2019.03.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 11/25/2022]
Abstract
Preschool play behaviors have been frequently shown to be associated with prenatal androgens. It has also been proposed that incongruent sex-typed play behaviors in childhood is associated with gender dysphoria in adulthood in both men and women. Most of these studies, however, have been conducted in western countries. In this study, we investigated the recalled childhood play behavior among a total number of 339 Iranian participants (n = 72 transwomen, n = 92 transmen, n = 75 cisgender men and n = 100 cisgender women) using Preschool Activity Inventory (PSAI). We found that PSAI mean scores of the four groups were significantly different (F(3,335 = 223.5, p < 0.001)). Both transmen and cisgender men scored significantly more masculine than transwomen and cisgender women but had no different with each other. Transwomen scored significantly more feminine than cisgender men and cisgender women. Our findings are in line with previous studies that suggest gender nonconforming play behaviors may be associated with gender dysphoria in adulthood. It also emphasizes the importance of this finding for in non-western clinical context and its implications.
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Affiliation(s)
- Ghasem M Roshan
- Transgender Studies Center, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Talaei
- Transgender Studies Center, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mostafa Sadr
- Transgender Studies Center, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Sanaz Arezoomandan
- Transgender Studies Center, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Sepideh Kazemi
- Transgender Studies Center, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Behzad S Khorashad
- Transgender Studies Center, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Sport, Exercise, and Health Sciences, Loughborough University, UK.
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Khorashad BS, Roshan GM, Reid AG, Aghili Z, Moghadam MD, Khazai B, Hiradfar M, Afkhamizadeh M, Ghaemi N, Talaei A, Abbaszadegan MR, Aarabi A, Dastmalchi S, Van de Grift TC. Childhood Sex-Typed Behavior and Gender Change in Individuals with 46,XY and 46,XX Disorders of Sex Development: An Iranian Multicenter Study. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2287-2298. [PMID: 30128981 DOI: 10.1007/s10508-018-1281-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 01/23/2018] [Accepted: 07/24/2018] [Indexed: 06/08/2023]
Abstract
Disorders of sex development (DSD) are congenital conditions in which the typical genetic and hormonal profiles are affected and thereby the usual process of sexual differentiation. Most of these studies, however, have been conducted in Western countries. In the present study, preschool sex-typed activities of Iranian individuals with DSD and their age-matched non-affected male and female relatives were assessed using the Pre-School Activities Inventory (PSAI) modified for retrospective self-report. A total of 192 individuals participated in our study, including 33 46,XX individuals with congenital adrenal hyperplasia (CAH; M age = 10.36, SD = 5.52), 15 46,XY individuals with complete androgen insensitivity syndrome (CAIS; M age = 19.8, SD = 7.14), and 16 46,XY individuals with 5-alpha reductase deficiency type-2 (5α-RD-2; M age = 17.31, SD = 7.28), as well as one age-matched non-affected male and female relative for each patient. With regard to PSAI scores, male-identifying participants with 5α-RD-2 and male controls reported similar levels of male-typical childhood play. Female-identifying participants with 5α-RD-2 and CAH showed comparable scores: significantly less masculine and more feminine than male controls, but significantly more masculine and less feminine than females with CAIS and female controls. These findings support the role of androgens in the development of sex-typical childhood play behavior, with those being exposed to higher levels of fetal functional androgens expressing more masculine behavior at preschool ages.
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MESH Headings
- 3-Oxo-5-alpha-Steroid 4-Dehydrogenase/deficiency
- 3-Oxo-5-alpha-Steroid 4-Dehydrogenase/genetics
- 3-Oxo-5-alpha-Steroid 4-Dehydrogenase/metabolism
- Adolescent
- Adrenal Hyperplasia, Congenital/genetics
- Adrenal Hyperplasia, Congenital/metabolism
- Adrenal Hyperplasia, Congenital/physiopathology
- Adult
- Androgen-Insensitivity Syndrome/genetics
- Androgen-Insensitivity Syndrome/metabolism
- Androgen-Insensitivity Syndrome/physiopathology
- Androgens/metabolism
- Child
- Child Behavior
- Child, Preschool
- Disorder of Sex Development, 46,XY/genetics
- Disorder of Sex Development, 46,XY/metabolism
- Disorder of Sex Development, 46,XY/physiopathology
- Female
- Gender Identity
- Humans
- Hypospadias/genetics
- Hypospadias/metabolism
- Hypospadias/physiopathology
- Iran
- Male
- Retrospective Studies
- Self Report
- Sex Characteristics
- Sex Differentiation
- Sexual Development
- Steroid Metabolism, Inborn Errors/genetics
- Steroid Metabolism, Inborn Errors/metabolism
- Steroid Metabolism, Inborn Errors/physiopathology
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Affiliation(s)
- Behzad S Khorashad
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ghasem M Roshan
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alistair G Reid
- Molecular Pathology Unit, Liverpool Clinical Laboratories, Liverpool, UK
| | - Zahra Aghili
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Behnaz Khazai
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehran Hiradfar
- Department of Pediatric Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mozhgan Afkhamizadeh
- Endocrine Research Center, Department of Endocrinology, Iman Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nosrat Ghaemi
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Abbaszadegan
- Division of Human Genetics, Immunology Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azadeh Aarabi
- Division of Human Genetics, Immunology Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Dastmalchi
- Faculty of Psychology, Islamic Azad University, Torbat-e-Jam Branch, Torbat-e-Jam, Iran
| | - Tim C Van de Grift
- Department of Medical Psychology (Gender and Sexology), VU University Medical Center, Amsterdam, The Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands
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Khorashad BS, Roshan GM, Reid AG, Aghili Z, Hiradfar M, Afkhamizadeh M, Talaei A, Aarabi A, Ghaemi N, Taghehchian N, Saberi H, Farahi N, Abbaszadegan MR. Sexual orientation and medical history among Iranian people with Complete Androgen Insensitivity Syndrome and Congenital Adrenal Hyperplasia. J Psychosom Res 2017; 92:55-62. [PMID: 27998513 DOI: 10.1016/j.jpsychores.2016.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 11/30/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To report sexual orientation, relationship status and medical history of Iranian people with Differences of Sex Development (DSD) who were raised female. METHODS Our participants consisted of nineteen 46,XY individuals with Complete Androgen Insensitivity Syndrome (CAIS) and eighteen 46,XX individuals with Congenital Adrenal Hyperplasia (CAH) who were raised as females and older than 13years. As well as their relationship status and detailed medical history, an expert psychiatrist assessed their sexual orientation by a semi-structured psychiatric interview with them and, where applicable, their parents. RESULTS Five percent of CAH participants and 42% of CAIS participants were in a relationship, which was significantly different. All CAH individuals had been diagnosed at birth; 89% of CAIS had been diagnosed after puberty and due to primary amenorrhea and 11% were diagnosed in childhood due to inguinal hernia. Genital reconstructive surgery had been performed in 100% of CAH participants and 37% of CAIS. Regarding sexual contact experiences and sexual fantasies (androphilic, gynephilic or both), no significant differences were found. However, CAH females had significantly more gynephilic dreams (P=0.045). CONCLUSION This study, notable as one of the rare from a non-western culture, described sexual, medical and socioeconomic status of 46,XX CAH and 46,XY CAIS individuals living in Iran. Although broadly in line with previous findings from Western cultures, Iranian CAH individuals had fewer romantic relationships, but in contrast to previous studies their sexual orientation was only different from CAIS in the contents of sexual dreams.
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Affiliation(s)
- Behzad S Khorashad
- Transgender Studies Center, Mashhad University of Medical Sciences, Mashhad, Iran; Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ghasem M Roshan
- Transgender Studies Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Alistair G Reid
- Molecular Pathology Unit, Liverpool Clinical Laboratories, Liverpool, UK.
| | - Zahra Aghili
- Transgender Studies Center, Mashhad University of Medical Sciences, Mashhad, Iran; Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mehran Hiradfar
- Department of Pediatric Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mozhgan Afkhamizadeh
- Endocrine Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Talaei
- Transgender Studies Center, Mashhad University of Medical Sciences, Mashhad, Iran; Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Azadeh Aarabi
- Division of Human Genetics, Immunology Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Nosrat Ghaemi
- Department of Pediatrics, School of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
| | - Negin Taghehchian
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Hedieh Saberi
- Transgender Studies Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Nazanin Farahi
- Transgender Studies Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohammad Reza Abbaszadegan
- Division of Human Genetics, Immunology Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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